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Jiang Y, Cai Y, Ding Y, Kong X, Li Z. The association between serum albumin and alkaline phosphatase in cancer patients. Medicine (Baltimore) 2024; 103:e37526. [PMID: 38552093 PMCID: PMC10977564 DOI: 10.1097/md.0000000000037526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 02/15/2024] [Indexed: 04/02/2024] Open
Abstract
The role of serum albumin (ALB) has been extensively studied in patients with cancer; however, research on its effect on bone metastasis in these patients remains limited. This study aimed to investigate the relationship between serum ALB and alkaline phosphatase (ALP) levels in patients with tumors. Using data from the National Health and Nutrition Examination Survey 2011 to 2018, we assessed the correlation between serum ALB and ALP levels using a weighted multivariate linear regression model, whereas a weighted generalized additive model and smooth curve fitting were used to address potential nonlinearities. A total of 1876 patients with cancer were included in our study. In the subgroup analysis stratified by sex, race/ethnicity, and liver disease, the negative correlation of ALB with ALP remained for most groups, except in blacks (β = -1.755, 95%CI: [-3.848, 0.338], P = .103) and patients with gout (β = -0.676, 95%CI: [-2.061, 0.709], P = .340). In black people and patients with gout, the relationship between ALB and ALP showed an inverted U-shaped curve, with an inflection point at approximately 42 g/dL. Our study showed an inverse correlation between ALB and ALP levels in most patients with tumors, but not in black patients and those with gout. The measurement of ALB levels can serve as a screening tool for bone metastases while guiding therapeutic intervention strategies.
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Affiliation(s)
- Yiqian Jiang
- Department of Radiotherapy, Xiaoshan Affiliated Hospital of Wenzhou Medical University, Hangzhou, Zhejiang, China
| | - Yong Cai
- Department of pediatrics, Xiaoshan Affiliated Hospital of Wenzhou Medical University, Hangzhou, Zhejiang, China
| | - Yingying Ding
- Department of Respiratory, Xiaoshan Affiliated Hospital of Wenzhou Medical University, Hagnzhou, Zhejiang, China
| | - Xiangyang Kong
- Department of Radiotherapy, Xiaoshan Affiliated Hospital of Wenzhou Medical University, Hangzhou, Zhejiang, China
| | - Zhaoyang Li
- Department of Oncology, Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, China
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Al-Ibraheem A, Al-Adhami DA, Abdlkadir AS, Mohamad I, Ghatasheh H, Qandeel M. FDG PET/CT reveals bone marrow oligometastasis in laryngeal squamous carcinoma: a case report with favorable outcome. BJR Case Rep 2023; 9:20230065. [PMID: 37928713 PMCID: PMC10621579 DOI: 10.1259/bjrcr.20230065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 07/28/2023] [Accepted: 08/14/2023] [Indexed: 11/07/2023] Open
Abstract
Laryngeal carcinoma is the most common head and neck cancer. The vast majority of laryngeal carcinomas are of squamous-cell histologic type. Metastasis of laryngeal cancer typically occurs within the cervical lymph nodes and seldom in other regions. Although a small percentage of patients experience distant metastases, bone marrow metastasis from laryngeal cancer is among the least common metastatic sites. Previous literature has suggested that bone marrow carcinomatosis is aggressive and has a poor outcome, particularly in patients with supraglottic tumors. Ante-mortem diagnosis of this metastatic pattern has been limited. To our knowledge, this case report highlights the first documented occurrence wherein the utilization of 18-fluorine fludeoxyglucose positron emission tomography/CT imaging played a pivotal role in the early detection of bone marrow metastasis in a patient diagnosed with transglottic laryngeal cancer. A solitary metastatic distant bone marrow lesion was identified early during follow-up. As a consequence, the patient exhibited a remarkable and unforeseen favorable clinical outcome.
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Affiliation(s)
| | - Dhuha Ali Al-Adhami
- Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center, Al-Jubeiha, Amman, Jordan
| | - Ahmed Saad Abdlkadir
- Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center, Al-Jubeiha, Amman, Jordan
| | - Issa Mohamad
- Department of Radiation Oncology, King Hussein Cancer Center, Jordan Al-Jubeiha, Amman, Jordan
| | - Hamza Ghatasheh
- Department of Radiation Oncology, King Hussein Cancer Center, Jordan Al-Jubeiha, Amman, Jordan
| | - Monther Qandeel
- Department of Diagnostic Radiology, King Hussein Cancer Center, Jordan Al-Jubeiha, Amman, Jordan
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Fu J, Du F, Tian T, Huang H, Zhang L, Li D, Liu Y, Zhang D, Gao L, Zheng T, Liu Y, Zhao Y. Development and validation of prognostic nomograms based on De Ritis ratio and clinicopathological features for patients with stage II/III colorectal cancer. BMC Cancer 2023; 23:620. [PMID: 37400788 DOI: 10.1186/s12885-023-11125-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 06/28/2023] [Indexed: 07/05/2023] Open
Abstract
BACKGROUND Metabolic derangements and systemic inflammation are related to the progression of colorectal cancer (CRC) and the prognoses of these patients. The survival of stage II and III CRC patients existed considerable heterogeneity highlighting the urgent need for new prediction models. This study aimed to develop and validate prognostic nomograms based on preoperative serum liver enzyme as well as evaluate the clinical utility. METHODS A total of 4014 stage II/III primary CRC patients pathologically diagnosed from January 2007 to December 2013 were included in this study. These patients were randomly divided into a training set (n = 2409) and a testing set (n = 1605). Univariate and multivariate Cox analyses were used to select the independent factors for predicting overall survival (OS) and disease-free survival (DFS) of stage II/III CRC patients. Next, nomograms were constructed and validated to predict the OS and DFS of individual CRC patients. The clinical utility of nomograms, tumor-node-metastasis (TNM), and the American Joint Committee on Cancer (AJCC) system was evaluated using time-dependent ROC and decision curve analyses. RESULTS Among seven preoperative serum liver enzyme markers, aspartate aminotransferase-to-alanine aminotransferase ratio (De Ritis ratio) was identified as an independent factor for predicting both OS and DFS of stage II/III CRC patients. The nomograms incorporated De Ritis ratio and significant clinicopathological features achieved good accuracy in terms of OS and DFS prediction, with C-index of 0.715 and 0.692, respectively. The calibration curve showed good agreement between prediction by nomogram and actual observation. The results of time-dependent ROC and decision curve analyses suggested that the nomograms had improved discrimination and greater clinical benefits compared with TNM and AJCC staging. CONCLUSIONS De Ritis ratio was an independent predictor in predicting both the OS and DFS of patients with stage II/III CRC. Nomograms based on De Ritis ratio and clinicopathological features showed better clinical utility, which is expected to help clinicians develop appropriate individual treatment strategies for patients with stage II /III CRC.
