Malnutrition is a prevalent issue among older patients with hip fracture and is significantly associated with poor outcomes. The Geriatric Nutritional Risk Index (GNRI) and Prognostic Nutritional Index (PNI) are nutritional screening tools that may assist in predicting outcomes in older patients undergoing hip fracture surgery. This study aimed to evaluate the effects of GNRI and PNI on 1-year mortality after hip fracture surgery in older patients.

This retrospective study included 577 patients aged 60 years and older with hip fractures treated surgically at a single center from January 2018 to December 2021. Nutritional status was evaluated using GNRI and PNI. The primary outcomes were 180-day and 1-year mortality, while secondary outcomes included short-term postoperative complications and length of stay. Univariate and multivariate analyses were performed to identify independent risk factors for 1-year mortality. Subgroup analysis was employed to identify potential population heterogeneity.

Patients with low GNRI and low PNI had significantly higher 1-year mortality rates and short-term postoperative complication rates compared to those with higher scores. Low GNRI was an independent risk factor for one-year mortality (95% CI 1.09 - 3.25, P = 0.022). Subgroup analyses revealed significant heterogeneity, with males patients and patients with ASA III-IV showing higher hazard ratios for 1-year mortality associated with low GNRI. Pulmonary infections and older age were also identified as independent risk factors for one-year mortality.

This study demonstrated that low GNRI was the risk factor for 1-year mortality after hip fracture surgery in older patients.

Pancreatic cancer is the leading cause of cancer-related deaths worldwide and most of the patients diagnosed at an advanced stage. Clinicians need simple, effective, and repeatable tools to predict the prognosis. This study aimed to evaluate the relationship between the HALP score and prognosis in patients with advanced pancreatic cancer.

Patients diagnosed with advanced pancreatic cancer at three centers in Turkey between 2009 and 2023 were included in this retrospective study. Demographic features, blood parameters, treatment received, treatment responses, and survival were recorded.

227 patients were included in the study. The median overall survival (OS) for the entire cohort was 10.4 months. The median OS was 8.7 months in the low-HALP group and 11.2 months in the high- HALP group. Patients in the low-HALP group had a significantly shorter median OS than those in the high-HALP group (log rank p=0.001).

The HALP score is a reliable and practical tool that can be utilized in clinical practice to predict prognosis in patients with advanced pancreatic cancer.

There is a lack of prognostic models to predict the outcomes of non-muscle-invasive bladder cancer (NMIBC) patients receiving Bacillus Calmette-Guérin (BCG) immunotherapy. Existing nutritional risk indicators, such as the prognostic nutritional index (PNI), geriatric nutritional risk index (GNRI) and Naples prognostic score (NPS), have demonstrated prognostic value in various malignancies. This study aimed to construct novel nutritional risk indexes (NRIs) using peripheral blood markers via Lasso-Cox regression and validate their prognostic value.

The electric medical records in our institution were searched and data of 525 NMIBC patients were collected. The Lasso-Cox regression was employed to screen preoperative blood biomarkers correlated with recurrence-free survival (RFS), time to BCG-treatment failure (TTF), and progression-free survival (PFS). NRIs were developed based on selected markers and validated against GNRI, PNI, NPS, and the EAU2021 risk model using Kaplan-Meier analysis, Cox regression, receiver-operating characteristic (ROC) curves, Concordance index (C-index) and Decision Curve analysis.

Lasso-Cox regression identified distinct blood biomarkers: gamma-glutamyl transpeptidase (GGT), serum total protein (TP), albumin and cholesterol were predictive of tumor recurrence and BCG failure, while GGT, TP, and coefficient variation of red blood cell volume distribution width were linked to tumor progression. Three NRIs-NRITR (RFS), NRIBF (TTF) and NRITP (PFS)-were constructed. The NRIs exhibited prognostic value through Kaplan-Meier analysis. Multivariate Cox analysis confirmed NRITR (HR = 0.38, 95%CI:0.28-0.53), NRIBF (HR = 0.45, 95%CI: 0.30-0.67), and NRITP (HR = 0.38, 95%CI: 0.21-0.69) as independent predictors. Nomograms incorporating NRIs demonstrated superior discriminative performance in predicting RFS (AUC = 0.739, C-index = 0.673), TTF (AUC = 0.795, C-index = 0.767), and PFS (AUC = 0.796, C-index = 0.788), and could bring more net benefit for NMIBC patients.

The Lasso-Cox regression may offer superior value in selecting prognostic biomarkers for NMIBC. The Lasso-Cox regression based NRIs enhance prognostic stratification for BCG-treated NMIBC, outperforming existing blood-based nutritional risk indicators and the EAU2021 model. Incorporation of blood-based nutritional indicators into clinical practice could optimization of personalized NMIBC treatment strategies and clinical decision-making. Further validation is warranted.

Acute pancreatitis (AP) is an emergency gastrointestinal disease that requires immediate diagnosis and urgent clinical treatment. An accurate assessment and precise staging of severity are essential in initial intensive therapy.

To explore the prognostic value of inflammatory markers and several scoring systems [Acute Physiology and Chronic Health Evaluation II, the bedside index of severity in AP (BISAP), Ranson's score, the computed tomography severity index (CTSI) and sequential organ failure assessment] in severity stratification of early-phase AP.

A total of 463 patients with AP admitted to our hospital between 1 January 2021 and 30 June 2024 were retrospectively enrolled in this study. Inflammation marker and scoring system levels were calculated and compared between different severity groups. Relationships between severity and several predictors were evaluated using univariate and multivariate logistic regression models. Predictive ability was estimated using receiver operating characteristic curves.

Of the 463 patients, 50 (10.80%) were classified as having severe AP (SAP). The results revealed that the white cell count significantly increased, whereas the prognostic nutritional index measured within 48 hours (PNI48) and calcium (Ca2+) were decreased as the severity of AP increased (P < 0.001). According to multivariate logistic regression, C-reactive protein measured within 48 hours (CRP48), Ca2+ levels, and PNI48 were independent risk factors for predicting SAP. The area under the curve (AUC) values for the CRP48, Ca2+, PNI48, Acute Physiology and Chronic Health Evaluation II, sequential organ failure assessment, BISAP, CTSI, and Ranson scores for the prediction of SAP were 0.802, 0.736, 0.871, 0.799, 0.783, 0.895, 0.931 and 0.914, respectively. The AUC for the combined CRP48 + Ca2+ + PNI48 model was 0.892. The combination of PNI48 and Ranson achieved an AUC of 0.936.

Independent risk factors for developing SAP include CRP48, Ca2+, and PNI48. CTSI, BISAP, and the combination of PNI48 and the Ranson score can act as reliable predictors of SAP.

