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Stares M, Brown LR, Abhi D, Phillips I. Prognostic Biomarkers of Systemic Inflammation in Non-Small Cell Lung Cancer: A Narrative Review of Challenges and Opportunities. Cancers (Basel) 2024; 16:1508. [PMID: 38672590 PMCID: PMC11048253 DOI: 10.3390/cancers16081508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 04/03/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
Non-small cell lung cancer (NSCLC) is a common malignancy and is associated with poor survival outcomes. Biomarkers of systemic inflammation derived from blood tests collected as part of routine clinical care offer prognostic information for patients with NSCLC that may assist clinical decision making. They are an attractive tool, as they are inexpensive, easily measured, and reproducible in a variety of healthcare settings. Despite the wealth of evidence available to support them, these inflammatory biomarkers are not yet routinely used in clinical practice. In this narrative review, the key inflammatory indices reported in the literature and their prognostic significance in NSCLC are described. Key challenges limiting their clinical application are highlighted, including the need to define the optimal biomarker of systemic inflammation, a lack of understanding of the systemic inflammatory landscape of NSCLC as a heterogenous disease, and the lack of clinical relevance in reported outcomes. These challenges may be overcome with standardised recording and reporting of inflammatory biomarkers, clinicopathological factors, and survival outcomes. This will require a collaborative approach, to which this field of research lends itself. This work may be aided by the rise of data-driven research, including the potential to utilise modern electronic patient records and advanced data-analysis techniques.
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Affiliation(s)
- Mark Stares
- Edinburgh Cancer Centre, NHS Lothian, Edinburgh EH4 2XU, UK
- Cancer Research UK Scotland Centre, University of Edinburgh, Edinburgh EH4 2XR, UK
| | - Leo R. Brown
- Cancer Research UK Scotland Centre, University of Edinburgh, Edinburgh EH4 2XR, UK
| | - Dhruv Abhi
- Edinburgh Cancer Centre, NHS Lothian, Edinburgh EH4 2XU, UK
| | - Iain Phillips
- Edinburgh Cancer Centre, NHS Lothian, Edinburgh EH4 2XU, UK
- Cancer Research UK Scotland Centre, University of Edinburgh, Edinburgh EH4 2XR, UK
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Lu Z, Fu S, Li W, Gao X, Wang J. Prognostic role of C-reactive protein to albumin ratio in lung cancer: An updated systematic review and meta-analysis. Chronic Dis Transl Med 2024; 10:31-39. [PMID: 38450307 PMCID: PMC10914016 DOI: 10.1002/cdt3.91] [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: 05/11/2023] [Revised: 06/18/2023] [Accepted: 07/24/2023] [Indexed: 03/08/2024] Open
Abstract
Background C-reactive protein to albumin ratio (CRP/Alb ratio, CAR) has been suggested as a potential prognostic biomarker in lung cancer. This updated systematic review and meta-analysis aimed to assess the association between CAR and lung cancer prognosis in current literature. Methods A systematic search of databases was conducted to identify relevant studies published up to April 2023. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated to assess the association between CAR and overall survival (OS) and progression-free survival (PFS) and recurrence-free survival (RF) in lung cancer patients. Results This meta-analysis includes 16 studies with a total of 5337 patients, indicating a significant association between higher CAR and poorer OS, PFS, and RFS in lung cancer patients, with a pooled HR of 1.78 (95% CI = 1.60-1.99), 1.57 (95% CI = 1.36-1.80), and 1.97 (95% CI = 1.40-2.77), respectively. Conclusions This updated meta-analysis provides evidence for the potential prognostic role of CAR in lung cancer, suggesting its utility as an effective and noninvasive biomarker for identifying high-risk patients and informing treatment decisions in a cost-effective manner. However, further large-scale studies will be necessary to establish the optimal cut-off value for CAR in lung cancer and confirm the present findings.