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Affiliation(s)
- Jinming Fu
- Department of Epidemiology, College of Public Health, Harbin Medical University, 157 Baojian Road, Harbin, 150081, Heilongjiang Province, People's Republic of China
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, 221004, China
| | - Fenqi Du
- Department of Colorectal Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, 150 Haping Road, Harbin, 150081, Heilongjiang Province, People's Republic of China
| | - Tian Tian
- Department of Epidemiology, College of Public Health, Harbin Medical University, 157 Baojian Road, Harbin, 150081, Heilongjiang Province, People's Republic of China
| | - Hao Huang
- Department of Epidemiology, College of Public Health, Harbin Medical University, 157 Baojian Road, Harbin, 150081, Heilongjiang Province, People's Republic of China
| | - Lei Zhang
- Department of Epidemiology, College of Public Health, Harbin Medical University, 157 Baojian Road, Harbin, 150081, Heilongjiang Province, People's Republic of China
| | - Dapeng Li
- Department of Epidemiology, College of Public Health, Harbin Medical University, 157 Baojian Road, Harbin, 150081, Heilongjiang Province, People's Republic of China
| | - Yupeng Liu
- Department of Epidemiology, College of Public Health, Harbin Medical University, 157 Baojian Road, Harbin, 150081, Heilongjiang Province, People's Republic of China
| | - Ding Zhang
- Department of Epidemiology, College of Public Health, Harbin Medical University, 157 Baojian Road, Harbin, 150081, Heilongjiang Province, People's Republic of China
| | - Lijing Gao
- Department of Epidemiology, College of Public Health, Harbin Medical University, 157 Baojian Road, Harbin, 150081, Heilongjiang Province, People's Republic of China
| | - Ting Zheng
- Department of Epidemiology, College of Public Health, Harbin Medical University, 157 Baojian Road, Harbin, 150081, Heilongjiang Province, People's Republic of China
| | - Yanlong Liu
- Department of Colorectal Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, 150 Haping Road, Harbin, 150081, Heilongjiang Province, People's Republic of China.
| | - Yashuang Zhao
- Department of Epidemiology, College of Public Health, Harbin Medical University, 157 Baojian Road, Harbin, 150081, Heilongjiang Province, People's Republic of China.
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Li J, Yang S, Li C, Zhu G, Xia J. Prognostic value of combined pre- and postoperative albumin-to-alkaline phosphatase ratio for patients with hepatocellular carcinoma undergoing trans-catheter chemoembolisation. Clin Radiol 2023; 78:301-309. [PMID: 36690510 DOI: 10.1016/j.crad.2022.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 11/04/2022] [Accepted: 12/16/2022] [Indexed: 01/13/2023]
Abstract
AIM To reveal the prognostic value of the postoperative and dynamic albumin-to-alkaline phosphatase ratio (AAPR) in hepatocellular carcinoma (HCC) patients undergoing trans-catheter chemoembolisation (TACE). MATERIALS AND METHODS In total, 545 HCC patients undergoing initial TACE were enrolled into the study. The receiver operating characteristic (ROC) curve was plotted to determine the best cut-off for AAPR. Univariate and multivariate Cox regression analyses were used to confirm the independent prognostic effect of AAPR on overall survival (OS). The predictive performance of AAPR was assessed by ROC curves, concordance index (C-index), and Akaike information criterion (AIC), and was compared to existing liver function assessment systems. RESULTS The optimal cut-off value for the AAPR was 0.26. Elevated AAPR (>0.26) was associated with a low risk of death after adjustment whether before (HR: 0.53; 95% CI: 0.4-0.69) or after (HR: 0.64; 95% CI: 0.43-0.95) TACE treatment. The combined pre- and postoperative AAPR showed much better performance in ROC curve (1-, 3-, and 5-year AUCs: 0.69, 0.71, 0.69), C-index (0.65; 95% CI: 0.59-0.72) and AIC analyses than pre-AAPR and post-AAPR alone or liver function assessment systems. CONCLUSION This study demonstrated both preoperative and postoperative AAPR were independent prognostic factors for HCC patients undergoing TACE. In addition, the combined pre- and post-AAPR showed better predictive performance than pre-AAPR and post-AAPR alone or liver function assessment systems.
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Affiliation(s)
- J Li
- Key Laboratory of Diagnosis and Treatment of Severe Hepato-Pancreatic Diseases of Zhejiang Province, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - S Yang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - C Li
- Key Laboratory of Diagnosis and Treatment of Severe Hepato-Pancreatic Diseases of Zhejiang Province, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - G Zhu
- Department of Interventional Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - J Xia
- Key Laboratory of Diagnosis and Treatment of Severe Hepato-Pancreatic Diseases of Zhejiang Province, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China; Department of Interventional Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China.
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Fan Z, Liu B, Shang P. Development and validation of a nomogram prediction model based on albumin-to-alkaline phosphatase ratio for predicting the prognosis of gallbladder carcinoma. Pathol Oncol Res 2023; 28:1610818. [PMID: 36685104 PMCID: PMC9845243 DOI: 10.3389/pore.2022.1610818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 12/16/2022] [Indexed: 01/06/2023]
Abstract
Gallbladder carcinoma (GBC) is a rare biliary tract cancer with a high recurrence rate and a poor prognosis. Albumin-alkaline phosphatase ratio (AAPR) has been demonstrated to be a prognostic predictor for several cancers, but its predictive value for GBC patients remains unknown. The aim of this study was to investigate the predictive role of AAPR in GBC patients and to develop a novel nomogram prediction model for GBC patients. We retrospectively collected data from 80 patients who underwent surgery at the Hospital of 81st Group Army PLA as a training cohort. Data were collected from 70 patients with the same diagnosis who underwent surgery at the First Affiliated Hospital of Hebei North University as an external verification cohort. The optimal cut-off value of AAPR was determined using X-tile software. A nomogram for the overall survival (OS) based on multivariate Cox regression analysis was developed and validated using calibration curves, Harrell's concordance index, the receiver operating characteristic curves, and decisive curve analyses. The optimal cut-off value of AAPR was .20. Univariate and multivariate Cox regression analyses demonstrated that BMI (p = .043), R0 resection (p = .001), TNM stage (p = .005), and AAPR (p = .017) were independent risk factors for GBC patients. In terms of consistency, discrimination, and net benefit, the nomogram incorporating these four independent risk factors performed admirably. AAPR is an independent predictor of GBC patients undergoing surgery, and a novel nomogram prediction model based on AAPR showed superior predictive ability.
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Affiliation(s)
- Zizheng Fan
- Department of Graduate School, Hebei North University, Zhangjiakou, China
| | - Bing Liu
- Department of Hepatobiliary Surgery, The Hospital of 81st Group Army PLA, Zhangjiakou, China
| | - Peizhong Shang
- Department of Hepatobiliary Surgery, The Hospital of 81st Group Army PLA, Zhangjiakou, China,*Correspondence: Peizhong Shang,
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Soni SV, Malhotra V, Sharma R, Singh M, Dixit R, Mallya V. Nasopharyngeal Carcinoma With Bilateral Breast Metastasis: A Report of an Elusive Case. Cureus 2022; 14:e27497. [PMID: 36060330 PMCID: PMC9424790 DOI: 10.7759/cureus.27497] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2022] [Indexed: 12/05/2022] Open
Abstract
Nasopharyngeal carcinoma is a prevalent head and neck cancer, especially in Southeast Asia. Although its potential for distant metastasis is well established, metastasis to the breast has seldom been reported. To the best of our knowledge, this is the fourth report of a case of nasopharyngeal carcinoma metastasizing to bilateral breasts. A 35-year-old patient presented with left nasal obstruction, epistaxis, and a palpable mass in her left breast, without any cervical or axillary lymph nodal enlargement. Radiological examination with contrast-enhanced computed tomography scan and magnetic resonance and imaging of breast revealed the presence of enhancing mass lesions in bilateral breasts. Histopathology of the nasal mass was suggestive of undifferentiated nasopharyngeal carcinoma. Breast fine needle aspiration revealed an abundance of metastatic squamous cells. Immunohistochemistry examination was positive for chromogranin A, synaptophysin, and cluster of differentiation-56, confirming the diagnosis of a primary nasopharyngeal malignancy metastasizing to bilateral breasts. Differentiation between metastatic disease and a coexisting second primary is imperative for planning appropriate treatment and defining the further outcomes.
