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Lee J, Yoo S, Choo MS, Cho MC, Son H, Jeong H. Prognostic Role of Preoperative Neutrophil-To-Lymphocyte Ratio (NLR) and Recurrence at First Evaluation after Bacillus Calmette-Guérin (BCG) Induction in Non-Muscle-Invasive Bladder Cancer. Diagnostics (Basel) 2023; 13:3114. [PMID: 37835857 PMCID: PMC10572862 DOI: 10.3390/diagnostics13193114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 09/14/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023] Open
Abstract
We investigated the prognosis of BCG induction-only treatment and non-complete response (CR) at the first 3-month evaluation and examined factors associated with CR. In total, 209 patients with moderate- and high-risk NMIBC who received BCG induction-only treatment between 2008 and 2020 were retrospectively analyzed. Recurrence-free survival (RFS) and progression-free survival (PFS) were assessed based on the initial NMIBC stage. PFS and associated factors of non-CR compared to CR were also assessed. Initial T1 high-grade (HG) (n = 93) had poorer RFS and PFS after BCG induction-only treatment than Ta low-grade (LG) (p = 0.029, p = 0.002). Non-CR (n = 37) had a different neutrophil-to-lymphocyte ratio (NLR) (2.81 ± 1.02 vs. 1.97 ± 0.92) and T staging from CR (p < 0.001, p = 0.008). T1HG recurrence was associated with a worse PFS compared to non-T1HG (13.7 months vs. 101.7 months, p < 0.001). There was no difference in PFS between T1HG and T1LG. T1 and NLR were predictors of response at 3 months in multivariable analysis (p = 0.004, p = 0.029). NLR was also found to be an associated factor with RFS and PFS of bladder cancer (p < 0.001, p < 0.001). BCG induction-only treatment was effective for high-risk TaLG but not for T1HG. T1HG recurrence at 3 months after BCG induction has a poor prognosis for bladder cancer. Preoperative NLR and T1 were predictors of non-CR, and NLR was also associated with the long-term prognosis of bladder cancer.
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Affiliation(s)
- Junghoon Lee
- Department of Urology, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Seoul National University College of Medicine, Seoul 07061, Republic of Korea; (J.L.)
| | - Sangjun Yoo
- Department of Urology, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Seoul National University College of Medicine, Seoul 07061, Republic of Korea; (J.L.)
| | - Min Soo Choo
- Department of Urology, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Seoul National University College of Medicine, Seoul 07061, Republic of Korea; (J.L.)
| | - Min Chul Cho
- Department of Urology, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Seoul National University College of Medicine, Seoul 07061, Republic of Korea; (J.L.)
| | - Hwancheol Son
- Department of Urology, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Seoul National University College of Medicine, Seoul 07061, Republic of Korea; (J.L.)
- Institute for Peace and Unification Studies, Seoul National University, Seoul 08826, Republic of Korea
| | - Hyeon Jeong
- Department of Urology, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Seoul National University College of Medicine, Seoul 07061, Republic of Korea; (J.L.)
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Siempis T, Georgalis PA, Lianos G, Kafritsas G, Metaxas D, Alexiou ES, Zika J, Sotiropoulos A, Alexiou GA, Voulgaris S. Blood Biomarkers for Prediction of Positive CT Findings in Mild Traumatic Brain Injury in Paediatric Population. J Integr Neurosci 2023; 22:91. [PMID: 37519178 DOI: 10.31083/j.jin2204091] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 04/16/2023] [Accepted: 04/20/2023] [Indexed: 08/01/2023] Open
Abstract
BACKGROUND Paediatric Traumatic Brain Injury (TBI) has received less research attention compared to TBI in adults, despite its potential morbidity in all ages. Our aim was to determine whether neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and glucose levels at admission can reliably predict the need for imaging in children presenting with mild TBI. METHODS We retrospectively reviewed the clinical records of paediatric patients who presented in the emergency department with mild TBI within a 5 year period and had undergone computed tomography (CT) scan of the head. RESULTS Overall, 43 eligible patients were included in the study, with falls being the most commonly reported cause of injury. Twenty-three children had positive CT findings. Patients with abnormal CT findings were found to have higher NLR ratios compated with patients with normal CT, with the mean NLR on admission being 5.2 ± 3.8. Children with abnormal CT findings had lower PLR levels and higher glucose levels at presentation compared to children with normal CT, however the differences were not statistically significant. Using the receiver operating characteristic (ROC) curve, we found that a NLR cut off value of 6.1 yielded a sensitivity of 54.2% and a specificity of 89.5% for the prediction of abnormal CT findings. CONCLUSIONS The findings of this study suggest that NLR may have a role in CT decision-making in the emergency department for mild TBI in paediatric patients.
