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Lo CM, Lu HI, Wang YM, Chen YH, Chen Y, Chen LC, Li SH. Preoperative neutrophil-to-lymphocyte ratio after chemoradiotherapy for esophageal squamous cell carcinoma associates with postoperative pulmonary complications following radical esophagectomy. Perioper Med (Lond) 2024; 13:65. [PMID: 38956623 PMCID: PMC11218404 DOI: 10.1186/s13741-024-00431-6] [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: 05/25/2022] [Accepted: 06/26/2024] [Indexed: 07/04/2024] Open
Abstract
OBJECTIVES Esophagectomy after chemoradiotherapy is associated with an increased risk of surgical complications. The significance of preoperative neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio after chemoradiotherapy in predicting pulmonary complications following radical esophagectomy in esophageal squamous cell carcinoma patients receiving preoperative chemoradiotherapy remains unknown. We aimed to investigate the utility of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in predicting the pulmonary complications of esophagectomy after preoperative chemoradiotherapy. METHODS We retrospectively reviewed 111 consecutive patients with stage III esophageal squamous cell carcinoma who received preoperative chemoradiotherapy followed by esophagectomy between January 2009 and December 2017. Laboratory data were collected before the operation and surgical outcomes and complications were recorded. We calculated neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio and correlated them with the clinical parameters, postoperative complications, overall survival, and disease-free survival. RESULTS Postoperative complications were observed in 75 (68%) patients, including 32 (29%) with pulmonary complications. The preoperative neutrophil-to-lymphocyte ratio of ≥ 3 (P = 0.008), clinical T4 classification (P = 0.007), and advanced stage IIIC (P = 0.012) were significantly associated with pulmonary complications. Pulmonary complication rates were 15% and 38% in patients with preoperative neutrophil-to-lymphocyte ratio of < 3 and ≥ 3, respectively. Preoperative neutrophil-to-lymphocyte ratio was not associated with the oncological stratification such as pathological T classification, pathological N classification, and pathological AJCC stage. The 3-year overall survival rates were 70% and 34% in patients with preoperative neutrophil-to-lymphocyte ratio of < 3 and ≥ 3, respectively (P = 0.0026). The 3-year disease-free survival rates were 57% and 29% in patients with preoperative neutrophil-to-lymphocyte ratio of < 3 and ≥ 3, respectively (P = 0.0055). The preoperative neutrophil-to-lymphocyte ratio of ≥ 3 was independently associated with more pulmonary complications, inferior overall survival, and worse disease-free survival. CONCLUSIONS Elevated preoperative neutrophil-to-lymphocyte ratio after chemoradiotherapy is independently associated with higher pulmonary complication rate following radical esophagectomy and poor prognosis in patients with esophageal squamous cell carcinoma receiving preoperative chemoradiotherapy. Preoperative neutrophil-to-lymphocyte ratio is routinely available in clinical practice and our findings suggest it can be used as a predictor for pulmonary complications after esophagectomy in patients with esophageal squamous cell carcinoma receiving preoperative chemoradiotherapy.
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Affiliation(s)
- Chien-Ming Lo
- Department of Thoracic & Cardiovascular Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Hung-I Lu
- Department of Thoracic & Cardiovascular Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yu-Ming Wang
- Deaprtment of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yen-Hao Chen
- Department of Hematology-Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yu Chen
- Department of Thoracic & Cardiovascular Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Li-Chun Chen
- Department of Thoracic & Cardiovascular Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Shau-Hsuan Li
- Department of Hematology-Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
- , No.123, Dapi Rd., Niaosong Dist., Kaohsiung City, 833, Taiwan.
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Qin L, Zhang L. The predictive value of serum inflammatory markers for the severity of cervical lesions. BMC Cancer 2024; 24:780. [PMID: 38943072 PMCID: PMC11212428 DOI: 10.1186/s12885-024-12561-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 06/25/2024] [Indexed: 07/01/2024] Open
Abstract
OBJECTIVE Exploring the predictive value of NLR, PLR, MLR, and SII for the severity of cervical cancer screening abnormalities in patients. METHODS A retrospective analysis was conducted on the data of 324 patients suspected of cervical lesions due to abnormal TCT and/or HPV in our hospital from January 2023 to December 2023, who underwent colposcopy. The pathological results of colposcopic biopsy confirmed that there were 140 cases of chronic cervicitis, which classified as the group without cervical lesions. The cervical lesion group included 184 cases, including 91 cases of LSIL, 71 cases of HSIL, and 22 cases of cervical cancer. Compared the differences in preoperative peripheral blood NLR, PLR, MLR, and SII among different groups of patients, and evaluated their predictive value for the severity of cervical lesions using Receiver Operating Characteristic (ROC) curves. RESULTS The levels of NLR, PLR, and SII in the group without cervical lesions were lower than those in the group with cervical lesions (p < 0.05), and there was no statistically significant difference in MLR (p > 0.05). The comparison of NLR among LSIL, HSIL, and cervical cancer groups showed statistically significant differences (p < 0.05), while PLR, MLR, and SII showed no statistically significant differences (p > 0.05). The AUC of peripheral blood NLR, PLR, and SII for predicting cervical lesions were 0.569, 0.582, and 0.572, respectively. The optimal cutoff values were 2.3,176.48, and 603.56. The sensitivity and specificity were 38.6% and 73.6%, 28.8% and 85.7%, 37.5% and 76.4%, respectively. At the same time, the joint testing of the three had the highest efficiency, with sensitivity of 69% and specificity of 45%. CONCLUSION Although the peripheral blood NLR, PLR, and SII of the cervical lesions patients were higher than those without cervical lesions in cervical cancer screening abnormal patients, the predictive ROC curve discrimination was low. Therefore, it is not recommended to use preoperative peripheral blood inflammatory markers as markers for cervical cancer screening abnormal patient diversion.
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Affiliation(s)
- Lin Qin
- Senior Department of Obstetrics & Gynecology, the Seventh Medical Center of PLA General Hospital, Beijing, China.
| | - Lina Zhang
- Senior Department of Obstetrics & Gynecology, the Seventh Medical Center of PLA General Hospital, Beijing, China
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Ma H, Liu Y, Ye H, Gao F, Li Z, Qin S. The prognostic value of preoperative laboratory data indicators in patients with esophageal carcinoma: An observational study. Medicine (Baltimore) 2024; 103:e38477. [PMID: 38875403 PMCID: PMC11175890 DOI: 10.1097/md.0000000000038477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/16/2024] Open
Abstract
Preoperative laboratory data indicators significantly affect the prognosis of a variety of tumors. Nevertheless, the combined effect of systemic immune-inflammation index (SII) and prognostic nutritional index (PNI) on overall survival (OS) in patients with esophageal carcinoma remains unclear. Thus, we examined these associations among patients with postoperative staged T3N0M0 esophageal carcinoma. The data of 246 patients with postoperative staged T3N0M0 esophageal carcinoma from January 1, 2010, to December 31, 2022, were retrospectively analyzed. OS was measured from the date of pathological diagnosis until either death or the last follow-up. The Kaplan-Meier method and multivariate Cox regression model were used to analyze the relationship between neutrophil-to-lymphocyte ratio (NLR), Platelet-to-lymphocyte ratio (PLR), Platelet-to-lymphocyte ratio (LMR), SII, PNI, and OS. The predictive value of SII and PNI as a combined index was analyzed by the receiver operating characteristic curve (ROC). A total of 246 patients aged 65.5 ± 7.4 years were included in this study and 181 (73.6%) were male. The univariate analysis revealed that differentiation, vessel involvement, postoperative treatment, NLR, SII, PLR, LMR, PNI were predictors of OS (P < .05). After adjusted for potential confounds, multivariate Cox regression analysis showed that the differentiation, SII, PNI, and postoperative treatment were independent prognostic factors correlated with OS in patients with postoperative staged T3N0M0 esophageal carcinoma (P < .05). SII and PNI, as a combined indicator, have a higher predictive value for OS. The NLR, SII, PLR, LMR, and PNI could all be used as independent predictors of OS in patients with postoperative staged T3N0M0 esophageal carcinoma. The combination of SII and PNI can significantly improve the accuracy of prediction.
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Affiliation(s)
- Hui Ma
- Department of Radiation Oncology, The First Affiliated Hospital of Soochow University, Su Zhou, P.R. China
- Department of Radiation Oncology, Taixing People' s Hospital Affiliated to Yangzhou University, Tai Xing, P.R. China
| | - Yangchen Liu
- Department of Radiation Oncology, Taixing People' s Hospital Affiliated to Yangzhou University, Tai Xing, P.R. China
| | - Hongxun Ye
- Department of Radiation Oncology, Taixing People' s Hospital Affiliated to Yangzhou University, Tai Xing, P.R. China
| | - Fei Gao
- Department of Radiation Oncology, Taixing People' s Hospital Affiliated to Yangzhou University, Tai Xing, P.R. China
| | - Zhu Li
- Department of Radiation Oncology, Taixing People' s Hospital Affiliated to Yangzhou University, Tai Xing, P.R. China
| | - Songbing Qin
- Department of Radiation Oncology, The First Affiliated Hospital of Soochow University, Su Zhou, P.R. China
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Fu M, Li Z, Ma J, Shen F, Zhang X. Study on the predictive value of pretreatment peripheral blood inflammatory markers regarding immunotherapy in patients with inoperable advanced or locally advanced oesophageal squamous cell carcinoma. Scand J Gastroenterol 2024; 59:722-729. [PMID: 38362884 DOI: 10.1080/00365521.2024.2319319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 02/11/2024] [Indexed: 02/17/2024]
Abstract
OBJECTIVE To explore the effects of pretreatment peripheral blood panimmune-inflammation value (PIV), systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) on the efficacy and prognostic value of immunotherapy in patients with inoperable advanced or locally advanced oesophageal squamous cell carcinoma (ESCC). METHODS Clinical data of 107 inoperable advanced or locally advanced ESCC patients were retrospectively analysed between May 2019 and August 2023, the receiver operating characteristic curves (ROCs) of PIV, SII, NLR, and PLR in patients prior to immunotherapy were plotted, and their optimal cutoff values were determined. The risk factors were determined by univariate and multivariate analyses in groups based on the optimal cut-off values. RESULTS Peripheral blood PIV, SII and PLR before immunotherapy had predictive value for the optimal efficacy of immunotherapy in patients with inoperable advanced or locally advanced ESCC; patients with PIV ≥415.885, SII ≥834.295 and NLR ≥3.740 had a low objective response rate (ORR), disease control rate (DCR), a short progression-free survival (PFS) and overall survival (OS) after immunotherapy (p < 0.05). Patient tumour stage, distant lymph node metastasis, lung metastasis, liver metastasis, PIV, SII, and NLR were risk factors affecting PFS and OS (p < 0.05). Tumour stage and SII were independent risk factors affecting PFS and OS (p < 0.05). CONCLUSION In patients with inoperable advanced or locally advanced ESCC, peripheral blood PIV, SII, and NLR have predictive value for immunotherapy outcome, SII is an independent risk factor affecting the survival prognosis, and SII ≥834.295 suggests a poor prognosis from immunotherapy.
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Affiliation(s)
- Maodong Fu
- Department of Integrative Medicine, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, Fujian, People's Republic of China
- Xiamen Clinical Research Center for Cancer Therapy, Xiamen, Fujian, People's Republic of China
| | - Zhiyong Li
- Xiamen Clinical Research Center for Cancer Therapy, Xiamen, Fujian, People's Republic of China
- Department of Medical Oncology, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, Fujian, People's Republic of China
| | - Jun Ma
- Department of Integrative Medicine, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, Fujian, People's Republic of China
- Xiamen Clinical Research Center for Cancer Therapy, Xiamen, Fujian, People's Republic of China
| | - Feng Shen
- Xiamen Clinical Research Center for Cancer Therapy, Xiamen, Fujian, People's Republic of China
- Department of Medical Oncology, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, Fujian, People's Republic of China
| | - Xiuping Zhang
- Xiamen Clinical Research Center for Cancer Therapy, Xiamen, Fujian, People's Republic of China
- Department of Medical Oncology, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, Fujian, People's Republic of China
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Wang Q, Zhang Q, Zhu J, Li L, Zeng R, Ding H, Li Z, Feng T, Hao R, Zhang G. Nomogram for predicting overall survival after curative gastrectomy using inflammatory, nutritional and pathological factors. Clin Transl Oncol 2024; 26:1001-1011. [PMID: 37996667 DOI: 10.1007/s12094-023-03340-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 10/20/2023] [Indexed: 11/25/2023]
Abstract
PURPOSE To establish a nomogram for predicting the overall survival (OS) in patients with gastric cancer (GC) based on inflammatory, nutritional and pathological factors. METHODS GC patients underwent curative gastrectomy from January 2012 to June 2017 in our hospital were included, and were classified into training set and validation set with a ratio of 7:3. Then variables associated with OS were analyzed using univariate and multivariate Cox regression analysis. Nomograms predicting OS were built using variables from multivariable Cox models. Finally, Kaplan-Meier curve and Log-rank test were also conducted to analyze the 1-yr, 3-yr and 5-yr OS to validate the efficiency of risk stratification of the nomogram. RESULTS A total of 366 GC patients were included. After univariate and multivariate Cox regression analysis, age (HR = 1.52, 95% CI = 1.01-2.30, P = 0.044), CA50 (HR = 1.90, 95% CI = 1.12-3.21, P = 0.017), PNI (HR = 1.65, 95% CI = 1.13-2.39, P = 0.009), SII (HR = 1.46, 95% CI = 1.03-2.08, P = 0.036), T stage (HR = 2.26, 95% CI = 1.01-5.05, P = 0.048; HR = 7.24, 95% CI = 3.64-14.40, P < 0.001) were independent influencing factors on the survival time of GC patients. Five factors including CEA, prognostic nutritional index (PNI), systemic immune-inflammation index (SII), ln (tumor size), T stage, and N stage were identified and entered the nomogram, which showed good discrimination and calibration in both sets. On internal validation, 1-yr, 3-yr and 5-yr nomogram demonstrated a good discrimination with an area under the ROC curve (AUC) of 0.77, 0.84 and 0.86, respectively. The AUC for 1-yr, 3-yr and 5-yr nomogram in validation set was 0.77, 0.79 and 0.81, respectively. The OS in low risk group of training cohort and validation cohort was significantly higher than that of intermediate risk group and high risk group, respectively. CONCLUSIONS We established a nomogram based on PNI, SII and pathological factors for predicting OS in GC patients. In addition, its efficiency was validated by validation set and stratified analysis.
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Affiliation(s)
- Qi Wang
- Department of General Surgery, The First Affiliated Hospital of Shandong First Medical University, Jinan, 250100, China
| | - Qiang Zhang
- Department of General Surgery, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital), Qingdao, 266000, China
| | - Jiankang Zhu
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Shandong First Medical University, No. 16766 Jingshi Road, Jinan, 250100, China
| | - Linchuan Li
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Shandong First Medical University, No. 16766 Jingshi Road, Jinan, 250100, China
| | - Runzhi Zeng
- Department of General Surgery, Shandong Provincial Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250014, China
| | - Huanxin Ding
- Department of General Surgery, Shandong Provincial Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250014, China
| | - Zhenmin Li
- Department of General Surgery, The First Affiliated Hospital of Shandong First Medical University, Jinan, 250100, China
| | - Tianyi Feng
- Department of General Surgery, Shandong Provincial Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250014, China
| | - Ruiqi Hao
- Department of General Surgery, The First Affiliated Hospital of Shandong First Medical University, Jinan, 250100, China
| | - Guangyong Zhang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Shandong First Medical University, No. 16766 Jingshi Road, Jinan, 250100, China.