The prognostic nutrition index (PNI) has recently been highlighted as a predictor of immune checkpoint (IC) inhibitor efficacy in gastric cancer (GC). Although LAG3, an IC molecule, has gained considerable attention, its association with PNI remains unexplored.

We retrospectively analyzed clinical data from 796 GC patients who underwent radical gastrectomy to identify which previously reported nutritional index had the greatest impact on prognosis. Single-cell RNA sequencing was performed on 38 GC tissues, and multiplex immunofluorescence staining was conducted on 59 GC tissues to evaluate the relationship between nutritional indices and IC molecule expression in cytotoxic CD8-positive T cells.

A low preoperative PNI was identified as the strongest predictor of poor prognosis among the nutritional indices in GC patients. The expression of not only PDCD1 (encoding PD1) but also LAG3 in cytotoxic CD8-positive T cells was significantly higher in GC with low PNI compared to those with high PNI. Among cytotoxic CD8-positive T cells, the proportion of LAG3-positive cells was greater than that of PDCD1-positive cells, particularly in GC with low PNI, and most LAG3-positive cells did not co-express PDCD1. Additionally, the expression of MHC class II, a ligand for LAG3, was higher in GC cells with high levels of epithelial-mesenchymal transition-related molecules in GC with low PNI compared to those with high PNI.

PNI can reflect LAG3 expression in cytotoxic CD8-positive T cells and MHC class II expression in GC cells.

Colorectal cancer (CRC) is a common malignancy that has become a global burden. The prognostic prediction of CRC patients on the basis of inflammatory biomarkers and nutritional biomarkers has shown some potential but has not been fully explored.

To develop and validate a prognostic model for CRC based on inflammation and nutrition-related biomarkers and to evaluate its predictive value for patient outcomes.

Patients were randomized at a 3:2 ratio into a training cohort (n = 282) or a validation cohort (n = 188). To identify the optimal prognostic factors for constructing the risk score (RS), LASSO Cox regression analysis was conducted. The association between the RS and overall survival (OS) was evaluated using receiver operating characteristic (ROC) curves and Kaplan-Meier (K-M) survival analysis. Independent risk factors were screened by multivariate Cox regression analysis. Nomograms were constructed and validated on the basis of these factors.

In the training cohort, univariate analysis of all the inflammatory and nutritional biomarkers demonstrated some predictive value. A LASSO-Cox analysis included four biomarkers and constructed an RS. Through ROC analysis, the area under the prognostic curve was 0.795. K-M survival curve analyses revealed that the five-year OS was significantly greater in the Low-RS group than in the High-RS group (P < 0.001). Multivariate analysis demonstrated that the degree of differentiation (P = 0.001), degree of nerve invasion (P = 0.022), and RS (P < 0.001) were independent risk factors. We constructed a nomogram to predict the OS of CRC patients and validated it in a separate cohort. The calibration curve showed high accuracy. Additionally, decision curve analysis for 1-year, 3-year, and 5-year survival probabilities indicated significant clinical utility in predicting survival outcomes.

This study developed a nomogram based on the RS to predict the OS of CRC patients. This nomogram can guide treatment decisions and enable the formulation of personalized follow-up strategies on the basis of predicted recurrence risk, aiming to improve long-term prognosis.

This study investigated the effects of post-discharge integrative telehealth-based nutritional care alone versus post-discharge integrative telehealth-based nutritional care combined with high-calorie/high-protein oral nutritional supplements (HCHP-ONS) on the nutritional status and quality of life in patients with hepatocellular carcinoma (HCC) or colorectal cancer (CRC) at risk of malnutrition.

We recruited HCC or CRC patients who were at moderate to high risk of malnutrition, defined as a score of 4-9 on the abridged Patient-Generated Subjective Global Assessment (aPG-SGA), and randomly assigned them to either a telehealth nutritional care-control group (C group) or a telehealth nutritional care combined with HCHP-ONS group (C+O group) for a 3-month intervention. In group C, a dietitian provided monthly telehealth-based nutritional assessments and guidance through a mobile application (LINE) or phone calls. In the C+O group, in addition to telehealth-based nutritional assessments and guidance, patients received a daily can of HCHP-ONS, which provided 425 kcal and 19.1 g of protein per serving. Blood tests, anthropometric indicators, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and a nutritional status assessment were conducted monthly.

Results showed that the C+O group had significantly reduced malnutrition risk scores at the 1st, 2nd, and 3rd months. By the 3rd month, the C+O group showed significant improvement in the Prognostic Nutritional Index (PNI), and notable improvements in diarrhea and respiratory distress scores.

In patients with HCC and CRC who were at risk of malnutrition, integrative telehealth-based nutritional care via LINE or phone calls effectively reduced malnutrition risk, maintained PNI, and supported quality of life (QOL). The addition of HCHP-ONS further enhanced nutritional outcomes, leading to greater improvements in PNI, diarrhea, and dyspnea by the 3rd month.

The aim of the study is to demonstrate the prognostic impact of preoperative nutritional status indicators, including prognostic nutritional index (PNI), hemoglobin-albumin-lymphocyte-platelet (HALP) score, sarcopenia index (SI), and bone mineral density (BMD) values, on postoperative complications and survival in patients with resectable pancreatic cancer (PC).

The medical data and computed tomography (CT) images of 85 patients who undergone surgery for PC between January 2017 and 2023 were evaluated retrospectively. Patients were grouped according to the presence or absence of sarcopenia and osteoporosis, high and low PNI and HALP scores. The groups were compared in terms of the complication development rate, 30- and 90-day mortality, and 5-years overall survival (OS). Sarcopenia and osteoporosis were determined from CT images (sarcopenia index used for sarcopenia, bone mineral density for osteoporosis).

Except from OS (p < 0.0001), no differences were found between sarcopenic and non-sarcopenic groups in terms of postoperative complications, 30- and 90-day mortality (p = 0.775, p = 0.704, p = 0.196, respectively). There were no differences between the groups with and without osteoporosis in terms of the presence of postoperative complications, 30- and 90-day mortality, and OS (p = 0.770, p = 0.608, p = 0.196, p = 0.09, respectively) as low and high HALP score groups (p = 0.236, p = 0.696, p = 0.299, p = 0.45, respectively). Except from a 30-day mortality (p = 0.03), no differences were found between low and high PNI groups in terms of postoperative complications, 90-day mortality, and OS (p = 0.82, p = 0.09, p = 0.18, respectively).

PNI may be used as prognostic data for early postoperative mortality, while sarcopenia may be indicative of 5-year OS in patients with resectable PC. Our results suggest that providing nutritional support may potentially improve prognosis. Future studies, in which other factors effective in prognosis are evaluated together with nutritional status, will show more information on this subject.