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Wu H, Wang Y, Li H, Meng L, Zheng N, Wang J. Protective Effect of Alkaline Phosphatase Supplementation on Infant Health. Foods 2022; 11:foods11091212. [PMID: 35563935 PMCID: PMC9101100 DOI: 10.3390/foods11091212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/13/2022] [Accepted: 04/13/2022] [Indexed: 12/03/2022] Open
Abstract
Alkaline phosphatase (ALP) is abundant in raw milk. Because of its high heat resistance, ALP negative is used as an indicator of successful sterilization. However, pasteurized milk loses its immune protection against allergy. Clinically, ALP is also used as an indicator of organ diseases. When the activity of ALP in blood increases, it is considered that diseases occur in viscera and organs. Oral administration or injecting ALP will not cause harm to the body and has a variety of probiotic effects. For infants with low immunity, ALP intake is a good prebiotic for protecting the infant’s intestine from potential pathogenic bacteria. In addition, ALP has a variety of probiotic effects for any age group, including prevention and treatment intestinal diseases, allergies, hepatitis, acute kidney injury (AKI), diabetes, and even the prevention of aging. The prebiotic effects of alkaline phosphatase on the health of infants and consumers and the content of ALP in different mammalian raw milk are summarized. The review calls on consumers and manufacturers to pay more attention to ALP, especially for infants with incomplete immune development. ALP supplementation is conducive to the healthy growth of infants.
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Affiliation(s)
- Haoming Wu
- State Key Laboratory of Animal Nutrition, Institute of Animal Sciences, Chinese Academy of Agricultural Sciences, Beijing 100193, China; (H.W.); (H.L.); (L.M.); (J.W.)
- Laboratory of Quality and Safety Risk Assessment for Dairy Products of Ministry of Agriculture and Rural Affairs, Institute of Animal Sciences, Chinese Academy of Agricultural Sciences, Beijing 100193, China
- Key Laboratory of Quality & Safety Control for Milk and Dairy Products of Ministry of Agriculture and Rural Affairs, Institute of Animal Sciences, Chinese Academy of Agricultural Sciences, Beijing 100193, China
| | - Yang Wang
- State Key Laboratory of Membrane Biology, Tsinghua University-Peking University Joint Center for Life Sciences, School of Life Sciences, Tsinghua University, Beijing 100084, China;
| | - Huiying Li
- State Key Laboratory of Animal Nutrition, Institute of Animal Sciences, Chinese Academy of Agricultural Sciences, Beijing 100193, China; (H.W.); (H.L.); (L.M.); (J.W.)
- Laboratory of Quality and Safety Risk Assessment for Dairy Products of Ministry of Agriculture and Rural Affairs, Institute of Animal Sciences, Chinese Academy of Agricultural Sciences, Beijing 100193, China
- Key Laboratory of Quality & Safety Control for Milk and Dairy Products of Ministry of Agriculture and Rural Affairs, Institute of Animal Sciences, Chinese Academy of Agricultural Sciences, Beijing 100193, China
| | - Lu Meng
- State Key Laboratory of Animal Nutrition, Institute of Animal Sciences, Chinese Academy of Agricultural Sciences, Beijing 100193, China; (H.W.); (H.L.); (L.M.); (J.W.)
- Laboratory of Quality and Safety Risk Assessment for Dairy Products of Ministry of Agriculture and Rural Affairs, Institute of Animal Sciences, Chinese Academy of Agricultural Sciences, Beijing 100193, China
- Key Laboratory of Quality & Safety Control for Milk and Dairy Products of Ministry of Agriculture and Rural Affairs, Institute of Animal Sciences, Chinese Academy of Agricultural Sciences, Beijing 100193, China
| | - Nan Zheng
- State Key Laboratory of Animal Nutrition, Institute of Animal Sciences, Chinese Academy of Agricultural Sciences, Beijing 100193, China; (H.W.); (H.L.); (L.M.); (J.W.)
- Laboratory of Quality and Safety Risk Assessment for Dairy Products of Ministry of Agriculture and Rural Affairs, Institute of Animal Sciences, Chinese Academy of Agricultural Sciences, Beijing 100193, China
- Key Laboratory of Quality & Safety Control for Milk and Dairy Products of Ministry of Agriculture and Rural Affairs, Institute of Animal Sciences, Chinese Academy of Agricultural Sciences, Beijing 100193, China
- Correspondence: ; Tel.: +86-10-62816069
| | - Jiaqi Wang
- State Key Laboratory of Animal Nutrition, Institute of Animal Sciences, Chinese Academy of Agricultural Sciences, Beijing 100193, China; (H.W.); (H.L.); (L.M.); (J.W.)
- Laboratory of Quality and Safety Risk Assessment for Dairy Products of Ministry of Agriculture and Rural Affairs, Institute of Animal Sciences, Chinese Academy of Agricultural Sciences, Beijing 100193, China
- Key Laboratory of Quality & Safety Control for Milk and Dairy Products of Ministry of Agriculture and Rural Affairs, Institute of Animal Sciences, Chinese Academy of Agricultural Sciences, Beijing 100193, China
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Yang L, Gao J, Zhou Y, Tao Z, He J, Yang J, Wang R, Zhang Y, Huang Y, Zhou L, Sun B. Prognostic Value of the Albumin-to-Alkaline Phosphatase Ratio before Chemoradiotherapy in Patients with Nonmetastatic Nasopharyngeal Carcinoma. Chemotherapy 2021; 66:40-46. [PMID: 33601377 DOI: 10.1159/000513058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Accepted: 11/13/2020] [Indexed: 12/24/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate the prognostic value of the albumin-to-alkaline phosphatase ratio (AAPR) in patients with nonmetastatic nasopharyngeal carcinoma (NPC). METHODS Patients with nonmetastatic NPC who underwent chemoradiotherapy (CRT) were retrospectively analyzed. The AAPR was calculated using the last value of albumin to alkaline phosphatase that was measured within 1 week before CRT. The optimal cutoff value for the AAPR value was determined by an X-tile plot. Propensity score matching (PSM) was performed to balance the differences of the baseline characteristics. The Kaplan-Meier method and log-rank test were used to calculate the survival. A Cox proportional hazards regression model was conducted for the multivariate analysis. RESULTS Totally, 87 patients with nonmetastatic NPC who underwent CRT were included in the analysis. The optimal cutoff level for the AAPR was 0.46. The group with an AAPR ≤0.46 was more likely to have poorer overall survival (OS), progression-free survival (PFS), and distant metastasis-free survival (DMFS) (p = 0.023, p = 0.031 and p = 0.027, for OS, PFS, and DMFS, respectively). In Cox proportional hazards analysis, high AAPR was a better prognostic predictor. CONCLUSION AAPR may be a reliable prognostic index for nonmetastatic NPC patients.