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Feng X, Sun Z, Huang Y, Zhang Y, Chen Y, Deng B. A Low Systemic Inflammatory Response Index Is Associated With Improved Survival in Adenoid Cystic Carcinoma Patients. J Oral Maxillofac Surg 2024:S0278-2391(24)00204-0. [PMID: 38615695 DOI: 10.1016/j.joms.2024.03.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 03/20/2024] [Accepted: 03/20/2024] [Indexed: 04/16/2024]
Abstract
BACKGROUND Predicting the long-term survival in adenoid cystic carcinoma (ACC) patients remains challenging. Inflammatory cell-based indices are emerging as prognostic indicators of oncology. PURPOSE This study aimed to determine the associations between the preoperative systemic inflammatory response index (SIRI) and the systemic immunoinflammatory index (SII) and the 10-year survival rates in patients with ACC of the head and neck (ACCHN). STUDY DESIGN, SETTING, SAMPLE This retrospective cohort study comprised ACCHN patients treated at the Chinese People's Liberation Army General Hospital between November 2003 and December 2020. PREDICTOR VARIABLE The inflammatory response, assessed using the SIRI and SII, was the predictor variable. The optimal cutoff values were based on the maximum Youden index values (sensitivity + specificity-1). The patients were divided into two groups each, based on the SIRI (low, ≤ 0.15) and (high, > 0.15), and SII (low, ≤ 562.8 and high, > 562.8) values. MAIN OUTCOME VARIABLE(S) Overall survival (OS), or the number of days, weeks, or months between treatment initiation and death (or the last follow-up date), was the primary outcome variable. COVARIATES The covariates were classified as demographic (age, gender, body mass index), medical (hypertension, diabetes), inflammatory (neutrophils, lymphocytes, monocytes, platelets, lymphocyte-monocyte ratio, platelet-lymphocyte ratio, neutrophil-lymphocyte ratio), and perioperative (tumor stage, lymph node metastasis, tumor size, treatment type). ANALYSES Descriptive, univariate, and multivariate Cox proportional risk regression analyses were performed to determine whether the SIRI and SII were independent prognostic factors for OS. Kaplan-Meier survival curves and log-rank tests were used to determine their associations with the OS. RESULTS The study sample comprised 162 patients (mean age, 52 ± 14; males, 39.5%). The median follow-up time was 6.81 ± 0.23, and the 10-year OS rate was 7.68 ± 0.25. The low and high SIRI groups comprised 109 and 53 patients, while the low and high SII groups comprised 116 and 46 patients, respectively. SIRI was identified as a prognostic factor (P < .01; hazard ratio, 2.45; 95% confidence interval, 1.35-4.45). CONCLUSION AND RELEVANCE The SIRI has the advantages of reproducibility, convenience, noninvasiveness, and affordability, making it a promising prognostic inflammatory index for patients with ACCHN.
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Affiliation(s)
- Xuanqi Feng
- Graduate Student, Medical School of Chinese PLA, Beijing, China
| | - Zhongyang Sun
- Resident Doctor, Department of Infectious Disease Management, The Second Affiliated Hospital of Xiamen Medical College (Xiamen Second Hospital), Xiamen, China
| | - Yang Huang
- Dentistry, Attending Physician, Department of Stomatology, The First Medical Center, Chinese PLA General, Medical School of Chinese PLA, Beijing, China
| | - Yu Zhang
- Graduate Student, Medical School of Chinese PLA, Beijing, China
| | - Yanru Chen
- Graduate Student, Medical School of Chinese PLA, Beijing, China
| | - Bin Deng
- Dentistry, Associate Chief Physician, Department of Stomatology, Medical School of Chinese PLA, The First Medical Center, Chinese PLA General, Medical School of Chinese PLA, Beijing, China.
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Wang X, Gong G, Sun Q, Meng X. Prediction of pCR based on clinical-radiomic model in patients with locally advanced ESCC treated with neoadjuvant immunotherapy plus chemoradiotherapy. Front Oncol 2024; 14:1350914. [PMID: 38571506 PMCID: PMC10989074 DOI: 10.3389/fonc.2024.1350914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 03/06/2024] [Indexed: 04/05/2024] Open
Abstract
Background The primary objective of this research is to devise a model to predict the pathologic complete response in esophageal squamous cell carcinoma (ESCC) patients undergoing neoadjuvant immunotherapy combined with chemoradiotherapy (nICRT). Methods We retrospectively analyzed data from 60 ESCC patients who received nICRT between 2019 and 2023. These patients were divided into two cohorts: pCR-group (N = 28) and non-pCR group (N = 32). Radiomic features, discerned from the primary tumor region across plain, arterial, and venous phases of CT, and pertinent laboratory data were documented at two intervals: pre-treatment and preoperation. Concurrently, related clinical data was amassed. Feature selection was facilitated using the Extreme Gradient Boosting (XGBoost) algorithm, with model validation conducted via fivefold cross-validation. The model's discriminating capability was evaluated using the area under the receiver operating characteristic curve (AUC). Additionally, the clinical applicability of the clinical-radiomic model was appraised through decision curve analysis (DCA). Results The clinical-radiomic model incorporated seven significant markers: postHALP, ΔHB, post-ALB, firstorder_Skewness, GLCM_DifferenceAverage, GLCM_JointEntropy, GLDM_DependenceEntropy, and NGTDM_Complexity, to predict pCR. The XGBoost algorithm rendered an accuracy of 0.87 and an AUC of 0.84. Notably, the joint omics approach superseded the performance of solely radiomic or clinical model. The DCA further cemented the robust clinical utility of our clinical-radiomic model. Conclusion This study successfully formulated and validated a union omics methodology for anticipating the therapeutic outcomes of nICRT followed by radical surgical resection. Such insights are invaluable for clinicians in identifying potential nICRT responders among ESCC patients and tailoring optimal individualized treatment plans.
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Affiliation(s)
- Xiaohan Wang
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Science, Jinan, China
| | - Guanzhong Gong
- Department of Radiotherapy, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Science, Jinan, China
| | - Qifeng Sun
- Department of Thoracic Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Xue Meng
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Science, Jinan, China
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Feng J, Wang L, Yang X, Chen Q, Cheng X. Pretreatment Pan-Immune-Inflammation Value (PIV) in Predicting Therapeutic Response and Clinical Outcomes of Neoadjuvant Immunochemotherapy for Esophageal Squamous Cell Carcinoma. Ann Surg Oncol 2024; 31:272-283. [PMID: 37838648 DOI: 10.1245/s10434-023-14430-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 09/26/2023] [Indexed: 10/16/2023]
Abstract
PURPOSE The pan-immune-inflammation value (PIV), which reflects the balance between the host immune and inflammatory status, is a readily available index for evaluating cancer outcomes. Until now, however, no study has demonstrated the clinical response of PIV to neoadjuvant immunochemotherapy (NICT) in esophageal squamous cell carcinoma (ESCC). METHODS This retrospective study included 218 patients with ESCC who underwent NICT. The relationship between PIV and therapeutic response (pathological complete response [PCR]) and clinical outcomes (overall survival [OS] and disease-free survival [DFS]) was examined. Cox proportional, hazard-regression analyses and the Kaplan-Meier method were used for survival analyses. Recursive partitioning analysis (RPA) was used to establish a novel risk stratification model. RESULTS Sixty-six patients (30.3%) achieved PCR after NICT. Using PCR as the endpoint of interest, patients were compared in groups based on the optimal threshold. PIV was closely related to PCR (odds ratio [OR] 0.311, 95% confidence interval [CI] 0.140-0.690, P = 0.004). Compared with patients in the low PIV cohort, patients with high PIV had worse 3-year OS (58.7% vs. 83.6%, P < 0.001) and DFS (51.9% vs. 79.1%, P < 0.001). PIV was an independent predictor of OS (hazard ratio [HR] 2.364, 95% CI 1.183-4.724, P = 0.015) and DFS (HR 1.729, 95% CI 1.026-2.913, P = 0.040). Three risk groups with varied DFS and OS were staged by using an RPA method, and the prognostication accuracy was considerably improved. CONCLUSIONS Pretreatment PIV can predict the therapeutic efficacy of NICT for ESCC. Because of better prognostic stratification, pretreatment PIV is a novel, sensitive, and effective indicator in ESCC receiving NICT. The prognostic results of PIV need to be verified in additional prospective studies.
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Affiliation(s)
- Jifeng Feng
- Department of Thoracic Oncological Surgery, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, China
- Key Laboratory of Prevention, Diagnosis and Therapy of Upper Gastrointestinal Cancer of Zhejiang Province, Zhejiang Cancer Hospital, Hangzhou, China
- Key Laboratory of Diagnosis and Treatment Technology on Thoracic Oncology (Lung and Esophagus) of Zhejiang Province, Zhejiang Cancer Hospital, Hangzhou, China
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
| | - Liang Wang
- Department of Thoracic Oncological Surgery, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, China
| | - Xun Yang
- Department of Thoracic Oncological Surgery, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, China
| | - Qixun Chen
- Department of Thoracic Oncological Surgery, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, China.
- Key Laboratory of Diagnosis and Treatment Technology on Thoracic Oncology (Lung and Esophagus) of Zhejiang Province, Zhejiang Cancer Hospital, Hangzhou, China.
| | - Xiangdong Cheng
- Key Laboratory of Prevention, Diagnosis and Therapy of Upper Gastrointestinal Cancer of Zhejiang Province, Zhejiang Cancer Hospital, Hangzhou, China.
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China.
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孔 德, 宋 丽, 向 阳. [Construction of a prognostic nomogram combining PET/CT metabolic parameters and blood inflammatory markers for non-small cell lung cancer treated with first-line chemotherapy]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2023; 43:2139-2144. [PMID: 38189402 PMCID: PMC10774112 DOI: 10.12122/j.issn.1673-4254.2023.12.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Indexed: 01/09/2024]
Abstract
OBJECTIVE To investigate the prognostic value of 18F-FDG-PET/CT metabolic parameters and blood inflammatory markers for advanced non-small cell lung cancer (NSCLC, stage Ⅳ/ⅢB) treated with first-line chemotherapy combined with immunotherapy and construct a nomogram prediction model for NSCLC. METHODS We retrospectively analyzed the metabolic parameters (SUVmax, MTV and TLG) and blood markers of inflammation (NLR, DNLR, PLR and SII) in 105 patients with advanced NSCLC receiving chemotherapy combined with baseline 18F-FDG-PET/CT prior to immunotherapy from March, 2019 to June, 2021. ROC curve was used to calculate the best cut-off points for grouping, and univariate and multivariate COX regression analyses were performed to screen the independent predictors of prognosis for a combined diagnostic analysis. The effective biomarkers were included in the prediction model, and the nomogram model was constructed using the cph function in the rms function package of R language software. RESULTS The patients were followed up for a median of 17.5 months, and their median progression-free survival (PFS) was 16 months with a median overall survival (OS) of 13.6 months. A high PLR (≥151.050) and a high TLG (≥101.940) were significant independent prognostic factors for PFS, and a high SII (≥941.385) and a high TLG (≥101.940) were independent prognostic factors for OS. The nomogram combining PET and blood markers of inflammation showed a good performance for prognostic prediction (with C-index of 0.682 for PFS and of 0.727 for OS) and good fitting of the calibration curve. The clinical decision curve showed good clinical utility of the nomogram. CONCLUSION The baseline PET/CT metabolic parameters and blood inflammatory markers are associated with PFS and OS of patients with advanced NSCLC receiving first-line chemotherapy, and the constructed nomogram based on these parameters has a good performance for prognostic prediction in these patients.
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Affiliation(s)
- 德贤 孔
- />锦州医科大学附属第一医院核医学科,辽宁 锦州 121000Department of Nuclear Medicine, First Affiliated Hospital of Jinzhou Medical University, Jinzhou 121000, China
| | - 丽萍 宋
- />锦州医科大学附属第一医院核医学科,辽宁 锦州 121000Department of Nuclear Medicine, First Affiliated Hospital of Jinzhou Medical University, Jinzhou 121000, China
| | - 阳 向
- />锦州医科大学附属第一医院核医学科,辽宁 锦州 121000Department of Nuclear Medicine, First Affiliated Hospital of Jinzhou Medical University, Jinzhou 121000, China
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Toprak K, Kaplangoray M, Inanır M, Memioğlu T. How Effective is the Systemic Inflammatory Immune Index in the Etiopathogenesis of Isolated Coronary Artery Ectasia?Reply. Arq Bras Cardiol 2023; 120:e20230048. [PMID: 37729252 PMCID: PMC10519350 DOI: 10.36660/abc.20230048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/09/2023] [Accepted: 02/09/2023] [Indexed: 09/22/2023] Open
Affiliation(s)
- Kenan Toprak
- Harran UniversityDepartment of CardiologySanliurfaTurquiaHarran University - Department of Cardiology, Sanliurfa – Turquia
| | - Mustafa Kaplangoray
- Bilecik Şeyh Edebali Üniversitesi – CardiologyBilecikTurquiaBilecik Şeyh Edebali Üniversitesi – Cardiology, Bilecik – Turquia
| | - Mehmet Inanır
- Abant Izzet Baysal UniversityCardiology DepartmentBoluTurquiaAbant Izzet Baysal University - Cardiology Department, Bolu – Turquia
| | - Tolga Memioğlu
- Abant Izzet Baysal UniversityCardiology DepartmentBoluTurquiaAbant Izzet Baysal University - Cardiology Department, Bolu – Turquia
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11
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Zeng X, Ye L, Luo M, Zeng D, Chen Y. Prognostic value of pretreatment systemic immune-inflammation index in Chinese esophageal squamous cell carcinoma patients receiving radical radiotherapy: A meta-analysis. Medicine (Baltimore) 2023; 102:e34117. [PMID: 37352061 PMCID: PMC10289742 DOI: 10.1097/md.0000000000034117] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 06/05/2023] [Accepted: 06/06/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND The association between pretreatment systemic immune-inflammation index (SII) and long-term survival among Chinese esophageal squamous cell carcinoma (ESCC) patients who received radical radiotherapy remains unclear. The aim of this study was to identify the prognostic role of pretreatment SII in Chinese ESCC patients receiving radical radiotherapy based on current evidence. METHODS The PubMed, EMBASE, Web of Science and CNKI databases were searched up to March 18, 2023. Primary and secondary outcomes were overall survival (OS) and progression-free survival (PFS), respectively. The hazard ratios (HRs) with corresponding 95% confidence intervals (CIs) were combined to assess the predictive role of pretreatment SII for long-term survival of Chinese ESCC patients receiving radiotherapy. All statistical analyses were conducted by STATA 15.0 software. RESULTS A total of 8 eligibility studies involving 2101 cases were included in this meta-analysis. The pooled results demonstrated that elevated pretreatment SII was significantly related to worse OS (HR = 1.59, 95% CI: 1.24-2.02, P < .001) and PFS (HR = 1.33, 95% CI: 1.13-1.57, P < .001). Besides, subgroup based on TNM stage showed similar results. CONCLUSION Pretreatment SII could serve as a novel prognostic factor in Chinese ESCC patients receiving definitive radiotherapy and patients with an elevated SII may experience poorer survival.
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Affiliation(s)
- Xiaoxiao Zeng
- Department of Oncology, The People’s Hospital of JianYang City, Jian Yang, China
| | - Ling Ye
- Department of Oncology, The People’s Hospital of JianYang City, Jian Yang, China
| | - Mingying Luo
- Department of Oncology, The People’s Hospital of JianYang City, Jian Yang, China
| | - Danli Zeng
- Department of Oncology, The People’s Hospital of JianYang City, Jian Yang, China
| | - Yang Chen
- Department of Oncology, The People’s Hospital of JianYang City, Jian Yang, China
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12
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Huang C, Wang M, Chen L, Wang H, Huang D, Shi J, Zhang W, Tian Y, Zhu Y. The pretherapeutic systemic inflammation score is a prognostic predictor for elderly patients with oesophageal cancer: a case control study. BMC Cancer 2023; 23:505. [PMID: 37270496 DOI: 10.1186/s12885-023-10982-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 05/19/2023] [Indexed: 06/05/2023] Open
Abstract
BACKGROUND The systemic inflammation score (SIS), based on serum albumin (Alb) and lymphocyte-to-monocyte ratio (LMR), is a novel prognostic tool for some tumours. Studies indicate that the SIS can be used as a postoperative prognostic marker. However, its predictive value in elderly oesophageal squamous cell carcinoma (ESCC) patients treated with radiotherapy is unclear. METHODS In total, 166 elderly ESCC patients who received radiotherapy with or without chemotherapy were included. Based on different combinations of Alb and LMR levels, the SIS was divided into 3 groups, SIS = 0 (n = 79), SIS = 1 (n = 71) and SIS = 2 (n = 16). The Kaplan-Meier method was used for survival analysis. Univariate and multivariate analyses were performed to assess prognosis. Time-dependent receiver operating characteristic (t-ROC) curves were used to compare the prognostic accuracy of the SIS with that of Alb, LMR, neutrophil-to lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammatory index (SII). RESULTS Decreased Alb and LMR were both associated with shorter OS, whereas a lower SIS was significantly associated with better outcomes. The OS of SIS = 0, SIS = 1 and SIS = 2 was 28.0 ± 2.9, 16.0 ± 2.8 and 10.0 ± 7.0 months, respectively (p = 0.000). Similar results were also observed for PFS. Multivariate analysis of the model with SIS revealed that the SIS was a significant independent biomarker for predicting OS and PFS. The nomogram showed that the C-index was improved to 0.677 when the SIS factor was incorporated. Furthermore, the 3-year OS rates for patients in the SIS-high group (SIS = 1 and SIS = 2) undergoing concurrent radiotherapy with a single agent (CCRT-1) and concurrent radiotherapy with two agents (CCRT-2) were 42% and 15%, respectively (p = 0.039). The t-ROC curve showed that the SIS was more sensitive than other prognostic factors for predicting overall survival. CONCLUSION The SIS may be a useful prognostic marker in elderly patients with ESCC receiving radiotherapy alone or chemoradiotherapy. The SIS showed a better predictive ability for OS than the continuous variable Alb and could stratify patient prognosis in different therapeutic regimens. CCRT-1 may be the best treatment for SIS-high patients.