The MOUSEION-010 Meta-Analysis assessed the association between nutritional status and clinical outcomes such as Progression Free Survival (PFS) and Overall Survival (OS) among cancer patients treated with immune checkpoint inhibitors (ICIs).

Nutritional status was assessed based on the Prognostic Nutrition Index (PNI), Geriatric Nutritional Risk Index (GNRI) and Controlling Nutritional Status (CONUT) indexes. Databases consulted were: Embase, PubMed, Scopus and Web of Science.

PNI and GNRI indexes did not show a significant association with both PFS and OS, while CONUT index displayed a significant difference in PFS between the two groups, in favor of the control group (Z = 4.04; p < 0.01) also without any publication bias (β= -1.27; 95% CI = [-2.13; -0.42]; p = 0.10]). The same trend was recorded in OS, too (Z = 4.24; p < 0.01). However, publication bias was present (β = 1.89; 95% CI = [1.26; 2.54]; p = 0.028]) and the numerosity of the studies did not reveal the sufficient statistical power to obtain reliable results.

Malnutrition could negatively impact cancer patients, especially in advanced phases. Our findings could be associated with the reduction of physical ability and daily activity performance, lower compliance with treatment protocols, and shorter survival outcomes.

The accurate prognosis of gastrointestinal stromal tumors (GISTs) has garnered substantial attention, yet a gap persists in understanding the influence of inflammatory markers on the prognosis of high-risk GIST patients. This study investigated the relationship between various factors and the prognosis of high-risk GIST patients, with a specific focus on first recurrence-free survival (RFS) and overall survival (OS) as crucial prognostic indicators.

A comprehensive collection of clinical data was conducted on 145 high-risk GIST patients meeting specific inclusion and exclusion criteria at 17 medical centers in Ningxia Hui Autonomous Region, China, covering the period from January 2013 to December 2019. Single-factor analysis and survival curves were used to analyze the variables, while the Cox regression model evaluated independent prognostic factors.

Within the cohort, a balanced male-to-female ratio of 1:1.1 was observed. Univariate analysis revealed compelling associations between RFS and age, preoperative neutrophil-to-lymphocyte ratio (NLR), preoperative platelet-to-lymphocyte ratio (PLR), preoperative systemic immune-inflammatory index (SII), preoperative prognostic nutritional index (PNI), mitotic index, and whether or not imatinib (IM) was taken regularly in high-risk GIST patients (P < 0.05). Except age, these other variables were also significantly correlated with OS (P < 0.05). Cox regression analysis showed that age, preoperative PNI, mitotic index and postoperative IM adjuvant therapy independently affected RFS (P < 0.05). In addition, preoperative PNI and postoperative IM adjuvant therapy were also independent factors of OS, with statistical significance (P < 0.05). Age was negatively correlated with RFS, and early routine IM treatment after operation significantly reduced the risk of recurrence and death. Higher mitotic index is closely related to poor RFS, and higher preoperative PNI indicates a better prognosis.

A close correlation between young age, low preoperative PNI, high mitotic index, and lack of IM treatment had an unfavorable prognosis in high-risk GIST patients. Notably, the PNI was identified as a potential additional prognostic factor, enhancing the accuracy of predicting treatment efficacy and patient outcomes in high-risk patients with GISTs. Therefore, we advocate for the serious consideration of the PNI as a valuable addition to standard clinical practice for managing high-risk GIST patients.

Severe fever with thrombocytopenia syndrome (SFTS) is a fatal tick-borne infectious disease lacking effective treatments or vaccines. Early identification of prognostic factors is essential for optimizing clinical management. This study investigated the predictors for mortality in SFTS patients.

We conducted a retrospective multicenter cohort study of 413 SFTS patients hospitalized in South Korea from 2013 to 2024. Clinical and laboratory data were comprehensively analyzed to evaluate associations between in-hospital mortality and various inflammatory, immune, and nutritional biomarkers. Cox regression and time-dependent receiver operating characteristic (ROC) analyses were performed to identify risk factors.

413 patients diagnosed with SFTS were included and In-hospital mortality was 17% (70/413). Multivariate Cox regression identified older age (HR: 1.042; 95% CI: 1.014-1.071), elevated PT(INR) (HR: 109.57; 95% CI: 19.79-606.57), and lower prognostic nutritional index (PNI) (HR: 0.937; 95% CI: 0.886-0.990) as early predictors of mortality. Time-dependent ROC analysis demonstrated predictive accuracy, with AUCs of 0.512 for age, 0.857 for PT(INR), and 0.694 for PNI at 30 days. Kaplan-Meier analysis revealed significant survival differences for patients stratified by PNI (< 40.75), PT(INR) (≥ 0.97), and age (≥ 59 years).

PNI, PT(INR), and age were identified as key early predictors of mortality in SFTS. PNI, as a novel biomarker, was found to be a useful index for risk level and treatment strategies in SFTS patients.

Not applicable.

Objective: Recurrence of pericardial effusion is possible despite the successful completion of pericardiocentesis and initiation of treatment. Predicting recurrence is important for determining treatment strategies. This study aimed to examine the factors that influence the recurrence of effusion in patients who had undergone pericardiocentesis. Method: A total of 113 patients with the evidence of tamponade or pericardial effusion over 10 mm were included in the study. The mean follow-up period was 49 months. Patients with and without recurrent effusion were divided into two groups. PNI calculation (PNI = 10 × serum albumin (g/dL) + 0.005 × total lymphocyte count (mm3) formula was used. Results: Recurrent pericardial effusion was observed in 30 patients during the follow-up period. There was no difference in age, gender, hypertension, LVEF%, hypertension, and appearance of fluid when the two groups were compared. There was a difference in PNI score and presence of malignancy between the two groups (p: 0.031 and 0.042, respectively). Multivariate logistic regression showed that malignancy and PNI score were independent predictors of recurrence in patients undergoing pericardiocentesis (p: 0.015 and p: 0.014, respectively). In the ROC analysis, PNI < 40.75 predicts recurrent pericardial effusion with 75% sensitivity and 58% specificity (AUC: 0.626, 95% CI: 0.509-0.742, and p=0.042). Conclusion: Predictors of recurrence in patients undergoing pericardiocentesis are important for patient follow-up. PNI is a simple and useful score that can be used to predict recurrent pericardial effusion.

The aim of this study was to discover immune-nutritional indicators that can preoperatively predict short-term mortality in older patients undergoing emergency gastrointestinal surgery.