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Affiliation(s)
- Liping Yang
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Jing Gao
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China,
| | - Yan Zhou
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Zhenchao Tao
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Jian He
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Jing Yang
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Ru Wang
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Yangyang Zhang
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Yifan Huang
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Lingran Zhou
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Bin Sun
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
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Phinyo P, Maihom T, Phanphaisarn A, Kerdsinchai P, Rattarittamrong E, Patumanond J, Pruksakorn D. Development of a clinical diagnostic tool to differentiate multiple myeloma from bone metastasis in patients with destructive bone lesions (MM-BM DDx). BMC FAMILY PRACTICE 2020; 21:215. [PMID: 33087068 PMCID: PMC7579980 DOI: 10.1186/s12875-020-01283-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 10/08/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND Most patients with destructive bone lesions undergo a comprehensive diagnostic procedure to ensure that proper treatment decisions are pursued. For patients with multiple myeloma, this can lead to delays in diagnosis and treatment initiation. This study was conducted to develop a diagnostic rule that could serve as a tool for early identification of multiple myeloma and promote timely referral of patients to haematologists. METHODS The clinical prediction rule was developed using a retrospective case-series of patients with multiple myeloma (MM) and those with bone metastasis (BM) at Chiang Mai University Hospital from 2012 to 2015. Multivariable fractional polynomial logistic regression was used to derive a diagnostic model to differentiate between MM and BM patients (MM-BM DDx). RESULTS A total of 586 patients (136 MM patients and 450 BM patients) were included. Serum creatinine, serum globulin, and serum alkaline phosphatase were identified as significant indicators for the differentiation of MM and BM patients. The MM-BM DDx model showed excellent discriminative ability [AuROC of 0.90 (95%CI 0.86 to 0.93)] and good calibration. CONCLUSIONS This MM-BM DDx model could potentially allow for early myeloma diagnosis and improvement of overall prognosis. A prospective validation study is needed to confirm the accuracy of the MM-BM DDx model prior to its application in clinical practice.
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Affiliation(s)
- Phichayut Phinyo
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Center for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Musculoskeletal Science and Translational Research (MSTR), Chiang Mai University, Chiang Mai, Thailand
| | - Titinat Maihom
- Musculoskeletal Science and Translational Research (MSTR), Chiang Mai University, Chiang Mai, Thailand
| | - Areerak Phanphaisarn
- Musculoskeletal Science and Translational Research (MSTR), Chiang Mai University, Chiang Mai, Thailand
| | - Pakorn Kerdsinchai
- Musculoskeletal Science and Translational Research (MSTR), Chiang Mai University, Chiang Mai, Thailand
| | - Ekarat Rattarittamrong
- Department of Internal Medicine, Faculty of Medicine, Division of hematology, Chiang Mai University, Chiang Mai, Thailand
| | - Jayanton Patumanond
- Center for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Dumnoensun Pruksakorn
- Musculoskeletal Science and Translational Research (MSTR), Chiang Mai University, Chiang Mai, Thailand.
- Biomedical Engineering Institute, Chiang Mai University, Chiang Mai, Thailand.
- Omics Center for Health Sciences (OCHS), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
- Department of Orthopedics, Faculty of Medicine, Orthopedic Laboratory and Research Network (OLARN), Chiang Mai University, Chiang Mai, Thailand.
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Thio QCBS, Karhade AV, Notman E, Raskin KA, Lozano-Calderón SA, Ferrone ML, Bramer JAM, Schwab JH. Serum alkaline phosphatase is a prognostic marker in bone metastatic disease of the extremity. J Orthop 2020; 22:346-351. [PMID: 32921951 DOI: 10.1016/j.jor.2020.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 08/11/2020] [Indexed: 11/16/2022] Open
Abstract
Purpose The purpose of this study was to determine the prognostic value of serum alkaline phosphatase for treatment decision making in metastatic bone disease. Methods 1090 patients who underwent surgery for extremity metastatic disease were retrospectively identified at two tertiary care centers. The association between alkaline phosphatase and mortality was assessed by bivariate and multivariate analyses. Results Three-month and one-year mortality rates were 305 (29%) and 639 (62%), respectively. Alkaline phosphatase was associated with mortality at both three months and one year. Conclusion Serum alkaline phosphatase may be a useful marker in prognostic algorithms for patients with extremity metastatic disease.
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Affiliation(s)
- Quirina C B S Thio
- Department of Orthopedic Surgery, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Aditya V Karhade
- Department of Orthopedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Emily Notman
- Department of Orthopedic Surgery, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Kevin A Raskin
- Department of Orthopedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Santiago A Lozano-Calderón
- Department of Orthopedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Marco L Ferrone
- Department of Orthopedic Surgery, Brigham and Womens Hospital, Harvard Medical School, Boston, MA, USA
| | - Jos A M Bramer
- Department of Orthopedic Surgery, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Joseph H Schwab
- Department of Orthopedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Yang J, Hu J, Wang D, Jia Q, Jiao J, Xiao J. Surgical Treatment Outcomes of Spinal Metastases of Nasopharyngeal Carcinoma: The First Report of 30 Patients from a Single Center. Cancer Manag Res 2020; 12:6999-7008. [PMID: 32821166 PMCID: PMC7418175 DOI: 10.2147/cmar.s257685] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 07/15/2020] [Indexed: 12/12/2022] Open
Abstract
Background Studies focused on surgical interventions of spinal metastases of nasopharyngeal carcinoma (SMNPC) are blank. Methods Patients with SMNPC who received surgical treatment in our center between 2005 and 2017 were included. Univariate and multivariate analysis of various clinical characteristics and operation-related data were analyzed to identify the independent factors that affected prognosis. Factors with P values of 0.1 or less were subjected to multivariate Cox regression analysis. P values of 0.05 or less were considered statistically significant. Results A total of 30 patients with SMNPC treated with surgery were included. The thoracic spine was the most frequently involved site. The patients in this series achieved good overall survival (OS, 20.26 months) with limited perioperative complications. The univariate analysis suggested that preoperative Karnofsky performance scale, number of spinal metastases, number of visceral metastases, preoperative Frankel score, surgical resection mode and Ki 67 were potential prognostic factors. In the multivariate analyses, number of visceral metastases, preoperative Frankel score and resection mode were found to be independent prognostic factors. Conclusion This is the first study focusing on surgical outcomes in SMNPC. The thoracic spine was the most frequently involved site of SMNPC. Preoperative Frankel score, number of visceral metastasis and surgical resection mode were independent prognostic factors for SMNPC. Combined with adjuvant therapies, surgical interventions should be recommended early when necessary.
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Affiliation(s)
- Jian Yang
- Department of Orthopedic Oncology, Changzheng Hospital, Navy Medical University, Shanghai, People's Republic of China
| | - Jinbo Hu
- Department of Orthopedic Oncology, Changzheng Hospital, Navy Medical University, Shanghai, People's Republic of China
| | - Da Wang
- Department of Orthopedic Oncology, Changzheng Hospital, Navy Medical University, Shanghai, People's Republic of China
| | - Qi Jia
- Department of Orthopedic Oncology, Changzheng Hospital, Navy Medical University, Shanghai, People's Republic of China
| | - Jian Jiao
- Department of Orthopedic Oncology, Changzheng Hospital, Navy Medical University, Shanghai, People's Republic of China
| | - Jianru Xiao
- Department of Orthopedic Oncology, Changzheng Hospital, Navy Medical University, Shanghai, People's Republic of China
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12
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Guo X, Zou Q, Yan J, Zhen X, Gu H. Prognostic effect of pretreatment albumin-to-alkaline phosphatase ratio in human cancers: A meta-analysis. PLoS One 2020; 15:e0237793. [PMID: 32822383 PMCID: PMC7444501 DOI: 10.1371/journal.pone.0237793] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 08/02/2020] [Indexed: 02/07/2023] Open
Abstract
Purpose It has been demonstrated that, for various types of cancer, the pretreatment albumin/alkaline phosphatase ratio (AAPR) was a prognostic factor. Therefore, in order to determine AAPR’s prognostic effect on cancer, the meta-analysis was hereby performed. Patients and methods The relevant studies conducted before November 10, 2019, were comprehensively searched in Web of Science, PubMed, and Embase. HRs(hazard ratios) with related 95%CIs(confidence intervals) were adopted to estimate AAPR’s prognostic impact on overall survival (OS) & disease-free survival (DFS). Results Our meta-analysis involved thirteen cohort studies, which included 5,204 cases of 8 types. The results of this meta-analysis indicated that higher AAPR was corrected with better OS (pooled HR = 0.52; 95%CI = 0.47–0.58; P<0.001) and DFS (pooled HR = 0.55; 95%CI = 0.47–0.66; P<0.001). Subgroup analysis on OS was based on the cancer system, treatment methods, and cutoff value. Moreover, higher AAPR was statistically in associated with lighter infiltration (pooled OR = 0.79; 95%CI = 0.73–0.85; P<0.001), no lymph nodes metastasis (pooled OR = 0.89; 95%CI = 0.83–0.95; P = 0.001), and no distant metastasis (pooled OR = 0.92; 95%CI = 0.86–0.99; P = 0.028). Conclusion Higher AAPR was related to better prognosis of cancer, and in cancer therapy, AAPR could be taken as a promising marker of prognosis. It might help physicians to select the most appropriate treatments by evaluating the current status of patients with cancer. Future multicenter prospective clinical trials were required to verify its applications.
