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Huang J, Hao J, Luo H, Chen L, Luo H, Liu H, Xu Y, Wang P. Construction of a C-reactive protein-albumin-lymphocyte index-based prediction model for all-cause mortality in patients on maintenance hemodialysis. Ren Fail 2025; 47:2444396. [PMID: 39809257 PMCID: PMC11734386 DOI: 10.1080/0886022x.2024.2444396] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2024] [Revised: 11/26/2024] [Accepted: 12/15/2024] [Indexed: 01/16/2025] Open
Abstract
OBJECTIVE The mortality rate of patients undergoing maintenance hemodialysis (MHD) remains high. The C-reactive protein-albumin-lymphocyte (CALLY) index is a novel biomarker that reflects inflammation, nutritional and immune status, all merged into one single derived parameter. No study has yet linked the CALLY index to survival in hemodialysis. This study aims to explore the correlation between the CALLY index and mortality in MHD patients, and develop and validate a nomogram to estimate the likelihood of death in this population. METHODS This retrospective cohort study collected data from 436 patients and they were divided into survival group (n = 335) and non-survival group (n = 101). Multivariate logistic regression analysis was used to screen factors associated with death, and nomograms were developed to estimate the risk of death in MHD patients. The discrimination and calibration of nomograms were validated using the area under the receiver operating characteristic (ROC) curve (AUC) and calibration curve. In the study, stratification analysis and covariate adjustment were conducted to explore the correlation between the CALLY index and the mortality of MHD patients. RESULTS In the final model, logistic regression showed that the CALLY index, creatinine, triglycerides, dialysis duration, absolute neutrophil count, blood urea nitrogen, sodium and ferritin were variables associated with mortality in MHD patients. A nomogram was developed to assess the risk of death in MHD patients. The AUC of the model was 0.821 (95% CI: 0.778-0.861). The results of stratified analysis and calibration model showed that the CALLY index was a protective factor for maintaining the mortality of MHD patients. CONCLUSIONS The CALLY index is closely related to the mortality of MHD patients. A nomogram constructed based on CALLY index can effectively evaluate the mortality risk of MHD patients.
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Affiliation(s)
- Junmin Huang
- Department of Nephrology, National Clinical Key Specialty Construction Program (2023), Institute of Nephrology, Guangdong Provincial Key Laboratory of Autophagy and Major Chronic Non-communicable Diseases, Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Junfeng Hao
- Department of Nephrology, National Clinical Key Specialty Construction Program (2023), Institute of Nephrology, Guangdong Provincial Key Laboratory of Autophagy and Major Chronic Non-communicable Diseases, Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Huasheng Luo
- Department of Nephrology, National Clinical Key Specialty Construction Program (2023), Institute of Nephrology, Guangdong Provincial Key Laboratory of Autophagy and Major Chronic Non-communicable Diseases, Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Lu Chen
- Department of Nephrology, National Clinical Key Specialty Construction Program (2023), Institute of Nephrology, Guangdong Provincial Key Laboratory of Autophagy and Major Chronic Non-communicable Diseases, Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Hongying Luo
- Department of Nephrology, National Clinical Key Specialty Construction Program (2023), Institute of Nephrology, Guangdong Provincial Key Laboratory of Autophagy and Major Chronic Non-communicable Diseases, Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Huafeng Liu
- Department of Nephrology, National Clinical Key Specialty Construction Program (2023), Institute of Nephrology, Guangdong Provincial Key Laboratory of Autophagy and Major Chronic Non-communicable Diseases, Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Yongzhi Xu
- Department of Nephrology, National Clinical Key Specialty Construction Program (2023), Institute of Nephrology, Guangdong Provincial Key Laboratory of Autophagy and Major Chronic Non-communicable Diseases, Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Peng Wang
- Department of Nephrology, National Clinical Key Specialty Construction Program (2023), Institute of Nephrology, Guangdong Provincial Key Laboratory of Autophagy and Major Chronic Non-communicable Diseases, Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
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Hu W, Yuan Q, Hu J, Li M, Xi Y, Luo L. The association between C-reactive protein-albumin-lymphocyte index and depression in adults with type 2 diabetes mellitus: A cross-sectional study from NHANES. Psychoneuroendocrinology 2025; 176:107442. [PMID: 40138851 DOI: 10.1016/j.psyneuen.2025.107442] [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: 11/10/2024] [Revised: 02/18/2025] [Accepted: 03/16/2025] [Indexed: 03/29/2025]
Abstract
OBJECTIVE Inflammation and nutrition are interrelated, and both are related to depression. This study explored the association between the C-reactive protein (CRP)-albumin-lymphocyte (CALLY) index, a novel immunonutrition scoring system, and depression in patients with type 2 diabetes mellitus (T2DM). METHODS We included 3517 patients with T2DM from the National Health and Nutrition Examination Survey 2005-2010 and 2015-2018. The Patient Health Questionnaire-9 was used to evaluate depression. The CALLY index was based on a comprehensive assessment of serum CRP, serum albumin, and the lymphocyte counts from whole blood. Weighted multivariate logistic regression models were used to examine the relationship between the CALLY index and depression. The restricted cubic spline was applied to explore the nonlinear relationship. RESULTS Compared with the non-depressed group, CALLY index and albumin in the depressed group were significantly reduced, while CRP and lymphocytes were significantly increased (P < 0.05). After adjusting for covariates, only the CALLY index significantly decreased (the highest quartile vs the lowest quartile, odds ratio = 0.58, 95 % confidence interval: 0.38-0.89, P = 0.014). The non-linear association between the CALLY index and depression was not significant (P for nonlinear=0.69). The results of subgroup analysis were basically consistent (P for interaction > 0.05). CONCLUSION The CALLY index was significantly negatively correlated with depression in American patients with diabetes and served as a potential marker for early identification.
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Affiliation(s)
- Wei Hu
- Department of Epidemiology, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510275, China
| | - Qian Yuan
- Dongguan Maternal and Child Health Care Hospital, Dongguan 523120, China
| | - Jie Hu
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Mingzi Li
- Department of Epidemiology and Medical Statistics, School of Public Health, Guangdong Medical University, Dongguan, Guangdong 523808, China
| | - Yue Xi
- Department of Epidemiology, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510275, China.
| | - Ling Luo
- School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China.
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Fu S, Chen Z, Wu H. Association between CRP-Albumin-Lymphocyte (CALLY) index and Asthma-COPD overlap: analysis of NHANES 2015-2018 data. BMC Pulm Med 2025; 25:257. [PMID: 40410717 PMCID: PMC12102915 DOI: 10.1186/s12890-025-03705-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2025] [Accepted: 05/05/2025] [Indexed: 05/25/2025] Open
Abstract
BACKGROUND The CRP-Albumin-Lymphocyte (CALLY) index, a novel inflammatory biomarker combining serum albumin, lymphocyte count, and C-reactive protein (CRP), has been proposed for clinical use. This study aimed to investigate the association between CALLY index and Asthma-COPD Overlap (ACO) in the general US population. METHODS We analyzed data from 6,797 participants aged ≥ 40 years from the 2015-2018 National Health and Nutrition Examination Survey (NHANES). Participants were categorized into quartiles based on natural logarithmic transformed (ln) CALLY index. ACO was defined as self-reported physician-diagnosed asthma and COPD. Logistic regression models were used to examine the association between ln CALLY and ACO, adjusting for potential confounders across three models. Generalized additive models, subgroup analyses, and receiver operating characteristic (ROC) curve analysis were also performed. RESULTS The prevalence of ACO across the four CALLY quartiles was 5.56%, 1.89%, 1.54%, and 0.66%. In the fully adjusted model, for each 1-unit increase in ln CALLY, the risk of ACO decreased by 43% (OR = 0.57, 95% CI: 0.44-0.73, P = 0.001). Compared with Q1, the risk of ACO in Q2, Q3, and Q4 was reduced by 63% (OR = 0.37), 66% (OR = 0.34), and 87% (OR = 0.13), respectively (P for trend = 0.003). Generalized additive models showed a non-linear negative relationship (P < 0.001). Subgroup analysis revealed that the association remained consistent across different sexes, age groups, races, smoking status, and disease statuses (arthritis, DM, and hypertension). ROC curve analysis indicated moderate predictive ability of ln CALLY for ACO (AUC = 0.675, 95% CI: 0.636-0.714), with an optimal cutoff value of 8.007 (sensitivity 0.669, specificity 0.598). CONCLUSION Higher CALLY index is independently associated with lower risk of ACO, suggesting its potential value as a biomarker for ACO risk assessment in clinical practice. By integrating inflammation, immune, and nutritional status evaluation, the CALLY index offers a novel perspective for early identification of high-risk individuals in clinical practice.
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Affiliation(s)
- Shasha Fu
- Department of Respiratory and Critical Care Medicine, Haikou Affiliated Hospital of Central South University Xiangya School of Medicine (Haikou People's Hospital), Haikou, 570208, China
| | - Zongcun Chen
- Department of Endocrinology, The Second Affiliated Hospital of Hainan Medical University, Haikou, 570311, China
| | - Hongchuan Wu
- Department of General Medicine, The Fourth People's Hospital of Haikou, Haikou, 571100, China.
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Hu T, Wang T, Luo X, Hu Z. Association between the C-reactive protein-albumin-lymphocyte index and all-cause mortality in Chinese older adults: a national cohort study based on CLHLS from 2014 to 2018. Front Nutr 2025; 12:1575470. [PMID: 40444244 PMCID: PMC12119284 DOI: 10.3389/fnut.2025.1575470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2025] [Accepted: 04/25/2025] [Indexed: 06/02/2025] Open
Abstract
Background The C-reactive protein-albumin-lymphocyte (CALLY) index, a novel inflammation-immune-nutritional biomarker, has not been comprehensively evaluated for mortality risk prediction in older populations. Here, we investigate the relationship between the CALLY index and all-cause mortality in Chinese adults aged ≥ 60 years. Methods Data were obtained from the 2014 to 2018 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Upon applying a natural logarithmic transformation to the CALLY index, the lnCALLY was stratified into tertiles. Kaplan-Meier analysis and the log-rank test were employed to assess the cumulative survival probability across lnCALLY-stratified older adults populations. Cox proportional hazards regression was utilized to investigate the association between lnCALLY and all-cause mortality. Receiver operating characteristic (ROC) curves and area under the curve (AUC) values were conducted to evaluate the predictive capacity of lnCALLY for all-cause mortality. Restricted cubic splines (RCS) with four knots were applied to explore the potential non-linear dose-response association of lnCALLY with all-cause mortality. Subgroup analyses and sensitivity analyses were conducted to ensure validity. Results A total of 1,738 older adults participants were included in this cohort. Over a median follow-up of 3.3 years, 580 deaths (33.3%) occurred. The multivariable Cox regression demonstrated that the highest lnCALLY tertile was associated with a 40% reduced mortality risk compared to the lowest tertile [adjusted hazard ratio (HR) = 0.60, 95% confidence interval (CI): 0.49-0.73]. Kaplan-Meier curves revealed significantly higher survival probabilities in individuals with elevated lnCALLY (P < 0.001). Time-dependent ROC analysis showed that the AUC of lnCALLY for predicting all-cause mortality at 1-, 2-, and 3-year were 0.751, 0.746, and 0.762, respectively. RCS demonstrated an approximate "L"-shaped negative correlation between lnCALLY and all-cause mortality (P overall < 0.001, P non- linearity = 0.364). Subgroup and sensitivity analyses confirmed robustness, with no significant interactions observed across demographic or clinical strata. Conclusion These findings suggest that the CALLY index serves as a practical prognostic biomarker for monitoring survival in older populations, underscoring the interplay of inflammation, immunity, and nutrition in aging-related mortality.