We retrospectively analyzed older patients older than 65 years of age who underwent various types of emergency gastrointestinal surgery under general anesthesia between January 2012 and December 2023. The immune-nutritional indicators were defined according to previous literature. The primary endpoint of this study was 90-day survival after surgery.

A total of 4120 patients older than 65 years were included in this study. ROC curves and the decision curve analysis for eight factors predicting 90-day postoperative survival were well predicted by the mGPS (0.68, 95% CI: 0.66-0.70), PNI (0.68, 95% CI: 0.66-0.71) and CONUT score (0.68, 95% CI: 0.66-0.70). The models constructed by LASSO Cox and CoxBoost were used to score the risk for each patient, and the high LASSO Cox model risk score group had worse 90-day survival than the low score group, whereas patients in the low CoxBoost model score group had a worse prognosis. The AUC of the CoxBoost model was greater than that of the LASSO Cox model. A nomogram model was constructed using the variables screened by the LASSO Cox model with a C-index of 0.706.

Immune-nutritional factors could be a favorable predictor for older patients undergoing emergency gastrointestinal surgery.

Tyrosine kinase inhibitors (TKIs) are crucial for improving the survival rates of individuals with metastatic thyroid cancer. Moreover, systemic inflammation and malnutrition are known to negatively affect metastatic thyroid cancer prognosis. Evaluating nutritional status at the start of treatment can improve survival rates. Purpose: This study investigated the correlation between the hemoglobin, albumin, lymphocyte count, and platelet (HALP) score and prognosis of patients with metastatic thyroid cancer undergoing first-line TKI therapy. Methods: We retrospectively analyzed data from 44 patients between January 2010 and June 2024. The primary outcomes evaluated in the study were time to treatment failure (TTF) and overall survival (OS); HALP scores were categorized as low (≤29.21) and high (>29.21) based on receiver operating characteristic analysis. Results: The 1-year survival rate was significantly lower in the low HALP score group compared to the high HALP score group (50% vs. 96.3%). Multivariate Cox regression analysis revealed that low HALP scores, elevated leukocyte counts, and lymphopenia were independent predictors of shorter TTF (HR = 0.272, p = 0.011) and OS (HR = 0.208, p = 0.028). Conclusions: The results obtained in the present study demonstrate that the HALP score has prognostic significance for patients with metastatic thyroid cancer who are undergoing first-line TKI treatment. In metastatic thyroid cancer patients, interventions focused on improving nutritional status at the start, during initiation, and throughout the TKI treatment may enhance treatment effectiveness. However, further prospective studies involving larger patient cohorts are necessary to validate our results.

Background: Sepsis is a critical condition characterized by severe immune dysregulation, ranking among the leading causes of morbidity and mortality in intensive care and internal medicine units. Nutritional status plays a pivotal role in modulating these responses, as when inadequate it can compromise immune defenses, the body's ability to handle stress and inflammation, and the clinical course. Malnutrition is frequently observed in septic patients and is strongly associated with worse clinical outcomes, including increased mortality, prolonged hospital stays, and greater complication rates. In this context, nutritional scoring systems have emerged as valuable tools to evaluate patients' nutritional status and predict clinical trajectories. Objectives: Given the absence of a direct comparison of their performance in an internal medicine setting, this study aimed to assess the effectiveness of various nutritional scores as predictive tools for clinical outcomes in septic patients, emphasizing their application within the field of internal medicine. Methods and Results: A retrospective analysis was conducted on 143 patients diagnosed with sepsis or septic shock who were admitted to an internal medicine unit. Key variables included clinical and laboratory parameters, comorbidities, and nutritional scores at the time of diagnosis. The modified Glasgow Prognostic Score (mGPS), the Prognostic Nutritional Index (PNI), the Controlling Nutritional Status (CONUT) score, the modified Nutrition Risk in Critically Ill (mNUTRIC) score, and the blood urea nitrogen-to-albumin ratio (BAR) were evaluated in forecasting mortality and clinical outcomes in patients with sepsis. Among them, the mNUTRIC score emerged as the strongest independent predictor of in-hospital mortality, with a good performance and a reasonable threshold for risk stratification. Conclusions: The study highlights the mNUTRIC score's practicality and reliability in assessing nutritional and inflammatory risks in septic patients, particularly in non-ICU settings. These findings suggest its potential utility in guiding nutritional interventions and improving clinical outcomes, emphasizing the importance of integrating nutritional assessment into sepsis management.

To investigate the prognostic value of inflammatory indexes based on peripheral blood cells in unresectable hepatocellular carcinoma (HCC) patients treated with Lenvatinib combined with PD-1 inhibitors.

This study retrospectively collected baseline inflammatory indexes from HCC patients received Lenvatinib and PD-1 inhibitor-based combination therapy at the Cancer Hospital of the Chinese Academy of Medical Sciences between October 2018 and October 2021. The optimal threshold values for inflammatory indexes determined using X-tile. The factors related to treatment response and survival outcomes were analyzed through logistic regression and Cox regression, respectively. A novel preoperative prognostic nomogram was constructed based on inflammatory indexes, and the predictive efficacy of the nomogram and BCLC staging was compared by the area under the ROC curve.

156 eligible patients with unresectable HCC were included, with median OS and PFS of 23.8 and 11.5 months, respectively, and ORR of 48.7%. The baseline SIRI was an independent factor of treatment response, with a significantly higher ORR for patients with a SIRI <0.8 than for patients with a SIRI ≥0.8 (59.7% vs 41.5%, P=0.03). SIRI and PNI were independent prognostic factors of PFS, and SIRI was an independent prognostic factor of OS. The AUC value of nomogram based on baseline SIRI, PNI, and tumor distribution in predicting the 6-,12- and 18-month PFS of patients was significantly higher than that of traditional BCLC stage, and its prediction performance was substantially better than that of BCLC stage system (C-index, 0.730 vs 0.535).

The baseline SIRI could be used as a potential non-invasive biomarker to predict the efficacy and survival benefit of immune combination therapy for HCC. The nomogram based on inflammation indexes could achieve better prediction performance and help clinicians to identify high-risk patients and formulate treatment plans.

This study aimed to evaluate the predictive performance of inflammatory and nutritional indices for adverse cardiovascular events (ACE) in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI) using a machine learning (ML) algorithm.

AMI patients who underwent PCI were recruited and randomly divided into non/ACE groups. Inflammatory and nutritional indices were graded according to the laboratory examination reports. Logistic Regression was used to screen for factors that were significant for ML model establishment. The performances of the algorithms were evaluated in terms of accuracy, kappa, F1, receiver operating characteristic, precision recall curve, etc. RESULTS: Age, LVEF%, Killip Grade, heart rate, creatinine, albumin, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and prognostic nutritional index (PNI) were significantly correlated with ACE by Logistic regression analysis (P < 0.05). These nine factors were employed to establish stepwise regression (SR), random forest (RF), naïve Bayes (NB), decision trees (DT), and artificial neutron network (ANN), whose performances were evaluated in terms of accuracy, kappa, F1, receiver operating characteristic, precision recall curve, etc. The accuracy of the decision tree was greater than that of other trees. The area under the curves was the highest in the ANN model compared with the other models.