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Affiliation(s)
- Xiaoli Guo
- Department of Radiology, Affiliated Hospital of Nantong University, Nantong University, Nantong, Jiangsu, China
| | - Qijiu Zou
- Department of Radiology, Affiliated Hospital of Nantong University, Nantong University, Nantong, Jiangsu, China
| | - Jiaxin Yan
- Department of Radiology, Affiliated Hospital of Nantong University, Nantong University, Nantong, Jiangsu, China
| | - Xingxing Zhen
- Department of Radiology, Nantong Tumor Hospital, Nantong University, Nantong, Jiangsu, China
| | - Hongmei Gu
- Department of Radiology, Affiliated Hospital of Nantong University, Nantong University, Nantong, Jiangsu, China
- * E-mail:
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13
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Goyal G. Comparison of Salivary and Serum Alkaline Phosphates Level and Lactate Dehydrogenase Levels in Patients with Tobacco Related Oral Lesions with Healthy Subjects - A Step Towards Early Diagnosis. Asian Pac J Cancer Prev 2020; 21:983-991. [PMID: 32334459 PMCID: PMC7445986 DOI: 10.31557/apjcp.2020.21.4.983] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Indexed: 11/25/2022] Open
Abstract
AIM To evaluate and compare salivary and serum levels of Alkaline Phosphates and Lactate Dehydrogenase in patients without the habit of tobacco, in patients with the habit of tobacco, in patients with benign oral lesions and in patients with oral premalignant lesions and oral malignant lesions. MATERIAL AND METHODOLOGY This study was comprised of 500 subjects, Group I: 100 healthy individuals without the habit of tobacco usage formed the control group. Group II: 100 patients with the habit of tobacco/ smoking consumption without any oral lesion. Group III: 100 patients with benign oral lesions. Group IV: 100 patients having the history of tobacco consumption and having apparent precancerous lesions like leukoplakia, erythroplakia. Group V:100 patients having frank oral cancer. The grade of dysplasia in these patients was statically correlated with the levels of serum and salivary ALP and LDH. RESULTS This study revealed that there was high expression of both serum and salivary ALP and LDH in group IV and Group V as compared with the other groups and mean difference showed a statistically significant p value of less than 0.01. This study revealed that the in group V, the highest level of serum and salivary ALP was found in those patients who were reported with poorly differentiated oral cancer. CONCLUSION Both Alkaline phosphates and Lactate dehydrogenase could be considered a sensitive markers for the detection of dysplasia with already existing precancancerous and cancerous lesions.
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Affiliation(s)
- Gaurav Goyal
- Departmen of Oral Medicine and Radiology, Genesis Institute of Dental Sciences and Research, Ferozepur, Punjab, India
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14
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S N, M E, S M, A B, Gh A, R AF. Radioprotective Effect of Arbutin in Megavoltage Therapeutic X-irradiated Mice using Liver Enzymes Assessment. J Biomed Phys Eng 2019; 9:533-540. [PMID: 31750267 PMCID: PMC6820023 DOI: 10.31661/jbpe.v0i0.1199] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 07/07/2019] [Indexed: 02/07/2023]
Abstract
Background Medical use of ionizing radiation has direct/indirect undesirable effects on normal tissues. In this study, the radioprotective effect of arbutin in megavoltage therapeutic x-irradiated mice was investigated using serum alkaline phosphatase (ALP), alanine aminotransferase (ALT), and asparate amniotransferase (AST) activity measurements. Material and Methods In this analytical and experimental lab study, sixty mice (12 identical groups) were irradiated with 6 MV x-ray beam (2 and 4 Gy in one fraction). Arbutin concentrations were chosen 50, 100, and 200 mg/kg and injected intraperitoneal 2 hours before irradiation. Samples of peripheral blood cells were collected and serum was separated on the 1, 3, and 7 days post-x-radiation; in addition, the level of ALP, ALT, and AST were measured. Data were analyzed using one-way ANOVA, and Tukey HSD test. Results X-radiation (2 and 4 Gy) increased the ALT and AST activity levels on the 1, 3, and 7 days post- irradiation, but the ALP level significantly increased on the 1 and 7 days and decreased on the third day compared to the control group (P< 0.001). ALP, ALT and AST activity levels in "2 and 4 Gy x irradiation + distilled water" groups were significantly higher than "2 and 4 Gy irradiation + 50, 100, and 200 mg/kg arbutin" groups on the first and seventh day post-irradiation (P< 0.001). Conclusion Arbutin is a strong radioprotector for reducing the radiation effect on the whole-body tissues by measuring ALP, ALT and AST enzyme activity levels. Furthermore, the concentration of 50 mg/kg arbutin showed higher radioprotective effect.
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Affiliation(s)
- Nadi S
- MSc, Department of Medical Physics Radiobiology and Radiation Protection, School of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Elahi M
- PhD, Medical Physics Department, Faculty of medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Moradi S
- MSc, Medical Physics Department, Faculty of medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Banaei A
- PhD, Medical Physics Department, Faculty of medical Sciences, Tarbiat Modares University, Tehran, Iran
- PhD, Department of Radiology, Faculty of paramedical Sciences, AJA University of Medical Sciences, Tehran, Iran
| | - Ataei Gh
- MSc, Department of Radiology Technology, Faculty of Paramedical Sciences, Babol University of Medical Science, Babol, Iran
| | - Abedi-Firouzjah R
- MSc, Department of Radiation Sciences, Yasuj University of Medical Sciences, Yasuj, Iran
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15
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Xia A, Chen Y, Chen J, Pan Y, Bao L, Gao X. Prognostic value of the albumin-to-alkaline phosphatase ratio on urologic outcomes in patients with non-metastatic renal cell carcinoma following curative nephrectomy. J Cancer 2019; 10:5494-5503. [PMID: 31632493 PMCID: PMC6775680 DOI: 10.7150/jca.34029] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 08/05/2019] [Indexed: 12/13/2022] Open
Abstract
Background: Few studies focused on the relationship between the albumin-to-alkaline phosphatase ratio (AAPR) and the urologic outcomes in patients with non-metastatic renal cell carcinoma (RCC) following curative surgery. The aim of this study was to evaluate the prognostic value of preoperative AAPR in non-metastatic RCC patients. Methods: The prognostic value of AAPR was evaluated in a primary cohort with 419 non-metastatic RCC patients following curative radical or partial nephrectomy and then further validated in an independent cohort consisting of 204 patients. A nomogram was developed based on the independent predictors, and its predictive value was assessed. Results: Kaplan-Meier survival analysis demonstrated that patients with low AAPR levels were significantly associated with worse overall survival (OS) and cancer-specific survival (CSS) compared with patients with high AAPR levels both in two cohorts. Univariate and multivariate analyses revealed that low AAPR was an independent risk factor for OS (HR = 2.745; 95%CI, 1.266-5.953; P = 0.011) and CSS (HR = 3.042; 95%CI, 1.278-7.243; P = 0.012). Moreover, subgroup analysis (Fuhrman grade G1+G2 and Fuhrman grade G3+G4; T1+T2 stage and T3+T4 stage) revealed that low AAPR was also related to worse urological outcomes. Although no significant differences between patients with low AAPR and patients with high AAPR can be observed with regard to CSS under Fuhrman grade G1+G2 (P=0.058) and T1+T2 stage (P=0.318), there was a worse CSS trend in low AAPR patients. The established nomograms for OS and CSS were well calibrated and had moderate discriminative ability (concordance index: 0.821 and 0.839, respectively) Conclusions: Preoperative AAPR might be an independent prognostic factor in patients with non-metastatic RCC. The ratio should be applied in RCC patients for risk stratification and clinical decision-making.