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Affiliation(s)
- Zhendong Lu
- Department of Medical Oncology, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing Chest HospitalCapital Medical UniversityBeijingChina
| | - Siyun Fu
- Department of Medical Oncology, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing Chest HospitalCapital Medical UniversityBeijingChina
| | - Wei Li
- Cancer Research Center, Beijing Chest Hospital, Beijing Tuberculosis and Thoracic Tumor Research InstituteCapital Medical UniversityBeijingChina
| | - Xiang Gao
- Department of Medical Oncology, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing Chest HospitalCapital Medical UniversityBeijingChina
| | - Jinghui Wang
- Department of Medical Oncology, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing Chest HospitalCapital Medical UniversityBeijingChina
- Cancer Research Center, Beijing Chest Hospital, Beijing Tuberculosis and Thoracic Tumor Research InstituteCapital Medical UniversityBeijingChina
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Akdag G, Alan Ö, Dogan A, Yildirim S, Kinikoglu O, Batu A, Kudu E, Geçmen GG, Isik D, Sever ON, Odabas H, Yildirim ME, Turan N. Prognostic scores in pulmonary large cell neuroendocrine carcinoma: A retrospective cohort study. Heliyon 2024; 10:e25029. [PMID: 38317875 PMCID: PMC10839983 DOI: 10.1016/j.heliyon.2024.e25029] [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: 10/29/2023] [Revised: 01/16/2024] [Accepted: 01/18/2024] [Indexed: 02/07/2024] Open
Abstract
Introduction Pulmonary large cell neuroendocrine carcinoma (PLCNEC) is a rare but aggressive subtype of lung cancer with an incidence of approximately 3 %. Identifying effective prognostic indicators is crucial for guiding treatments. This study examined the relationship between inflammatory markers and PLCNEC patient overall survival (OS) and sought to determine their prognostic significance in PLCNEC. Methods Patients diagnosed with PLCNEC between 2007 and 2022 at the oncology center, were retrospectively included. Patients who underwent surgery were pathologically re-staged post-surgery. Potential prognostic parameters (neutrophil/lymphocyte ratio, platelet/lymphocyte ratio [PLR], panimmune inflammatory value, prognostic nutritional index and modified Glasgow prognostic score [mGPS]) were calculated at that time of diagnosis. Results Sixty patients were included. The median follow-up was 23 months. Thirty-eight patients initially diagnosed with early or locally advanced. The mGPS was identified as a poor prognostic factor that influenced disease free survival (DFS) fourfold (p = 0.03). All patients' median OS was 45 months. Evaluating factors affecting OS in all patients, statistically significant relationships were observed between OS and the prognostic nutritional index (p = 0.001), neutrophil/lymphocyte ratio (p = 0.03), platelet/lymphocyte ratio (p = 0.002), and pan-immunoinflammatory value (p = 0.005). Upon multivariate analysis, the platelet/lymphocyte ratio was identified as an independent poor prognostic factor for OS, increasing the mortality risk by 5.4 times (p = 0.002). Conclusion mGPS was significantly linked with prognosis in non-metastatic PLCNEC, with patients with higher mGPS exhibiting poorer long-term DFS. This finding contributes to the evolving understanding of PLCNEC. The multivariable predictive model we employed suggests that PLR is an independent predictor of OS at all stages. A lower PLR was correlated with worse overall survival. Thus, PLR can be a readily accessible and cost-effective prognostic factor in PLCNEC patients.