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Affiliation(s)
- Chunyue Huang
- Department of Radiation Oncology, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, China
| | - Mengyao Wang
- Department of Radiation Oncology, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, China
| | - Liwen Chen
- Department of Medical Imaging, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, China
| | - Hongmei Wang
- Department of Radiation Oncology, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, China
| | - Donglan Huang
- Department of Radiation Oncology, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, China
| | - Jianjun Shi
- Department of Radiation Oncology, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, China
| | - Weijun Zhang
- Department of Radiation Oncology, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, China.
| | - Yunhong Tian
- Department of Radiation Oncology, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, China.
| | - Yujia Zhu
- Department of Radiation Oncology, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China.
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Yang J, Zheng J, Qiu J, Zhang M, Liu L, Wang Z, Zheng Q, Liu Y, Chen M, Li J. Systemic Immune-Inflammatory Index, Tumor-Infiltrating Lymphocytes, and Clinical Outcomes in Esophageal Squamous Cell Carcinoma Receiving Concurrent Chemoradiotherapy. J Immunol Res 2023; 2023:4275998. [PMID: 37228442 PMCID: PMC10205413 DOI: 10.1155/2023/4275998] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 04/06/2023] [Accepted: 04/25/2023] [Indexed: 05/27/2023] Open
Abstract
Background Systemic inflammation may be involved in the entire cancer process as a promoter and is associated with antitumor immunity. The systemic immune-inflammation index (SII) has been shown to be a promising prognostic factor. However, the relationship between SII and tumor-infiltrating lymphocytes (TIL) have not been established in esophageal cancer (EC) patients receiving concurrent chemoradiotherapy (CCRT). Methods Retrospective analysis of 160 patients with EC was performed, peripheral blood cell counts were collected, and TIL concentration was assessed in H&E-stained sections. Correlations of SII and clinical outcomes with TIL were analyzed. Cox proportional hazard model and Kaplan-Meier method were used to perform survival outcomes. Results Compared with high SII, low SII had longer overall survival (OS) (P = 0.036, hazard ratio (HR) = 0.59) and progression-free survival (PFS) (P = 0.041, HR = 0.60). Low TIL showed worse OS (P < 0.001, HR = 2.42) and PFS (P < 0.001, HR = 3.05). In addition, research have shown that the distribution of SII, platelet-to-lymphocyte ratio, and neutrophil-to-lymphocyte ratio were negatively associated with the TIL state, while lymphocyte-to-monocyte ratio presented a positive correlation. Combination analysis observed that SIIlow + TILhigh had the best prognosis of all combinations, with a median OS and PFS of 36 and 22 months, respectively. The worst prognosis was identified as SIIhigh + TILlow, with a median OS and PFS of only 8 and 4 months. Conclusion SII and TIL as independent predictors of clinical outcomes in EC receiving CCRT. Furthermore, the predictive power of the two combinations is much higher than a single variable.
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Affiliation(s)
- Jun Yang
- Department of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, No. 420 Fuma Road Jin'an District, Fuzhou 350014, Fujian Province, China
- Clinical Oncology School of Fujian Medical University, No. 420 Fuma Road Jin'an District, Fuzhou 350014, Fujian Province, China
| | - Jifang Zheng
- Department of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, No. 420 Fuma Road Jin'an District, Fuzhou 350014, Fujian Province, China
- Clinical Oncology School of Fujian Medical University, No. 420 Fuma Road Jin'an District, Fuzhou 350014, Fujian Province, China
| | - Jianjian Qiu
- Department of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, No. 420 Fuma Road Jin'an District, Fuzhou 350014, Fujian Province, China
- Clinical Oncology School of Fujian Medical University, No. 420 Fuma Road Jin'an District, Fuzhou 350014, Fujian Province, China
| | - Mengyan Zhang
- Department of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, No. 420 Fuma Road Jin'an District, Fuzhou 350014, Fujian Province, China
- Clinical Oncology School of Fujian Medical University, No. 420 Fuma Road Jin'an District, Fuzhou 350014, Fujian Province, China
| | - Lingyun Liu
- Department of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, No. 420 Fuma Road Jin'an District, Fuzhou 350014, Fujian Province, China
- Clinical Oncology School of Fujian Medical University, No. 420 Fuma Road Jin'an District, Fuzhou 350014, Fujian Province, China
| | - Zhiping Wang
- Department of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, No. 420 Fuma Road Jin'an District, Fuzhou 350014, Fujian Province, China
- Clinical Oncology School of Fujian Medical University, No. 420 Fuma Road Jin'an District, Fuzhou 350014, Fujian Province, China
| | - Qunhao Zheng
- Department of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, No. 420 Fuma Road Jin'an District, Fuzhou 350014, Fujian Province, China
- Clinical Oncology School of Fujian Medical University, No. 420 Fuma Road Jin'an District, Fuzhou 350014, Fujian Province, China
| | - Yanyan Liu
- Department of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, No. 420 Fuma Road Jin'an District, Fuzhou 350014, Fujian Province, China
- Clinical Oncology School of Fujian Medical University, No. 420 Fuma Road Jin'an District, Fuzhou 350014, Fujian Province, China
| | - Mingqiu Chen
- Department of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, No. 420 Fuma Road Jin'an District, Fuzhou 350014, Fujian Province, China
- Clinical Oncology School of Fujian Medical University, No. 420 Fuma Road Jin'an District, Fuzhou 350014, Fujian Province, China
| | - Jiancheng Li
- Department of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, No. 420 Fuma Road Jin'an District, Fuzhou 350014, Fujian Province, China
- Clinical Oncology School of Fujian Medical University, No. 420 Fuma Road Jin'an District, Fuzhou 350014, Fujian Province, China
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Li M, Cai G, Gao Z, Meng X, Han X. Inflammatory biomarkers as predictors of immune activation to different irradiated sites and short-term efficacy in advanced squamous cell esophageal carcinoma received radioimmunotherapy. Front Oncol 2023; 13:1117648. [PMID: 37234974 PMCID: PMC10206221 DOI: 10.3389/fonc.2023.1117648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 04/27/2023] [Indexed: 05/28/2023] Open
Abstract
Purpose The present study aimed to compare immune activation among different irradiated sites and identify potential short-term efficacy prognostic factors in patients with advanced squamous cell esophageal carcinoma (ESCC) who received radiotherapy (RT) and immunotherapy. Patients and methods We recorded the clinical characteristics, blood cell counts, and derived blood index ratios, including neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII), at three time points (before, during, and after RT) in 121 patients with advanced ESCC who had received RT and immunotherapy. Chi-square test and univariate and multivariate logistic regression analyses were used to calculate the relationships among inflammatory biomarkers (IBs), irradiated sites, and short-term efficacy. Results Delta-IBs were calculated as (medio-IBs - pre-IBs) ÷ pre-IBs. The medians of delta-LMR, and delta-ALC were the highest, whereas the median of delta-SII was the lowest in patients with brain radiation. Treatment responses were observed within 3 months after RT or until the beginning of the next line therapy, and the disease control rate (DCR) was 75.2%. The areas under the receiver operating characteristic curve (AUCs) for delta-NLR and delta-SII were 0.723 (p = 0.001) and 0.725 (p < 0.001), respectively. Multivariate logistic regression analysis showed that the treatment lines of immunotherapy (odds ratio [OR], 4.852; 95% confidence interval [CI], 1.595-14.759; p = 0.005) and delta-SII (OR, 5.252; 95% CI, 1.048-26.320; p = 0.044) were independent indicators of short-term efficacy. Conclusion In this study, we found that RT to the brain had a stronger immune activation effect than RT to extracranial organs. We also found that earlier-line immunotherapy plus RT and a decrease in SII during RT may generate better short-term efficacy in advanced ESCC.
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Affiliation(s)
- Mengying Li
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Guoxin Cai
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
- Department of Radiation Oncology, School of Medicine, Shandong University, Jinan, China
| | - Zhenhua Gao
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Xue Meng
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Xiao Han
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
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The preoperative systemic immune-inflammation index is associated with an unfavorable prognosis for patients undergoing curative resection of esophageal squamous cell carcinoma after neoadjuvant therapy. Surg Today 2023:10.1007/s00595-023-02658-0. [PMID: 36797438 DOI: 10.1007/s00595-023-02658-0] [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: 09/21/2022] [Accepted: 12/23/2022] [Indexed: 02/18/2023]
Abstract
PURPOSES Systemic inflammation and immune status play a critical role in the development and progression of cancers. We evaluated the clinical significance of the preoperative systemic immune-inflammation index (SII) for predicting the long-term outcomes of patients who received neoadjuvant therapy for esophageal squamous cell carcinoma (ESCC). METHODS The subjects of this study were 277 patients who underwent curative resection of ESCC after neoadjuvant therapy. The SII was calculated as follows: SII = neutrophil × platelet/lymphocyte counts. Patients were stratified into high and low preoperative SII groups according to the cut-off value calculated by a receiver operating characteristic curve analysis. The Kaplan-Meier method and Cox proportional regression analysis were used to evaluate the correlation of SII to prognosis. RESULTS The optimal cutoff of the preoperative SII was set at 700. Patients were categorized into preoperative SII-low (n = 203) and SII-high (n = 74) groups. The preoperative SII was significantly associated with tumor size. The relapse-free survival of patients in the SII-high group was significantly shorter (P = 0.0087) and preoperative SII-high was identified as an independent prognostic factor (hazard ratio [HR] 1.55, 95% confidence interval [CI] 1.06-2.28, P = 0.0229). The prevalence of hematogenous recurrence was significantly higher in the SII-high group. When we stratified patients into three groups with an additional cutoff value of 1200, we observed an incremental decrease in relapse-free survival rates. CONCLUSIONS High preoperative SII was associated with shorter relapse-free survival times for ESCC patients who underwent curative resection after neoadjuvant therapy.
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Koca F, Levent F, Sensoy B, Tenekecioglu E. The predictive value of the systemic immune-inflammatory index for left atrial appendage thrombus in non-valvular atrial fibrillation. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2023. [PMID: 36756877 DOI: 10.5507/bp.2023.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
Abstract
OBJECTIVE The systemic immune inflammatory index (SII) has prognostic value in cardiovascular diseases. The aim of current study was to investigate whether or not left atrial appendage (LAA) thrombus could be predicted by SII in patients with non-valvular atrial fibrillation. METHOD The study included 525 patients newly diagnosed with non-valvular atrial fibrillation, who had not previously had anticoagulant treatment (50.7% male, mean age 62.94±10.79 years). All patients underwent transoesophageal echocardiography. RESULTS LAA thrombus was observed in 86 patients (16.4%). In the ROC curve SII had a good diagnostic power in predicting LAA thrombus (AUC: 0.760, 95% CI: 0.703-0.818, P<0.001). In the multivariate regression analysis, diabetes (Hazard ratio: 2.264, 95% CI: 1.169-4.389, P=0.015), LAA emptying rate of <20 cm/s (Hazard ratio: 59.347, 95% CI: 25.397-138.680, P<0.001), and SII value of >750 (Hazard ratio: 4.291, 95% CI: 2.144-8.586 P<0.001) were determined as independent predictors for LAA thrombus. A poor correlation was found between SII and the CHADS2 VASc score (r=0.239, P<0.001) Conclusion: The SII, a practical and easily obtained test, can be used as a predictor of LAA thrombus in patients with non-valvular atrial fibrillation, and to decide on the anticoagulant treatment.
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Affiliation(s)
- Fatih Koca
- Bursa Education and Research Hospital, University of Health Sciences, Bursa, Turkey
| | - Fatih Levent
- Bursa Education and Research Hospital, University of Health Sciences, Bursa, Turkey
| | - Baris Sensoy
- Bursa Education and Research Hospital, University of Health Sciences, Bursa, Turkey
| | - Erhan Tenekecioglu
- Bursa Education and Research Hospital, University of Health Sciences, Bursa, Turkey
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Dolu AK, Karayiğit O, Ozkan C, Çelik MC, Kalçık M. Relationship between intracoronary thrombus burden and systemic immune-inflammation index in patients with ST-segment elevation myocardial infarction. Acta Cardiol 2023; 78:72-79. [PMID: 35105281 DOI: 10.1080/00015385.2022.2035082] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
AIM This study aimed to evaluate the relationship between intracoronary thrombus burden and systemic immune-inflammation index (SII) and to compare the predictive capacity of SII together with the neutrophil-lymphocyte ratio (NLR), and the platelet-lymphocyte ratio (PLR) in patients with ST-elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PPCI). PATIENT & METHODS A total of 425 patients were included in the study. The clinical, laboratory, and demographic characteristics of the patients were recorded. The thrombus classification "Thrombolysis in myocardial infarction (TIMI)" was used to assess the intracoronary thrombus burden. According to the TIMI thrombus classification, 229 (54%) patients with low thrombus burden (grade 0-3) and 196 (46%) patients with high thrombus burden (grade 4 and 5) were compared. SII was calculated as platelet × neutrophil/lymphocyte counts. RESULTS High NLR (OR: 1.068, 95% CI:1.023-1.404; p = 0.031), PLR(OR: 1.012, 95% CI:1.002-1.018; p = 0.043), SII(OR: 1.325, 95% CI: 1.156-1.879; p = 0.015) and low left ventricle ejection fraction (LVEF) (OR: 0.957, 95% CI:0.924-0.990; p = 0.012) were found to be independent predictors of high thrombus burden. SII values above 812 predicted a high thrombus burden with a sensitivity of 82% and specificity of 73% (AUC: 0.836; 95% CI:0.795-0.877; p < 0.001). This predictiveness of SII was stronger as compared to NLR (0.836 vs. 0.818, p = 0.043) and PLR (0.836 vs. 0.780, p < 0.001). CONCLUSION SII is an independent predictor of high thrombus burden in patients with STEMI. In addition, SII is superior to NLR and PLR in this regard.
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Affiliation(s)
- Abdullah Kadir Dolu
- Department of Cardiology, Izmir Katip Çelebi University Ataturk Education and Research Hospital, Izmir, Turkey
| | - Orhan Karayiğit
- Department of Cardiology, Yozgat City Hospital, Yozgat, Turkey
| | - Can Ozkan
- Department of Cardiology, Muş State Hospital, Muş, Turkey
| | - Muhammet Cihat Çelik
- Department of Cardiology, Hitit University Erol Olçok Education and Research Hospital, Corum, Turkey
| | - Macit Kalçık
- Department of Cardiology, Faculty of Medicine, Hitit University, Corum, Turkey
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Dindas F, Koyun E, Turkyilmaz E, Abacioglu OO, Yildirim A, Sahin A, Dindar B, Dogdus M, Candan O. Systemic Immune Inflammation Index is a Novel Marker in Predicting the Presence and Severity of Isolated Coronary Artery Ectasia. Arq Bras Cardiol 2023; 120:e20220056. [PMID: 36629598 PMCID: PMC9833212 DOI: 10.36660/abc.20220056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 06/26/2022] [Accepted: 09/01/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The underlying pathology of isolated coronary artery ectasia (CE) has not been fully elucidated. OBJECTIVE We aimed to examine the relationship between the systemic immune inflammation index (Sıı), which corresponds to the multiplying of the neutrophil-to-lymphocyte ratio (NLR) and the platelet counts, and isolated CE. METHOD The retrospective study population included 200 patients with isolated CE, 200 consecutive with obstructive coronary artery disease, and 200 consecutive with a normal coronary artery angiogram. A 2-sided p-value of <0.05 was considered significant. RESULTS Sıı, NLR, platelet-to-lymphocyte ratio (PLR), and monocyte-to-high density lipoprotein cholesterol ratio (MHR) were significantly higher in the CE group compared with the other groups (all p<0.001). In multivariate analysis, Sıı (p<0.001, OR = 1.005, 95% CI =1.004-1.005) was found to be an independent predictor of isolated CE. In Receiver Operating Characteristic curve analysis, Sıı had a higher Area Under the Curve than NLR, PLR, and MHR. Sıı value of >517.35 has 79% sensitivity, 76% specificity for the prediction of the CE [AUC: 0.832, (p<0.001)]. Sıı had a significant correlation with the number of ectatic coronary arteries and Markis classification (r:0.214 p=0.002; r:-0.195, p=0.006, respectively). CONCLUSION To the best of our knowledge, this is the first study that Sıı was significantly associated with isolated CE presence and anatomical severity.