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Affiliation(s)
- Tian Hu
- Department of Rehabilitation Medicine, JieYang People’s Hospital, Jieyang, Guangdong, China
| | - Taotao Wang
- Department of Rehabilitation Medicine, Zhongshan People’s Hospital, Zhongshan, Guangdong, China
| | - Xiaojing Luo
- Department of Rehabilitation Medicine, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Zheng Hu
- Department of Spine Surgery, JieYang People’s Hospital, Jieyang, Guangdong, China
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Bekki T, Shimomura M, Yano T, Watanabe A, Ishikawa S, Imaoka K, Ono K, Matsubara K, Mochizuki T, Hattori M, Akabane S, Ohdan H. C-reactive Protein-albumin-lymphocyte Index Is a Useful Indicator for Recurrence and Survival Following Curative Resection of Stage I-III Colorectal Cancer. J Anus Rectum Colon 2025; 9:192-201. [PMID: 40302855 PMCID: PMC12035343 DOI: 10.23922/jarc.2024-070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2024] [Accepted: 12/03/2024] [Indexed: 05/02/2025] Open
Abstract
Objectives Recently, several simple inflammation-based prognostic scores that can be calculated easily from serum parameters, have been reported to be related to colorectal cancer prognosis. This study aimed to investigate factors influencing the prognosis of patients, including inflammation-based prognostic scores, with stage I-III colorectal cancer following curative resection. Methods This single-center study included 608 patients with stage I-III colorectal cancer who underwent curative resection between April 2010 and December 2018. A retrospective analysis was performed to identify the prognosis-associated variables in these patients. As a multi-center study, the Hiroshima Surgical study Group of Clinical Oncology database was used to analyze 1659 patients with stage I-III colorectal cancer who underwent curative resection to confirm the results of our single-center study. Results Of the inflammation-based prognostic scores, only preoperative C-reactive protein-albumin-lymphocyte index was revealed to predict a poor prognosis in patients with stage I-III colorectal cancer following curative resection. The low C-reactive protein-albumin-lymphocyte index was associated with poor overall survival and recurrence-free survival, which was similar in patients from multi-center database. The C-reactive protein-albumin-lymphocyte index was found to be associated with patient age, systemic condition, comorbidities, and tumor factors. The time-dependent area under the curve for the postoperative proghosis of the C-reactive protein-albumin-lymphocyte index was superior to those of other inflammation-based prognostic scores in most postoperative observation periods. Conclusions The preoperative C-reactive protein-albumin-lymphocyte index was independently associated with long-term prognosis in patients with stage I-III colorectal cancer following curative resection.
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Affiliation(s)
- Tomoaki Bekki
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Manabu Shimomura
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Takuya Yano
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Atsuhiro Watanabe
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Sho Ishikawa
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kouki Imaoka
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kosuke Ono
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Keiso Matsubara
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tetsuya Mochizuki
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Minoru Hattori
- Medical Education Center, Hiroshima University, Hiroshima, Japan
| | - Shintaro Akabane
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Pan Y, Liu Z, Tu R, Feng X, Yu F, Wei M, Feng J, Xie W, Deng B, Xia J, Yin J. The value of the CRP-albumin-lymphocyte index (CALLY index) as a prognostic biomarker in acute ischemic stroke. Sci Rep 2025; 15:13672. [PMID: 40258922 PMCID: PMC12012108 DOI: 10.1038/s41598-025-97538-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2024] [Accepted: 04/04/2025] [Indexed: 04/23/2025] Open
Abstract
This study aims to evaluate the predictive capability of CRP-albumin-lymphocyte (CALLY) index in relation to hemorrhagic transformation (HT) and functional outcome in acute ischemic stroke (AIS). A total of 439 AIS patients were included in this analysis. Multivariate logistic regression was conducted to examine the relationship between the CALLY index, HT, and functional outcomes. To address its non-linear association, a restricted cubic spline (RCS) model identified an optimal threshold for the CALLY index. Subgroup analyses further explored the association between the CALLY index and HT. The receiver operating characteristic (ROC) curve, the net reclassification index (NRI), and the integrated discrimination index (IDI) were used to assess and compare the predictive performance of the CALLY index with established models for HT. Furthermore, mediation analysis was performed to elucidate the causal pathways linking the CALLY index, HT, and functional outcomes. Among the participants, 9.79% (43/439) experienced HT, and 49.32% (182/369) encountered adverse outcomes. A higher CALLY index was associated with a lower risk of developing HT (OR 0.449, 95% CI 0.283-0.713) and poor outcome (OR 0.691, 95% CI 0.558-0.855). RCS curves demonstrated an increased risk of HT when the CALLY index fell below 1.188. Compared to existing HT prediction models, the CALLY index demonstrates superior predictive performance, with an AUC of 0.746. Furthermore, the CALLY index exhibits improved reclassification ability, as indicated by enhanced NRI and IDI values. The CALLY index independently predicts HT and adverse outcomes in AIS, demonstrating superior accuracy to existing risk scores and offering a practical biomarker for clinical prognosis.
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Affiliation(s)
- Yinghuan Pan
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Clinical Research Center for Cerebrovascular Disease of Hunan Province, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zeyu Liu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Clinical Research Center for Cerebrovascular Disease of Hunan Province, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ruxin Tu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Clinical Research Center for Cerebrovascular Disease of Hunan Province, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xianjing Feng
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Clinical Research Center for Cerebrovascular Disease of Hunan Province, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Fang Yu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Clinical Research Center for Cerebrovascular Disease of Hunan Province, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Minping Wei
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Clinical Research Center for Cerebrovascular Disease of Hunan Province, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jie Feng
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Clinical Research Center for Cerebrovascular Disease of Hunan Province, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Weijia Xie
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Clinical Research Center for Cerebrovascular Disease of Hunan Province, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Bi Deng
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Clinical Research Center for Cerebrovascular Disease of Hunan Province, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jian Xia
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Clinical Research Center for Cerebrovascular Disease of Hunan Province, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jun Yin
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China.
- Clinical Research Center for Cerebrovascular Disease of Hunan Province, Central South University, Changsha, Hunan, China.
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China.
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Wu B, Liu J, Shao C, Yu D, Liao J. Integrating inflammation, nutrition, and immunity: the CALLY index as a prognostic tool in digestive system cancers - a systematic review and meta-analysis. BMC Cancer 2025; 25:672. [PMID: 40217204 PMCID: PMC11992890 DOI: 10.1186/s12885-025-14074-3] [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: 02/11/2025] [Accepted: 04/02/2025] [Indexed: 04/14/2025] Open
Abstract
BACKGROUND Digestive system cancers remain a leading cause of cancer-related mortality globally, underscoring the need for reliable prognostic tools. The C-reactive protein-Albumin-Lymphocyte (CALLY) index, which reflects inflammation, nutrition, and immunity, has shown potential in predicting survival. However, comprehensive evaluations of its role in digestive system cancers are still limited. METHODS A meta-analysis of English-language studies from online databases was performed to assess the prognostic value of the CALLY index. Pooled hazard ratios (HRs) were calculated for overall survival (OS), disease-free survival (DFS), recurrence-free survival (RFS), and cancer-specific survival (CSS). RESULTS A total of eighteen articles (19 studies, encompassing 7,951 patients) were included. A lower CALLY index was significantly associated with poorer outcomes across all survival endpoints. The pooled HR for OS was 1.973 (95% CI: 1.734-2.244), with HRs for DFS, RFS, and CSS being 2.093 (95% CI: 1.682-2.604), 1.462 (95% CI: 1.292-1.654), and 2.456 (95% CI: 1.887-3.221), respectively (all P < 0.001). Subgroup analyses for OS demonstrated consistent prognostic significance across various treatment strategies, cancer types, cutoff values, sample sizes, and regions. Notably, the CALLY index was a strong predictor of OS in surgical patients (HR = 2.014, 95% CI: 1.794-2.260, P < 0.001). Sensitivity analyses validated the robustness of these findings, with minimal publication bias (Egger's test P = 0.053). CONCLUSIONS The CALLY index serves as a cost-effective and reliable biomarker for predicting prognosis in digestive system cancers. Its utility as a pre-treatment risk stratification tool, which integrates key factors of inflammation, nutrition, and immunity, renders it valuable for guiding clinical decision-making.
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Affiliation(s)
- Bo Wu
- Department of Surgery, Zhejiang Hospital, 12 Lingyin Road, Zhejiang, 310013, China
| | - Jingting Liu
- Department of Health Management, Sir Run Run Shaw International Medical Centre, 9 Jingtan Road, Hangzhou, Zhejiang, 310000, China
| | - Chaodan Shao
- Department of Surgery, Zhejiang Hospital, 12 Lingyin Road, Zhejiang, 310013, China
| | - Dongli Yu
- Department of Surgery, Zhejiang Hospital, 12 Lingyin Road, Zhejiang, 310013, China
| | - Jianhua Liao
- Department of Surgery, Zhejiang Hospital, 12 Lingyin Road, Zhejiang, 310013, China.