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Affiliation(s)
- Aidan Xia
- Department of Hematology, The Third Clinical Institute Affiliated to Wenzhou Medical University, People's Hospital of Wenzhou, Wenzhou, Zhejiang province, 325006, P.R. China
| | - Yuming Chen
- Department of Urology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu province, 225001, P.R. China
| | - Jingfeng Chen
- Department of Anorectal surgery, sixth affiliated hospital of Wenzhou medical university (Lishui People's Hospital), Lishui, Zhejiang province, 323000, P.R. China
| | - Yue Pan
- Department of Urology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang province,325006, P.R. China
| | - Lianmin Bao
- Department of Respiratory, Rui'an People's Hospital, The Third Affiliated Hospital of the Wenzhou Medical University, Wenzhou, Zhejiang province, 325200, P.R. China
| | - Xiaomin Gao
- Department of Urology, Changhai Hospital, Second Military Medical University, Shanghai, 200433, P.R. China
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16
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Long ZQ, Hua X, Zhang WW, Lv SW, Deng JP, Guo L, He ZY, Lin HX. Prognostic impact of the pretreatment albumin to alkaline phosphatase ratio for nonmetastatic breast cancer patients. Cancer Manag Res 2019; 11:4809-4814. [PMID: 31213902 PMCID: PMC6549394 DOI: 10.2147/cmar.s200759] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 05/06/2019] [Indexed: 12/17/2022] Open
Abstract
Introduction: Albumin and alkaline phosphatase have been previously demonstrated as independent prognostic factors for various types of cancer. Here, we aimed to explore the potential value of pretreatment albumin to alkaline phosphatase ratio (AAPR) on overall survival (OS) in nonmetastatic breast cancer patients. Methods: A total of 746 nonmetastatic breast cancer patients were enrolled in this study. Receiver characteristic curve was used to analyze the AAPR threshold. Survival analysis was conducted using the Kaplan–Meier method and compared with the log-rank test. Both univariate and multivariate analyses were performed using Cox proportional hazards regression methodology. Results: The optimal cutoff value of AAPR in predicting OS in nonmetastatic breast cancer patients was 0.525. Increased pretreatment AAPR level was related to age at diagnosis (≥60 years vs <60 years, P=0.000), tumor size (T≤2 cm vs T>2 cm, P=0.034), estrogen receptor (positive vs negative, P=0.022), progesterone receptor (positive vs negative, P=0.025), carcino-embryonic antigen (abnormal vs normal, P=0.016), surgery (lumpectomy vs mastectomy, P=0.002), chemotherapy (yes vs no, P=0.004), radiotherapy (yes vs no, P=0.013), endocrine therapy (yes vs no, P=0.027) but not with lymph node involvement, HER-2 status or CA-153. The 5-year OS rate was 80.16% for the low AAPR group and 92.66% for the high AAPR group. Kaplan–Meier analysis indicated that patients with low-AAPR levels had shorter OS than patients with high-AAPR levels (P=0.001). N classification (P<0.05), Ki-67 (HR=3.603, 95% CI=1.046–12.414, P=0.042) and AAPR (HR=0.447, 95% CI=0.205–0.976, P=0.043) were related to OS in multivariate analyses, respectively. Conclusion: AAPR is an independent prognostic factor for OS in nonmetastatic breast cancer patients. Further prospective studies are required to confirm our findings.
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Affiliation(s)
- Zhi-Qing Long
- Department of Radiotherapy, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, People's Republic of China
| | - Xin Hua
- Department of Radiotherapy, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, People's Republic of China
| | - Wen-Wen Zhang
- Department of Radiotherapy, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, People's Republic of China
| | - Shao-Wen Lv
- Department of Radiotherapy, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, People's Republic of China
| | - Jia-Peng Deng
- Department of Radiotherapy, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, People's Republic of China
| | - Ling Guo
- Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, People's Republic of China
| | - Zhen-Yu He
- Department of Radiotherapy, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, People's Republic of China
| | - Huan-Xin Lin
- Department of Radiotherapy, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, People's Republic of China
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17
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Li X, Li B, Zeng H, Wang S, Sun X, Yu Y, Wang L, Yu J. Prognostic value of dynamic albumin-to-alkaline phosphatase ratio in limited stage small-cell lung cancer. Future Oncol 2019; 15:995-1006. [PMID: 30644319 DOI: 10.2217/fon-2018-0818] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
AIM To dynamically investigate the prognostic value of albumin-to-alkaline phosphatase ratio (AAPR) in limited stage small-cell lung cancer. MATERIALS & METHODS The AAPR within 1 week before and after chemoradiation therapy (pre- and post-AAPR) was collected and analyzed. RESULTS Patients with low pre- or post-AAPR had shorter overall survival and progression-free survival than the high groups (p-values all <0.05). Post-AAPR was an independent prognostic factor for progression-free survival (p = 0.007) and overall survival (p = 0.003). The integration of pre- or post-AAPR improved the prognostic ability of Tumor, Node, Metastasis stage alone (0.55-0.64 and 0.68, respectively). CONCLUSION Post-AAPR is a reliable prognostic factor for limited stage small-cell lung cancer patients. The complementary value of AAPR to Tumor, Node, Metastasis stage is worth further validation in the future.
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Affiliation(s)
- Xiaogang Li
- School of Medicine & Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Jinan, PR China.,Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Shandong Academy of Medical Science, Jinan, PR China
| | - Butuo Li
- Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Shandong Academy of Medical Science, Jinan, PR China.,Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention & Therapy, Tianjin, PR China
| | - Haiyan Zeng
- Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Shandong Academy of Medical Science, Jinan, PR China
| | - Shijiang Wang
- Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Shandong Academy of Medical Science, Jinan, PR China
| | - Xindong Sun
- Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Shandong Academy of Medical Science, Jinan, PR China
| | - Yishan Yu
- Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Shandong Academy of Medical Science, Jinan, PR China.,School of Medicine, Shandong University, Jinan, Shandong, PR China
| | - Linlin Wang
- Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Shandong Academy of Medical Science, Jinan, PR China
| | - Jinming Yu
- Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Shandong Academy of Medical Science, Jinan, PR China
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Wu YJ, Wang Y, Qin R, Cao ZY, Zhao HZ, Du XH, Yang B. Serum Alkaline Phosphatase Predicts Poor Disease-Free Survival in Patients Receiving Radical Gastrectomy. Med Sci Monit 2018; 24:9073-9080. [PMID: 30550533 PMCID: PMC6302660 DOI: 10.12659/msm.910480] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background Serum alkaline phosphatase (ALP) has been proved to be a negative prognostic factor for several malignancies, but its clinical significance in gastric cancer (GC) patients has not been sufficiently studied. In the present retrospective study, we investigated the effect of serum ALP on disease-free survival (DFS) after radical gastrectomy. Material/Methods We included 491 GC patients receiving radical gastrectomy at the Chinese People’s Liberation Army 309th Hospital. Univariate and multivariate analyses were performed to determine factors influencing serum ALP and DFS. The changes in serum ALP and its clinical relevance were also analyzed using the log-rank test and Cox proportional hazards model. Results There were 491 patients who met our inclusion and exclusion criteria. Pre-treatment serum ALP was elevated in 87 of these patients and was normal in the other 404 patients. Elevation of pre-treatment serum ALP was correlated with the tumor diameter (OR=2.642, P=0.017), TNM stage (OR=4.592, P=0.005), and T classification (OR=1.746, P=0.043). DFS was significantly different between patients with normal or elevated pre-treatment serum ALP (median 42.1 vs. 32.8 months, P=0.001) and multivariate analysis suggested pre-treatment serum ALP is an independent risk factor for poor DFS after radical gastrectomy (HR=2.035, P=0.021). In addition, removal of the primary tumor lesion led to an obvious decline in serum ALP activity (median 262 U/L vs. 152 U/L, P<0.001), and monitoring changes in serum ALP can help evaluate the risk of tumor relapse in GC patients (χ2=17.814, P<0.001). Conclusions Serum ALP is a good predictor of GC patient DFS after radical gastrectomy, and patients with elevated serum ALP have shorter relapse times.