ANN predictive performance had an advantage over other ML algorithms based on age, LVEF%, Killip Grade, heart rate, creatinine, albumin, NLR, PLR, and PNI.

Inflammatory, nutritional, and immune biomarkers are associated with the prognosis of patients with various tumors. Recently, a comprehensive predictive biomarker, the hemoglobin, albumin, lymphocyte, and platelet (HALP) score, was introduced to predict clinical outcomes. We investigated the prognostic impact of preoperative HALP scores in patients who underwent hepatectomy for colorectal liver metastasis (CRLM).

The subjects of this study were 209 patients who underwent hepatectomy for CRLM between February, 2005 and September, 2023. The HALP score was defined as (albumin [mg/dL] × hemoglobin [g/L] × lymphocyte [count/L]) / platelet [count/L]. The cutoff value was calculated according to the receiver operating characteristic curve based on 3-year survival.

The cutoff value of the HALP score was 35, and a low HALP score was confirmed in 107 patients (51%). Multivariate analysis of disease-free survival identified lymph node metastasis (HR 1.53, p = 0.03), extrahepatic lesions (HR 2.48, p < 0.01), and a low HALP score (HR 2.0, p < 0.01) as independently poor prognostic factors. Multivariate analysis of overall survival identified extrahepatic lesions (HR 2.98, p < 0.01), a high CEA (HR 1.78, p = 0.02), and a low HALP score (HR 1.92, p = 0.02) as independently poor prognostic factors.

The HALP score is a useful prognostic factor for patients undergoing hepatectomy for CRLM.

Previous studies have demonstrated that PNI can predict the prognosis of gastric cancer (GC) patients. However, few studies have focused on the auxiliary role of miRNA in predicting the prognosis of GC.

This research seeks to clarify the role of the combined use of miR-132-3p and PNI in predicting the prognosis of GC patients.

The qRT-PCR was used to assess the expression of miR-132-3p in tumor and adjacent normal tissues with GC patients. The predictive value of miR-132-3p and PNI for postoperative prognosis, and the relationships between miR-132-3p, PNI, and preoperative clinical characteristics, were assessed using ROC, χ², Kaplan-Meier survival analysis, and Cox regression analysis.

miR-132-3p was found to be downregulated in GC tumor tissues and significantly positively correlated with PNI. Both miR-132-3p and PNI were significantly associated with TNM stage and lymph node metastasis. Postoperative GC patients with low miR-132-3p expression and low PNI had lower survival rates, and both were independent risk factors for poor prognosis. The combination of miR-132-3p and PNI demonstrated better sensitivity and specificity in predicting postoperative prognosis than either indicator alone.

The combination of miR-132-3p and PNI can effectively improve the predictive value of postoperative prognosis in GC patients.

The importance of nutritional status is underappreciated in patients with heart failure (HF). This study aimed to describe the range of the prognostic nutrition index (PNI), and the clinical characteristics and outcomes according to PNI, in patients with HF with preserved ejection fraction (HFpEF) and reduced ejection fraction (HFrEF). The primary outcome was the composite of HF hospitalization or cardiovascular death.

Individual patient data from the PARAGON-HF (Prospective Comparison of ARNI [Angiotensin Receptor-Neprilysin Inhibitor] with ARB [Angiotensin Receptor Blocker] Global Outcomes in HFpEF) and PARADIGM-HF (Prospective Comparison of ARNI With ACEI [Angiotensin-Converting Enzyme Inhibitor] to Determine Impact on Global Mortality and Morbidity in HF) trials were used to examine patient characteristics and outcomes according to quartiles of PNI. Cox regression was used to analyze clinical outcomes, and multivariable fractional polynomial interaction analysis to examine the effects of sacubitril-valsartan, according to PNI. Patients with lower PNI (poorer nutrition) were older, frailer, and had more comorbidities and worse HF status, with greater congestion. Patients with lower PNI had biomarker abnormalities indicating inflammation, bone marrow suppression, and increased collagen turnover, among other physiologic perturbations. Lower PNI was associated with worse outcomes; that is, the rate of the primary end point among patients in the first quartile was 11.31 (10.20-12.54) compared with 7.09 (6.17-8.14) per 100 person-years in the fourth quartile. These associations persisted after adjustment for other prognostic variables. PNI did not modify the effects of sacubitril-valsartan in HFrEF although sacubitril/valsartan seemed to have a greater benefit in patients with HFpEF with a higher PNI.

Nutritional status, assessed using PNI, is an independent predictor of poor outcomes in HF. Evaluation of nutritional status in clinical practice, the causes of undernutrition, and whether undernutrition should be a therapeutic target, are all worthy of further investigation in HF.

To analyze the association between the prognostic nutritional index and surgical morbidity in women with gynecologic cancers.

This is a retrospective cohort study of women with ovarian, endometrial, or cervical cancer who underwent surgery between January 2013 and December 2020 at a cancer center. Demographic and clinical data were extracted from electronic medical records. The prognostic nutritional index was calculated during the immediate pre-operative period. Binomial logistic regression was conducted to identify the association of the prognostic nutritional index with the outcome of surgical complications after Clavien-Dindo classification, adjusting for confounding variables.

A total of 1000 women were included: 114 (11.4%) were diagnosed with cervical cancer, 551 (55.1%) with ovarian cancer, and 335 (33.5%) with endometrial cancer. Patients with a prognostic nutritional index >40 had a decreased possibility of surgical complications (OR=0.39, 95% CI 0.29 to 0.52); basal blood hemoglobin, volume of surgical bleeding, operative time, and length of hospital stay were also explanatory factors. The prognostic nutritional index has a significant effect on patients with endometrial and cervical cancer, but conversely is not significant in patients with ovarian cancer.

The prognostic nutritional index is associated with surgical morbidity in endometrial and cervical cancers and thus can be a useful tool for predicting morbidity and guide pre-operative interventions in patients with gynecological cancers.

This study aimed to compare three objective nutritional screening tools for identifying GLIM-defined malnutrition in patients with gastric cancer (GC).