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Affiliation(s)
- Timoleon Siempis
- Department of Neurosurgery, University Hospital of Ioannina, 45500 Ioannina, Greece
| | - Pavlos A Georgalis
- Department of Neurosurgery, University Hospital of Ioannina, 45500 Ioannina, Greece
| | - Georgios Lianos
- Department of Surgery, University Hospital of Ioannina, 45500 Ioannina, Greece
| | - Georgios Kafritsas
- Department of Neurosurgery, University Hospital of Ioannina, 45500 Ioannina, Greece
| | - Dimitrios Metaxas
- Department of Neurosurgery, University Hospital of Ioannina, 45500 Ioannina, Greece
| | | | - Jiolanda Zika
- Department of Neurosurgery, University Hospital of Ioannina, 45500 Ioannina, Greece
| | | | - George A Alexiou
- Department of Neurosurgery, University Hospital of Ioannina, 45500 Ioannina, Greece
| | - Spyridon Voulgaris
- Department of Neurosurgery, University Hospital of Ioannina, 45500 Ioannina, Greece
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Ma A, Zhang L, Ye X, Chen J, Yu J, Zhuang L, Weng C, Petersen F, Wang Z, Yu X. High Levels of Circulating IL-8 and Soluble IL-2R Are Associated With Prolonged Illness in Patients With Severe COVID-19. Front Immunol 2021; 12:626235. [PMID: 33584733 PMCID: PMC7878368 DOI: 10.3389/fimmu.2021.626235] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 01/04/2021] [Indexed: 01/10/2023] Open
Abstract
Objectives The coordinated immune response of the host is the key of the successful combat of the body against SARS-CoV-2 infection and is decisive for the development and progression of COVID-19. In this study, we aimed to investigate whether the immunological phenotype of patients are associated with duration of illness in patients with severe COVID-19. Method In this single-center study, 69 patients with severe or critical COVID-19 were recruited retrospectively. Immunological parameters including counts of white blood cells, neutrophils, lymphocytes, the neutrophil-to-lymphocyte ratio, and levels of circulating cytokines and cytokine receptors were screened for their association with disease severity, survival and duration of illness of COVID-19. Results Our data confirmed previous results that neutrophil-to-lymphocyte ratio and circulating levels of IL-6 represent prominent biomarker for the prediction of disease severity and survival of COVID-19. However, this study shows for the first time that duration of illness in patients with severe COVID-19 is positively associated with serum levels of IL-8 (P=0.004) and soluble IL-2Rα (P=0.025). Conclusion The significant association of duration of illness with circulating levels of IL-8 and soluble IL-2Rα in patients with severe COVID-19 implicates that neutrophils and T cells are involved in the evolution of COVID-19.
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Affiliation(s)
- Aiping Ma
- Department of Respiratory and Critical Medicine, The First Affiliated Hospital, School of Medicine, Xiamen University, Xiamen, China
| | - Liang Zhang
- Priority Area Asthma & Allergy, Research Center Borstel, Airway Research Center North (ARCN), Members of the German Center for Lung Research (DZL), Borstel, Germany
| | - Xiaokai Ye
- Department of Respiratory and Critical Medicine, Xiamen Haicang Hospital, Xiamen, China
| | - Jing Chen
- Department of Critical Care Medicine, The First Affiliated Hospital, School of Medicine, Xiamen University, Xiamen, China
| | - Jie Yu
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liangjin Zhuang
- Division of Quality Management, The First Affiliated Hospital, School of Medicine, Xiamen University, Xiamen, China
| | - Chaohang Weng
- Department of Respiratory and Critical Medicine, Xiamen Haicang Hospital, Xiamen, China
| | - Frank Petersen
- Priority Area Asthma & Allergy, Research Center Borstel, Airway Research Center North (ARCN), Members of the German Center for Lung Research (DZL), Borstel, Germany
| | - Zhanxiang Wang
- Department of Neurosurgery, The First Affiliated Hospital, School of Medicine, Xiamen University, Xiamen, China
| | - Xinhua Yu
- Priority Area Asthma & Allergy, Research Center Borstel, Airway Research Center North (ARCN), Members of the German Center for Lung Research (DZL), Borstel, Germany
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Ferro M, Di Lorenzo G, Buonerba C, Lucarelli G, Russo GI, Cantiello F, Farhan ARA, Di Stasi S, Musi G, Hurle R, Vincenzo S, Busetto GM, De Berardinis E, Perdonà S, Borghesi M, Schiavina R, Almeida GL, Bove P, Lima E, Grimaldi G, Matei DV, Mistretta FA, Crisan N, Terracciano D, Paolo V, Battaglia M, Guazzoni G, Autorino R, Morgia G, Damiano R, Muto M, Rocca RL, Mirone V, de Cobelli O, Vartolomei MD. Predictors of Residual T1 High Grade on Re-Transurethral Resection in a Large Multi-Institutional Cohort of Patients with Primary T1 High-Grade/Grade 3 Bladder Cancer. J Cancer 2018; 9:4250-4254. [PMID: 30519326 PMCID: PMC6277616 DOI: 10.7150/jca.26129] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Accepted: 09/09/2018] [Indexed: 12/21/2022] Open