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Affiliation(s)
- Ferhat Dindas
- Usak UniversityTraining and Research HospitalDepartment of CardiologyUsakTurquia Usak University , Training and Research Hospital , Department of Cardiology , Usak – Turquia
| | - Emin Koyun
- Sivas Cumhuriyet UniversityDepartment of CardiologySivasTurquia Sivas Cumhuriyet University , Department of Cardiology , Sivas – Turquia
| | - Erdem Turkyilmaz
- Usak UniversityTraining and Research HospitalDepartment of CardiologyUsakTurquia Usak University , Training and Research Hospital , Department of Cardiology , Usak – Turquia
| | - Ozge Ozcan Abacioglu
- University of Health SciencesAdana Health Practice and Research CenterAdanaTurquia University of Health Sciences , Adana Health Practice and Research Center , Adana – Turquia
| | - Arafat Yildirim
- University of Health SciencesAdana Health Practice and Research CenterAdanaTurquia University of Health Sciences , Adana Health Practice and Research Center , Adana – Turquia
| | - Anil Sahin
- University of Health SciencesAdana Health Practice and Research CenterAdanaTurquia University of Health Sciences , Adana Health Practice and Research Center , Adana – Turquia
| | - Baris Dindar
- Usak UniversityTraining and Research HospitalDepartment of CardiologyUsakTurquia Usak University , Training and Research Hospital , Department of Cardiology , Usak – Turquia
| | - Mustafa Dogdus
- Usak UniversityTraining and Research HospitalDepartment of CardiologyUsakTurquia Usak University , Training and Research Hospital , Department of Cardiology , Usak – Turquia
- University of Health SciencesAdana Health Practice and Research CenterAdanaTurquia University of Health Sciences , Adana Health Practice and Research Center , Adana – Turquia
| | - Ozkan Candan
- Usak UniversityTraining and Research HospitalDepartment of CardiologyUsakTurquia Usak University , Training and Research Hospital , Department of Cardiology , Usak – Turquia
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Xiaobin C, Jiaqi Y, Zhaojun X, Mingquan P, Ying Z, Lizhao H, Li R, Haijiu W, Zhixin W, Haining F, Lin C. Correlation between systemic immune inflammatory index and prognosis of patients with hepatic alveolar hydatid disease and establishment of a nomogram prediction model. Front Surg 2023; 9:1019963. [PMID: 36684205 PMCID: PMC9852715 DOI: 10.3389/fsurg.2022.1019963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 11/21/2022] [Indexed: 01/09/2023] Open
Abstract
Background To explore the evaluation value of systemic immune inflammation index (SII) in the prognosis of patients with alveolar hydatid disease, and establish a nomogram prediction model. Methods Collect the clinical data of 351 patients undergoing hepatic alveolar hydatid surgery admitted to the Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of Qinghai University from January 2015 to December 2020, calculate the SII value, and use the receiver operating characteristic curve (ROC curve) to determine According to the optimal clinical cut-off value of SII, patients were divided into two groups with high SII and low SII, and the relationship between SII and clinicopathological factors and prognosis of patients with alveolar echinococcosis was analyzed. Establish a nomogram prediction model based on independent risk factors for patient prognosis, and evaluate the prediction accuracy and discrimination ability of the nomogram through the consistency index (C-index) and calibration curve. The result is through the use of bootstrapping validation with 1,000 re-sampling Method for internal verification. Results The ROC curve was used to determine the optimal cut-off value of SII before operation 761.192, and patients were divided into low SII group (n = 184) cases and high SII group (n = 167) cases. The 1, 3, and 5-year survival rates of patients with hepatic alveolar hydatid in the low SII group and the high SII group were 98.90%, 96.90%, 86.50% and 98.20%, 72.50%, 40.30%, respectively. The survival rate of worm disease patients was significantly better than that of the high SII group, and the overall survival rate difference between the two groups was statistically significant (P < 0.001). Multivariate Cox regression model analysis results showed that intraoperative blood loss (HR = 1.810, 95%CI: 1.227-2.668, P = 0.003), SII (HR = 5.011, 95%CI: 3.052-8.228, P < 0.001), Complications (HR = 1.720, 95%CI: 1.162-2.545, P = 0.007) are independent risk factors for the prognosis of patients with alveolar hydatid disease. Draw a nomogram and include statistically significant factors in the multivariate Cox regression model to predict the overall survival rate of patients with alveolar hydatid disease at 1, 3, and 5 years. The survival probability calibration curve is displayed. The nomogram is compared with The actual results have a high degree of agreement. The concordance index (C-index) of the nomogram model in the modeling sample is 0.777, and the C-index in the verification sample is 0.797, indicating that the nomogram model of this study has good accuracy and discrimination. Conclusions SII has a clear correlation to the prognosis of patients with alveolar echinococcosis. The nomogram prediction model constructed on this basis is beneficial to the clinically individualized analysis of the patient's prognosis.
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Affiliation(s)
- Chen Xiaobin
- Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Qinghai University, Qinghai, China,Qinghai Research Key Laboratory for Echinococcosis, Qinghai, China
| | - Yuan Jiaqi
- Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Qinghai University, Qinghai, China,Qinghai Research Key Laboratory for Echinococcosis, Qinghai, China
| | - Xu Zhaojun
- Department of Gastrointestinal Surgery, Affiliated Hospital of Qinghai University, Qinghai, China
| | - Pan Mingquan
- Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Qinghai University, Qinghai, China,Qinghai Research Key Laboratory for Echinococcosis, Qinghai, China
| | - Zhou Ying
- Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Qinghai University, Qinghai, China,Qinghai Research Key Laboratory for Echinococcosis, Qinghai, China
| | - Hou Lizhao
- Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Qinghai University, Qinghai, China,Qinghai Research Key Laboratory for Echinococcosis, Qinghai, China
| | - Ren Li
- Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Qinghai University, Qinghai, China,Qinghai Research Key Laboratory for Echinococcosis, Qinghai, China
| | - Wang Haijiu
- Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Qinghai University, Qinghai, China,Qinghai Research Key Laboratory for Echinococcosis, Qinghai, China
| | - Wang Zhixin
- Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Qinghai University, Qinghai, China,Qinghai Research Key Laboratory for Echinococcosis, Qinghai, China,Correspondence: Fan Haining Wang Zhixin
| | - Fan Haining
- Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Qinghai University, Qinghai, China,Qinghai Research Key Laboratory for Echinococcosis, Qinghai, China,Correspondence: Fan Haining Wang Zhixin
| | - Chen Lin
- Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Qinghai University, Qinghai, China
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Demir M, Demircan NC. The CONUT score is prognostic in esophageal cancer treated with chemoradiotherapy. Saudi J Gastroenterol 2022; 29:119-126. [PMID: 36412459 DOI: 10.4103/sjg.sjg_384_22] [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] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Malnutrition is a frequent issue in esophageal cancer (EC). The Controlling Nutritional Status (CONUT) Score has been established as a prognostic indicator in EC patients who underwent surgery. We aimed to investigate the role of the CONUT Score in EC patients treated with chemoradiotherapy (CRT). METHODS The trial included 101 non-metastatic EC patients. Receiver operating characteristic (ROC) curve analyses were used to determine cut-off values for the CONUT Score and other indices. Cox regression analyses were performed to determine prognostic markers. RESULTS Of 101 patients, 59.4% (n = 60) and 40.6% (n = 41) of patients were treated with CRT alone and CRT plus surgery, respectively. ROC curve analyses determined an optimal cut-off for CONUT Score in overall survival (OS), which was 3.5 (AUC = 0.63, CI 95%: 0.51-0.76, P = 0.05). The sensitivity and specificity of CONUT were 66% and 61%, respectively. Low CONUT (≤3.5) patients had significantly longer median OS than high CONUT (>3.5) patients (57.1 vs. 23 months; P = 0.009). Multivariate regression analysis revealed a CONUT Score hazard ratio (HR) of 1.96 for OS (CI 95%: 1.03-3.75, P = 0.04). CONCLUSION The CONUT Score might be a useful prognostic tool in EC patients treated with CRT. Appropriate nutritional support might provide a better prognosis, which underlines the importance of multidisciplinary assessment of malnutrition in EC patients.
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Affiliation(s)
- Metin Demir
- Department of Medical Oncology, Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Nazim Can Demircan
- Department of Medical Oncology, Erzurum Regional Training and Research Hospital, Erzurum, Turkey
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Xu X, Jing J. Inflammation-related parameter serve as prognostic biomarker in esophageal squamous cell carcinoma. Front Oncol 2022; 12:900305. [PMID: 36338698 PMCID: PMC9634080 DOI: 10.3389/fonc.2022.900305] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 08/24/2022] [Indexed: 12/24/2022] Open
Abstract
Objective The aim of this study was to explore the predictive role of inflammation-related parameters in prognosis of esophageal squamous cell carcinoma (ESCC). Methods A total of 370 ESCC patients subjected to curative surgery were enrolled. All patients had complete medical records and did not receive preoperative adjuvant therapy. Preoperative systemic immune-inflammation index (SII) was calculated as platelet count × neutrophil count/lymphocyte count, prognostic nutrition index (PNI) as albumin concentration (g/L) + 5 × total lymphocyte count (109/L), and systemic inflammation response index (SIRI) as neutrophil count × monocyte count/lymphocyte count. The optimal cut‐off values of preoperative SII, neutrophil‐to‐lymphocyte ratio (NLR), platelet‐to‐lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), PNI, and SIRI were determined via receiver operating characteristic (ROC) analysis, and their correlations with clinical parameters and survival analyzed. Results NLR was associated with gender (P = 0.022), and PLR (P = 0.037), PNI (P = 0.017) was associated with survival status, LMR was related with gender (P = 0.034) and survival status (P = 0.01), SIRI was correlated with gender (P = 0.000), smoking history (P = 0.000) and drinking history (P = 0.004). Survival analysis indicated that high PLR (P = 0.042), low LMR (P = 0.001), and low PNI (P = 0.007) were predictive of poor prognosis of ESCC. Stratified analysis revealed the prognostic predictor roles of distinct markers in different ESCC subgroups. SII and SIRI were predominantly correlated with the clinical outcome in the lymphatic metastasis subgroup. Further univariate analysis disclosed that T stage, smoking history, lymphatic metastasis, TNM staging, PLR, LMR, and PNI potentially serve as influencing factors(P < 0.05). Multivariate analysis identified T stage (HR = 1.781, P = 0.002), TNM staging (HR = 8.617, P = 0.001) and LMR (HR = 0.504, P = 0.001) as independent predictors for outcomes of ESCC. Conclusions Low LMR could serve as an independent marker of poor prognosis in patients with ESCC. Inflammation-related markers have distinct predictive roles in ESCC subgroups with different features.
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Du X, Dong J, Yan K, Wang X, Shen W, Zhu S. Novel nomograms predicting the survival of patients with nonsurgical thoracic esophageal squamous cell carcinoma treated with IMRT: A retrospective analysis. Medicine (Baltimore) 2022; 101:e30305. [PMID: 36221349 PMCID: PMC9543077 DOI: 10.1097/md.0000000000030305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
The purpose of this study was to evaluate several preradiotherapy serum inflammatory indicators, including the neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and systemic inflammation score (SIS), and compare which of these indicators had the highest value in predicting survival. Inflammatory markers were combined with traditional prognostic factors, and novel nomogram models were developed to predict overall survival (OS) and progression-free survival (PFS) for patients with esophageal squamous cell carcinoma. A total of 245 patients were enrolled. The Kaplan-Meier method and univariate and multivariate analyses were used to compare survival differences. A total of 239 patients met the eligibility criteria. The survival numbers at 1, 3, and 5 years were 176, 83, and 62, respectively. The OS and PFS rates estimated at 1, 3, and 5 years were 74.6%, 36.8%, and 26.5% and 58.4%, 31.3%, and 20.5%, respectively. The differences in patients' OS and PFS were significant when univariate analysis was applied based on inflammation-based measures. Multivariate analysis showed that tumor length, tumor stage, tumor/node/metastasis stage, chemotherapy, and SIS value were predictive variables for OS and PFS. The nomogram model established based on the multivariate models of the training data set had good predictive ability. The unadjusted C-index was 0.701 (95% CI, 0.662-0.740) and 0.695 (95% CI, 0.656-0.734) for OS and PFS, respectively. This study showed that the SIS-based nomogram could accurately predict the OS and PFS of patients with esophageal squamous cell carcinoma.
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Affiliation(s)
- Xingyu Du
- Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, P.R. China
| | - Jing Dong
- Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, P.R. China
| | - Ke Yan
- Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, P.R. China
| | - Xiaobin Wang
- Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, P.R. China
| | - Wenbin Shen
- Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, P.R. China
| | - Shuchai Zhu
- Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, P.R. China
- *Correspondence: Shuchai Zhu, Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei 050011, P.R. China (e-mail: )
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Chen L, Chen L, Wang YY, Zhang LX, Xia XG. A predictive model of bowel resection for incarcerated inguinal hernia based on the systemic immune-inflammation index. Front Surg 2022; 9:990481. [PMID: 36211270 PMCID: PMC9537729 DOI: 10.3389/fsurg.2022.990481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 09/06/2022] [Indexed: 11/26/2022] Open
Abstract
Background and Purpose An inguinal hernia is a common surgical disease. Once incarcerated or strangulated, it may endanger the life of the patient. Therefore, it is essential to study the risk factors of incarcerated inguinal hernia (IIH) and strangulated inguinal hernia (SIH). One of the serious complications of IIH and SIH is intestinal necrosis, which occurs owing to blood supply disorder. The study explores the risk factors of intestinal resection and establishes a simple model to assess the incidence of intestinal resection to provide significant assistance and limited guidance for clinical work. Patients and Methods Our research team collected and retrospectively analysed the clinical data of 338 patients with IIH who were hospitalized in the First Affiliated Hospital of Wenzhou Medical University between September 2008 and December 2016. According to the surgical plan, we divided the included cases into two groups, non-intestinal and intestinal resection groups, and the clinical case characteristics of these groups were statistically analysed. Results Based on multivariable logistic regression analysis, we found that increased risk of bowel resection was highly correlated among the elderly (≥70 years), and for people with high temperature (≥37.3°C), high systemic immune-inflammation index(SII) values (≥1230.13), presence of bowel obstruction, and signs of peritonitis. Further, we processed the five independent risk factors using special software to obtain a simple model called a nomogram. To verify the nomogram’s accuracy and predictive ability, we calculate the C-index: 0.806 and use the calibration curve to evaluate its stability and predictive performance. We constructed the ROC curve nomogram and other sub-variables, and calculated the area under the curve (AUC) corresponding to the nomogram (AUC = 0.808, 95% CI = 0.762 to 0.848), SII (AUC = 0.752, 95% CI = 0.703 to 0.797), age (AUC = 0.641, 95% CI = 0.587 to 0.692), temperature (AUC = 0.579, 95% CI = 0.524 to 0.632), bowel obstruction (AUC = 0.685, 95% CI = 0.633 to 0.734), and signs of peritonitis (AUC = 0.580, 95% CI = 0.525 to 0.633). Conclusion It can be said that we found for the first time that clinical variables such as SII are independent risk factors for enterectomy for IIH. The nomogram based on SII and other variables can accurately and easily predict the probability of IIH requiring bowel resection.
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Affiliation(s)
- Lei Chen
- Department of General Surgery, Xiang’an Hospital of Xiamen University, Xiamen, China
- Department of General Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Lei Chen
- Department of Emergency, Xiang’an Hospital of Xiamen University, Xiamen, China
| | - Ying-ying Wang
- Department of Neurology, Xiang’an Hospital of Xiamen University, Xiamen, China
| | - Li-xiang Zhang
- Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Correspondence: Lixiang Zhang Xiao-Gang Xia
| | - Xiao-gang Xia
- Department of General Surgery, Xiang’an Hospital of Xiamen University, Xiamen, China
- Correspondence: Lixiang Zhang Xiao-Gang Xia
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Li X, Zhang S, Lu J, Li C, Li N. The prognostic value of systemic immune-inflammation index in surgical esophageal cancer patients: An updated meta-analysis. Front Surg 2022; 9:922595. [PMID: 36090319 PMCID: PMC9459851 DOI: 10.3389/fsurg.2022.922595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 08/12/2022] [Indexed: 12/03/2022] Open
Abstract
Purpose To identify the prognostic role of systemic immune-inflammation index (SII) in esophageal cancer patients receiving operation. Methods The PubMed, EMBASE, Web of Science, Cochrane Library, WanFang and CNKI electronic databases were searched up to February 17, 2022 for relevant studies. The hazard ratios (HRs) and 95% confidence intervals (CIs) were combined to assess the association between SII and prognosis in surgical esophageal cancer patients. The primary outcome was overall survival (OS) and secondary outcomes were progression-free survival (PFS) and cancer-specific survival (CSS). All statistical analyses were conducted by STATA 15.0 software. Results A total of nine retrospective studies involving 3,565 participates were included. The pooled results indicated that high SII was significantly related with poor OS (HR = 1.58, 95% CI: 1.23–2.02, P < 0.001). However, subgroup analysis based on pathological type demonstrated that high SII was an independent predictor for poor OS only in esophageal squamous cell carcinoma (ESCC) patients (HR = 1.72, 95% CI: 1.34–2.21, P < 0.001). Besides, SII was also significantly associated with poor PFS (HR = 1.94, 95% CI: 1.61–2.35, P < 0.001) and CSS (HR = 1.44, 95% CI: 1.04–1.99, P = 0.027) in ESCC patients. Conclusion The SII could serve as an independent prognostic factor in surgical ESCC patients and higher SII was related with worse survival. However, more prospective high-quality studies are still needed to verify above findings.