Objective nutritional screening tools including geriatric nutritional risk index (GNRI), prognostic nutritional index (PNI), and controlling nutritional status (CONUT) score, were evaluated in patients with GC at our institution. Malnutrition was diagnosed according to the GLIM criteria. The diagnostic value of GNRI, PNI, and COUNT scores in identifying GLIM-defined malnutrition was assessed by conducting Receiver Operating Characteristic (ROC) curves and calculating the area under the curve (AUC). Additionally, sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) were determined. The Kappa coefficient (k) was used to assess agreement between three objective nutritional screening tools and GLIM criteria.

A total of 316 patients were enrolled in this study, and malnutrition was diagnosed in 151 (47.8%) patients based on the GLIM criteria. The GNRI demonstrated good diagnostic accuracy (AUC = 0.805, 95% CI: 0.758-0.852) for detecting GLIM-defined malnutrition, while the PNI and COUNT score showed poor diagnostic accuracy with AUCs of 0.699 (95% CI: 0.641-0.757) and 0.665 (95% CI: 0.605-0.725) respectively. Among these objective nutritional screening tools, the GNRI-based malnutrition risk assessment demonstrated the highest specificity (80.0%), accuracy (72.8%), PPV (74.8%), NPV (71.4%), and consistency (k = 0.452) with GLIM-defined malnutrition.

Compared to PNI and COUNT scores, GNRI demonstrated superior performance as an objective nutritional screening tool for identifying GLIM-defined malnutrition in GC patients.

The immunonutritional status of cancer patients has a profound impact on lifespan. Prognostic Nutritional Index (PNI) evaluates prognosis in operated patients with both neoplastic and non-neoplastic conditions. This study estimates the overall survival (OS) of Mexican patients operated on gastrointestinal stromal tumors (GIST) based on PNI.

Immune-nutritional status was retrospectively analyzed in a cohort of 104 patients operated on GIST. Receiver operating characteristic (ROC) curves and X-tile software were used to estimate the optimal cutoff point and predict OS stratifying patients by PNI. Survival curves were obtained through Kaplan-Meier and log-rank methods. Multivariate analysis of survival was performed by Cox regression.

PNI (≥ 36.5) (p = 0.024) and mitotic index (≥ 5) (p = 0.013) were the only independent prognostic scores; the PNI-high group had better survival with 81.5% less risk of death (HR = 0.185). High PNI was correlated with favorable characteristics, i.e., low/intermediate risk (p = 0.046), reduced mitotic index (< 5) (p = 0.001), and younger age (< 55 years, p = 0.047).

PNI ≥ 36.5 entails a better prognosis for Mexican patients with surgically resected GIST. PNI represents a simple, reliable, and cost-effective prognostic tool, besides the pathological approach.

The prognostic nutritional index (PNI) has emerged as a potential predictor of clinical outcomes in various cancers. However, a quantativetily analysis of its role in endometrial cancer (EC) remains lacking. This meta-analysis aims to evaluate the prognostic value of PNI on the survival outcomes of patients with EC. A comprehensive literature search was conducted in PubMed, EMBASE, Web of Science, Wanfang, and CNKI to identify relevant cohort studies. Studies were included if they provided sufficient data to calculate hazard ratios (HRs) for overall survival (OS) and progression-free survival (PFS) based on PNI levels. Data extraction and quality assessment were performed independently by two reviewers. Pooled HRs with 95% confidence intervals (CIs) were calculated using a random-effects model to account for heterogeneity. A total of 10 studies, encompassing 3656 patients, met the inclusion criteria. The meta-analysis revealed that a low PNI was significantly associated with poorer OS (HR = 2.01, 95% CI = 1.62-2.49, p < 0.05; I2 = 54%) and PFS (HR = 2.75, 95% CI = 1.74-4.33, p < 0.05; I2 = 78%) in patients with EC. Subgroup analyses indicated that the prognostic impact of PNI was consistent in studies from Asian and non-Asian countries, and across studies with different ages of the patients, cutoff values of PNI, and follow-up duration (p for subgroup difference all > 0.05). In conclusion, the PNI is a prognostic marker for survival in patients with EC.

The prognostic nutritional index (PNI) integrates both nutritional and immune indicators and provides promising prognostic value for various malignancies. However, there is still no specific consensus relating to the precise relationship between the pretreatment PNI and the survival outcome of patients with prostate cancer (PCa). Here, we performed a meta-analysis to determine the prognostic significance of PNI for patients with PCa.

We used the PubMed, EMBASE, Web of Science, Cochrane Library (CENTRAL), and CNKI databases to identify and retrieve eligible articles that were published in any language up to the 1st March 2023. Our analysis considered hazard ratios (HRs) and 95% confidence intervals (CIs) published in the included studies. Data synthesis and analysis were conducted using Stata 15.1 software.

A total of ten studies featuring 1631 cases were included in our quantitative analysis. Analysis showed that a low PNI at baseline was significantly associated with poor overall survival (OS) (HR: 2.16; 95% CI: 1.40-3.34; p = 0.01), progression-free survival (PFS) (HR: 2.17; 95% CI 1.63-2.89; p < 0.001). Owing to high levels of heterogeneity, we performed subgroup analysis based on disease staging, sample size, and cutoff value; we found that disease staging may have been the source of the heterogeneity. A low pretreatment PNI was associated with poor survival outcomes for both metastatic castration-resistant prostate cancer (mCRPC) patients and nonmetastatic castration-resistant prostate cancer (nmCRPC) patients.

A low pretreatment PNI was significantly correlated with a worse OS and PFS in patients with PCa. A low pretreatment PNI may act as a reliable and effective predictor for the prognosis of patients with PCa. Further well-designed studies should be performed to fully evaluate the prognostic performance of this novel indicator for PCa.

The Controlling Nutritional Status (CONUT) score is an immunonutritional test tool based on serum albumin, total cholesterol, and lymphocyte counts. It has been studied as a simple prognostic predictor for various carcinomas. This study aimed to investigate the association between preoperative CONUT scores and the clinicopathological characteristics in papillary thyroid carcinoma (PTC) patients.

This study included 2,403 PTC patients who underwent total thyroidectomy between 2012 and 2016 at a single tertiary medical center. The CONUT scores were calculated based on preoperative blood tests. The clinicopathological characteristics were retrospectively reviewed. The patients were categorized by the CONUT score (relatively low, 0-2; relatively high, 3-5).

Among the 2,997 PTC patients who underwent total thyroidectomy at Pusan National University Hospital between 2012 and 2016, those without preoperative blood test were excluded (n=149). Finally 2,403 patients were analyzed after excluding 439 patients taking lipid-lowering drugs and six patients without available T stage data after surgery. Based on the CONUT score, the relatively high score group had a lower body mass index (23.7±3.3 kg/m2 vs. 21.9±2.9 kg/m2, P<0.001), more advanced T stage (T stage 3/4, 5.9% vs. 11.4%, P=0.045), and higher extrathyroidal extension (2.1% vs. 7.6%, P=0.005).