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Affiliation(s)
- Goncagul Akdag
- Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, Istanbul, Turkey
| | - Özkan Alan
- Division of Medical Oncology, School of Medicine, Koç University, Istanbul, Turkey
| | - Akif Dogan
- Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, Istanbul, Turkey
| | - Sedat Yildirim
- Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, Istanbul, Turkey
| | - Oguzcan Kinikoglu
- Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, Istanbul, Turkey
| | - Aziz Batu
- Division of Medical Oncology, Department of Internal Medicine, Ümraniye Research and Training Hospital, Istanbul, Turkey
| | - Emre Kudu
- Department of Emergency Medicine, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey
| | - Gonca Gül Geçmen
- Department of Pathology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, Istanbul, Turkey
| | - Deniz Isik
- Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, Istanbul, Turkey
| | - Ozlem Nuray Sever
- Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, Istanbul, Turkey
| | - Hatice Odabas
- Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, Istanbul, Turkey
| | - Mahmut Emre Yildirim
- Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, Istanbul, Turkey
| | - Nedim Turan
- Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, Istanbul, Turkey
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Gui L, Cheng M, Zheng M, Ning C, Huo Q. Effects of omega-3 fatty acid supplementation on nutritional status and inflammatory response in patients with stage II-III NSCLC undergoing postoperative chemotherapy: a double-blind randomized controlled trial. Front Nutr 2023; 10:1266584. [PMID: 37964929 PMCID: PMC10641022 DOI: 10.3389/fnut.2023.1266584] [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: 07/25/2023] [Accepted: 10/12/2023] [Indexed: 11/16/2023] Open
Abstract
Background The primary objective of this study was to investigate the effects of oral omega-3 fatty acids in lowering the risk of malnutrition and improving the inflammatory response in patients with stage II-III lung cancer receiving postoperative chemotherapy. Methods One hundred and three lung cancer patients identified as being at risk for malnutrition according to the 2002 nutritional risk screening criteria were randomized into either the omega-3 fatty acid supplementation group or the placebo group during postoperative chemotherapy. Data on anthropometric parameters, laboratory nutritional indicators, and inflammatory markers were collected, and changes and differences between the two groups were compared and analyzed. Results Sixty three patients were included in the final analysis. The baseline information of the two groups of patients was comparable (p > 0.05). After 12 weeks, patients in the treatment group exhibited significantly higher levels of hemoglobin (11.26 ± 1.25 vs.10.60 ± 0.94, p = 0.021) and serum albumin (45.38 ± 5.06 vs.42.66 ± 5.06, p = 0.036) compared with those in the placebo group. Meanwhile, the levels of inflammatory factors C-reactive protein (2.16 ± 1.06 vs. 4.11 ± 1.72, p < 0.001), interleukin-1 (6.61 ± 2.19 vs.10.85 ± 3.61, p < 0.001), interleukin-6 (2.48 ± 1.20 vs. 4.53 ± 0.98, p < 0.001), interleukin-8 (9.26 ± 2.69 vs. 39.01 ± 6.53, p < 0.001), and tumor necrosis factor-α (1.88 ± 0.60 vs. 4.07 ± 0.97, p < 0.001) were significantly decreased in the treatment group. In contrast, differences in weight, BMI, upper arm circumference, triceps skinfold thickness, triglycerides, cholesterol, and IFN-γ between the two groups were not statistically significant (p > 0.05). Finally, in the treatment group, the levels of hemoglobin (10.89 ± 1.15 vs. 11.82 ± 1.21, p = 0.042), triglyceride (0.92 ± 0.29 vs. 1.03 ± 0.22, p = 0.043), and cholesterol (3.56 ± 0.82 vs. 4.23 ± 0.88, p = 0.045) were higher in stage II patients after the intervention compared with stage III patients. Conclusion Supplementation with omega-3 fatty acids improved nutritional status and reduced chronic inflammatory responses in patients with stage II-III non-small cell lung cancer undergoing postoperative chemotherapy. Clinical Trial Registration AEA RCT Registry, identifier AEARCTR-0007165.