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Affiliation(s)
- You-Jun Wu
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing, China (mainland).,Department of General Surgery, Chinese People's Liberation Army 309th Hospital, Beijing, China (mainland)
| | - Yue Wang
- Department of General Surgery, Chinese People's Liberation Army 309th Hospital, Beijing, China (mainland)
| | - Rong Qin
- Department of General Surgery, Chinese People's Liberation Army 309th Hospital, Beijing, China (mainland)
| | - Zhi-Yu Cao
- Department of General Surgery, Chinese People's Liberation Army 309th Hospital, Beijing, China (mainland)
| | - Hua-Zhou Zhao
- Department of General Surgery, Chinese People's Liberation Army 309th Hospital, Beijing, China (mainland)
| | - Xiao-Hui Du
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing, China (mainland)
| | - Bo Yang
- Department of General Surgery, Chinese People's Liberation Army 309th Hospital, Beijing, China (mainland)
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Girgin R, Cinar O, Bulut E, Akduman B, Mungan N. The Role of the Platelet Mass Index (PMI) as a New Prognostic Factor in Fournier’s Gangrene. AFRICAN JOURNAL OF UROLOGY 2018. [DOI: 10.1016/j.afju.2018.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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20
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The prognostic significance of Albumin-to-Alkaline Phosphatase Ratio in upper tract urothelial carcinoma. Sci Rep 2018; 8:12311. [PMID: 30120312 PMCID: PMC6097991 DOI: 10.1038/s41598-018-29833-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 07/19/2018] [Indexed: 02/05/2023] Open
Abstract
To assess the prognostic impact of pretreatment albumin-to-alkaline phosphatase ratio (AAPR) in patients with upper tract urothelial carcinoma (UTUC), the data of 692 patients, operated between 2003 and 2016 in our center, were retrospectively assessed. The threshold of AAPR was defined as 0.58 by using the receiver-operating curve analysis. Overall survival (OS), cancer-specific survival (CSS), and recurrence-free survival (RFS) were evaluated using the Kaplan-Meier method. And the univariate and multivariate Cox’s regression models were performed to identify independent prognostic predictors. The results showed that AAPR <0.58 was significantly related to higher pT stage and grade, concomitant variant histology, anemia and larger tumor size. Additionally, patients with a lower AAPR had an inferior survival outcomes than those with an AAPR ≥0.58 (all P < 0.001). Multivariate analysis suggested that the lower AAPR was also an independent risk factor for poor OS (HR 1.587, 95%CI: 1.185–2.126; P = 0.002), CSS (HR 1.746, 95%CI: 1.249–2.440; P = 0.001), and RFS (HR 1.337, 95%CI: 1.027–1.739; P = 0.031). Moreover, subgroup analysis demonstrated the lower AAPR was related to worse prognosis in high-grade UTUC patients; but in those with low-grade disease, no relationship between them was observed. In conclusion, our results found that the decreased AAPR was independently related to poor survival outcomes in UTUC patients. Using the AAPR for subclassification of high-grade UTUC seems to further identify a poor prognostic group and contribute to clinical decisions making.
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Nie M, Sun P, Chen C, Bi X, Wang Y, Yang H, Liu P, Li Z, Xia Y, Jiang W. Albumin-to-Alkaline Phosphatase Ratio: A Novel Prognostic Index of Overall Survival in Cisplatin-based Chemotherapy-treated Patients with Metastatic Nasopharyngeal Carcinoma. J Cancer 2017; 8:809-815. [PMID: 28382143 PMCID: PMC5381169 DOI: 10.7150/jca.17536] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Accepted: 10/29/2016] [Indexed: 11/05/2022] Open
Abstract
The Albumin-to-Alkaline Phosphatase Ratio (AAPR) has been recently revealed as a prognostic index for hepatocellular carcinoma, whereas its role in metastatic nasopharyngeal cancer (NPC) remains unclear. The aim of this study was to evaluate the clinical value of AAPR in patients with metastatic NPC. We retrospectively reviewed 209 metastatic NPC patients treated with cisplatin-based regimens. Survival data were calculated using the Kaplan-Meier method and were compared using the log-rank test. Univariate and multivariate survival analyses were conducted using the Cox proportional hazards regression methodology. The optimal cutoff level of AAPR for assessing overall survival (OS) was 0.447, which was determined by R software. An AAPR less than 0.447 was significantly associated with a higher lactate dehydrogenase (LDH) level (273 vs. 185 U/L, P = 0.004), a higher EBV DNA viral load (5.59×105 vs. 3.49×104 copies/ml, P = 0.001), and more liver and bone metastases (P = 0.005 and P = 0.001, respectively). Additionally, patients with an AAPR < 0.447 had a shorter overall survival and progression-free survival (hazard ratio: 3.269, 95% confidence interval: 1.710-6.248; HR: 2.295, 95% confidence interval: 1.217-4.331, respectively) than those with an AAPR ≥ 0.447. Our study suggested that the AAPR might be a novel prognostic factor in metastatic NPC patients treated with cisplatin-based regimens. However, a prospective study to validate its prognostic value is needed, and the mechanisms underlying the low AAPR and poor survival in metastatic NPC need to be further investigated.