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Affiliation(s)
- Xiaoqu Li
- Department of Thoracic Surgery, Sichuan GEM Flower Hospital, North Sichuan Medical College, Chengdu, Sichuan, China
| | - Shuhao Zhang
- Department of Thoracic Surgery, Sichuan GEM Flower Hospital, North Sichuan Medical College, Chengdu, Sichuan, China
| | - Juan Lu
- Rehabilitation Department, Sichuan GEM Flower Hospital, North Sichuan Medical College,Chengdu, Sichuan, China
| | - Chao Li
- Department of Thoracic Surgery, Sichuan GEM Flower Hospital, North Sichuan Medical College, Chengdu, Sichuan, China
| | - Naibin Li
- Department of Thoracic Surgery, Sichuan GEM Flower Hospital, North Sichuan Medical College, Chengdu, Sichuan, China
- Correspondence: Naibin Li
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High Systemic Immune-Inflammation Index and Body Mass Index Are Independent Risk Factors of the Thoracic Ossification of the Ligamentum Flavum. Mediators Inflamm 2022; 2022:4300894. [PMID: 35996410 PMCID: PMC9392597 DOI: 10.1155/2022/4300894] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 07/29/2022] [Indexed: 11/18/2022] Open
Abstract
Background Inflammation has been considered to play an important role in the pathogenesis of the thoracic ossification of the ligamentum flavum (OLF). However, the inflammation-related risk factors of thoracic OLF have not been fully investigated to date. Methods A total of 95 patients (48 in the OLF group and 47 in the control group) were included in this retrospective study to explore the independent risk factors of thoracic OLF. The following demographic and clinical variables were compared between the two groups: gender, age, body mass index (BMI), coexistence of hypertension or diabetes, and inflammation-related variables. Multivariate logistic regression analysis was utilized to determine the independent risk factors. Results High systemic immune-inflammation index (SII) (≥621) (odds ratio [OR] = 12.16, 95% confidence interval [CI] = 2.95–50.17, p < 0.01) and BMI (≥25 kg/m2) (OR = 9.17, 95%CI = 3.22–26.08, p < 0.01) were independent risk factors of thoracic OLF. SII (R = 0.38, p < 0.01) and BMI (R = 0.46, p < 0.01) were positively associated with OLF score. Conclusion High SII and BMI were the independent risk factors of thoracic OLF. Multicenter prospective studies with a large population should be conducted in the future to verify our findings.
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Kuş G, Çağırcı G, Bayar N, Özgünoğlu EC, Güven R, Arslan Ş. Usefulness of systemic immune-inflammation index in predicting atrial fibrillation recurrence after direct current cardioversion. Biomark Med 2022; 16:847-855. [PMID: 35833842 DOI: 10.2217/bmm-2022-0120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background: We aimed to determine whether there is a relationship between the systemic immune-inflammation (SII) index and the recurrence of atrial fibrillation (AF) after successful direct current cardioversion (DCCV). Methods: The study included 99 patients with persistent AF who underwent successful cardioversion between 2015 and 2020. Results: In multiple regression analyses, the SII index was found to be a better independent predictor of AF recurrence after successful DCCV (p < 0.001). The cut-off value of SII (563) was associated with 96.9% sensitivity and 55.2% specificity to predict AF recurrence after DCCV. Conclusion: As a simple biomarker, SII index is an independent parameter for predicting AF recurrence after successful DCCV in patients with persistent AF. Also, SII levels can predict AF recurrence better than neutrophil-to-lymphocyte ratio.
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Affiliation(s)
- Görkem Kuş
- Department of Cardiology, Antalya Education & Research Hospital, Antalya, 07050, Turkey
| | - Göksel Çağırcı
- Department of Cardiology, Antalya Education & Research Hospital, Antalya, 07050, Turkey
| | - Nermin Bayar
- Department of Cardiology, Antalya Education & Research Hospital, Antalya, 07050, Turkey
| | - Edip C Özgünoğlu
- Department of Cardiology, Antalya Education & Research Hospital, Antalya, 07050, Turkey
| | - Ramazan Güven
- Department of Emergency Medicine, University of Health Sciences, Basaksehir Cam ve Sakura City Hospital, İstanbul, 34010, Turkey
| | - Şakir Arslan
- Department of Cardiology, Antalya Education & Research Hospital, Antalya, 07050, Turkey
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The relationship between pan-immune-inflammation value and survival outcomes in patients with metastatic renal cell carcinoma treated with nivolumab in the second line and beyond: a Turkish oncology group kidney cancer consortium (TKCC) study. J Cancer Res Clin Oncol 2022; 148:3537-3546. [PMID: 35616728 DOI: 10.1007/s00432-022-04055-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 05/03/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Pan-immune-inflammation value (PIV) is an easily accessible immune marker based on peripheral blood to estimate prognosis in patients with cancer. This study evaluates the prognostic value of PIV in patients with metastatic renal cell carcinoma (mRCC) treated with nivolumab. METHODS In this retrospective cohort study, patients with mRCC treated with nivolumab in the second line and beyond were selected from the Turkish Oncology Group Kidney Cancer Consortium (TKCC) database. PIV was calculated using the following formula: neutrophil (103/mm3) x monocyte (103/mm3) x platelet (103/mm3)/lymphocyte (103/mm3). RESULTS A total of 152 patients with mRCC were included in this study. According to cut-off value for PIV, 77 (50.7%) and 75 (49.3%) patients fell into PIV-low ([Formula: see text] 372) and PIV-high (> 372) groups, respectively. In multivariate analysis, PIV-high (HR: 1.64, 95% CI 1.04-2.58, p = 0.033 for overall survival (OS); HR: 1.55, 95% CI 1.02-2.38, p = 0.042 for progression-free survival (PFS)) was independent risk factor for OS and PFS after adjusting for confounding variables, such as performance score, the International mRCC Database Consortium (IMDC) risk score, and liver metastasis. CONCLUSION This study established that pre-treatment PIV might be a prognostic biomarker in patients with mRCC treated with nivolumab in the second line and beyond.
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Detection of Specific Immune Cell Subpopulation Changes Associated with Systemic Immune Inflammation–Index Level in Germ Cell Tumors. Life (Basel) 2022; 12:life12050678. [PMID: 35629346 PMCID: PMC9147028 DOI: 10.3390/life12050678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 04/27/2022] [Accepted: 04/29/2022] [Indexed: 11/21/2022] Open
Abstract
The tumor microenvironment (TME) and the host inflammatory response are closely interconnected. The interplay between systemic inflammation and the local immune response may influence tumor development and progression in various types of cancer. The systemic immune–inflammation index (SII) represents a prognostic marker for germ cell tumors (GCTs). The aim of the present study was to detect specific immune cell subpopulation changes which were associated with the SII level in chemotherapy-naïve GCT patients. In total, 51 GCT patients, prior to cisplatin-based chemotherapy, were included in the present study. Immunophenotyping of peripheral blood leukocyte subpopulations was performed using flow cytometry. The SII level was correlated with the percentage of various leukocyte subpopulations. The obtained results demonstrated that SII levels above the cut-off value of SII ≥ 1003 were associated with higher neutrophil percentages. An inverse correlation was found between the SII and the peripheral lymphocyte percentage that logically reflects the calculations of the SII index. Furthermore, the presented data also showed that in the lymphocyte subpopulation, the association with the SII was driven by T-cell subpopulations. In innate immunity–cell subpopulations, we observed a correlation between SII level and neutrophils as well as associations with eosinophil, basophil, natural killer cell and dendritic cell percentages. We suppose that the described interactions represent a manifestation of cancer-induced immune suppression. The results of the present study contribute to the elucidation of the interrelationship between tumor cells and the innate/adaptive immune system of the host.
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Gao H, Wusiman L, Cao BW, Wujieke A, Zhang WB. The role of preoperative systemic immune-inflammation index in predicting the prognosis of patients with digestive tract cancers: A meta-analysis. Transpl Immunol 2022; 73:101613. [DOI: 10.1016/j.trim.2022.101613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 04/23/2022] [Accepted: 04/26/2022] [Indexed: 12/01/2022]
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Su R, Zhu J, Wu S, Luo H, He Y. Prognostic Significance of Platelet (PLT) and Platelet to Mean Platelet Volume (PLT/MPV) Ratio During Apatinib Second-Line or Late-Line Treatment in Advanced Esophageal Squamous Cell Carcinoma Patients. Technol Cancer Res Treat 2022; 21:15330338211072974. [PMID: 35072577 PMCID: PMC8808027 DOI: 10.1177/15330338211072974] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background: Apatinib has a certain efficacy for advanced esophageal squamous cell carcinoma (ESCC). This study aimed to investigate the prognostic significance of platelet (PLT) and platelet to mean platelet volume (PLT/MPV) ratio for advanced ESCC patients with apatinib second-line or late-line treatment. Methods: A retrospective study included 80 patients with advanced ESCC who received Apatinib ≥ 2 lines targeted therapy. We collected baseline clinical characteristics and blood parameters from the patients. Kaplan-Meier plots and univariate and multivariate analysis were used to find the factors related to progression-free survival (PFS). Results: The optimal cut-off values of PLT and PLT/MPV ratio were determined by X-tile software. Kaplan-Meier analysis demonstrated that patients in the high PLT group had better PFS than those in the low PLT group (156 d vs 80 d, P <.001), and patients in the high PLT/MPV ratio group had better PFS than those in low PLT/MPV ratio group (157 d vs 85 d, P <.001). Univariate analysis revealed pretreatment PLT and PLT/MPV ratio were significantly correlated with PFS. Multivariate analysis revealed high levels of pretreatment PLT/MPV ratio was an independent predictor of longer PFS (HR: 0.257, 95% CI: 0.089-0.743, P = .012). Conclusion: High levels of baseline PLT and PLT/MPV may indicate a better prognosis in apatinib ≥ 2 lines treatment for advanced ESCC patients.
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Affiliation(s)
- Rixin Su
- Anhui Provincial Hospital Affiliated to Anhui Medical University,
Luyang District, Hefei, China
| | - Jingya Zhu
- Anhui Provincial Hospital Affiliated to Anhui Medical University,
Luyang District, Hefei, China
| | - Shusheng Wu
- West Branch of the First Affiliated Hospital of University of
Science and Technology of China, Shushan District, Hefei, China Rixin Su and Jingya
Zhu contributed equally to this work and should be considered co-first
authors
| | - Huiqin Luo
- West Branch of the First Affiliated Hospital of University of
Science and Technology of China, Shushan District, Hefei, China Rixin Su and Jingya
Zhu contributed equally to this work and should be considered co-first
authors
| | - Yifu He
- West Branch of the First Affiliated Hospital of University of
Science and Technology of China, Shushan District, Hefei, China Rixin Su and Jingya
Zhu contributed equally to this work and should be considered co-first
authors
- Yifu He, West Branch of the First
Affiliated Hospital of University of Science and Technology of China, No. 107
Huanhudong Road, Shushan District, Hefei, China.
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The development of a nomogram and the prognostic prediction value of patients with esophageal squamous cell carcinoma undergoing radical radiotherapy. Future Sci OA 2022; 8:FSO781. [PMID: 35251695 PMCID: PMC8890129 DOI: 10.2144/fsoa-2021-0080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 01/06/2022] [Indexed: 12/24/2022] Open
Abstract
Aim: This study aimed to explore the role of the developed nomogram in the prognosis of esophageal squamous cell carcinoma (ESCC). Methods: A total of 181 ESCC patients were randomly divided into a training cohort (n = 141) and a validation cohort (n = 40). Significant factors impacting overall survival (OS) were identified in the training set and integrated into the nomogram based on Cox proportional hazards regression. Results: In the training cohort, the median OS in the high group (≥222) was 49.9 months and the median OS in the low group (<222) was 14.4 months. Multivariate analysis revealed that age, Karnofsky performance status score, tumor stage, chemotherapy, BMI, cervical esophageal carcinoma index and neutrophil to lymphocyte ratio were predictors of OS. Conclusion: The developed nomogram can effectively predict the survival prognosis of ESCC patients.
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Zhaojun X, Xiaobin C, Juan A, Jiaqi Y, Shuyun J, Tao L, Baojia C, Cheng W, Xiaoming M. Correlation analysis between preoperative systemic immune inflammation index and prognosis of patients after radical gastric cancer surgery: based on propensity score matching method. World J Surg Oncol 2022; 20:1. [PMID: 34980151 PMCID: PMC8722317 DOI: 10.1186/s12957-021-02457-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 11/17/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND To explore the correlation between the preoperative systemic immune inflammation index (SII) and the prognosis of patients with gastric carcinoma (GC). METHODS The clinical data of 771 GC patients surgically treated in the Department of Gastrointestinal Surgery, Qinghai University Affiliated Hospital from June 2010 to June 2015 were retrospectively analyzed, and their preoperative SII was calculated. The optimal cut-off value of preoperative SII was determined using the receiver operating characteristic (ROC) curve, the confounding factors between the two groups were eliminated using the propensity score matching (PSM) method, and the correlation between preoperative SII and clinicopathological characteristics was assessed by chi-square test. Moreover, the overall survival was calculated using Kaplan-Meier method, the survival curve was plotted, and log-rank test was performed for the significance analysis between the curves. Univariate and multivariate analyses were also conducted using the Cox proportional hazards model. RESULTS It was determined by the ROC curve that the optimal cut-off value of preoperative SII was 489.52, based on which 771 GC patients were divided into high SII (H-SII) group and low SII (L-SII) group, followed by PSM in the two groups. The results of Kaplan-Meier analysis showed that before and after PSM, the postoperative 1-, 3-, and 5-year survival rates in L-SII group were superior to those in H-SII group, and the overall survival rate had a statistically significant difference between the two groups (P < 0.05). Before PSM, preoperative SII [hazard ratio (HR) = 2.707, 95% confidence interval (CI) 2.074-3.533, P < 0.001] was an independent risk factor for the prognosis of GC patients. After 1:1 PSM, preoperative SII (HR = 2.669, 95%CI 1.881-3.788, P < 0.001) was still an independent risk factor for the prognosis of GC patients. CONCLUSIONS Preoperative SII is an independent risk factor for the prognosis of GC patients. The increase in preoperative SII in peripheral blood indicates a worse prognosis.
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Affiliation(s)
- Xu Zhaojun
- Graduate School, Qinghai University, Xining, 810001, China.,Department of Gastrointestinal Surgery, Qinghai University Affiliated Hospital, Xining, 810001, China
| | - Chen Xiaobin
- Department of General Surgery, 900th Hospital of Joint Logistics Support Force, Fuzhou City, 350001, Fujian Province, China
| | - An Juan
- Graduate School, Qinghai University, Xining, 810001, China.,Department of Basic Medical Sciences, Qinghai University Medical College, No.251 of Ningda Road, Xining City, 810016, Qinghai Province, China.,State Key Laboratory of Plateau Ecology and Agriculture, Qinghai University, No.251, Ningda Road, Xining City, 810016, Qinghai Province, China
| | - Yuan Jiaqi
- Graduate School, Qinghai University, Xining, 810001, China
| | - Jiang Shuyun
- Graduate School, Qinghai University, Xining, 810001, China
| | - Liu Tao
- Graduate School, Qinghai University, Xining, 810001, China.,Department of Gastrointestinal Surgery, Qinghai University Affiliated Hospital, Xining, 810001, China
| | - Cai Baojia
- Department of Gastrointestinal Surgery, Qinghai University Affiliated Hospital, Xining, 810001, China
| | - Wang Cheng
- Department of Gastrointestinal Surgery, Qinghai University Affiliated Hospital, Xining, 810001, China
| | - Ma Xiaoming
- Department of Gastrointestinal Surgery, Qinghai University Affiliated Hospital, Xining, 810001, China.