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Affiliation(s)
- Long Gui
- Department of Cardiothoracic Surgery, Lu’an Hospital Affiliated to Anhui Medical University, Lu’an, China
- Department of Cardiothoracic Surgery, Lu’an People’s Hospital, Lu’an, China
| | - Mingjin Cheng
- Department of Cardiothoracic Surgery, Lu’an Hospital Affiliated to Anhui Medical University, Lu’an, China
- Department of Cardiothoracic Surgery, Lu’an People’s Hospital, Lu’an, China
| | - Min Zheng
- Department of Cardiothoracic Surgery, Lu’an Hospital Affiliated to Anhui Medical University, Lu’an, China
- Department of Cardiothoracic Surgery, Lu’an People’s Hospital, Lu’an, China
- Department of Nursing, Lu’an Hospital Affiliated to Anhui Medical University, Lu’an, China
| | - Chengdong Ning
- Department of Cardiothoracic Surgery, Lu’an Hospital Affiliated to Anhui Medical University, Lu’an, China
- Department of Cardiothoracic Surgery, Lu’an People’s Hospital, Lu’an, China
| | - Qianlun Huo
- Department of Cardiothoracic Surgery, Lu’an Hospital Affiliated to Anhui Medical University, Lu’an, China
- Department of Cardiothoracic Surgery, Lu’an People’s Hospital, Lu’an, China
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Shen S, Xiao Y. Association Between C-Reactive Protein and Albumin Ratios and Risk of Mortality in Patients with Chronic Obstructive Pulmonary Disease. Int J Chron Obstruct Pulmon Dis 2023; 18:2289-2303. [PMID: 37873518 PMCID: PMC10590598 DOI: 10.2147/copd.s413912] [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: 03/23/2023] [Accepted: 09/14/2023] [Indexed: 10/25/2023] Open
Abstract
Purpose This study was to evaluate the association between C-reactive protein (CRP) to albumin (ALB) ratio (CAR) and the risk of mortality in patients with chronic obstructive pulmonary disease (COPD). Methods In this retrospective cohort study, clinical data were extracted from the National Institutes of Health National Health and Nutrition Examination Survey (NHANES) database between 2007 and 2010. Cox proportional hazard regressions were performed to assess the association between CAR and 5-year mortality in COPD patients. Subgroup analyses were applied to identify the consistency of the association based on the severity of COPD, gender, body mass index (BMI), smoking status, cardiovascular disease (CVD), and chronic kidney disease (CKD), and diabetes. The area under the curve (AUC) of the receiver operator characteristic (ROC) curve analysis was used to evaluate the predictive performance of CAR. Results A total of 1210 COPD patients were included, of which 110 COPD patients (9.09%) had 5-year mortality. The mean follow-up was 57.76 (0.33) months. A higher CAR was associated with an increased risk of 5-year mortality in COPD patients [hazard ratio (HR): 1.94, 95% confidence interval (CI): 1.07 to 3.50, P =0.029)]. Subgroup analysis showed that the association between CAR and mortality was especially suitable for COPD patients with mild COPD, in COPD patients who were still smoking, in COPD patients with BMI <=29.9 kg/m2, in COPD patients who were without CVD, in COPD patients who were without diabetes, and COPD patients who were without CKD. The AUCs of CAR for predicting 1-year, 3-year, and 5-year mortality in COPD patients were 0.735, 0.615, and 0.608, respectively. Conclusion CAR is strongly correlated with mortality in patients with COPD and CAR could be served as a prognostic biomarker for patients with COPD. This study may provide a promising prognostic biomarker for risk stratification and clinical management of patients with COPD.