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Affiliation(s)
- Man Nie
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong, People's Republic of China
- State Key Laboratory of Oncology in South China, Guangzhou 510060, Guangdong, People's Republic of China
- Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, Guangdong, People's Republic of China
| | - Peng Sun
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong, People's Republic of China
- State Key Laboratory of Oncology in South China, Guangzhou 510060, Guangdong, People's Republic of China
- Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, Guangdong, People's Republic of China
| | - Cui Chen
- Department of Oncology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510060, Guangdong, People's Republic of China
| | - Xiwen Bi
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong, People's Republic of China
- State Key Laboratory of Oncology in South China, Guangzhou 510060, Guangdong, People's Republic of China
- Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, Guangdong, People's Republic of China
| | - Yu Wang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong, People's Republic of China
- State Key Laboratory of Oncology in South China, Guangzhou 510060, Guangdong, People's Republic of China
- Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, Guangdong, People's Republic of China
| | - Hang Yang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong, People's Republic of China
- State Key Laboratory of Oncology in South China, Guangzhou 510060, Guangdong, People's Republic of China
- Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, Guangdong, People's Republic of China
| | - Panpan Liu
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong, People's Republic of China
- State Key Laboratory of Oncology in South China, Guangzhou 510060, Guangdong, People's Republic of China
- Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, Guangdong, People's Republic of China
| | - Zhiming Li
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong, People's Republic of China
- State Key Laboratory of Oncology in South China, Guangzhou 510060, Guangdong, People's Republic of China
- Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, Guangdong, People's Republic of China
| | - Yi Xia
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong, People's Republic of China
- State Key Laboratory of Oncology in South China, Guangzhou 510060, Guangdong, People's Republic of China
- Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, Guangdong, People's Republic of China
| | - Wenqi Jiang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong, People's Republic of China
- State Key Laboratory of Oncology in South China, Guangzhou 510060, Guangdong, People's Republic of China
- Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, Guangdong, People's Republic of China
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He S, Wang Y, Peng H, Yang L, Chen H, Liang S, Lu L, Chen Y. Pretreatment Alkaline Phosphatase and Epstein-Barr Virus DNA Predict Poor Prognosis and Response to Salvage Radiotherapy in Patients with Nasopharyngeal Carcinoma and Metachronous Bone-Only Metastasis. J Cancer 2017; 8:417-424. [PMID: 28261343 PMCID: PMC5332893 DOI: 10.7150/jca.17310] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 10/29/2016] [Indexed: 01/25/2023] Open
Abstract
Background: The bones are the most common site of distant metastasis in nasopharyngeal carcinoma (NPC). Few prognostic markers are available to guide treatment and sub-classify patients with bone metastasis. We aimed to identify the prognostic value of pretreatment serum alkaline phosphatase (ALP) and plasma Epstein-Barr virus DNA (EBV DNA) in patients with bone-only metastasis. Methods: A total of 272 patients who developed bone-only metastases after therapy were retrospectively analyzed. Patients were categorized according to pretreatment serum ALP (< or ≥ 110 U/L) and pretreatment plasma EBV DNA (< or ≥ 6,750 copies ml-1). Univariate and multivariate analyses of clinical variables were performed using Cox proportional hazards regression models. Overall survival (OS) was analyzed using the Kaplan-Meier method and compared using the log-rank test. Results: Median OS for the cohort was 34.06 months (range, 2.53-143.87 months). Multivariate Cox proportional hazard analysis verified pretreatment serum ALP and pretreatment plasma EBV DNA were independent prognostic factors for OS. In stratified survival analysis of patients with elevated pretreatment serum ALP and/or plasma EBV DNA, delivery of radiotherapy (RT) to bone metastases provided a significant OS benefit compared to other therapeutic methods (P < 0.05). Conclusions: This study demonstrates two important points: firstly, pretreatment serum ALP and plasma EBV DNA have prognostic value at the first diagnosis of bone-only metastasis in NPC. Secondly, radiotherapy of bone metastasis improves the prognosis of patients with elevated pretreatment serum ALP and plasma EBV DNA.
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Affiliation(s)
- ShaSha He
- Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, China;; State Key Laboratory of Oncology in Southern China, Guangzhou, China;; Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Yan Wang
- Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, China;; State Key Laboratory of Oncology in Southern China, Guangzhou, China;; Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Hao Peng
- Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, China;; State Key Laboratory of Oncology in Southern China, Guangzhou, China;; Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Lin Yang
- Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, China;; State Key Laboratory of Oncology in Southern China, Guangzhou, China;; Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - HaiYang Chen
- The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | | | - LiXia Lu
- Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, China;; State Key Laboratory of Oncology in Southern China, Guangzhou, China;; Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Yong Chen
- Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, China;; State Key Laboratory of Oncology in Southern China, Guangzhou, China;; Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
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23
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Ji F, Fu SJ, Guo ZY, Pang H, Ju WQ, Wang DP, Hua YP, He XS. Prognostic value of combined preoperative lactate dehydrogenase and alkaline phosphatase levels in patients with resectable pancreatic ductal adenocarcinoma. Medicine (Baltimore) 2016; 95:e4065. [PMID: 27399091 PMCID: PMC5058820 DOI: 10.1097/md.0000000000004065] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Serum enzymes, including lactate dehydrogenase (LDH) and alkaline phosphatase (ALP), have recently been reported to play important roles in tumor growth. Increases in LDH and ALP have been confirmed to predict poor prognosis in patients with various cancers. However, their prognostic value in pancreatic cancer has not been well studied. Therefore, we reviewed the preoperative data on LDH and ALP in 185 pancreatic ductal adenocarcinoma (PDAC) patients who underwent surgery between July 2005 and December 2010 to explore the prognostic value of these markers. The cutoff points were determined based on the upper limit of their normal values. The Chi-square test was used to analyze the relationships between LDH/ALP and clinical characteristics. Univariate and multivariate analyses were performed to identify the predictive value of the above factors for disease-free survival (DFS) and overall survival (OS). We found that elevation of LDH was related to carbohydrate antigen 19-9 (CA19-9), lymph node involvement, tumor size, TNM, distant metastasis, and recurrence. Additionally, ALP was correlated to perineural invasion. After multivariate analysis, LDH and ALP were identified as independent prognostic factors for DFS and OS, and elevation of LDH/ALP was correlated with poor DFS and OS. Notably, there was a positive correlation between LDH and ALP. The predictive power of LDH combined with ALP was more sensitive than that of either one alone. Therefore, we conclude that the preoperative LDH and ALP values are prognostic factors for PADC, and the prognostic accuracy of testing can be enhanced by the combination of LDH and ALP.
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Affiliation(s)
- Fei Ji
- Organ Transplant Center, the First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, Guangdong Provincial international Cooperation Base of Science and Technology, Guangzhou, P.R. China
| | - Shun-Jun Fu
- Organ Transplant Center, the First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, Guangdong Provincial international Cooperation Base of Science and Technology, Guangzhou, P.R. China
| | - Zhi-Yong Guo
- Organ Transplant Center, the First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, Guangdong Provincial international Cooperation Base of Science and Technology, Guangzhou, P.R. China
| | | | - Wei-Qiang Ju
- Organ Transplant Center, the First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, Guangdong Provincial international Cooperation Base of Science and Technology, Guangzhou, P.R. China
| | - Dong-Ping Wang
- Organ Transplant Center, the First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, Guangdong Provincial international Cooperation Base of Science and Technology, Guangzhou, P.R. China
| | - Yun-Peng Hua
- Department of Liver Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, P.R. China
- Correspondence: Xiao-Shun He, Organ Transplant Center, the First Affiliated Hospital, Sun Yat-sen University; Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology; Guangdong Provincial international Cooperation Base of Science and Technology, Guangzhou 510080, P. R. China (e-mail: ). Yun-Peng Hua, Department of Liver Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P. R. China (e-mail: )
| | - Xiao-Shun He
- Organ Transplant Center, the First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, Guangdong Provincial international Cooperation Base of Science and Technology, Guangzhou, P.R. China
- Correspondence: Xiao-Shun He, Organ Transplant Center, the First Affiliated Hospital, Sun Yat-sen University; Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology; Guangdong Provincial international Cooperation Base of Science and Technology, Guangzhou 510080, P. R. China (e-mail: ). Yun-Peng Hua, Department of Liver Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P. R. China (e-mail: )
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Erol B, Tuncel A, Tok A, Hanci V, Sari U, Sendogan F, Budak S, Aydemir H, Amasyali AS, Yildirim A, Caskurlu T. Low magnesium levels an important new prognostic parameter can be overlooked in patients with Fournier’s gangrene: a multicentric study. Int Urol Nephrol 2015; 47:1939-45. [DOI: 10.1007/s11255-015-1131-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2015] [Accepted: 09/29/2015] [Indexed: 11/30/2022]
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