Patients included in this large, single-center study all had a preoperative CONUT score of 0-5, but this study demonstrated that higher preoperative CONUT scores were significantly associated with advanced T stage and extrathyroidal extension. The CONUT score, which can be easily used in clinical practice, is thought to be helpful in predicting the aggressiveness of PTC.

Our perioperative management center provides preoperative intervention and functional and nutritional assessments for colorectal cancer patients aged over 75 years. This study evaluated the associations of preoperative nutritional status with postoperative outcomes and prognosis in colorectal cancer patients aged 75 years or older.

This was a prospective, observational study of 71 colorectal cancer patients aged 75 years or older who underwent surgery between July 2020 and September 2022. The Subjective Global Assessment (SGA) was evaluated as a nutritional index. The patients were classified into three groups: SGA-A (well nourished), B (moderately malnourished), and C (severely malnourished), and the correlations with postoperative outcomes and prognosis were examined.

The median age of the 71 patients (34 males, 37 females) was 78 (75-92) years, and their median body mass index (BMI) was 22.3 (13.4-31.9) kg/m2. Forty-eight patients had colon cancer, and 23 had rectal cancer. On the SGA, 28 patients were SGA-A, 25 SGA-B, and 18 SGA-C. The SGA-B/C group had significantly higher BMI (p < 0.01) and more ICU admissions (p = 0.02). The G8 score was significantly lower (p = 0.03) in the SGA-B/C group, suggesting coexisting functional decline. In terms of postoperative outcomes, the SGA-B/C group had a significantly longer postoperative hospital stay (p = 0.04). The 3-year OS rates for all stages were 100% in the SGA-A group and 49.7% in the SGA-B/C group (p = 0.03), while the 3-year OS rates for patients excluding Stage IV were 100% in the SGA-A group and 68.5% in the SGA-B/C group, not significantly different (p = 0.14). The 3-year RFS rate was 95.5% in the SGA-A group and 65.3% in the SGA-B/C group (p = 0.15).

The SGA is a promising nutritional index associated with short-term outcomes in older patients undergoing colorectal cancer surgery. The SGA can be assessed in a few minutes during an outpatient visit, making it useful for routine clinical use.

The prognostic nutritional index (PNI) is an integrated index of serum albumin and peripheral lymphocyte count, where low values may reflect poor nutritional status or inflammation. The long-term effect of PNI on renal function is not well known in the general population. Therefore, we investigated whether the PNI is related to renal function changes in the general population.

Data from participants who underwent a health check-up between 2002 and 2018 were retrospectively examined. PNI was computed by 10×serum albumin (g/dL) + 0.005×total lymphocyte count (per mm3). The primary exposure was PNI, divided into quintiles. The primary outcome was a 25% decline in eGFR from baseline over a 5-year follow-up period.

This study included 15,437 participants (mean [standard deviation, SD] age, 43.7 [7.9] years; 46% male). The median (interquartile ranges) 5-year change of eGFR was - 5.2 (- 18.8, - 3.3) mL/min/1.73m2. A total of 2,272 participants (14.7%) experienced a 25% decline in eGFR at 5 years. Compared to the highest PNI group, lower PNI groups were at greater risk for a 25% decline in eGFR; odds ratios and 95% confidence intervals were 1.42 (1.20, 1.68), 1.23 (1.04, 1.45), 1.21 (1.03, 1.43), and 1.19 (1.01, 1.40) for the first to fourth quintiles of PNI, respectively. In linear regression analyses, lower PNI groups also showed a larger decline in eGFR over 5 years compared to the highest PNI group.

Lower PNI was associated with a larger decline in renal function in the general population.

Background and Objectives: Neoadjuvant chemotherapy (NAC) improves survival by increasing pathologic complete response (pCR). Blood-based indexes have been studied in breast cancer for predicting pCR and prognosis, but the results are conflicting. We aimed to assess the impact of inflammatory and nutritional indexes on pCR and survival. Materials and Methods: We retrospectively analyzed 304 patients. Pre-NAC laboratory data were used to calculate their neutrophil-to-lymphocyte ratios (NLR), pan-immune inflammation values (PIV), lactate dehydrogenase-albumin ratios (LAR), and prognostic nutritional indexes. The optimal cut-off values were determined through an analysis of the receiver operating characteristic curve. Survival analyses were performed using the Kaplan-Meier method. Multivariate regression analyses were performed to reveal the factors predicting pCR. Univariate and multivariate survival analyses were conducted to identify prognostic factors predicting survival. Results: The median follow-up was 38.5 months. pCR was achieved in 41.4% of the patients. In the univariate analyses, the NLR (p = 0.032) and PIV (p = 0.002) were indexes associated with pCR. In the multivariate analysis, the PIV (p = 0.008) was the only index significantly correlated with pCR. According to the multivariate Cox regression analyses, clinical stage 3 (p = 0.032), a pathologic response other than pCR (p = 0.021), and a high LAR (≥4.72) (p = 0.002) were correlated with increased recurrence risk. The univariate Cox regression analyses revealed that failure to achieve pCR (p = 0.037) and the presence of a high LAR (p = 0.044) were significant predictors of overall survival. However, the multivariate analyses failed to identify any significant predictors of death. Conclusions: We found that the PIV was more effective than the other indexes in predicting pCR. To our knowledge, this study is the first to determine an association between the LAR and disease-free survival in patients with breast cancer receiving NAC. We concluded that a high LAR was a poor prognostic factor, especially in patients without a pCR. Therefore, close postoperative monitoring and the intensification of adjuvant treatment should be considered for these patients. However, further studies are needed to confirm our findings.

This study aimed to analyze factors associated with recent complications after colorectal cancer surgery, constructing a nomogram to aid gastrointestinal surgeons in preoperative decision-making for patients at risk of such complications.

In this retrospective study, clinical data were collected from patients undergoing radical colorectal cancer surgery at the Department of Gastrointestinal Surgery of the Affiliated Cancer Hospital of Guizhou Medical University and the Second People's Hospital of Chengdu from November 1, 2021, to January 26, 2024. Univariable and multivariable logistic regression analyses were conducted to assess risk factors for recent postoperative complications and develop a prediction model. External validation was performed using data from 48 postoperative colorectal cancer patients in the Second People's Hospital of Chengdu City from January 1, 2023, to May 30, 2023. Evaluation included receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis using R4.2.2 statistical software.