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Affiliation(s)
- Shenghua Shen
- Department of Pulmonary and Critical Care Medicine, The Affiliated Changzhou Second People’s Hospital of Nanjing Medical University, Changzhou, Jiangsu, 213004, People’s Republic of China
| | - Yuan Xiao
- Department of Pulmonary and Critical Care Medicine, The Affiliated Changzhou Second People’s Hospital of Nanjing Medical University, Changzhou, Jiangsu, 213004, People’s Republic of China
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Tanimura K, Takeda T, Yoshimura A, Honda R, Goda S, Shiotsu S, Fukui M, Chihara Y, Uryu K, Takei S, Katayama Y, Hibino M, Yamada T, Takayama K. Predictive Value of Modified Glasgow Prognostic Score and Persistent Inflammation among Patients with Non-Small Cell Lung Cancer Treated with Durvalumab Consolidation after Chemoradiotherapy: A Multicenter Retrospective Study. Cancers (Basel) 2023; 15:4358. [PMID: 37686634 PMCID: PMC10486354 DOI: 10.3390/cancers15174358] [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: 07/01/2023] [Revised: 08/23/2023] [Accepted: 08/28/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Durvalumab consolidation after chemoradiotherapy (CRT) is a standard treatment for locally advanced non-small cell lung cancer (NSCLC). However, studies on immunological and nutritional markers to predict progression-free survival (PFS) and overall survival (OS) are inadequate. Systemic inflammation causes cancer cachexia and negatively affects immunotherapy efficacy, which also reflects survival outcomes. PATIENTS AND METHODS We retrospectively investigated 126 patients from seven institutes in Japan. RESULTS The modified Glasgow Prognostic Score (mGPS) values, before and after CRT, were the essential predictors among the evaluated indices. A systemic inflammation-based prognostic risk classification was created by combining mGPS values before CRT, and C-reactive protein (CRP) levels after CRT, to distinguish tumor-derived inflammation from CRT-induced inflammation. Patients were classified into high-risk (n = 31) and low-risk (n = 95) groups, and the high-risk group had a significantly shorter median PFS of 7.2 months and an OS of 19.6 months compared with the low-risk group. The hazard ratios for PFS and OS were 2.47 (95% confidence interval [CI]: 1.46-4.19, p < 0.001) and 3.62 (95% CI: 1.79-7.33, p < 0.001), respectively. This association was also observed in the subgroup with programmed cell death ligand 1 expression of ≥50%, but not in the <50% subgroup. Furthermore, durvalumab discontinuation was observed more frequently in the high-risk group than in the low-risk group. CONCLUSION Combining pre-CRT mGPS values with post-CRT CRP levels in patients with locally advanced NSCLC helps to predict the PFS and OS of durvalumab consolidation after CRT.
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Affiliation(s)
- Keiko Tanimura
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daini Hospital, Kyoto 602-8026, Japan; (K.T.); (A.Y.)
| | - Takayuki Takeda
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daini Hospital, Kyoto 602-8026, Japan; (K.T.); (A.Y.)
| | - Akihiro Yoshimura
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daini Hospital, Kyoto 602-8026, Japan; (K.T.); (A.Y.)
| | - Ryoichi Honda
- Department of Respiratory Medicine, Asahi General Hospital, Asahi 289-2511, Japan;
| | - Shiho Goda
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto 605-0981, Japan; (S.G.); (S.S.)
| | - Shinsuke Shiotsu
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto 605-0981, Japan; (S.G.); (S.S.)
| | - Mototaka Fukui
- Department of Respiratory Medicine, Uji-Tokushukai Medical Center, Uji 611-0041, Japan; (M.F.); (Y.C.)
| | - Yusuke Chihara
- Department of Respiratory Medicine, Uji-Tokushukai Medical Center, Uji 611-0041, Japan; (M.F.); (Y.C.)
| | - Kiyoaki Uryu
- Department of Respiratory Medicine, Yao Tokushukai General Hospital, Yao 581-0011, Japan;
| | - Shota Takei
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (S.T.); (Y.K.); (T.Y.); (K.T.)
| | - Yuki Katayama
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (S.T.); (Y.K.); (T.Y.); (K.T.)
| | - Makoto Hibino
- Department of Respiratory Medicine, Shonan Fujisawa Tokushukai Hospital, Fujisawa 251-0041, Japan;
| | - Tadaaki Yamada
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (S.T.); (Y.K.); (T.Y.); (K.T.)
| | - Koichi Takayama
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (S.T.); (Y.K.); (T.Y.); (K.T.)