Abstract
The aim of this multi-institutional study was to identify predictors of residual high-grade (HG) disease at re-transurethral resection (reTUR) in a large cohort of primary T1 HG/Grade 3 (G3) bladder cancer patients. A total of 1155 patients with primary T1 HG/G3 bladder cancer from 13 academic institutions that underwent a reTUR within 6 weeks after first TUR were evaluated. Logistic regression analysis was performed to assess the association of predictive factors with residual HG at reTUR. Residual HG cancer was found in 288 (24.9%) of patients at reTUR. Patients presenting residual HG cancer were more likely to have carcinoma in situ (CIS) at first resection (p<0.001), multiple tumors (p=0.02), and tumor size larger than 3 cm (p=0.02). Residual HG disease at reTUR was associated with increased preoperative neutrophil-to-lymphocytes ratio (NLR) (p=0.006) and body mass index (BMI)>=25 kg/m2. On multivariable analysis, independent predictors for HG residual disease at reTUR were tumor size >3cm (OR = 1.37; 95% CI: 1.02-1.84, p=0.03), concomitant CIS (OR 1.92; 95% CI: 1.32-2.78, p=0.001), being overweight (OR= 2.08; 95% CI: 1.44-3.01, p<0.001) and obesity (OR 2.48; 95% CI: 1.64-3.77, p<0.001). A reTUR in high grade T1 bladder cancer is mandatory as about 25% of patients, presents residual high grade disease. Independent predictors to identify patients at risk of residual high grade disease after a complete TUR include tumor size, presence of carcinoma in situ, and BMI >=25 kg/m2.
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Affiliation(s)
- Matteo Ferro
- Division of Urology, European Institute of Oncology, Milan, Italy
| | - Giuseppe Di Lorenzo
- Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy
| | - Carlo Buonerba
- Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy.,Istituto Zooprofilattico Sperimentale del Mezzogiorno, Portici, Italy
| | - Giuseppe Lucarelli
- Department of Emergency and Organ Transplantation, Urology, Andrology and Kidney Transplantation Unit, University of Bari, Bari, Italy
| | | | - Francesco Cantiello
- Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | | | - Savino Di Stasi
- Urology Unit, Policlinico Tor Vergata, University of Rome, Rome, Italy
| | - Gennaro Musi
- Division of Urology, European Institute of Oncology, Milan, Italy
| | - Rodolfo Hurle
- Department of Urology, Istituto Clinico Humanitas, Clinical and Research Hospital, Milan, Italy
| | | | | | | | - Sisto Perdonà
- Department of Uro-Gynaecological Oncology, Istituto Nazionale Tumori "Fondazione G. Pascale", IRCCS, Naples, Italy
| | - Marco Borghesi
- Department of Urology, University of Bologna, Bologna, Italy
| | | | | | - Pierluigi Bove
- Department of Experimental Medicine and Surgery, Urology Unit, Azienda Policlinico Tor Vergata, Rome, Italy
| | - Estevao Lima
- Department of CUF Urology and Life and Health Sciences Research Institute, School of Medicine, University of Minho, Portugal
| | - Giovanni Grimaldi
- Department of CUF Urology and Life and Health Sciences Research Institute, School of Medicine, University of Minho, Portugal
| | | | | | - Nicolae Crisan
- Department of Urology, University of Medicine and Pharmacy "Iuliu Hațieganu", Cluj-Napoca, Romania
| | - Daniela Terracciano
- Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy
| | - Verze Paolo
- Department of Neurosciences, Sciences of Reproduction and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | - Michele Battaglia
- Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy
| | - Giorgio Guazzoni
- Department of Urology, Istituto Clinico Humanitas, Clinical and Research Hospital, Milan, Italy
| | - Riccardo Autorino
- Division of Urology, Virginia Commonwealth University, Richmond, VA, USA
| | - Giuseppe Morgia
- Istituto Zooprofilattico Sperimentale del Mezzogiorno, Portici, Italy
| | - Rocco Damiano
- Department of Emergency and Organ Transplantation, Urology, Andrology and Kidney Transplantation Unit, University of Bari, Bari, Italy
| | - Matteo Muto
- Department of Clinical Medicine and Surgery, Federico II University Medical School of Naples, Italy
| | - Roberto La Rocca
- Department of Neurosciences, Sciences of Reproduction and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | - Vincenzo Mirone
- Department of Neurosciences, Sciences of Reproduction and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | - Ottavio de Cobelli
- Division of Urology, European Institute of Oncology, Milan, Italy.,University of Milan, Milan, Italy
| | - Mihai Dorin Vartolomei
- Division of Urology, European Institute of Oncology, Milan, Italy.,Department of Cell and Molecular Biology, University of Medicine and Pharmacy, Tirgu Mures, Romania
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