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Yekedüz E, Dogan İ, Kaya DM, Özgür İ, Utkan G, Vatansever S, Demirci S, Akbulut H, Ürün Y. Systemic Immune-Inflammation Index as a Prognostic Marker of Late Recurrence in Operable Gastric Cancer: a Dual-Center Study. J Gastrointest Cancer 2021; 53:870-879. [PMID: 34845631 DOI: 10.1007/s12029-021-00769-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2021] [Indexed: 01/03/2023]
Abstract
AIM To evaluate the prognostic role of the systemic immune-inflammation index (SII) in patients with operable gastric cancer. METHODS We assessed 354 patients with operable gastric cancer from tertiary centers in Turkey. SII was calculated by following formula: [neutrophil (cells × 109/L) × platelet (cells × 109/L)]/lymphocyte (cells × 109/L). The best cut-off value for SII was determined by using "receiver operating characteristics (ROC)" analysis. We used log-rank and Cox-regression analysis for survival analyses. RESULTS One hundred twenty patients were in the late recurrence group (recurrences have developed 36 months after the surgery). SII was not a prognostic factor in the early recurrence group. However, relapse-free survival (RFS) was longer in SII-low patients than SII-high patients in the late recurrence group. In multivariable analysis, SII was the only independent prognostic factor for RFS in the late recurrence group (hazard ratio (HR): 5.42, 95% CI: 1.18-24.82, p = 0.03). CONCLUSION SII was an independent prognostic factor for RFS in GC patients with late recurrence. Late recurrence risk was higher in SII-high patients than SII-low patients. Inflammation contributes to tumor progression, invasion, and metastasis. Prolonged exposure to chronic inflammation could explain the results of this study.
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Affiliation(s)
- Emre Yekedüz
- Department of Medical Oncology, Faculty of Medicine, Ankara University, Ankara, Turkey.
- Ankara University Cancer Research Institute, Ankara, Turkey.
- Ankara Üniversitesi Tıp Fakültesi, Tıbbi Onkoloji Bilim Dalı Cebeci Hastanesi, 06590, Cebeci, Ankara, Turkey.
| | - İzzet Dogan
- Department of Medical Oncology, Istanbul University Institute of Oncology, Istanbul, Turkey
| | | | - İlker Özgür
- Department of General Surgery, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey
| | - Güngör Utkan
- Department of Medical Oncology, Faculty of Medicine, Ankara University, Ankara, Turkey
- Ankara University Cancer Research Institute, Ankara, Turkey
| | - Sezai Vatansever
- Department of Medical Oncology, Istanbul University Institute of Oncology, Istanbul, Turkey
| | - Salim Demirci
- Ankara University Cancer Research Institute, Ankara, Turkey
- Department of Surgical Oncology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Hakan Akbulut
- Department of Medical Oncology, Faculty of Medicine, Ankara University, Ankara, Turkey
- Ankara University Cancer Research Institute, Ankara, Turkey
| | - Yüksel Ürün
- Department of Medical Oncology, Faculty of Medicine, Ankara University, Ankara, Turkey
- Ankara University Cancer Research Institute, Ankara, Turkey
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The Value of the Systemic Immune-Inflammation Index in Predicting Survival Outcomes in Patients with Brain Metastases of Non-Small-Cell Lung Cancer Treated with Stereotactic Radiotherapy. Mediators Inflamm 2021; 2021:2910892. [PMID: 34744510 PMCID: PMC8570891 DOI: 10.1155/2021/2910892] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 10/07/2021] [Indexed: 01/21/2023] Open
Abstract
Background As a parameter integrating platelet (P), neutrophil (N), and lymphocyte (L) levels, the systemic immune-inflammation index (SII) has been used as a prognostic marker for patient survival in various types of solid malignant tumors. However, there is no in-depth study in non-small-cell lung cancer (NSCLC) patients with brain metastases after stereotactic radiotherapy. Therefore, we performed a retrospective analysis to determine the clinical and prognostic value of the SII in NSCLC patients with brain metastases who underwent stereotactic radiotherapy. Materials and Methods We enrolled 124 NSCLC patients with brain metastases treated with stereotactic radiotherapy in our hospital between May 2015 and June 2018. We obtained all baseline blood samples within one week prior to stereotactic radiotherapy. The SII was calculated by the following formula: neutrophil counts × platelet counts/lymphocyte counts. The optimal cutoff value of the SII for predicting prognosis was assessed by receiver operating characteristic (ROC) curves with the maximum log-rank values. The discriminative ability of predicting prognosis was calculated and compared using the Kaplan–Meier method and log-rank test. The hazard ratio (HR) and 95% confidence interval (CI) were combined to evaluate the prognostic impact of the blood index on overall survival (OS) and progression-free survival (PFS). Only those parameters that proved to be associated with statistically significant differences in clinical outcomes were compared in multivariate analysis using a multiple Cox proportional hazard regression model to identify independent prognostic factors. Results Of the total enrolled patients, 53.2% and 46.8% have high SII and low SII, respectively. In this study, Kaplan–Meier curve analysis revealed that the median PFS was 9 months (range: 2–22 months) and the median OS was 18 months (range: 4–37 months). Applying an optimal cutoff of 480 (SII), the median PFS was better in the low SII group patients (11.5 vs. 9 months), and the median OS was significantly longer in the low SII group patients (20 vs. 18 months). A SII > 480 was significantly associated with worse OS (HR: 2.196; 95% CI 1.259–3.832; P = 0.006) and PFS (HR: 2.471; 95% CI 1.488–4.104; P < 0.001) according to univariate analysis. In multivariate analysis, only age (HR: 2.159; 95% CI 1.205–3.869; P = 0.010), KPS (HR: 1.887; 95% CI 1.114–3.198; P = 0.018), and SII (HR: 1.938; 95% CI 1.046–3.589; P = 0.035) were independently correlated with OS, and SII (HR: 2.224; 95% CI 1.298–3.810; P = 0.004) was an independent prognostic predictor of PFS, whereas we found that other inflammation-based indices lost their independent value. Conclusions The SII, which is an integrated blood parameter based on platelet, neutrophil, and lymphocyte counts, may be an independent prognostic indicator and may be useful for the identification of NSCLC patients with brain metastases after stereotactic radiotherapy at high risk for recurrence.
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Shimizu Y, Ashida R, Sugiura T, Okamura Y, Ito T, Yamamoto Y, Ohgi K, Otsuka S, Notsu A, Uesaka K. Prognostic Impact of Indicators of Systemic Inflammation and the Nutritional Status of Patients with Resected Carcinoma of the Ampulla of Vater: A Single-Center Retrospective Study. World J Surg 2021; 46:246-258. [PMID: 34661701 DOI: 10.1007/s00268-021-06346-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2021] [Indexed: 01/04/2023]
Abstract
BACKGROUND Several indicators of systemic inflammation and nutritional status were recently shown to serve as novel prognostic factors for certain cancers. Here, we aimed to investigate the prognostic impact of preoperative indicators of systemic inflammation and nutritional status associated with the survival of patients with resected ampulla of Vater carcinoma (AC). METHODS We retrospectively analyzed the records of 91 patients who underwent pancreatoduodenectomy (PD) for AC from January 2002 through December 2018. Indices for systemic inflammation and nutritional status (Systemic immune-inflammation index [SII], Prognostic nutritional index [PNI], modified Glasgow prognostic score [mGPS], and Controlling nutritional status score [CONUT]) were determined using preoperative blood tests. Clinicopathological factors and these indices were analyzed to identify predictors of overall survival (OS). RESULTS The median preoperative SII and PNI values were 456.7 and 47.5, respectively, and their optimal cut-off values were 670.0 and 50.0, respectively. Univariate analysis revealed that high SII, low PNI, mGPS ≥ 1, and malnutrition, assessed using the CONUT, were significant predictors of shorter OS. Multivariate analysis revealed that high SII (HR = 2.71, p = 0.023) and malnutrition assessed using the CONUT (hazard ratio = 3.98, p = 0.006) were independent predictors of shorter OS. CONCLUSION SII and the CONUT predicted the survival of patients with AC after radical resection. These indicators are easily calculated using preoperative blood tests and may contribute to the development of improved strategies to treat AC.
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Affiliation(s)
- Yuji Shimizu
- Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, 1007, Shimo-Nagakubo, Sunto-Nagaizumi, Shizuoka, 411-8777, Japan
| | - Ryo Ashida
- Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, 1007, Shimo-Nagakubo, Sunto-Nagaizumi, Shizuoka, 411-8777, Japan.
| | - Teiichi Sugiura
- Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, 1007, Shimo-Nagakubo, Sunto-Nagaizumi, Shizuoka, 411-8777, Japan
| | - Yukiyasu Okamura
- Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, 1007, Shimo-Nagakubo, Sunto-Nagaizumi, Shizuoka, 411-8777, Japan
| | - Takaaki Ito
- Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, 1007, Shimo-Nagakubo, Sunto-Nagaizumi, Shizuoka, 411-8777, Japan
| | - Yusuke Yamamoto
- Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, 1007, Shimo-Nagakubo, Sunto-Nagaizumi, Shizuoka, 411-8777, Japan
| | - Katsuhisa Ohgi
- Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, 1007, Shimo-Nagakubo, Sunto-Nagaizumi, Shizuoka, 411-8777, Japan
| | - Shimpei Otsuka
- Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, 1007, Shimo-Nagakubo, Sunto-Nagaizumi, Shizuoka, 411-8777, Japan
| | - Akifumi Notsu
- Clinical Research Center, Shizuoka Cancer Center, Sunto-Nagaizumi, Shizuoka, Japan
| | - Katsuhiko Uesaka
- Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, 1007, Shimo-Nagakubo, Sunto-Nagaizumi, Shizuoka, 411-8777, Japan
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Zinellu A, Collu C, Nasser M, Paliogiannis P, Mellino S, Zinellu E, Traclet J, Ahmad K, Mangoni AA, Carru C, Pirina P, Fois AG, Cottin V. The Aggregate Index of Systemic Inflammation (AISI): A Novel Prognostic Biomarker in Idiopathic Pulmonary Fibrosis. J Clin Med 2021; 10:jcm10184134. [PMID: 34575245 PMCID: PMC8466198 DOI: 10.3390/jcm10184134] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/09/2021] [Accepted: 09/12/2021] [Indexed: 12/30/2022] Open
Abstract
Variable patterns of disease progression are typically observed in patients with idiopathic pulmonary fibrosis (IPF). We sought to determine the prognostic capacity of blood cell count indexes, derived from routine complete blood cell (CBC) count, in a cohort of IPF patients. The neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (dNLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), systemic inflammation index (SII), systemic inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI) were calculated at baseline in a consecutive series of 82 IPF patients followed for four years. After adjusting for age, gender, body mass index, smoking status, and disease stage, only the AISI was significantly associated with mortality (HR 1.0013, 95% CI 1.0003–1.0023, p = 0.015). Patients with AISI <434 and ≥434 had a median survival from the diagnosis of 35.3 ± 15.2 and 26.6 ± 16.3 months (p = 0.015), and a four-year survival rate of 54% and 34%, respectively. The AISI, easily derivable from routine laboratory tests, is independently associated with mortality in patients with IPF. Prospective studies in larger cohorts are required to confirm this association.
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Affiliation(s)
- Angelo Zinellu
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy; (P.P.); (S.M.); (C.C.)
- Correspondence:
| | - Claudia Collu
- Department of Clinical, Surgical and Experimental Medicine, University of Sassari, 07100 Sassari, Italy; (C.C.); (P.P.); (A.G.F.)
| | - Mouhamad Nasser
- Department of Respiratory Medicine, National Coordinating Reference Centre for Rare Pulmonary Diseases, Louis Pradel Hospital, 69677 Lyon, France; (M.N.); (J.T.); (K.A.); (V.C.)
| | - Panagiotis Paliogiannis
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy; (P.P.); (S.M.); (C.C.)
| | - Sabrina Mellino
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy; (P.P.); (S.M.); (C.C.)
| | - Elisabetta Zinellu
- Unit of Respiratory Diseases, University Hospital Sassari (AOU), 07100 Sassari, Italy;
| | - Julie Traclet
- Department of Respiratory Medicine, National Coordinating Reference Centre for Rare Pulmonary Diseases, Louis Pradel Hospital, 69677 Lyon, France; (M.N.); (J.T.); (K.A.); (V.C.)
| | - Kais Ahmad
- Department of Respiratory Medicine, National Coordinating Reference Centre for Rare Pulmonary Diseases, Louis Pradel Hospital, 69677 Lyon, France; (M.N.); (J.T.); (K.A.); (V.C.)
| | - Arduino Aleksander Mangoni
- Discipline of Clinical Pharmacology, College of Medicine and Public Health, Flinders University, Bedford Park, SA 5042, Australia;
| | - Ciriaco Carru
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy; (P.P.); (S.M.); (C.C.)
| | - Pietro Pirina
- Department of Clinical, Surgical and Experimental Medicine, University of Sassari, 07100 Sassari, Italy; (C.C.); (P.P.); (A.G.F.)
- Unit of Respiratory Diseases, University Hospital Sassari (AOU), 07100 Sassari, Italy;
| | - Alessandro Giuseppe Fois
- Department of Clinical, Surgical and Experimental Medicine, University of Sassari, 07100 Sassari, Italy; (C.C.); (P.P.); (A.G.F.)
- Unit of Respiratory Diseases, University Hospital Sassari (AOU), 07100 Sassari, Italy;
| | - Vincent Cottin
- Department of Respiratory Medicine, National Coordinating Reference Centre for Rare Pulmonary Diseases, Louis Pradel Hospital, 69677 Lyon, France; (M.N.); (J.T.); (K.A.); (V.C.)
- Claude Bernard University Lyon 1, UMR754, IVPC, 69007 Lyon, France
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Zhang X, Ding R, Li H, Liu Y, Ou W, Hu J, Tian Y, Wang Q. An Association between Inflammation and Cerebral Venous Thrombosis: A Retrospective Study. J Stroke Cerebrovasc Dis 2021; 30:106084. [PMID: 34507256 DOI: 10.1016/j.jstrokecerebrovasdis.2021.106084] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 08/20/2021] [Accepted: 08/24/2021] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES Evidence is currently accumulating for the role of inflammation in cerebral venous thrombosis (CVT). Neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), monocyte/high-density lipoprotein ratio (MHR), and systematic immune-inflammation index (SII) are easily obtainable indicators of systemic inflammations. However, there were few studies on the relationship between them and CVT. Therefore, we aimed to evaluate the connection between the occurrence of CVT and the inflammatory markers described. MATERIALS AND METHODS The samples from 150 participants (including 90 CVT and 60 primary headaches as controls) with similar baseline characteristics were collected in this retrospective study. The NLR, PLR, MHR, SII and file records were employed to compare CVT patients with the control group. RESULTS The levels of NLR (3.93 [2.27, 7.87] vs. 1.65 [1.31, 2.06], P < 0.001), PLR (149.52 [98.39, 198.82] vs. 107.34 [83.31, 129.47], P < 0.001), SII (896.84 [559.89, 1591.87] vs. 382.45 [273.51, 520.92], P < 0.001) and MHR (0.51 [0.40, 0.64] vs. 0.41 [0.29, 0.53], P = 0.001) were significantly higher in the CVT group. After multivariate logistic regression analysis, the SII degree (13.136, [5.675, 30.407], P < 0.001) and MHR degree (2.620, [1.123, 6.113], P < 0.01) were found as independent predictors of CVT. CONCLUSIONS NLR, PLR, SII, and MHR may be able to assist in the diagnosis of CVT which confirmed that inflammation played an important role in CVT.
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Affiliation(s)
- Xifang Zhang
- Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Guangzhou, 510282, China
| | - Rui Ding
- Department of Cerebrovascular Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, No 600 Tianhe Road, Guangzhou, 510630, Guangdong, China
| | - Haiyan Li
- Department of Cerebrovascular Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, No 600 Tianhe Road, Guangzhou, 510630, Guangdong, China
| | - Yaqi Liu
- Department of Cerebrovascular Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, No 600 Tianhe Road, Guangzhou, 510630, Guangdong, China
| | - Weiyang Ou
- Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Guangzhou, 510282, China
| | - Jiangang Hu
- Department of Neurosurgery, Shenzhen Baoan People's Hospital, Southern Medical University, Shenzhen 518101, China
| | - Yu Tian
- Southern Medical University, Guangzhou 510282, China
| | - Qiujing Wang
- Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Guangzhou, 510282, China; Department of Cerebrovascular Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, No 600 Tianhe Road, Guangzhou, 510630, Guangdong, China.