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The prognostic role of C-reactive protein to albumin ratio and anti-MDA5 antibody-positive in idiopathic inflammatory myopathy: a retrospective study. Sci Rep 2023; 13:3863. [PMID: 36890164 PMCID: PMC9992913 DOI: 10.1038/s41598-023-30595-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 02/27/2023] [Indexed: 03/10/2023] Open
Abstract
This cohort study aimed to identify the characteristics and risk factors of adult idiopathic inflammatory myopathy-associated interstitial lung disease (IIM-ILD) and further explore the prognostic factors of IIM-ILD. We extracted data regarding 539 patients with laboratory-confirmed idiopathic inflammatory myopathy (IIM) with or without interstitial lung disease (ILD) from the Second Xiangya Hospital of Central South University between January 2016 and December 2021. The regression analysis was conducted to identify the possible risk factors for ILD as well as mortality. Of 539 IIM patients, 343 (64.6%) were diagnosed with IIM-ILD. The median (IQR) baseline neutrophil-to-lymphocyte ratio (NLR), C-reactive protein to albumin ratio (CAR) and ferritin were 4.1371 (2.6994-6.8143), 0.1685 (0.0641-0.5456) and 393.6 (210.6-532.2), respectively. Risk factors associated with IIM-ILD were older age (p = 0.002), arthralgia (p = 0.014), lung infection (p = 0.027), hemoglobin (p = 0.022), high CAR (p = 0.014), anti-aminoacyl-tRNA synthetase (anti-ARS) antibody-positive (p < 0.001), and anti-MDA5 antibody-positive (p < 0.001). The IIM-ILD patients whose age at diagnosis of disease ≥ 59.5 (HR = 2.673, 95% CI 1.588-4.499, p < 0.001), NLR ≥ 6.6109 (HR = 2.004, 95% CI 1.193-3.368, p = 0.009), CAR ≥ 0.2506 (HR = 1.864, 95% CI 1.041-3.339, p = 0.036), ferritin ≥ 397.68 (HR = 2.451, 95% CI 1.245-4.827, p = 0.009) and anti-MDA5 antibody-positive (HR = 1.928, 95% CI 1.123-3.309, p = 0.017) had a higher mortality rate. High CAR and anti-MDA5 antibody-positive are more likely to be associated with a high mortality rate of IIM-ILD, which can be used as serum biomarkers, especially the CAR, a simple, objective tool to assess the prognosis of IIM.
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Yang C, Ren G, Yang Q. Prognostic value of preoperative modified Glasgow prognostic score in surgical non-small cell lung cancer: A meta-analysis. Front Surg 2023; 9:1094973. [PMID: 36700011 PMCID: PMC9869682 DOI: 10.3389/fsurg.2022.1094973] [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: 11/10/2022] [Accepted: 12/09/2022] [Indexed: 01/11/2023] Open
Abstract
Background and purpose The predictive role of modified Glasgow prognostic score (mGPS) for long-term survival in several types of cancers has been well manifested. We supposed that preoperative mGPS might also be associated with long-term survival of operated non-small cell lung cancer (NSCLC) patients. The aim of this meta-analysis was to identify the prognostic value of preoperative mGPS in surgical NSCLC patients. Methods The PubMed, Web of Science, EMBASE and CNKI databases were searched for relevant studies up to November 7, 2022. The primary and secondary outcomes were overall survival (OS) and disease-free survival (DFS), respectively. The hazard ratios (HRs) and 95% confidence intervals (CIs) were combined. Results A total of 3,803 patients from 11 studies were enrolled and analyzed. The combined results demonstrated elevated preoperative mGPS was significantly related to poorer OS (HR = 2.11, 95% CI: 1.83-2.44, P < 0.001) and DFS (HR = 1.70, 95% CI: 1.42-2.03, P < 0.001). Subgroup analysis for the OS further identified the predictive role of elevated preoperative mGPS for worse OS in NSCLC. Conclusion Preoperative mGPS was significantly associated with prognosis in NSCLC and patients with elevated preoperative mGPS experienced poorer long-term survival.