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Shao Y, Chen C, Yu X, Yan J, Guo J, Ye G. Comprehensive analysis of scRNA-seq and bulk RNA-seq data via machine learning and bioinformatics reveals the role of lysine metabolism-related genes in gastric carcinogenesis. BMC Cancer 2025; 25:644. [PMID: 40205350 PMCID: PMC11984278 DOI: 10.1186/s12885-025-14051-w] [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: 11/02/2024] [Accepted: 03/31/2025] [Indexed: 04/11/2025] Open
Abstract
BACKGROUND Gastric cancer (GC) is a highly aggressive and heterogeneous cancer with extremely complex biological characteristics. Lysine and its metabolism are closely related to human cancer, but little is known about how lysine metabolism-related genes contribute to gastric carcinogenesis. METHODS The roles of lysine metabolism-related genes in GC were investigated by in-depth analysis of single-cell RNA sequencing (scRNA-seq) and bulk RNA sequencing (RNA-seq) data via machine learning and multiple bioinformatics methods and confirmed by multiple cell and molecular biology methods. RESULTS By systematically analyzing the heterogeneity of GC cells and interactions among cell subtypes, two key genes, solute carrier family 7 member 7 (SLC7A7) and vimentin (VIM), were innovatively identified as lysine metabolism-related genes involved in gastric carcinogenesis. The potential functional mechanisms involved immune infiltration, signaling pathway regulation, drug sensitivity, molecular regulatory networks, tumor regulatory genes, and metabolic pathways. A reliable prognostic risk nomogram was established for GC prognosis prediction. Moreover, the expression of the lysine metabolism-related genes SLC7A7 and VIM and their effect on cellular phenotypes in gastric carcinogenesis were verified in clinical samples and in vitro experiments, including cell proliferation, migration, invasion and cell cycle assays. CONCLUSIONS We explored the role of lysine metabolism-related genes and prognostic models in GC with multiple datasets, providing novel metabolic targets.
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Affiliation(s)
- Yongfu Shao
- Department of Gastroenterology, the First Affiliated Hospital of Ningbo University, Ningbo, 315020, China
- Health Science Center, Ningbo University, Ningbo, 315211, China
| | - Chujia Chen
- Health Science Center, Ningbo University, Ningbo, 315211, China
| | - Xuan Yu
- Health Science Center, Ningbo University, Ningbo, 315211, China
| | - Jianing Yan
- Department of Gastroenterology, the First Affiliated Hospital of Ningbo University, Ningbo, 315020, China
| | - Junming Guo
- Health Science Center, Ningbo University, Ningbo, 315211, China.
| | - Guoliang Ye
- Department of Gastroenterology, the First Affiliated Hospital of Ningbo University, Ningbo, 315020, China.
- Institute of Digestive Disease of Ningbo University, Ningbo, 315020, China.
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Chen D, Ma Y, Li J, Wen L, Liu L, Su J, Wu J, Wang P, Zhang G, Huang C, Yao X. Prognostic and clinicopathological significance of C-reactive protein-albumin-lymphocyte(CALLY) in patients with digestive system neoplasms: a systematic review and meta-analysis. World J Surg Oncol 2025; 23:114. [PMID: 40176025 PMCID: PMC11963618 DOI: 10.1186/s12957-025-03779-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2025] [Accepted: 03/25/2025] [Indexed: 04/04/2025] Open
Abstract
OBJECTIVE The prognostic significance of the C-reactive protein-albumin-lymphocyte (CALLY) index in digestive system neoplasms (DSNs) has been investigated in several studies, but inconsistencies remain between the results of different studies. Therefore, the aim of this study was to confirm the prognostic significance of CALLY in patients with DSNs and its association with clinicopathological characteristics (CPCs). METHODS The databases PubMed, Cochrane Library, Web of Science, Research Square and Embase were systematically searched for clinical trials with databases up to 1 November 2024. The value of CALLY in predicting overall survival (OS), disease-free survival (DFS) and recurrence-free survival (RFS) versus cancer-specific survival (CSS) in patients with DSNs was confirmed by calculating the combined hazard ratio (HR) and 95% CI. The combined OR and 95% CI were calculated to assess the association between CALLY and CPCs in patients with DSNs. RESULTS A total of 18 studies with 7916 patients with DSNs were included in this study. Pooled analysis showed that lower CALLY was associated with poor OS, DFS, RFS and CSS were significantly associated. In addition, low CALLY index was associated with male gender, T3-T4, lymph node metastasis, lymph vessel invasion, complications, stage III-IV and surgical approach were significantly associated. However, there was no association between low CALLY index and histological type, adjuvant chemotherapy, and neoadjuvant chemotherapy. CONCLUSIONS In this meta-analysis, a low CALLY index was significantly associated with poor OS, DFS, RFS and CSS in patients with DSNs and with several CPCs in patients with DSNs. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42024622973.
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Affiliation(s)
- Dengzhuo Chen
- Gannan Medical University, Ganzhou, China
- Ganzhou Hospital of Guangdong Provincial People's Hospital, Ganzhou Municipal Hospital, Ganzhou, China
- Department of Gastrointestinal Surgery, Department of General Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China
| | - Yongli Ma
- Ganzhou Hospital of Guangdong Provincial People's Hospital, Ganzhou Municipal Hospital, Ganzhou, China
| | - Jinghui Li
- Gannan Medical University, Ganzhou, China
- Ganzhou Hospital of Guangdong Provincial People's Hospital, Ganzhou Municipal Hospital, Ganzhou, China
- Department of Gastrointestinal Surgery, Department of General Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China
| | - Liang Wen
- Gannan Medical University, Ganzhou, China
- Ganzhou Hospital of Guangdong Provincial People's Hospital, Ganzhou Municipal Hospital, Ganzhou, China
- Department of Gastrointestinal Surgery, Department of General Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China
| | - Linfeng Liu
- Gannan Medical University, Ganzhou, China
- Ganzhou Hospital of Guangdong Provincial People's Hospital, Ganzhou Municipal Hospital, Ganzhou, China
- Department of Gastrointestinal Surgery, Department of General Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China
| | - Jiarui Su
- Department of Gastrointestinal Surgery, Department of General Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China
| | - Jiawei Wu
- Department of Gastrointestinal Surgery, Department of General Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China
| | - Ping Wang
- Department of Gastrointestinal Surgery, Department of General Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China
| | - Guosheng Zhang
- Ganzhou Hospital of Guangdong Provincial People's Hospital, Ganzhou Municipal Hospital, Ganzhou, China
| | - Chengzhi Huang
- Department of Gastrointestinal Surgery, Department of General Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China.
| | - Xueqing Yao
- Gannan Medical University, Ganzhou, China.
- Ganzhou Hospital of Guangdong Provincial People's Hospital, Ganzhou Municipal Hospital, Ganzhou, China.
- Department of Gastrointestinal Surgery, Department of General Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China.
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Li J, Zhang S, Hu X, Huang T, Chen M. Correlation between the C-reactive protein (CRP)-albumin-lymphocyte (CALLY) index and the prognosis of gastric cancer patients after gastrectomy: a systematic review and meta-analysis. Surg Today 2025; 55:483-491. [PMID: 39158606 DOI: 10.1007/s00595-024-02921-y] [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: 05/31/2024] [Accepted: 07/28/2024] [Indexed: 08/20/2024]
Abstract
The C-Reactive Protein (CRP)-Albumin-Lymphocyte (CALLY) index is an established immuno-nutritional scoring system. We screened relevant literature from the major databases up until May, 2024, and extracted the data for analysis. A total of 2829 gastric cancer (GC) patients from six studies were included in this meta-analysis, the results of which revealed that the CALLY index was an independent prognostic factor for OS and RFS in both univariate analyses and multivariate analyses, and that a high CALLY index was a favorable prognostic factor. Moreover, GC patients in the high CALLY index group seemed to have better 5-year OS and 5-year RFS than those in the low CALLY index group. There was a higher proportion of patients with T1 status in the high CALLY index group than in the low CALLY index group. However, the opposite results were found in the analyses of lymph node metastasis positivity, lymph-vascular invasion positivity, postoperative complications, differentiated histological type, anastomotic leakage, and adjuvant chemotherapy. The present meta-analysis concluded that the CALLY index was a simple and useful independent prognostic biomarker for GC patients after gastrectomy.
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Affiliation(s)
- Jinquan Li
- Department of Gastrointestinal Surgery, The First People's Hospital of Jingdezhen, No. 317 Zhonghuabei Road, Zhushan District, Jingdezhen, 33300, Jiangxi, China
| | - Shanzhong Zhang
- Department of Gastrointestinal Surgery, The First People's Hospital of Jingdezhen, No. 317 Zhonghuabei Road, Zhushan District, Jingdezhen, 33300, Jiangxi, China.
| | - Xiaosheng Hu
- Department of Gastrointestinal Surgery, The First People's Hospital of Jingdezhen, No. 317 Zhonghuabei Road, Zhushan District, Jingdezhen, 33300, Jiangxi, China
| | - Tao Huang
- Department of Gastrointestinal Surgery, The First People's Hospital of Jingdezhen, No. 317 Zhonghuabei Road, Zhushan District, Jingdezhen, 33300, Jiangxi, China
| | - Mingmin Chen
- Department of Gastrointestinal Surgery, The First People's Hospital of Jingdezhen, No. 317 Zhonghuabei Road, Zhushan District, Jingdezhen, 33300, Jiangxi, China
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Güven B, Deniz MF, Geylan NA, Kültürsay B, Dönmez A, Bulat Z, Gül ÖB, Kaya M, Oktay V. A novel indicator of all-cause mortality in acute coronary syndrome: the CALLY index. Biomark Med 2025; 19:287-294. [PMID: 40125936 PMCID: PMC11980495 DOI: 10.1080/17520363.2025.2483159] [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: 01/15/2025] [Accepted: 03/19/2025] [Indexed: 03/25/2025] Open
Abstract
AIMS This study aimed to identify the prognostic significance of the C-reactive protein-albumin-lymphocyte (CALLY) index for predicting all-cause mortality in acute coronary syndrome (ACS) patients who have undergone primary percutaneous coronary intervention (pPCI) for revascularization. MATERIALS AND METHODS 505 patients who presented with ACS and underwent pPCI were retrospectively included in this single center study. CALLY index and other five prognostic scores were calculated. The median follow-up was 40 months. All-cause mortality was defined as the primary endpoint. RESULTS The median age of the patients was 59 years, 23.4% were female. The CALLY index was categorized into low (<0.7) and high (≥0.7). Age (p = 0.038), concomitant atrial fibrillation (p = 0.023), previous CABG (p = 0.001), ACE-I/ARB/ARNI use (p = 0.015), diuretic use (p = 0.021), and a low-CALLY index (p < 0.001) were identified as independent predictors of all-cause mortality in multivariate cox regression analysis. When compared to other prognostic scores according to AUC in ROC analysis, the CALLY index demonstrated the best ability to predict all-cause mortality. Additionally, patients with a high-CALLY index exhibited significantly better survival outcomes compared to those with a low-CALLY index (log-rank:p < 0.001). CONCLUSIONS CALLY index can be utilized as a novel prognostic score for predicting all-cause mortality in ACS patients who have undergone pPCI.