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Li J, Mei X, Sun D, Guo M, Xie M, Chen X. A Nutrition and Inflammation-Related Nomogram to Predict Overall Survival in Surgically Resected Esophageal Squamous Cell Carcinoma (ESCC) Patients. Nutr Cancer 2021; 74:1625-1635. [PMID: 34369223 DOI: 10.1080/01635581.2021.1957131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Pretreatment inflammation-based biomarkers and the prognostic nutrition index (PNI) have been used to evaluate prognosis in cancer patients. However, few studies have focused on the prognostic value of post-treatment inflammation-based biomarkers and PNI in ESCC patients. We aimed to investigate the values of pre/post-treatment inflammatory parameters and PNI for establishing a nomogram to predict overall survival (OS) in ESCC patients. A retrospective review was performed on 268 ESCC patients with esophagectomy. The prognostic values of inflammatory and nutrition indexes were evaluated. Based on the results of multivariable Cox analysis, a nomogram was developed. The predictive accuracy and discriminative ability of the nomogram were determined using the concordance-index (C-index) and a calibration curve and subsequently compared to tumor-node-metastasis (TNM) staging by C-index, receiver operating characteristic (ROC) and decision curve analysis (DCA). PreSII, PostSII, PrePNI, N stage, and TNM classification were assembled into a nomogram. The C-index of the nomogram was 0.774, and the area under curve (AUC) of the nomogram was 0.862. DCA demonstrated that the established nomogram was a better predictive model compared to the TNM system. The developed nomogram with superior predictive ability provides more valuable prognostic information for patients and clinicians than TNM classification.
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Affiliation(s)
- Juan Li
- Department of Thoracic Surgery, the First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, Hefei, Anhui, P.R. China
| | - Xinyu Mei
- Department of Thoracic Surgery, the First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, Hefei, Anhui, P.R. China
| | - Di Sun
- Department of Thoracic Surgery, the First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, Hefei, Anhui, P.R. China
| | - Mingfa Guo
- Department of Thoracic Surgery, the First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, Hefei, Anhui, P.R. China
| | | | - Xia Chen
- Department of Southern District Nursing, the First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, Hefei, Anhui, P.R. China
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OZTURK S, ERDOĞAN M, TURAN Y. Systemic immune-inflammation index and high-sensitivity cardiac troponin T in acute coronary syndromes. ACTA MEDICA ALANYA 2021. [DOI: 10.30565/medalanya.936506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Öztürk R, İnan D, Güngör B. Systemic Immune-Inflammation Index Is a Predictor of Contrast-Induced Nephropathy in Patients With ST-Segment Elevation Myocardial Infarction. Angiology 2021; 73:125-131. [PMID: 34231412 DOI: 10.1177/00033197211029094] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
We evaluated the predictive value of admission systemic immune-inflammation index (SII) for the risk of contrast-induced nephropathy (CIN) in patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI). The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and SII (platelet × NLR) levels were calculated in 1621 consecutive patients with STEMI. The relationship of these parameters with CIN development within 72 hours of pPCI was analyzed. Of the study population, 343 (21.1%) cases developed CIN. The frequency of CIN was 11.1% in the first SII quartile, 11.6% in the second SII quartile, 26.8% in the third SII quartile, and 35% in the fourth SII quartile, which differed significantly between groups (P < .01). Age, baseline glomerular filtration rate, contrast media volume, hypertension, C-reactive protein levels, and the quartiles of SII were independent predictors of CIN. Patients in the third SII quartile versus first SII quartile (OR: 2.906, 95% CI, 1.903-4.437; P < .001), and fourth SII quartile versus first SII quartile (OR: 4.168, 95% CI, 2.754-6.313; P < .001) had a significantly higher risk for CIN in the multivariable model. The SII may be a promising inflammatory parameter to predict CIN after pPCI.
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Affiliation(s)
- Recep Öztürk
- Department of Cardiology, University of Health Sciences, Dr. Siyami Ersek Training and Research Hospital, Istanbul, Turkey
| | - Duygu İnan
- Department of Cardiology, Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey
| | - Barış Güngör
- Department of Cardiology, University of Health Sciences, Dr. Siyami Ersek Training and Research Hospital, Istanbul, Turkey
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Brewczyński A, Jabłońska B, Mazurek AM, Mrochem-Kwarciak J, Mrowiec S, Śnietura M, Kentnowski M, Kołosza Z, Składowski K, Rutkowski T. Comparison of Selected Immune and Hematological Parameters and Their Impact on Survival in Patients with HPV-Related and HPV-Unrelated Oropharyngeal Cancer. Cancers (Basel) 2021; 13:cancers13133256. [PMID: 34209764 PMCID: PMC8268778 DOI: 10.3390/cancers13133256] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 06/20/2021] [Accepted: 06/25/2021] [Indexed: 01/21/2023] Open
Abstract
Simple Summary This is a research article on oropharyngeal cancer (OPC). The aim of the study was to assess and compare basic immune parameters and ratios in patients with Human Papilloma Virus (HPV)+ and HPV− OPC, before and after radiotherapy (RT) or chemoradiotherapy (CRT), and to investigate their impact on overall survival (OS) and disease-free survival (DFS). The higher neutrophil-lymphocyte ratio (NLR) and systemic immune inflammation (SII) are significant adverse prognostic factors for HPV+ OPC patients, because they are significantly associated with both inferior OS and DFS in this group, whereas the higher platelet cells (PLT) count is significant adverse prognostic factor for HPV− OPC patients, because it is significantly associated with inferior OS and DFS in this group. This study confirmed that determination of HPV etiology as well as analysis of various hematological and immune parameters should be a standard management in OPC patients in order to properly treat them for improved prognosis. Abstract Several immune and hematological parameters are associated with survival in patients with oropharyngeal cancer (OPC). The aim of the study was to analyze selected immune and hematological parameters of patients with HPV-related (HPV+) and HPV-unrelated (HPV−) OPC, before and after radiotherapy/chemoradiotherapy (RT/CRT) and to assess the impact of these parameters on survival. One hundred twenty seven patients with HPV+ and HPV− OPC, treated with RT alone or concurrent chemoradiotherapy (CRT), were included. Patients were divided according to HPV status. Confirmation of HPV etiology was obtained from FFPE (Formalin-Fixed, Paraffin-Embedded) tissue samples and/or extracellular circulating HPV DNA was determined. The pre-treatment and post-treatment laboratory blood parameters were compared in both groups. The neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), monocyte/lymphocyte ratio (MLR), and systemic immune inflammation (SII) index were calculated. The impact of these parameters on overall (OS) and disease-free (DFS) survival was analyzed. In HPV+ patients, a high pre-treatment white blood cells (WBC) count (>8.33 /mm3), NLR (>2.13), SII (>448.60) significantly correlated with reduced OS, whereas high NLR (>2.29), SII (>462.58) significantly correlated with reduced DFS. A higher pre-treatment NLR and SII were significant poor prognostic factors for both OS and DFS in the HPV+ group. These associations were not apparent in HPV− patients. There are different pre-treatment and post-treatment immune and hematological prognostic factors for OS and DFS in HPV+ and HPV− patients. The immune ratios could be considered valuable biomarkers for risk stratification and differentiation for HPV− and HPV+ OPC patients.
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Affiliation(s)
- Adam Brewczyński
- I Radiation and Clinical Oncology Department of Maria Skłodowska-Curie National Research Institute of Oncology, 44-102 Gliwice Branch, Poland; (A.B.); (M.K.); (K.S.); (T.R.)
| | - Beata Jabłońska
- Department of Digestive Tract Surgery, Medical University of Silesia, 40-752 Katowice, Poland;
- Correspondence:
| | - Agnieszka Maria Mazurek
- Centre for Translational Research and Molecular Biology of Cancer of Maria Skłodowska-Curie National Research Institute of Oncology, 44-102 Gliwice Branch, Poland;
| | - Jolanta Mrochem-Kwarciak
- The Analytics and Clinical Biochemistry Department of Maria Skłodowska-Curie National Research Institute of Oncology, 44-102 Gliwice Branch, Poland;
| | - Sławomir Mrowiec
- Department of Digestive Tract Surgery, Medical University of Silesia, 40-752 Katowice, Poland;
| | - Mirosław Śnietura
- Tumor Pathology Department of Maria Skłodowska-Curie National Research Institute of Oncology, 44-102 Gliwice Branch, Poland;
| | - Marek Kentnowski
- I Radiation and Clinical Oncology Department of Maria Skłodowska-Curie National Research Institute of Oncology, 44-102 Gliwice Branch, Poland; (A.B.); (M.K.); (K.S.); (T.R.)
| | - Zofia Kołosza
- Department of Biostatistics and Bioinformatics of Maria Skłodowska-Curie National Research Institute of Oncology, 44-102 Gliwice Branch, Poland;
| | - Krzysztof Składowski
- I Radiation and Clinical Oncology Department of Maria Skłodowska-Curie National Research Institute of Oncology, 44-102 Gliwice Branch, Poland; (A.B.); (M.K.); (K.S.); (T.R.)
| | - Tomasz Rutkowski
- I Radiation and Clinical Oncology Department of Maria Skłodowska-Curie National Research Institute of Oncology, 44-102 Gliwice Branch, Poland; (A.B.); (M.K.); (K.S.); (T.R.)
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Wang Y, Lyu J, Jia H, Liang L, Xiao L, Liu Y, Liu X, Li K, Chen T, Zhang R, Zhang H, Tang C, Li T. Clinical utility of the systemic immune-inflammation index for predicting survival in esophageal squamous cell carcinoma after radical radiotherapy. Future Oncol 2021; 17:2647-2657. [PMID: 34008415 DOI: 10.2217/fon-2021-0304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: To explore the clinical utility of the systemic immune-inflammation index (SII) for predicting the prognosis of esophageal squamous cell carcinoma (ESCC). Patients & methods: After calculating the SII in 180 patients with ESCC, the relationship between SII values and the pre-/post-radiotherapy SII ratio and overall survival was determined. Results: The median overall survival was 649 days for the entire group and 909 and 466 days for the high and low pre-/post-radiotherapy SII ratio groups, respectively. Multivariate analysis identified Karnofsky performance status (p = 0.045), lymphatic metastasis (p = 0.032), mid-radiotherapy SII (p < 0.001) and pre-/post-radiotherapy SII ratio (p = 0.003) as independent prognostic factors. Conclusion: The pre-/post-radiotherapy SII ratio and mid-radiotherapy SII are potentially effective markers for predicting ESCC prognosis.
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Affiliation(s)
- Yuan Wang
- School of Medicine, University of Electronic Science & Technology of China, Chengdu, 610054, China
| | - Jiahua Lyu
- School of Medicine, University of Electronic Science & Technology of China, Chengdu, 610054, China.,Sichuan Cancer Hospital Institute/Sichuan Cancer Center/School of Medicine, University of Electronic Science & Technology of China, Chengdu, 610041, China
| | - Hongyuan Jia
- Sichuan Cancer Hospital Institute/Sichuan Cancer Center/School of Medicine, University of Electronic Science & Technology of China, Chengdu, 610041, China
| | - Long Liang
- Sichuan Cancer Hospital Institute/Sichuan Cancer Center/School of Medicine, University of Electronic Science & Technology of China, Chengdu, 610041, China
| | - Ling Xiao
- School of Medicine, University of Electronic Science & Technology of China, Chengdu, 610054, China
| | - Yudi Liu
- School of Medicine, University of Electronic Science & Technology of China, Chengdu, 610054, China
| | - Xiao Liu
- School of Clinical Medical Sciences, Southwest Medical University, Luzhou, 646000, China
| | - Ke Li
- School of Clinical Medical Sciences, Southwest Medical University, Luzhou, 646000, China
| | - Taiyu Chen
- School of Clinical Medical, Chengdu Medical College, Chengdu, 610599, China
| | - Rongke Zhang
- School of Clinical Medical Sciences, Southwest Medical University, Luzhou, 646000, China
| | - Hangyue Zhang
- School of Clinical Medical Sciences, Southwest Medical University, Luzhou, 646000, China
| | - Chunhan Tang
- School of Clinical Medical, Chengdu Medical College, Chengdu, 610599, China
| | - Tao Li
- School of Medicine, University of Electronic Science & Technology of China, Chengdu, 610054, China.,Sichuan Cancer Hospital Institute/Sichuan Cancer Center/School of Medicine, University of Electronic Science & Technology of China, Chengdu, 610041, China
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Xu J, Gao Y, Hu S, Li S, Wang W, Wu Y, Su Z, Zhou X, Cheng X, Zheng Q. A composite risk model predicts disease progression in early stages of COVID-19: A propensity score-matched cohort study. Ann Clin Biochem 2021; 58:434-444. [PMID: 33827266 PMCID: PMC8685757 DOI: 10.1177/00045632211011194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background Recently, studies on COVID-19 have focused on the epidemiology of the disease and clinical characteristics of patients, as well as on the risk factors associated with mortality during hospitalization in critical COVID-19 cases. However, few research has been performed on the prediction of disease progression in particular group of patients in the early stages of COVID-19. Methods The study included 338 patients with COVID-19 treated at two hospitals in Wuhan, China, from December 2019 to March 2020. Predictors of the progression of COVID-19 from mild to severe stages were selected by the logistic regression analysis. Results COVID-19 progression to severe and critical stages was confirmed in 78 (23.1%) patients. The average value of the neutrophil-to-lymphocyte ratio (NLR) was higher in patients in the disease progression group than in the improvement group. Multivariable logistic regression analysis revealed that elevated NLR, LDH and IL-10 were independent predictors of disease progression. The optimal cut-off value of NLR was 3.75. The values of the area under the curve, reflecting the accuracy of predicting COVID-19 progression by NLR was 0.739 (95%CI: 0.605–0.804). The risk model based on NLR, LDH and IL-10 had the highest area under the ROC curve. Conclusions The performed analysis demonstrates that high concentrations of NLR, LDH and IL-10 were independent risk factors for predicting disease progression in patients at the early stage of COVID-19. The risk model combined with NLR, LDH and IL-10 improved the accuracy of the prediction of disease progression in patients in the early stages of COVID-19.
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Affiliation(s)
- Jianjun Xu
- Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yang Gao
- Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shaobo Hu
- Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Department of General Surgery, The People's Hospital of Honghu City, Honghu, China
| | - Suzhen Li
- Department of Gastroenterology, Wuhan Asia General Hospital, Wuhan, China
| | - Weimin Wang
- Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuzhe Wu
- Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhe Su
- Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xing Zhou
- Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiang Cheng
- Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qichang Zheng
- Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Xu J, Hu S, Li S, Wang W, Wu Y, Su Z, Zhou X, Gao Y, Cheng X, Zheng Q. Systemic immune-inflammation index predicts postoperative acute kidney injury in hepatocellular carcinoma patients after hepatectomy. Medicine (Baltimore) 2021; 100:e25335. [PMID: 33832108 PMCID: PMC8036044 DOI: 10.1097/md.0000000000025335] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Accepted: 02/26/2021] [Indexed: 01/05/2023] Open
Abstract
The systemic immune-inflammation index (SII) is an independent prognostic predictor of hepatocellular carcinoma (HCC). The present investigation examined whether an association exists between preoperative SII value and postoperative acute kidney injury (pAKI) in HCC patients.The study included 479 hepatitis B virus (HBV)-associated HCC patients undergoing hepatectomy. The SII was calculated as P × N/L, where P, N, and L represent the counts of platelets, neutrophils, and lymphocytes in routine blood test, respectively. After propensity score matching, logistic regression analysis was used to explore independent predictors of pAKI in HCC patients.pAKI was confirmed in 51 patients (10.8%). The average SII value was higher in patients with pAKI than patients without pAKI. After multivariate logistic regression analysis, SII, history of hypertension, and tumor size, among others, were found to be predictors of pAKI. The optimal threshold value of SII for predicting pAKI was found to be 547.84 × 109/L. Multivariate analysis performed after propensity score matching confirmed that SII ≥ 547.84 × 109/L was an independent predictor of pAKI.The preoperative SII qualifies as a novel, independent predictor of pAKI in HCC patients with HBV infection who underwent hepatectomy.