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Affiliation(s)
- Chenli Yang
- Department of Cardiothoracic Surgery, Gansu Provincial Hospital of TCM, Lanzhou, China
| | - Guangshu Ren
- Department of Thoracic Surgery, The 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Lanzhou, China
| | - Qingqing Yang
- Department of Traditional Chinese Medicine, Gaolan Country People’s Hospital, Lanzhou, China,Correspondence: Qingqing Yang
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Yu Q, Weng W, Luo H, Yan J, Zhao X. The Novel Predictive Biomarkers for Type 2 Diabetes Mellitus in Active Pulmonary Tuberculosis Patients. Infect Drug Resist 2022; 15:4529-4539. [PMID: 35992755 PMCID: PMC9384973 DOI: 10.2147/idr.s377465] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 08/04/2022] [Indexed: 11/30/2022] Open
Abstract
Purpose This study was to explore the predictive value of monocyte to high-density lipoprotein cholesterol ratio (MHR), neutrophils to high-density lipoprotein cholesterol ratio (NHR), C-reactive protein-to-lymphocyte ratio (CLR), and C-reactive protein-to-albumin ratio (CAR) for type 2 diabetes mellitus (T2DM) in patients with active pulmonary tuberculosis (APTB). Patients and Methods A total of 991 active pulmonary tuberculosis (APTB) patients (201 with T2DM) were hospitalized in the Department of Tuberculosis, Wuhan Jinyintan Hospital, Tongji Medical College, Huazhong University of Science and Technology were included. The routine blood examination indicators and biochemical parameters were collected to calculate MHR, NHR, CLR, and CAR. The Pearson correlation analysis, Univariate Logistic regression analysis, and receiver operating characteristic (ROC) curve analysis were performed to assess the predictive value of MHR, NHR, CLR, and CAR for APTB-T2DM patients. Results The levels of MHR, NHR, CLR, and CAR in the APTB-T2DM patients were significantly higher than in the APTB-no T2DM patients (P < 0.05). Additionally, the MHR, NHR, CLR, and CAR have a positive correlation with fasting blood glucose in the whole study population. However, in the APTB-T2DM patients, MHR, NHR, and CAR were not correlated with fasting blood glucose, and only CLR was positively correlated with fasting blood glucose. The area under curve (AUC) predicting APTB-T2DM patients of the MHR, NHR, CLR, and CAR was 0.632, 0.72, 0.715, and 0.713, respectively. Further, univariate logistic regression analyses showed that the higher MHR, NHR, CLR, and CAR were independent risk factors for APTB-T2DM (P < 0.01). The MHR, NHR, CLR, and CAR quartiles were used to divide the APTB patients into four groups for further analysis. The prevalence of T2DM was significantly higher in APTB individuals as MHR, NHR, CLR, and CAR values increased (P < 0.05). Conclusion MHR, NHR, CLR, and CAR are simple and practicable inflammatory parameters that could be used for assessing T2DM in APTB. APTB patients have a greater possibility to be diagnosed with T2DM with the higher MHR, NHR CLR, and CAR values. Therefore, more attention should be given to the indicator in the examination of APTB.