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Affiliation(s)
- Barış Güven
- Department of Cardiology, Idil State Hospital, Sirnak, Turkey
- Department of Cardiology, Sirnak State Hospital, Sirnak, Turkey
| | - Muhammed Furkan Deniz
- Department of Cardiology, Bagcilar Research and Education Hospital, Istanbul, Turkey
| | - Neziha Aybüke Geylan
- Department of Cardiology, Istanbul University Cerrahpasa Institute of Cardiology, Istanbul, Turkey
| | - Barkın Kültürsay
- Department of Cardiology, Tunceli State Hospital, Tunceli, Turkey
| | - Ayça Dönmez
- Department of Cardiology, Istanbul University Cerrahpasa Institute of Cardiology, Istanbul, Turkey
| | - Zübeyir Bulat
- Department of Cardiology, Sirnak State Hospital, Sirnak, Turkey
| | - Ömer Burak Gül
- Department of Cardiology, Istanbul University Cerrahpasa Institute of Cardiology, Istanbul, Turkey
| | - Melike Kaya
- Department of Cardiology, Istanbul University Cerrahpasa Institute of Cardiology, Istanbul, Turkey
| | - Veysel Oktay
- Department of Cardiology, Istanbul University Cerrahpasa Institute of Cardiology, Istanbul, Turkey
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Geng M, Zhang K. CRP-Albumin-Lymphocyte index (CALLYI) as a risk-predicting biomarker in association with osteoarthritis. Arthritis Res Ther 2025; 27:57. [PMID: 40108660 PMCID: PMC11921634 DOI: 10.1186/s13075-025-03530-x] [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] [Subscribe] [Scholar Register] [Received: 08/29/2024] [Accepted: 03/10/2025] [Indexed: 03/22/2025] Open
Abstract
PURPOSE As a novel biomarker, the C-reactive protein-Albumin-Lymphocyte Index (CALLYI) offers a comprehensive evaluation of the human body from three perspectives. However, the association between CALLYI and the incidence of osteoarthritis (OA) remains unclear. This cross-sectional study investigates the potential relationship between CALLYI and OA in US adults, develops a clinical prediction model, and validates its effectiveness. METHOD The study cohort consisted of 18,624 U.S. adults who participated in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2010. The CALLYI was calculated using the formula: albumin * lymphocytes / CRP * 10. Three weighted multiple regression models were constructed to investigate the correlation between CALLYI and OA. Restricted cubic splines (RCS) were employed to evaluate the nonlinear relationship between these two variables. Subgroup analyses were conducted to examine interactions. Univariate logistic regression, binary logistic regression, and least absolute shrinkage and selection operator (LASSO) were utilized for variable selection in the prediction model. Decision curve analysis (DCA) and receiver operating characteristic (ROC) curve analysis were applied to assess the predictive performance of the models. RESULTS The total sample size analyzed in this study was 18,624, of which 1,977 (10.62%) were diagnosed with OA. And the mean value of CALLYI was 5.13 (2.12,12.86). The multivariate logistic regression model revealed a negative correlation between elevated CALLYI and OA. The fully adjusted Model 3 demonstrated a significant 28% reduction in OA risk in the Q4 compared to the Q1 of CALLYI (OR = 0.72 95% CI: 0.59-0.88, p = 0.001). Subgroup analyses did not reveal any significant interactions (p > 0.05). Additionally, a significant non-linear relationship between CALLYI and OA using RCS (p < 0.0001). After variable screening, we constructed an OA prediction model incorporating CALLYI, and the results were visualized using a nomogram. The area under the curve (AUC) was 0.825 (95% CI: 0.817-0.834), and DCA indicated that the model holds clinical significance. CONCLUSION This study, utilizing NHANES statistics, is the first to establish a nonlinear negative relationship between CALLYI and OA, with no significant interaction observed in subgroup analyses. In the OA prediction model incorporating CALLYI, we validated the effectiveness and clinical utility of this model, providing evidence that CALLYI can serve as a biomarker for OA risk prediction. Nevertheless, larger multicenter prospective cohort studies are necessary to mitigate the limitations inherent in cross-sectional designs and self-reported OA diagnoses.
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Affiliation(s)
- Maosen Geng
- Department of Orthopedic, Xi'an Central Hospital, No. 161, West 5th Road, Xincheng District, Xi'an, Shaanxi, China
| | - Ke Zhang
- Department of Orthopedic, Xi'an Central Hospital, No. 161, West 5th Road, Xincheng District, Xi'an, Shaanxi, China.
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Zhu JM, Chen SH, Xu YC, Gao RC, Cai H, Zheng QS, Sun XL, Xue XY, Wei Y, Xu N. ALB inhibits tumor cell proliferation and invasion by regulating immune microenvironment and endoplasmic reticulum stress in clear cell renal cell carcinoma. Biochim Biophys Acta Mol Basis Dis 2025; 1871:167672. [PMID: 39862995 DOI: 10.1016/j.bbadis.2025.167672] [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: 10/21/2024] [Revised: 12/29/2024] [Accepted: 01/13/2025] [Indexed: 01/27/2025]
Abstract
OBJECTIVE The aim of this work is to identify putative hub genes for the advancement of clear cell renal cell carcinoma (ccRCC) and determine the fundamental mechanisms. METHODS We employed multiple bioinformatics techniques to screen hub genes. Key hub gene expression levels in ccRCC were assessed. A plethora of functional experiments were carried out to explore the biological role of hub gene. Based on genome-wide association studies, a Mendelian randomization research was conducted to ascertain the causative relationship between albumin (ALB) and ccRCC. RESULTS ALB was low expression in ccRCC tissues and cell lines. It was an independent predictor of progression-free survival following treatment and the overall survival of ccRCC patients. ALB overexpression exhibited the reverse effects of ALB knockdown, which increased cell proliferation, migration, and invasion while inhibiting cell death. Similarly, ALB overexpression inhibited the growth of ccRCC tumors in vivo. Consistent with functional enrichment analysis, ALB overexpression activates the endoplasmic reticulum stress (ERS) in vitro and vivo. The Mendelian randomization showed ALB was associated with the risk of ccRCC. Additionally, ALB was causally associated with γδT cells infiltrates in ccRCC. CONCLUSION ALB plays an important effect in ccRCC via activation of the ERS and regulating immune microenvironment.
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Affiliation(s)
- Jun-Ming Zhu
- Department of Urology, Urology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China; Department of Urology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, China
| | - Shao-Hao Chen
- Department of Urology, Urology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China; Department of Urology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, China
| | - Yi-Cheng Xu
- Department of Urology, Urology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China; Department of Urology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, China
| | - Rui-Cheng Gao
- Department of Urology, Urology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China; Department of Urology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, China
| | - Hai Cai
- Department of Urology, Urology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China; Department of Urology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, China
| | - Qing-Shui Zheng
- Department of Urology, Urology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China; Department of Urology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, China
| | - Xiong-Lin Sun
- Department of Urology, Urology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China; Department of Urology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, China
| | - Xue-Yi Xue
- Department of Urology, Urology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China; Department of Urology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, China; Fujian Key Laboratory of Precision Medicine for Cancer, the First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
| | - Yong Wei
- Department of Urology, Urology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China; Department of Urology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, China.
| | - Ning Xu
- Department of Urology, Urology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China; Department of Urology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, China; Fujian Key Laboratory of Precision Medicine for Cancer, the First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China.
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Su K, Xiao S, Wang M, Wang K, Fan Q, Sha S, Cheng Y, Liu X, Shi H. Predictive Value of Albumin to Fibrinogen Ratio and CALLY Index for Diagnosis of Ulcerative Colitis and Mucosal Healing After Vedolizumab Treatment. J Inflamm Res 2025; 18:589-600. [PMID: 39831197 PMCID: PMC11742243 DOI: 10.2147/jir.s500600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2024] [Accepted: 01/06/2025] [Indexed: 01/22/2025] Open
Abstract
Purpose The albumin to fibrinogen ratio (AFR), a biomarker associated with inflammatory, nutritional, and coagulation status, and the CALLY index, a biomarker combining C-reactive protein, albumin, and lymphocyte count, have been suggested to correlate with prognosis in a variety of diseases in previous studies; however, studies of these two markers in ulcerative colitis (UC) are lacking. The aim of this study was to evaluate the clinical significance of AFR and CALLY index in UC. Methods The study included 109 UC patients and 126 healthy controls. For UC patients treated with Vedolizumab (50 patients), they were categorized into mucosal healing group (MH group) and non- mucosal healing group (non-MH group) based on Mayo endoscopic score (MES) after 14 weeks of treatment. The differences in AFR and CALLY index were compared between the UC group and the healthy control group, and between the MH group and the non-MH group. Then, the correlation of the AFR and CALLY index with UC activity was assessed, and the predictive value of the AFR and CALLY index was evaluated using the receiver operating characteristic (ROC) curve. Results The results showed that both AFR and CALLY index were significantly decreased in the UC group compared with the healthy control group (both p<0.001); the area under the curve (AUC) of the AFR and CALLY index differentiating between the healthy control group and the UC group were 0.782 and 0.773, respectively. For Vedolizumab treatment, the non-MH group had significantly lower baseline AFR and CALLY index compared to the MH group; the AUC for baseline AFR and CALLY index discriminating the MH group from the non-MH group were 0.665 and 0.721, respectively. In addition, AFR and CALLY index were negatively correlated with the MES and inflammatory load of UC. The results of multivariate logistic regression analysis showed that the CALLY index was an independent predictor of UC diagnosis and mucosal healing after 14 weeks of Vedolizumab treatment. Conclusion AFR and CALLY index can be used as novel serologic markers for diagnosing UC and predicting the efficacy of Vedolizumab treatment.
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Affiliation(s)
- Kairong Su
- Department of Gastroenterology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
| | - Sinan Xiao
- Department of Gastroenterology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
| | - Mei Wang
- Department of Gastroenterology, Xi’an International Medical Center Hospital, Xi’an, Shaanxi, People’s Republic of China
| | - Kairuo Wang
- Department of Gastroenterology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
| | - Qing Fan
- Department of Gastroenterology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
| | - Sumei Sha
- Department of Gastroenterology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
| | - Yongli Cheng
- Department of Gastroenterology, Xi’an Chang’an District Hospital, Xi’an, Shaanxi, People’s Republic of China
| | - Xin Liu
- Department of Gastroenterology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
| | - Haitao Shi
- Department of Gastroenterology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
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Fedai H, Sariisik G, Toprak K, Taşcanov MB, Efe MM, Arğa Y, Doğanoğulları S, Gez S, Demirbağ R. A Machine Learning Model for the Prediction of No-Reflow Phenomenon in Acute Myocardial Infarction Using the CALLY Index. Diagnostics (Basel) 2024; 14:2813. [PMID: 39767174 PMCID: PMC11674398 DOI: 10.3390/diagnostics14242813] [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: 11/16/2024] [Revised: 12/05/2024] [Accepted: 12/12/2024] [Indexed: 01/11/2025] Open
Abstract
BACKGROUND Acute myocardial infarction (AMI) constitutes a major health problem with high mortality rates worldwide. In patients with ST-segment elevation myocardial infarction (STEMI), no-reflow phenomenon is a condition that adversely affects response to therapy. Previous studies have demonstrated that the CALLY index, calculated using C-reactive protein (CRP), albumin, and lymphocytes, is a reliable indicator of mortality in patients with non-cardiac diseases. The objective of this study is to investigate the potential utility of the CALLY index in detecting no-reflow patients and to determine the predictability of this phenomenon using machine learning (ML) methods. METHODS This study included 1785 STEMI patients admitted to the clinic between January 2020 and June 2024 who underwent percutaneous coronary intervention (PCI). Patients were in no-reflow status, and other clinical data were analyzed. The CALLY index was calculated using data on patients' inflammatory status. The Extreme Gradient Boosting (XGBoost) ML algorithm was used for no-reflow prediction. RESULTS No-reflow was detected in a proportion of patients participating in this study. The model obtained with the XGBoost algorithm showed high accuracy rates in predicting no-reflow status. The role of the CALLY index in predicting no-reflow status was clearly demonstrated. CONCLUSIONS The CALLY index has emerged as a valuable tool for predicting no-reflow status in STEMI patients. This study demonstrates how machine learning methods can be effective in clinical applications and paves the way for innovative approaches for the management of no-reflow phenomenon. Future research needs to confirm and extend these findings with larger sample sizes.