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Affiliation(s)
- Jianjun Xu
- Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan
| | - Shaobo Hu
- Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan
- Department of General Surgery, The People's Hospital of Honghu City, Honghu
| | - Suzhen Li
- Department of Gastroenterology, Wuhan Asia General Hospital, Wuhan, China
| | - Weimin Wang
- Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan
| | - Yuzhe Wu
- Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan
| | - Zhe Su
- Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan
| | - Xing Zhou
- Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan
| | - Yang Gao
- Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan
| | - Xiang Cheng
- Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan
| | - Qichang Zheng
- Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan
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Erdoğan M, Öztürk S, Kardeşler B, Yiğitbaşı M, Kasapkara HA, Baştuğ S, Erdöl MA, Akar Bayram N, Akçay M, Durmaz T. The relationship between calcific severe aortic stenosis and systemic immune-inflammation index. Echocardiography 2021; 38:737-744. [PMID: 33772853 DOI: 10.1111/echo.15044] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 03/08/2021] [Accepted: 03/15/2021] [Indexed: 12/30/2022] Open
Abstract
AIM Calcific aortic stenosis (AS) is a common valvular disease especially in elderly population. Inflammation plays significant role in the pathophysiological mechanism. Systemic immune-inflammation index (SII) is a novel marker of immune system and inflammation that includes neutrophil, lymphocyte, and platelet cell counts. The aim of this study was to investigate the predictive value of SII in calcific severe AS. MATERIALS AND METHODS Severe calcific AS patients were categorized into two groups: High flow-high gradient (HFHG) AS (n = 289) and low flow-low gradient AS (n = 79). Control group included 273 patients with similar clinical and demographic characteristics but without AS. SII was calculated as absolute platelet count × absolute neutrophil count/absolute lymphocyte count. RESULTS SII levels were 525 ± 188, 835 ± 402, and 784 ± 348 in control, HFHG AS, and LFLG AS groups, respectively (P < .001). Correlation analyses revealed significant and positive correlation between SII and mean aortic transvalvular pressure gradient (r = .342, P < .001), and negative and significant correlation between SII and AVA (r = -.461, P < .001). Multivariate analysis performed in separate models demonstrated sex, CAD, LDL, and SII levels (Odds ratio [OR]: 1.004, 95 CI%:1.003-1.004) as independent predictors of severe AS in Model 1. According to Model 2, sex, CAD, LDL, and high SII (>661) (OR:5.78, 95 CI%:3.93-4.89) remained as independent predictors of severe AS. CONCLUSION SII levels can be useful to predict severe calcific AS patients and significantly correlate with AVA and mean aortic transvalvular pressure gradient.
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Affiliation(s)
- Mehmet Erdoğan
- Department of Cardiology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkey.,Department of Cardiology, Ministry of Health, Ankara Bilkent City Hospital, Ankara, Turkey
| | - Selçuk Öztürk
- Department of Cardiology, Faculty of Medicine, Yozgat Bozok University, Yozgat, Turkey
| | - Burak Kardeşler
- Department of Cardiology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Murat Yiğitbaşı
- Department of Cardiology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Hacı Ahmet Kasapkara
- Department of Cardiology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkey.,Department of Cardiology, Ministry of Health, Ankara Bilkent City Hospital, Ankara, Turkey
| | - Serdal Baştuğ
- Department of Cardiology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkey.,Department of Cardiology, Ministry of Health, Ankara Bilkent City Hospital, Ankara, Turkey
| | - Mehmet Akif Erdöl
- Department of Cardiology, Ministry of Health, Ankara Bilkent City Hospital, Ankara, Turkey
| | - Nihal Akar Bayram
- Department of Cardiology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkey.,Department of Cardiology, Ministry of Health, Ankara Bilkent City Hospital, Ankara, Turkey
| | - Murat Akçay
- Department of Cardiology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkey.,Department of Cardiology, Ministry of Health, Ankara Bilkent City Hospital, Ankara, Turkey
| | - Tahir Durmaz
- Department of Cardiology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkey.,Department of Cardiology, Ministry of Health, Ankara Bilkent City Hospital, Ankara, Turkey
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Xiong Y, Shi LL, Zhu LS, Ding Q, Ba L, Peng G. Prognostic efficacy of the combination of the pretreatment systemic Immune-Inflammation Index and Epstein-Barr virus DNA status in locally advanced Nasopharyngeal Carcinoma Patients. J Cancer 2021; 12:2275-2284. [PMID: 33758605 PMCID: PMC7974890 DOI: 10.7150/jca.52539] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 01/13/2021] [Indexed: 02/07/2023] Open
Abstract
Background: The systemic immune-inflammation index (SII) and Epstein-Barr virus DNA (EBV DNA) levels has been used as a prognostic marker for nasopharyngeal carcinoma (NPC) patients, but there is no in-depth study in locally advanced NPC patients and no research on the predictive value of their combination. Our study aimed to evaluate the prognostic efficacy of the pretreatment SII, EBV DNA levels and their combination in locally advanced NPC patients receiving induction chemotherapy (IC) followed by concurrent chemoradiotherapy (CCRT). Materials and methods: 319 patients diagnosed with locally advanced NPC receiving IC followed by CCRT were retrospectively reviewed (213 in the training cohort and 106 in the validation cohort). The cut-off value for the SII was determined using receiver operating characteristic (ROC) curve. Correlations between characteristics of patients were assessed using the Pearson correlation coefficient. Survival curves for the SII, EBV DNA levels and their combination were analyzed using the Kaplan-Meier method and compared using the log-rank test. Univariate and multivariate analyses were performed by the Cox proportional hazards regression model to evaluate the prognostic impact on overall survival (OS) and progression-free survival (PFS). A prognostic nomogram was generated and its prediction ability was measured by the concordance index (C-index). Results: The optimal cutoff point for the SII was 402.10. A higher SII and EBV DNA positivity were demonstrated to be related to poorer survival outcomes (P < 0.05). Multivariate analyses showed that a higher SII, EBV DNA positivity and their combination were powerful independent risk factors for OS and PFS (P < 0.05). The SII - EBV DNA had the largest area under the curve (AUC) compared to either score alone. The incorporation of the SII - EBV DNA into established nomogram achieved higher C-index in the prediction of OS and PFS, indicating its superior for predicting survival. All results were found in the training cohort and confirmed in the validation cohort. Conclusions: The pretreatment SII and EBV DNA levels are promising factors for predicting survival in locally advanced NPC patients. The combination of them, which was superior to either score alone, was a complement to the conventional TNM staging system.
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Affiliation(s)
- Ying Xiong
- Cancer Center, Union hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Liang-Liang Shi
- Cancer Center, Union hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Li-Sheng Zhu
- Cancer Center, Union hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Qian Ding
- Cancer Center, Union hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Li Ba
- Cancer Center, Union hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Gang Peng
- Cancer Center, Union hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
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Correlates of Long-Term Survival of Patients with pN+ Esophageal Squamous Cell Carcinoma after Esophagectomy. JOURNAL OF ONCOLOGY 2021; 2021:6675691. [PMID: 33679976 PMCID: PMC7906819 DOI: 10.1155/2021/6675691] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 01/14/2021] [Accepted: 02/02/2021] [Indexed: 11/30/2022]
Abstract
Esophageal squamous cell carcinoma (ESCC) is the most common pathological type of esophageal cancer in China. Patients with ESCC have poor long-term survival, especially those with lymphatic metastasis (pN + ESCC). In this retrospective study, we evaluated the correlates of long-term survival time of patients with pN + ESCC. A total of 453 patients with pN + ESCC who underwent surgical R0 resection between Jan 2008 and Sep 2011 were enrolled. The follow-up ended on December 2019. The clinical, pathological, inflammation-related factors and general survival data of these patients were analyzed using SPSS 22.0 software. The 1-, 3-, and 5-year overall survival (OS) rates were 73.7%, 34.6%, and 25.6%, respectively; the 1-, 3-, and 5-year disease-free survival (DFS) rates were 45.0%, 26.3%, and 20.4%, respectively. The median OS and DFS were 23 and 14 months, respectively. On multivariate analyses, gender, site of lesion, number of dissected lymph nodes, stage pTNM, adjuvant therapy, and neutrophil lymphocyte ratio were independent predictors of OS. Site of lesion, stage pTNM, and adjuvant therapy were independent predictors of DFS. Recursive partitioning analysis (RPA) scores of each patient were calculated based on the independent predictors of OS, and the patients were divided into 3 classes: low-risk, medium-risk, and high-risk. The OS, DFS, and local recurrence-free survival were significantly different among these three RPA classes (P < 0.001). Several factors showed an independent association with long-term postoperative survival of pN + ESCC patients after radical surgery. RPA scores can potentially be used to predict the prognosis of ESCC.
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Wang Q, Peng L, Han Y, Li T, Dai W, Wang Y, Wu L, Wei Y, Xie T, Fang Q, Li Q, Lang J, Cao B. Preoperative Serum Sodium Level as a Prognostic and Predictive Biomarker for Adjuvant Therapy in Esophageal Cancer. Front Oncol 2021; 10:555714. [PMID: 33552948 PMCID: PMC7858663 DOI: 10.3389/fonc.2020.555714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 12/11/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Low serum sodium has been associated with unfavorable outcome in several cancers. The prognostic value of serum sodium in esophageal carcinoma (EC) remains unclear. This study aimed to investigate preoperative serum sodium in association with outcome and survival benefit of adjuvant therapy for patients with EC. METHODS Preoperative serum sodium and clinicopathological indexes were retrospectively analyzed in 2155 patients who underwent esophagectomy at Sichuan cancer hospital. Overall survival (OS) and disease-free survival (DFS) were analyzed by using Kaplan-Meier method and Cox regression. Benefit of adjuvant therapy was estimated by using Propensity Score Matching. RESULTS The incidence of hyponatremia and hypernatremia were 2% (43/2155) and 3.5% (76/2155) in treatment-naive patients. Both sodium disorders indicated unfavorable OS (hyponatremia, adjusted HR[95% CI] = 1.78[1.2-2.62]; hypernatremia, adjusted HR = 1.52[1.1-2.11]) and DFS (hyponatremia, adjusted HR[95% CI] = 1.52[1.03-2.23]; hypernatremia, adjusted HR = 1.45[1.06-1.99]). Decreased sodium concentrations within the normal range were associated with poor OS and DFS. Postoperative adjuvant therapy was associated with improved three-year OS (56.6 vs. 40%; adjusted HR = 0.55 [95% CI, 0.41-0.73]) and DFS (51.9 vs. 36.2%; adjusted HR = 0.63 [95% CI, 0.48-0.83]) versus surgery alone in patients with low serum sodium (Na < 139.6 mmol/liter), but not in other sodium subgroups. Meanwhile, serum sodium was inversely correlated with cell counts of leukocytes, neutrophils, monocytes and C-reactive protein levels. CONCLUSIONS These results suggested that low preoperative serum sodium is associated with poor outcome in EC patients, and may predict survival benefit of adjuvant therapy.
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Affiliation(s)
- Qifeng Wang
- Department of Radiation Oncology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
- Radiation Oncology Key Laboratory of Sichuan Province, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Lin Peng
- Department of Thoracic Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yongtao Han
- Department of Thoracic Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Tao Li
- Department of Radiation Oncology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
- Radiation Oncology Key Laboratory of Sichuan Province, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Wei Dai
- Department of Thoracic Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yi Wang
- Department of Radiation Oncology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Lei Wu
- Department of Radiation Oncology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yang Wei
- Department of medical oncology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Tianpeng Xie
- Department of Thoracic Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Qiang Fang
- Department of Thoracic Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Qiang Li
- Department of Thoracic Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Jinyi Lang
- Department of Radiation Oncology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
- Radiation Oncology Key Laboratory of Sichuan Province, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Bangrong Cao
- Radiation Oncology Key Laboratory of Sichuan Province, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
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Liu X, Ge H, Feng X, Hang J, Zhang F, Jin X, Bao H, Zhou M, Han F, Li S, Qian Y, Jie Z, Gu W, Gao B, Yu L, Wang J, Ji H, Zhang J, Zhu H. The Combination of Hemogram Indexes to Predict Exacerbation in Stable Chronic Obstructive Pulmonary Disease. Front Med (Lausanne) 2020; 7:572435. [PMID: 33381510 PMCID: PMC7769039 DOI: 10.3389/fmed.2020.572435] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 09/30/2020] [Indexed: 01/14/2023] Open
Abstract
Background: Chronic obstructive pulmonary disease (COPD) is characterized by pulmonary and systemic inflammatory processes, and exacerbation of COPD represents a critical moment in the progression of COPD. Several biomarkers of inflammation have been proposed to have a predictive function in acute exacerbation. However, their use is still limited in routine clinical practice. The purpose of our study is to explore the prognostic efficacy of novel inflammatory hemogram indexes in the exacerbation among stable COPD patients. Method: A total of 275 stable COPD patients from the Shanghai COPD Investigation Comorbidity Program were analyzed in our study. Blood examinations, especially ratio indexes like platelet-lymphocyte ratio (PLR), platelet × neutrophil/lymphocyte ratio [systemic immune-inflammation index (SII)], and monocyte × neutrophil/lymphocyte ratio [systemic inflammation response index (SIRI)], lung function test, CT scans, and questionnaires were performed at baseline and routine follow-ups. Clinical characteristics and information of exacerbations were collected every 6 months. The relationship between hemogram indexes and diverse degrees of exacerbation was assessed by logistic regression. The receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to evaluate the ability of hemogram indexes to predict exacerbation of COPD. Furthermore, the discrimination and accuracy of combined indexes were measured by ROC and calibration curve. Result: There was a significant positive correlation between PLR levels and total exacerbation of COPD patients in a stable stage in a year. Also, the predictive ability of PLR exceeded any other ratio indexes, with an AUC of 0.66. SII and SIRI ranked second only to PLR, with an AUC of 0.64. When combining PLR with other indexes (sex, COPD year, and St. George's Respiratory Questionnaire scores), they were considered as the most suitable panel of index to predict total exacerbation. Based on the result of the ROC curve and calibration curve, the combination shows optimal discrimination and accuracy to predict exacerbation events in COPD patients. Conclusion: The hemogram indexes PLR, SII, and SIRI were associated with COPD exacerbation. Moreover, the prediction capacity of exacerbation was significantly elevated after combining inflammatory hemogram index PLR with other indexes, which will make it a promisingly simple and effective marker to predict exacerbation in patients with stable COPD.
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Affiliation(s)
- Xuanqi Liu
- Department of Respiratory and Critical Care Medicine, Huadong Hospital, Fudan University, Shanghai, China
| | - Haiyan Ge
- Department of Respiratory and Critical Care Medicine, Huadong Hospital, Fudan University, Shanghai, China
| | - Xiumin Feng
- Department of Respiratory and Critical Care Medicine, Changji Branch of First Affiliated Hospital of Xinjiang Medical University, Xinjiang, China
| | - Jingqing Hang
- Department of Respiratory Medicine, Putuo People's Hospital, Shanghai, China
| | - Fengying Zhang
- Department of Respiratory Medicine, Putuo People's Hospital, Shanghai, China
| | - Xiaoyan Jin
- Department of Respiratory Medicine, Tongren Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Hong Bao
- Department of Respiratory Medicine Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China
| | - Min Zhou
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Fengfeng Han
- Department of Respiratory Medicine, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Shengqing Li
- Department of Respiratory and Critical Care Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Yechang Qian
- Baoshan District Hospital of Integrated Traditional Chinese and Western Medicine Hospital, Shanghai, China
| | - Zhijun Jie
- Department of Respiratory Medicine, Shanghai Fifth's Hospital, Fudan University, Shanghai, China
| | - Wenchao Gu
- Department of Respiratory Medicine, Pudong New District People's Hospital, Shanghai, China
| | - Beilan Gao
- Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University, Shanghai, China
| | - Li Yu
- Department of Pulmonary and Critical Care Medicine, Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jian Wang
- Department of Respiratory Medicine, Shanghai Ninth's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Haiying Ji
- Department of Respiratory and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jingxi Zhang
- Department of Respiratory and Critical Care Medicine, Changji Branch of First Affiliated Hospital of Xinjiang Medical University, Xinjiang, China.,Department of Respiratory and Critical Care Medicine, Changhai Hospital Affiliated to Navy Military Medical University, Shanghai, China
| | - Huili Zhu
- Department of Respiratory and Critical Care Medicine, Huadong Hospital, Fudan University, Shanghai, China
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Erdoğan M, Erdöl MA, Öztürk S, Durmaz T. Systemic immune-inflammation index is a novel marker to predict functionally significant coronary artery stenosis. Biomark Med 2020; 14:1553-1561. [DOI: 10.2217/bmm-2020-0274] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Aim: The study aimed to investigate and compare the predictive capacity of a systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) to determine a hemodynamically significant coronary artery stenosis assessed by fractional flow reserve (FFR). Patients & methods: A total of 207 chronic coronary syndrome patients with FFR measurement were enrolled in the study. NLR, PLR and SII levels were calculated. Results: The cut-off value of the SII (620) was associated with 78.4% sensitivity and 64.0% specificity to predict a hemodynamically significant stenosis. SII level independently predicted FFR ≤0.80. Conclusion: SII is an independent predictor of functionally significant coronary stenosis detected by FFR in chronic coronary syndrome patients. SII levels can predict hemodynamically severe obstruction better than NLR and PLR.
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Affiliation(s)
- Mehmet Erdoğan
- Department of Cardiology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara 06830, Turkey
- Department of Cardiology, Ankara Bilkent City Hospital, University of Health Sciences, Ankara 06800, Turkey
| | - Mehmet A Erdöl
- Department of Cardiology, Ankara Bilkent City Hospital, University of Health Sciences, Ankara 06800, Turkey
| | - Selçuk Öztürk
- Department of Cardiology, Faculty of Medicine, Bozok University, Yozgat 66900, Turkey
| | - Tahir Durmaz
- Department of Cardiology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara 06830, Turkey
- Department of Cardiology, Ankara Bilkent City Hospital, University of Health Sciences, Ankara 06800, Turkey
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