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Affiliation(s)
- Qi Yu
- Department of Infectious Diseases, Wuhan Jinyintan Hospital, Tongji Medical College of Huazhong University of Science and Technology; Hubei Clinical Research Center for Infectious Diseases; Wuhan Research Center for Communicable Disease Diagnosis and Treatment, Chinese Academy of Medical Sciences; Joint Laboratory of Infectious Diseases and Health, Wuhan Institute of Virology and Wuhan Jinyintan Hospital, Chinese Academy of Sciences, Wuhan, 430023, People's Republic of China
| | - Wujin Weng
- Department of Oncology, Quzhou Hospital of Traditional Chinese Medicine, Zhejiang University of Chinese Medicine, Quzhou, 310053, People's Republic of China
| | - Hong Luo
- Department of Respiratory and Critical Care Medicine, Wuhan Jinyintan Hospital, Tongji Medical College of Huazhong University of Science and Technology; Hubei Clinical Research Center for Infectious Diseases; Wuhan Research Center for Communicable Disease Diagnosis and Treatment, Chinese Academy of Medical Sciences; Joint Laboratory of Infectious Diseases and Health, Wuhan Institute of Virology and Wuhan Jinyintan Hospital, Chinese Academy of Sciences, Wuhan, 430023, People's Republic of China
| | - Jisong Yan
- Department of Respiratory and Critical Care Medicine, Wuhan Jinyintan Hospital, Tongji Medical College of Huazhong University of Science and Technology; Hubei Clinical Research Center for Infectious Diseases; Wuhan Research Center for Communicable Disease Diagnosis and Treatment, Chinese Academy of Medical Sciences; Joint Laboratory of Infectious Diseases and Health, Wuhan Institute of Virology and Wuhan Jinyintan Hospital, Chinese Academy of Sciences, Wuhan, 430023, People's Republic of China
| | - Xin Zhao
- Department of Pediatrics, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510799, People's Republic of China
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Pu Q, Yu L, Wang X, Yan H, Xie Y, Du J, Yang Z. Establishment of Nomogram Model for Minimally Invasive Treatment of Small Hepatocellular Carcinoma Based on CD8+T Cell Counts. Onco Targets Ther 2022; 15:925-940. [PMID: 36068914 PMCID: PMC9441171 DOI: 10.2147/ott.s373631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 08/22/2022] [Indexed: 01/08/2023] Open
Abstract
Purpose Minimally invasive treatment of small hepatocellular carcinoma (HCC) is the main way of treatment, which can cause the change of HCC immune microenvironment. T lymphocytes are an important part of the immune microenvironment and may be powerful predictors of prognosis. The purpose of this study was to explore the effect of T lymphocytes on the prognosis of HCC and establish a prognostic model. Patients and Methods We conducted a retrospective study of 300 patients with small HCC and developed a clinical prediction model. The selection of modeling variables was performed by combining backward stepwise Cox regression using Akaike’s Information Criteria (AIC) and the Least Absolute Shrinkage and Selection Operator (LASSO) regression. Establish a dynamic nomogram model to predict 1-, 2-, and 3-year overall survival (OS). Receiver operating characteristic curve (ROC curve) was used to verify the model discriminative ability, calibration curve was used to examine the model calibration ability, and decision curve analysis (DCA) was used to evaluate the clinical value. Results The nomogram to predict the OS of small HCC includes the following four variables: aspartate aminotransferase (AST), alpha fetoprotein (AFP), C-reactive protein (CRP) and CD8+T cell counts, represented liver function index, tumor-related index, Inflammatory index and immune-related index, respectively. The area under the receiver operating characteristic curves (AUC) of predicting 1-, 2-, and 3-year overall survival were 0.846, 0.824 and 0.812, and the model was excellent in discrimination, calibration and clinical applicability. Conclusion Our study provides a nomogram based on CD8+T cell counts that can help predict the prognosis of small HCC after minimally invasive treatment, which suggests that T lymphocytes can be used as a prognostic factor for HCC. Larger trials are needed to verify our results.
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Affiliation(s)
- Qing Pu
- Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People’s Republic of China
| | - Lihua Yu
- Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People’s Republic of China
| | - Xinhui Wang
- Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People’s Republic of China
| | - Huiwen Yan
- Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People’s Republic of China
| | - Yuqing Xie
- Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People’s Republic of China
| | - Juan Du
- Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People’s Republic of China
- Correspondence: Juan Du, Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People’s Republic of China, Email
| | - Zhiyun Yang
- Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People’s Republic of China
- Zhiyun Yang, Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People’s Republic of China, Tel/Fax +86-10-84322148, Email
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