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Affiliation(s)
- Halil Fedai
- Department of Cardiology, Harran University Faculty of Medicine, Şanlıurfa 63300, Turkey; (K.T.); (M.B.T.); (S.D.); (S.G.); (R.D.)
| | - Gencay Sariisik
- Department of Industrial Engineering, Harran University Faculty of Engineering, Şanlıurfa 63300, Turkey;
| | - Kenan Toprak
- Department of Cardiology, Harran University Faculty of Medicine, Şanlıurfa 63300, Turkey; (K.T.); (M.B.T.); (S.D.); (S.G.); (R.D.)
| | - Mustafa Beğenç Taşcanov
- Department of Cardiology, Harran University Faculty of Medicine, Şanlıurfa 63300, Turkey; (K.T.); (M.B.T.); (S.D.); (S.G.); (R.D.)
| | | | - Yakup Arğa
- Clinic of Cardiology, Viranşehir State Hospital, Şanlıurfa 63700, Turkey;
| | - Salih Doğanoğulları
- Department of Cardiology, Harran University Faculty of Medicine, Şanlıurfa 63300, Turkey; (K.T.); (M.B.T.); (S.D.); (S.G.); (R.D.)
| | - Sedat Gez
- Department of Cardiology, Harran University Faculty of Medicine, Şanlıurfa 63300, Turkey; (K.T.); (M.B.T.); (S.D.); (S.G.); (R.D.)
| | - Recep Demirbağ
- Department of Cardiology, Harran University Faculty of Medicine, Şanlıurfa 63300, Turkey; (K.T.); (M.B.T.); (S.D.); (S.G.); (R.D.)
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Huma L, Suciu H, Avram C, Suteu RA, Danilesco A, Baba DF, Moldovan DA, Sin AI. Implications of Preoperative C-Reactive Protein Levels in Heart Transplant Patients-A Single-Center Retrospective Study. J Clin Med 2024; 13:7466. [PMID: 39685924 DOI: 10.3390/jcm13237466] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2024] [Revised: 12/04/2024] [Accepted: 12/06/2024] [Indexed: 12/18/2024] Open
Abstract
Background: Heart transplant is the final therapeutic option for end-stage heart failure patients. It has been used with increasing success as a surgical procedure, greatly influenced by advances in diagnostic and prognostic tools. The aim of this paper was to study potential implications of C-reactive protein (CRP) in patients who underwent heart transplants. Methods: Our cohort included 43 adult patients from the Emergency Institute for Cardiovascular Diseases and Transplant of Târgu Mureș who underwent heart transplants in our center between 2011 and 2023. Correlations between CRP levels and different characteristics of the patients were investigated, and the optimal cut-off value for CRP levels in relation to the 6-month mortality rate was determined. The central tendencies of the baseline characteristics of patients who had a CRP value lower than the cut-off and those with a value higher than it were compared using parametric or nonparametric tests. Results: Significant correlations between the preoperative CRP levels and 6-month mortality rate (r = 0.35; 95%CI: 0.05-0.60; p = 0.02), as well as previous cardiac resynchronization therapy (CRT) and preoperative CRP levels (r = -0.37; 95%CI: -0.61--0.07, p = 0.01) were highlighted. A value for CRP > 1.66 mg/dL was found to be associated with 6-month mortality (OR = 18.00; 95%CI: 1.90-170.33, p < 0.01). Moreover, the patients who received CRT before transplantation had significantly lower levels of CRP when compared to those who did not receive CRT (p = 0.01). Conclusions: Preoperative CRP levels could represent a valuable asset in the follow-up algorithm of heart transplant patients. The lower levels of CRP in patients who benefited from CRT before transplantation highlights the importance of understanding the complex mechanisms of inflammation and increasing focus on device therapy for future transplant recipients. Further prospective studies with larger cohorts are needed for validation.
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Affiliation(s)
- Laurentiu Huma
- Department of Cell and Molecular Biology, "George Emil Palade" University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540142 Târgu Mureș, Romania
- Emergency Institute for Cardiovascular Diseases and Transplant, 540136 Târgu Mureș, Romania
- Doctoral School, "George Emil Palade" University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540142 Târgu Mureș, Romania
| | - Horatiu Suciu
- Emergency Institute for Cardiovascular Diseases and Transplant, 540136 Târgu Mureș, Romania
- Department of Surgery, "George Emil Palade" University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540142 Târgu Mureș, Romania
| | - Calin Avram
- Department of Medical Informatics and Biostatistics, "George Emil Palade" University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540142 Târgu Mureș, Romania
| | - Radu-Adrian Suteu
- Emergency Institute for Cardiovascular Diseases and Transplant, 540136 Târgu Mureș, Romania
| | | | - Dragos-Florin Baba
- Department of Cell and Molecular Biology, "George Emil Palade" University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540142 Târgu Mureș, Romania
- Emergency Institute for Cardiovascular Diseases and Transplant, 540136 Târgu Mureș, Romania
| | - Diana-Andreea Moldovan
- Emergency Institute for Cardiovascular Diseases and Transplant, 540136 Târgu Mureș, Romania
- Doctoral School, "George Emil Palade" University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540142 Târgu Mureș, Romania
- Department of Family Medicine, "George Emil Palade" University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540142 Târgu Mureș, Romania
| | - Anca-Ileana Sin
- Department of Cell and Molecular Biology, "George Emil Palade" University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540142 Târgu Mureș, Romania
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Zhu D, Lin YD, Yao YZ, Qi XJ, Qian K, Lin LZ. Negative association of C-reactive protein-albumin-lymphocyte index (CALLY index) with all-cause and cause-specific mortality in patients with cancer: results from NHANES 1999-2018. BMC Cancer 2024; 24:1499. [PMID: 39639229 PMCID: PMC11619214 DOI: 10.1186/s12885-024-13261-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Accepted: 11/26/2024] [Indexed: 12/07/2024] Open
Abstract
BACKGROUND The CALLY index, which is derived from C-reactive protein (CRP) content, serum albumin level, and total lymphocyte count, reflects the immune, nutritional, and inflammatory status of the body. Lack of sufficient evidence on the correlation between the CALLY index and the prognosis of cancer patients with various cancer forms. This study seeks to elucidate the association between the CALLY index and mortality from all causes as well as specific causes in cancer patients within a U.S. POPULATION METHODS This investigation encompassed 3511 cancer-afflicted adults from the National Health and Nutritional Examination Surveys (NHANES) spanning 1999 to 2018. The CALLY index was measured at baseline only. The relationship between the CALLY index and mortality from both all causes and cancer specifically was examined using Cox proportional hazards models. Additionally, restricted cubic spline, piecewise linear regression, and various subgroup and sensitivity analyses were employed. RESULTS Over a median follow-up of 103 months, 1,355 deaths occurred, and the incidence of all-cause mortality for these participants was 38.34%. Our findings indicate that an elevated CALLY index correlates with a diminished risk of all-cause mortality. Upon applying a natural logarithmic transformation to the CALLY index, the comprehensively adjusted model revealed that each one-unit increment in ln CALLY corresponded to a 18% decrease in all-cause mortality risk among cancer patients (HR = 0.82, 95% CI:0.79-0.86). Analyses of mortality due to cardiac and cancer-related causes yielded consistent results, which were robust across various subgroup and sensitivity analyses. CONCLUSION The CALLY index demonstrated a linear and negative association with all-cause mortality, as well as mortality caused by cancer and cardiac conditions, highlighting its significant prognostic value in patients with oncological conditions.
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Affiliation(s)
- Di Zhu
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Ye-Ding Lin
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Yan-Zhu Yao
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Xiang-Jun Qi
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Kai Qian
- Shenzhen Bao'an Chinese Medicine Hospital, Shenzhen, Guangdong, China
| | - Li-Zhu Lin
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
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Kılıç Ö, Tecer D, Canbaş M, Kaya MN, Çınar M, Yılmaz S. Immune nutrition indices are associated with disease activity in rheumatoid arthritis: a cross-sectional study. Biomark Med 2024; 18:1093-1102. [PMID: 39573913 DOI: 10.1080/17520363.2024.2430942] [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: 08/25/2024] [Accepted: 11/14/2024] [Indexed: 12/18/2024] Open
Abstract
AIM This study aimed to evaluate the relationship between immune nutrition indices and disease activity in rheumatoid arthritis (RA). METHODS The current study included a cross-sectional analysis of 90 age and gender-matched healthy controls and 116 RA patients who satisfied the 2010 American College of Rheumatology and European League Against Rheumatism categorization criteria. Patients were categorized into remission (disease activity score 28- erythrocyte sedimentation rate (DAS 28-ESR) <2.6) and active disease (DAS 28-ESR ≥2.6) groups. RESULTS Systemic immune-inflammatory index (SII), controlling nutritional status (CONUT), and fibrinogen-to-albumin ratio (FAR) were higher in the RA group than in controls, whereas CRP-albumin-lymphocyte ratio (CALLY) and prognostic nutrition index (PNI) were considerably lower in RA (p < 0.001). The clinical and simplified disease activity index, DAS 28-ESR had negative correlation with PNI and CALLY (p < 0.001). PNI and CALLY were independently related markers of disease activity (p < 0.001) by regression analysis. According to receiver operating characteristic curve analysis, the ideal cutoff values for the active disease are as follows: CONUT, 0.5; CALLY, 12.5, SII, 579.43, FAR, 90.43, and PNI, 40. CALLY was the most sensitive (84.06%) and specific marker (95.74%). CONCLUSIONS CALLY and PNI may be useful prognostic markers for assessing disease activity in RA patients.
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Affiliation(s)
- Özlem Kılıç
- Gülhane Training and Research Hospital, Rheumatology Department, University of Health Sciences, Ankara, Turkey
| | - Duygu Tecer
- Gülhane Training and Research Hospital, Rheumatology Department, University of Health Sciences, Ankara, Turkey
| | - Muhammed Canbaş
- Gülhane Training and Research Hospital, Rheumatology Department, University of Health Sciences, Ankara, Turkey
| | - Mehmet Nur Kaya
- Gülhane Training and Research Hospital, Rheumatology Department, University of Health Sciences, Ankara, Turkey
| | - Muhammet Çınar
- Gülhane Training and Research Hospital, Rheumatology Department, University of Health Sciences, Ankara, Turkey
| | - Sedat Yılmaz
- Gülhane Training and Research Hospital, Rheumatology Department, University of Health Sciences, Ankara, Turkey
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Liu Q, Xie H, Cheng W, Liu T, Liu C, Zhang H, Lin S, Liu X, Tian H, Li X, Zheng X, Chen Y, Shi J, Zhao H, Shi H. The preoperative hemoglobin, albumin, lymphocyte, and platelet score (HALP) as a prognostic indicator in patients with non-small cell lung cancer. Front Nutr 2024; 11:1428950. [PMID: 39668902 PMCID: PMC11634593 DOI: 10.3389/fnut.2024.1428950] [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: 05/07/2024] [Accepted: 11/14/2024] [Indexed: 12/14/2024] Open
Abstract
Background The Hemoglobin, Albumin, Lymphocyte, and Platelet score (HALP) is an inflammatory nutrition-related biomarker based on hemoglobin and albumin levels, as well as the lymphocyte and platelet load index, which has been reported to be associated with the prognosis of various types of tumors. This study aims to investigate the prognostic value of HALP in patients with non-small cell lung cancer (NSCLC). Methods A total of 2,428 patients with NSCLC were enrolled in the INSCOC study. Time-patient survival trends were validated using Kaplan-Meier curves and log-rank tests. The Restricted Cubic Spline function was used to analyze the relationship between the HALP index and overall survival (OS). The Cox regression model was used for univariate and multivariate analyses. Results The study included 2,053 patients with detailed biological information and follow-up data, consisting of 1,346 men (65.6%) and 707 women (34.4%). Within this cohort, 138 patients (6.7%) had stage I disease, 282 (13.7%) had stage II, 477 (23.2%) had stage III, and 1,156 (56.3%) had stage IV. A total of 536 patients (26.1%) underwent surgery, 1,494 (72.8%) received chemotherapy, and 271 (13.2%) received radiotherapy. The 1-, 2-, 3-, and 5-year survival rates for patients with NSCLC were 68.6, 48.6, 37.4, and 30.9%, respectively. The optimal cut-off for HALP was determined to be 29.71, with a sensitivity of 53.1% and specificity of 62.9%, leading to the categorization of patients into low (<29.71) (n = 963) and high (≥29.71) (n = 1,090) HALP groups. Patients with a high HALP demonstrated a significantly higher 5-year overall survival (OS) rate compared to those with a low HALP (38% vs. 23%, p < 0.001). Multivariable Cox proportional hazards regression analysis identified that low HALP was an independent risk factor for the survival of patients with non-small cell lung cancer. Conclusion The HALP index can be used as an independent prognostic factor for patients with NSCLC, offering clinicians a reference to identify high-risk patient with poor long-term prognoses and improve individualized treatment.
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Affiliation(s)
- Qiteng Liu
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Department of Radiotherapy, Beijing Luhe Hospital, Affiliated to Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Hailun Xie
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Wenjuan Cheng
- Department of Anesthesiology, Beijing Luhe Hospital, Affiliated to Capital Medical University, Beijing, China
| | - Tong Liu
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Chenan Liu
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Heyang Zhang
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Shiqi Lin
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Xiaoyue Liu
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Haiying Tian
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Xiangrui Li
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Xin Zheng
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Yue Chen
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Jinyu Shi
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Hong Zhao
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Hanping Shi
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
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Ji H, Luo Z, Ye L, He Y, Hao M, Yang Y, Tao X, Tong G, Zhou L. Prognostic significance of C-reactive protein-albumin-lymphocyte (CALLY) index after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction. Int Immunopharmacol 2024; 141:112860. [PMID: 39142002 DOI: 10.1016/j.intimp.2024.112860] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 07/22/2024] [Accepted: 07/31/2024] [Indexed: 08/16/2024]
Abstract
BACKGROUND In this study, the relationship between C-reactive protein-albumin-lymphocyte (CALLY) index, a novel composite indicator based on inflammation and nutrition, and major adverse cardiovascular events (MACEs) was investigated in patients with ST-segment elevation myocardial infarction (STEMI). MATERIALS AND METHODS This retrospective study included 438 patients with STEMI who were treated at a single center between January 2017 and December 2020. The CALLY index was calculated for each patient on admission. The predictive value of the CALLY index for short- and long-term MACEs was evaluated using the area under the curve (AUC) analysis, and the corresponding AUC values were calculated. Clinical characteristics were analyzed after categorizing the population based on the optimal cut-off value of the CALLY index. Multivariate Cox regression analysis was used to determine factors independently associated with MACEs, while logistic regression analysis was used to identify factors independently associated with the severity of coronary artery lesions. Kaplan-Meier estimation and log-rank test were used to assess event-free survival rates among different CALLY index groups. Additionally, Spearman's correlation test was used to determine the association between the CALLY index and the Gensini score. RESULTS The AUC for predicting short-term MACEs in STEMI patients using the CALLY index was 0.758, while the AUC for predicting long-term MACEs was 0.740. Similarly, the AUC values were 0.815 and 0.819, respectively, when evaluating the short- and long-term mortality rates using the CALLY index. Multivariable Cox regression analysis revealed that a high CALLY index (threshold of 1.50) independently reduced the risk of short-term MACEs in patients with STEMI (hazard ratio [HR] = 0.274, 95 % confidence interval [CI] = 0.121-0.621, P=0.002). Multivariable Cox regression also demonstrated that a high CALLY index (threshold > 0.91) independently reduced the occurrence of long-term MACEs during follow-up in STEMI patients (HR=0.439, 95 % CI=0.292-0.659, P<0.001). Furthermore, multivariate logistic regression analysis revealed that a high CALLY index (threshold > 1.13) independently reduced the risk of severe coronary artery lesions in patients with STEMI (odds ratio = 0.299 [95 % CI=184-0.485], P<0.001). A positive correlation was observed between the CALLY index and the Gensini score (P<0.001). CONCLUSION The CALLY index is a novel, convenient, and valuable prognostic indicator exhibiting a protective effect against both short- and long-term MACEs in patients with STEMI, emphasizing the significance of inflammation/nutrition in this patient population.
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Affiliation(s)
- Hao Ji
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, No. 548 Binwen Road, Binjiang District, Hangzhou, Zhejiang Province 310053, China
| | - Zan Luo
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, No. 548 Binwen Road, Binjiang District, Hangzhou, Zhejiang Province 310053, China
| | - Lu Ye
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, No. 548 Binwen Road, Binjiang District, Hangzhou, Zhejiang Province 310053, China
| | - Ying He
- Cardiac Ultrasound Center, Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Shangcheng District, Hangzhou, Zhejiang Province 310000, China
| | - Mengyao Hao
- Key Laboratory of Systems Microbial Biotechnology, Tianjin Institute of Industrial Biotechnology, Chinese Academy of Sciences, No. 32 West 7th Avenue, Dongli District, Tianjin 300308, China
| | - Yang Yang
- Department of Geriatric Respiratory, Xuzhou New Health Hospital, North Hospital of Xuzhou Cancer Hospital, No 108 Benteng Avenue, Gulou District, Xuzhou, Jiangsu Province 221007, China
| | - Xingyu Tao
- Department of Geriatric Respiratory, Xuzhou New Health Hospital, North Hospital of Xuzhou Cancer Hospital, No 108 Benteng Avenue, Gulou District, Xuzhou, Jiangsu Province 221007, China
| | - Guoxin Tong
- Department of Cardiology, Affiliated Hangzhou First People's Hospital, Westlake University School of Medicine, No. 261, Huansha Road, Hangzhou 310006, China.
| | - Liang Zhou
- Department of Cardiology, Affiliated Hangzhou First People's Hospital, Westlake University School of Medicine, No. 261, Huansha Road, Hangzhou 310006, China.
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Sakurai K, Kubo N, Hasegawa T, Nishimura J, Iseki Y, Nishii T, Inoue T, Yashiro M, Nishiguchi Y, Maeda K. Clinical significance of the CALLY index in patients with gastric cancer undergoing gastrectomy. World J Surg 2024; 48:2749-2759. [PMID: 39349360 DOI: 10.1002/wjs.12357] [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: 06/16/2024] [Accepted: 09/15/2024] [Indexed: 10/02/2024]
Abstract
BACKGROUND The aim of this study was to elucidate the clinical impact of the CALLY index in patients with gastric cancer (GC) undergoing gastrectomy. METHODS Between January 2014 and December 2020, 617 patients who underwent gastrectomy for GC at the Osaka City General Hospital were enrolled in this study. The CALLY index was calculated using the following formula: [albumin (g/dL) × lymphocytes (/μl)]/[CRP (mg/dL) × 104]. We compared the predictive value of four biomarkers [CALLY index, modified Glasgow prognostic score (mGPS), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR)] for short- and long-term outcomes and focused on the CALLY index to elucidate its clinical value. RESULTS Receiver operating characteristic analysis showed that the area under the curve for the CALLY index was the highest among the four biomarkers. The 5-year overall survival (OS) and cancer-specific survival (CSS) rates in the low and the high CALLY groups were statistically significant. Multivariate analysis identified the CALLY index as an independent factor for OS and CSS but not NLR or PLR. The mGPS was an independent factor for OS but not for CSS in multivariate analysis. Regarding complications, only the CALLY index was an independent predictor of major complications (≧ Clavien-Dindo grade 3) in multivariate analysis but not others. CONCLUSIONS The CALLY index may have a clinical value in predicting OS, CSS, and major complications in GC patients undergoing gastrectomy.
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Affiliation(s)
- Katsunobu Sakurai
- Department of Gastroenterological Surgery, Osaka City General Hospital, Osaka, Japan
| | - Naoshi Kubo
- Department of Gastroenterological Surgery, Osaka City General Hospital, Osaka, Japan
| | - Tsuyoshi Hasegawa
- Department of Gastroenterological Surgery, Osaka City General Hospital, Osaka, Japan
| | - Junya Nishimura
- Department of Gastroenterological Surgery, Osaka City General Hospital, Osaka, Japan
| | - Yasuhito Iseki
- Department of Gastroenterological Surgery, Osaka City General Hospital, Osaka, Japan
| | - Takafumi Nishii
- Department of Gastroenterological Surgery, Osaka City General Hospital, Osaka, Japan
| | - Toru Inoue
- Department of Gastroenterological Surgery, Osaka City General Hospital, Osaka, Japan
| | - Masakazu Yashiro
- Department of Gastroenterological Surgery, Osaka Metropolitan University, Osaka, Japan
| | - Yukio Nishiguchi
- Department of Gastroenterological Surgery, Osaka City General Hospital, Osaka, Japan
| | - Kiyoshi Maeda
- Department of Gastroenterological Surgery, Osaka Metropolitan University, Osaka, Japan
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Hirata H, Fujii N, Oka S, Nakamura K, Shimizu K, Kobayashi K, Hiroyoshi T, Isoyama N, Shiraishi K. C-reactive Protein-albumin-lymphocyte Index as a Novel Biomarker for Progression in Patients Undergoing Surgery for Renal Cancer. CANCER DIAGNOSIS & PROGNOSIS 2024; 4:748-753. [PMID: 39502622 PMCID: PMC11534045 DOI: 10.21873/cdp.10391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2024] [Revised: 09/03/2024] [Accepted: 09/04/2024] [Indexed: 11/08/2024]
Abstract
Background/Aim Some patients with renal cell carcinoma (RCC) develop early or late recurrence after surgery. However, there is no clear consensus on which patients with postoperative RCC should be treated. This study aimed to establish a biomarker for selecting patients who are at a higher risk of relapse following renal cancer surgery. Patients and Methods A total of 378 patients who underwent nephrectomy or partial nephrectomy for a diagnosis of RCC at our hospital were included, with a focus on pT3 cases at high risk of recurrence. Factors associated with postoperative progression, including pathological and hematological parameters, were examined. Results Sarcomatoid features, Fuhrman grade 4, and C-reactive protein-albumin-lymphocyte (CALLY) index were statistically significant predictive factors for progression-free survival after surgery (p<0.0011, p=0.0047, and p<0.0001, respectively). In the multivariate Cox proportional regression analysis, the CALLY index was the most statistically significant predictor of the risk of postoperative recurrence (p=0.0002). Conclusion In addition to the existing risk factors for RCC recurrence, such as sarcomatoid features and Fuhrman grade, we propose that the CALLY index is a predictor of postoperative recurrence and that patients with a low CALLY index are good candidates for postoperative treatment. Our study may help select patients with pT3 disease with a high risk of recurrence who require postoperative treatment.
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Affiliation(s)
- Hiroshi Hirata
- Department of Urology, Graduate School of Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Nakanori Fujii
- Department of Urology, Graduate School of Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Shintaro Oka
- Department of Urology, Graduate School of Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Kimihiko Nakamura
- Department of Urology, Graduate School of Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Kosuke Shimizu
- Department of Urology, Graduate School of Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Keita Kobayashi
- Department of Urology, Graduate School of Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Toshiya Hiroyoshi
- Department of Urology, Graduate School of Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Naohito Isoyama
- Department of Urology, Graduate School of Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Koji Shiraishi
- Department of Urology, Graduate School of Medicine, Yamaguchi University, Yamaguchi, Japan
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Kawahara S, Aoyama T, Murakawa M, Kanemoto R, Matsushita N, Hashimoto I, Kamiya M, Maezawa Y, Kobayashi S, Ueno M, Yamamoto N, Oshima T, Yukawa N, Saito A, Morinaga S. Clinical usefulness of C-reactive protein-albumin-lymphocyte (CALLY) index as a prognostic biomarker in patients undergoing surgical resection of pancreatic cancer. Langenbecks Arch Surg 2024; 409:317. [PMID: 39432010 DOI: 10.1007/s00423-024-03512-8] [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: 05/17/2024] [Accepted: 10/14/2024] [Indexed: 10/22/2024]
Abstract
PURPOSE The C-reactive protein-albumin-lymphocyte (CALLY) index, which simultaneously evaluates the nutritional, immunological, and inflammatory statuses, is a new prognostic biomarker in patients with various cancers; however, no study has reported the clinical significance of the CALLY index in patients with pancreatic cancer. This study aimed to investigate whether the preoperative CALLY index is a prognostic biomarker in patients undergoing surgical resection of pancreatic cancer. METHODS We retrospectively enrolled 461 patients with pancreatic cancer who underwent surgical resection between January 2013 and December 2022. The overall survival (OS) and relapse-free survival (RFS) rates were calculated using the Kaplan-Meier method. Univariate and multivariate analyses were performed using Cox proportional hazards regression models. RESULTS The optimal cut-off value for the preoperative CALLY index was 1.9. In the low CALLY group, patients were older (p = 0.012), more patients underwent pancreaticoduodenectomy (p = 0.002), the median tumor size was larger (p < 0.001), more patients had pathologically confirmed metastatic lymph nodes (p = 0.015) and worse pathological stage (p = 0.015), and fewer patients received adjuvant chemotherapy (p = 0.003). A low CALLY index was associated with decreased OS (22.1 vs. 37.9 months) and RFS (12.4 vs. 16.4 months). Univariate and multivariate analyses showed that the preoperative CALLY index was an independent prognostic factor for OS (p < 0.001) and RFS (p = 0.045). CONCLUSION The preoperative CALLY index is a prognostic biomarker for both OS and RFS in patients undergoing surgery for pancreatic cancer.
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Affiliation(s)
- Shinnosuke Kawahara
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-Ku, Yokohama, 241-8515, Japan.
| | - Toru Aoyama
- Department of Surgery, Yokohama City University, 3-9 Fukuura, Kanazawa-Ku, Yokohama, 236-0004, Japan
| | - Masaaki Murakawa
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-Ku, Yokohama, 241-8515, Japan
| | - Rei Kanemoto
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-Ku, Yokohama, 241-8515, Japan
| | - Naohiko Matsushita
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-Ku, Yokohama, 241-8515, Japan
| | - Itaru Hashimoto
- Department of Surgery, Yokohama City University, 3-9 Fukuura, Kanazawa-Ku, Yokohama, 236-0004, Japan
| | - Mariko Kamiya
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-Ku, Yokohama, 241-8515, Japan
| | - Yukio Maezawa
- Department of Surgery, Yokohama City University, 3-9 Fukuura, Kanazawa-Ku, Yokohama, 236-0004, Japan
| | - Satoshi Kobayashi
- Department of Gastroenterology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-Ku, Yokohama, 241-8515, Japan
| | - Makoto Ueno
- Department of Gastroenterology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-Ku, Yokohama, 241-8515, Japan
| | - Naoto Yamamoto
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-Ku, Yokohama, 241-8515, Japan
| | - Takashi Oshima
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-Ku, Yokohama, 241-8515, Japan
| | - Norio Yukawa
- Department of Surgery, Yokohama City University, 3-9 Fukuura, Kanazawa-Ku, Yokohama, 236-0004, Japan
| | - Aya Saito
- Department of Surgery, Yokohama City University, 3-9 Fukuura, Kanazawa-Ku, Yokohama, 236-0004, Japan
| | - Soichiro Morinaga
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-Ku, Yokohama, 241-8515, Japan
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Luo L, Li M, Xi Y, Hu J, Hu W. C-reactive protein-albumin-lymphocyte index as a feasible nutrition-immunity-inflammation marker of the outcome of all-cause and cardiovascular mortality in elderly. Clin Nutr ESPEN 2024; 63:346-353. [PMID: 38985666 DOI: 10.1016/j.clnesp.2024.06.054] [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: 01/19/2024] [Revised: 05/12/2024] [Accepted: 06/28/2024] [Indexed: 07/12/2024]
Abstract
BACKGROUND & AIMS The imbalance of nutrition-immunity-inflammation status might be associated with the mortality risk in the elderly. This study aimed to assess the relationship between the C-reactive protein (CRP)-albumin-lymphocyte (CALLY) index and all-cause and cardiovascular disease (CVD) mortality in the elderly. METHODS The data from records of older adults (≥ 60 years) were derived from 1999 to 2010 and 2015-2018 National Health and Nutrition Examination Survey. Weighted Cox proportional hazard regression was used to analyze the relationship between CALLY and all-cause mortality and CVD mortality in three different models, and the linear trend was analyzed. A restricted cubic spline model was used to evaluate the nonlinear dose-response relationship and determine the critical threshold of CALLY to divide the population into two groups. Kaplan-Meier analysis and log-rank test were used to evaluate the cumulative survival rates of different groups. Subgroup analyses and sensitivity analyses were performed to ensure robustness. RESULTS Compared to the first quartile of natural log-transformation (ln) CALLY, the highest quartile of ln CALLY was negatively correlated with the risk of all-cause mortality (HR = 0.67, 95% CI: 0.56-0.79. P < 0.05) and CVD mortality (HR = 0.65, 95% CI: 0.47-0.89. P < 0.05) in model 3. Ln CALLY was linear dose-response correlated with mortality. We determined that the critical threshold for ln CALLY in elderly was 1.00. Elderly with higher ln CALLY (≥ 1.00) had significantly increased survival rates (P < 0.05). CONCLUSION CALLY showed a significant negative linear association with the risk of all-cause mortality and CVD mortality, and higher CALLY was beneficial to the survival outcomes of the elderly.
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Affiliation(s)
- Ling Luo
- Department of Epidemiology and Medical Statistics, School of Public Health, Guangdong Medical University, Dongguan, Guangdong, 523808, China
| | - Mingzi Li
- Department of Epidemiology and Medical Statistics, School of Public Health, Guangdong Medical University, Dongguan, Guangdong, 523808, China
| | - Yue Xi
- Department of Epidemiology, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, 510275, China
| | - Jie Hu
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China.
| | - Wei Hu
- Department of Epidemiology, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, 510275, China.
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Yasuda S, Matsuo Y, Doi S, Sakata T, Nagai M, Nakamura K, Terai T, Kohara Y, Sho M. Preoperative predictors of very early recurrence in patients with hepatocellular carcinoma beyond the Milan criteria. Langenbecks Arch Surg 2024; 409:283. [PMID: 39292284 DOI: 10.1007/s00423-024-03474-x] [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: 05/29/2024] [Accepted: 09/08/2024] [Indexed: 09/19/2024]
Abstract
PURPOSE Hepatocellular carcinoma (HCC) patients beyond the Milan criteria (MC) who undergo liver resection have high recurrence rates and poor prognosis, and sometimes experience very early recurrence (VER) within six months after surgery. This study aimed to identify predictive factors, including the newly proposed C-reactive protein (CRP)-albumin-lymphocyte (CALLY) index, for VER after surgery for HCC beyond MC. METHODS We included patients who underwent initial liver resection for HCC beyond MC between 2000 and 2021. We defined VER as recurrence within six months after surgery and compared the clinicopathological factors and long-term prognosis between the VER and non-VER groups. Multivariate analysis identified risk factors for VER and evaluated the potential for prognostic stratification using these factors. RESULTS The overall survival (OS) and post-recurrence survival were significantly worse in the VER group compared to patients with recurrence in 7-12 months, over 12 months, and without recurrence (median survival time (MST) 1.16 vs. 5.14, 7.26, and undefined; and MST 0.81 vs. 4.34, and 5.48, respectively, P < 0.01). Alpha-fetoprotein (AFP) ≥ 200, non-simple nodule (SN) type on preoperative imaging, and CALLY index < 2.8 were independent prognostic factors (P < 0.01 for all). An increased risk factor count was correlated with poorer VER and OS rates, allowing for effective stratification. CONCLUSION VER after hepatic resection for HCC beyond MC was associated with a significantly poorer prognosis. AFP, non-SN type on imaging, and CALLY index are valuable preoperative indicators. Patients with multiple risk factors have a worse prognosis and may be candidates for multimodal treatment.
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Affiliation(s)
- Satoshi Yasuda
- Department of Surgery, Nara Medical University, 840 Shijo-cho Kashihara-shi, Nara, 634-8522, Japan.
| | - Yasuko Matsuo
- Department of Surgery, Nara Medical University, 840 Shijo-cho Kashihara-shi, Nara, 634-8522, Japan
| | - Shunsuke Doi
- Department of Surgery, Nara Medical University, 840 Shijo-cho Kashihara-shi, Nara, 634-8522, Japan
| | - Takeshi Sakata
- Department of Surgery, Nara Medical University, 840 Shijo-cho Kashihara-shi, Nara, 634-8522, Japan
| | - Minako Nagai
- Department of Surgery, Nara Medical University, 840 Shijo-cho Kashihara-shi, Nara, 634-8522, Japan
| | - Kota Nakamura
- Department of Surgery, Nara Medical University, 840 Shijo-cho Kashihara-shi, Nara, 634-8522, Japan
| | - Taichi Terai
- Department of Surgery, Nara Medical University, 840 Shijo-cho Kashihara-shi, Nara, 634-8522, Japan
| | - Yuichiro Kohara
- Department of Surgery, Nara Medical University, 840 Shijo-cho Kashihara-shi, Nara, 634-8522, Japan
| | - Masayuki Sho
- Department of Surgery, Nara Medical University, 840 Shijo-cho Kashihara-shi, Nara, 634-8522, Japan
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Tang X, Jin T, Zhang X, Tang X, Ding X. Clinical value of prognostic nutritional index combined with C-reactive protein and albumin in early prediction of anastomotic leakage after radical gastric cancer surgery. Am J Transl Res 2024; 16:3081-3089. [PMID: 39114734 PMCID: PMC11301467 DOI: 10.62347/ldoz1986] [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: 03/08/2024] [Accepted: 05/28/2024] [Indexed: 08/10/2024]
Abstract
OBJECTIVE To evaluate the predictive value of the Prognostic Nutritional Index (PNI) combined with C-reactive protein (CRP) and albumin (ALB) for anastomotic leakage following radical gastric cancer surgery. METHODS A retrospective case-control study was conducted with 275 gastric cancer patients at the Second People's Hospital of Lanzhou City from September 2019 to October 2022. Patients were categorized into an anastomotic leakage group (n=31) or a non-leakage group. Clinical, surgical, and pathological data were analyzed using logistic regression to develop two risk models: a combined clinical-laboratory index (RISK1) and a separate laboratory index (RISK2). Model effectiveness was compared using Receiver Operating Characteristic (ROC) curves. RESULTS Anastomotic leakage occurred in 11.27% of patients, predominantly in those with advanced TNM stages (P=0.006). Notably, higher operative times (P=0.049) and increased intraoperative bleeding (P=0.027) were associated with the leakage group. Significant differences in ALB, PNI, and CRP levels were observed between the groups. Both RISK1 and RISK2 identified ALB, CRP, PNI, operative time, and intraoperative bleeding as independent predictors of leakage, demonstrating high predictive accuracy (RISK1 AUC=0.937, RISK2 AUC=0.911), with no significant difference in performance between the models (P=0.245). CONCLUSION The combination of ALB, CRP, and PNI effectively predicts the risk of anastomotic leakage in patients undergoing gastric cancer surgery. These biomarkers can significantly enhance postoperative management and improve patient outcomes.
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Affiliation(s)
- Xiaodong Tang
- Department of General Surgery I, The Second People’s Hospital of Lanzhou CityNo. 388 Jingyuan Road, Chengguan District, Lanzhou 730046, Gansu, China
| | - Ting Jin
- Department of Digestive Endoscopy Center, The Second People’s Hospital of Lanzhou CityNo. 388 Jingyuan Road, Chengguan District, Lanzhou 730046, Gansu, China
| | - Xinhua Zhang
- Department of Gastroenterology, Xianyang First People’s HospitalNo. 10 Biyuan Road, Qindu District, Xianyang 712000, Shaanxi, China
| | - Xiuli Tang
- Department of Gastroenterology, Xianyang First People’s HospitalNo. 10 Biyuan Road, Qindu District, Xianyang 712000, Shaanxi, China
| | - Xiaolong Ding
- Department of Gastroenterology, Xianyang First People’s HospitalNo. 10 Biyuan Road, Qindu District, Xianyang 712000, Shaanxi, China
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Jiang T, Sun H, Xu T, Xue S, Xia W, Xiao X, Wang Y, Guo L, Lin H. Significance of Pre-Treatment CALLY Score Combined with EBV-DNA Levels for Prognostication in Non-Metastatic Nasopharyngeal Cancer Patients: A Clinical Perspective. J Inflamm Res 2024; 17:3353-3369. [PMID: 38803689 PMCID: PMC11129745 DOI: 10.2147/jir.s460109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 05/09/2024] [Indexed: 05/29/2024] Open
Abstract
Background The C-reactive protein-albumin-lymphocyte (CALLY) score is a novel indicator associated with inflammation, immunity, and nutrition, utilized for cancer prognostic stratification. This study aimed to evaluate the integrated prognostic significance of the pre-treatment CALLY score and Epstein-Barr virus (EBV) DNA levels in nasopharyngeal carcinoma (NPC) patients and to develop prognostic models. Patients and Methods A total of 1707 NPC patients from September 2015 to December 2017 were retrospectively enrolled. The cut-off point for the CALLY score, determined by maximum selected rank statistics, integrates with the published cut-off point for pre-EBV DNA to develop a comprehensive index. Subsequently, patients were randomly allocated in a 1:1 ratio into training and validation cohorts. Survival analysis was conducted using the Kaplan-Meier method with Log rank tests, and the Cox proportional hazards model was applied to identify independent prognostic factors for constructing predictive nomograms. The predictive ability of the nomograms were assessed through the concordance index (C-index), calibration curves, and decision curve analysis. Results By integrating CALLY scores and EBV-DNA levels, patients were categorized into three risk clusters. Kaplan-Meier curves reveal significant differences in overall survival (OS), distant metastasis-free survival (DMFS), and locoregional relapse-free survival (LRRFS) outcomes among different risk groups (all P values < 0.05). Multivariate analysis revealed that CALLY-EBV DNA index serves as an independent prognostic factor for the OS, DMFS, and LRRFS. The prognostic nomograms based on the CALLY-EBV DNA index provided accurate predictions for 1-year, 3-year, and 5-year OS, DMFS, and LRRFS. Additionally, compared to the traditional TNM staging system, the nomograms exhibited enhanced discriminatory power, calibration capability, and clinical applicability. All results were in agreement with the validation cohort. Conclusion The CALLY-EBV DNA index is an independent prognostic biomarker. The nomogram prediction models, constructed based on the CALLY-EBV DNA index, demonstrates superior predictive performance compared to the traditional TNM staging.
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Affiliation(s)
- Tongchao Jiang
- Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People’s Republic of China
| | - Haishuang Sun
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People’s Republic of China
| | - Tiankai Xu
- Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People’s Republic of China
| | - Shuyu Xue
- Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People’s Republic of China
| | - Wen Xia
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People’s Republic of China
| | - Xiang Xiao
- Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People’s Republic of China
| | - Ying Wang
- Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People’s Republic of China
| | - Ling Guo
- Department of Nasopharyngeal Carcinoma, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People’s Republic of China
| | - Huanxin Lin
- Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People’s Republic of China
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Li S, Che J, Gu B, Li Y, Han X, Sun T, Pan K, Lv J, Zhang S, Wang C, Zhang T, Wang J, Xue F. Metabolites, Healthy Lifestyle, and Polygenic Risk Score Associated with Upper Gastrointestinal Cancer: Findings from the UK Biobank Study. J Proteome Res 2024; 23:1679-1688. [PMID: 38546438 DOI: 10.1021/acs.jproteome.3c00827] [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] [Indexed: 05/04/2024]
Abstract
Previous metabolomics studies have highlighted the predictive value of metabolites on upper gastrointestinal (UGI) cancer, while most of them ignored the potential effects of lifestyle and genetic risk on plasma metabolites. This study aimed to evaluate the role of lifestyle and genetic risk in the metabolic mechanism of UGI cancer. Differential metabolites of UGI cancer were identified using partial least-squares discriminant analysis and the Wilcoxon test. Then, we calculated the healthy lifestyle index (HLI) score and polygenic risk score (PRS) and divided them into three groups, respectively. A total of 15 metabolites were identified as UGI-cancer-related differential metabolites. The metabolite model (AUC = 0.699) exhibited superior discrimination ability compared to those of the HLI model (AUC = 0.615) and the PRS model (AUC = 0.593). Moreover, subgroup analysis revealed that the metabolite model showed higher discrimination ability for individuals with unhealthy lifestyles compared to that with healthy individuals (AUC = 0.783 vs 0.684). Furthermore, in the genetic risk subgroup analysis, individuals with a genetic predisposition to UGI cancer exhibited the best discriminative performance in the metabolite model (AUC = 0.770). These findings demonstrated the clinical significance of metabolic biomarkers in UGI cancer discrimination, especially in individuals with unhealthy lifestyles and a high genetic risk.
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Affiliation(s)
- Shuting Li
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Jiajing Che
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Bingbing Gu
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Yunfei Li
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Xinyue Han
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Tiantian Sun
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Keyu Pan
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Jiali Lv
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Shuai Zhang
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Cheng Wang
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Tao Zhang
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Jialin Wang
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250117, China
| | - Fuzhong Xue
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
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