A total of 324 patients who underwent radical colorectal cancer surgery were enrolled. The training cohort (n=176) identified four independent risk factors for recent complications: PNI ≥45 (OR=4.17, P<0.001), Albumin <40 g/L (OR=3.9, P<0.001), ASA score III-IV (OR=6.29, P<0.001), and Tumor diameter ≥5 cm (OR=4.24, P<0.001). A nomogram was constructed incorporating these factors. The AUC of the nomogram model in the training cohort was 0.835, with subsequent internal and external validation cohort AUCs of 0.815 and 0.819, respectively, indicating strong discriminatory ability. The calibration curve demonstrated good consistency, and decision curve analysis indicated high clinical utility.

PNI ≥45, Albumin <40 g/L, ASA score III-IV, and Tumor diameter ≥5 cm emerged as independent risk factors for recent complications following colorectal cancer surgery. We developed a nomogram model for these complications, potentially aiding gastrointestinal surgeons in preoperative patient evaluation and treatment planning for colorectal cancer surgery.

The concentration of albumin and lymphocyte in the body can serve as indicators of both nutritional status and inflammation. The predictive significance of the prognostic nutritional index (PNI) has been documented in multiple cancer types. Consequently, a meta-analysis was conducted in order to investigate the prognostic impact of PNI on survival outcomes among individuals diagnosed with prostate cancer.

A systematic search was conducted across 4 electronic databases to identify pertinent studies that evaluated the predictive significance of pretreatment PNI in patients with prostate cancer. The outcomes of interest in this study were overall survival (OS) and progression-free survival (PFS). The researchers utilized random-effect models to summarize the time-to-event outcomes, presenting the results as adjusted hazard ratios (aHR) along with their corresponding 95% confidence intervals (CI).

A total of 2229 prostate cancer patients in 13 studies were included. Pooled analysis from these studies showed that low PNI value was associated with shorter OS [aHR 1.99 (95% CI, 1.45-2.72), P < .0001], and PFS [aHR 1.97 (95% CI, 1.55-2.51), P < .00001]. Sub-group analysis revealed that the ability of PNI to predict poor outcomes was better observed in patients with metastatic castration-resistant prostate cancer (mCRPC) and those who received androgen receptor pathway inhibitors (ARPIs).

This study suggests the role of PNI in predicting the survival and progression of prostate cancer. PNI values can be used in the risk stratification of patients with prostate cancer.

Identifying patients with peritoneal metastasis (PMs) of colorectal cancer (CRC) who will benefit from cytoreductive surgery and hyperthermic intraperitoneal chemotherapy is crucial before surgery. Inflammatory and nutritional indicators play essential roles in cancer development and metastasis.

To investigate the association of preoperative inflammatory and nutritional markers with prognosis in patients with CRC-PM.

We included 133 patients diagnosed with CRC-PM between July 2012 and July 2018. Patients' demographics, overall survival (OS), and preoperative inflammatory and nutritional markers were evaluated. The Kaplan-Meier method and log-rank test were used to estimate differences.

Of the 133 patients, 94 (70.6%) had normal hemoglobin (Hb) and 54 (40.6%) had a high neutrophil-to-lymphocyte ratio (NLR). The median OS (mOS) was significantly lower for patients with high NLR (7.9 months) than for those with low NLR (25.4 months; P = 0.002). Similarly, patients with normal Hb had a longer mOS (18.5 months) than those with low Hb (6.3 months; P < 0.001). Multivariate analysis identified age, carbohydrate antigen 199 levels, NLR, Hb, and peritoneal cancer index as independent predictors of OS. Based on these findings, a nomogram was constructed, which demonstrated a good capacity for prediction, with a C-index of 0.715 (95% confidence interval: 0.684-0.740). Furthermore, the 1- and 2-year survival calibration plots showed good agreement between predicted and actual OS rates. The areas under the curve for the 1- and 2-year survival predictions of the nomogram were 0.6238 and 0.6234, respectively.

High NLR and low Hb were identified as independent predictive risk factors for poor prognosis in patients with CRC-PM. The established nomogram demonstrated high accuracy in predicting OS for patients with CRC-PM, indicating its potential as a valuable prognostic tool for this patient population.

Inflammation-related markers including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI) and prognostic nutritional index (PNI) could reflect tumor immune microenvironment and predict prognosis of cancers. However, it had not been explored in alpha-fetoprotein (AFP) producing gastric cancer (GC).

To determine the predictive value of inflammation-related peripheral blood markers including as NLR, PLR, MLR, SII, SIRI and PNI in the prognosis of AFP- producing GC (AFPGC). Besides, this study would also compare the differences in tumor immune microenvironment, clinical characteristics and prognosis between AFPGC and AFP- GC patients to improve the understanding of this disease.

573 patients enrolled were retrospectively studied. They were divided into AFP+ group (AFP ≥ 20 ng/mL) and AFP- group (AFP < 20 ng/mL), comparing the levels of NLR/PLR/MLR/SII/SIRI/PNI and prognosis. In AFP+ group, the impact of NLR/PLR/MLR/SII/SIRI/PNI and their dynamic changes on prognosis were further explored.

Compared with AFP- patients, AFP+ patients had higher NLR/PLR/MLR/SII/SIRI and lower PNI levels and poorer overall survival (OS). In the AFP+ group, mortality was significantly lower in the lower NLR/PLR/MLR/SII/SIRI group and higher PNI group. Moreover, the dynamic increase (NLR/PLR/MLR/SII/SIRI) or decrease (PNI) was associated with the rise of mortality within 1 year of follow-up.

Compared with AFP- patients, the level of inflammation-related peripheral blood markers significantly increased in AFP+ patients, which was correlated with OS of AFP+ patients. Also, the gradual increase of SII and SIRI was associated with the risk of death within one year in AFP+ patients. AFPGC should be considered as a separate type and distinguished from AFP- GC because of the difference in tumor immune microenvironment. It requires basic experiments and large clinical samples in the future.

Background: Malnutrition harms treatment outcomes, QoL, and survival in lung cancer patients. Effective dietary counseling can improve nutrition, but few randomized controlled trials have focused on lung cancer patients. The objective of this study was to determine if dietary counseling improves nutritional and treatment outcomes when compared to routine care. Methods: This open-label parallel RCT was conducted at Maharaj Nakorn Chiang Mai Hospital in Thailand. The investigators used computer-generated blocked randomization to assign patients to dietary counseling by a nutritionist or routine care. The nutritionist sessions occurred before treatment, with follow-ups at 3-4 weeks and 12 weeks. The primary outcome was the mean percentage change in the body weight of patients at 12 weeks. Secondary outcomes included changes in the BMI, nutrition score, QoL, serum albumin level, lymphocyte count, energy and protein intake, treatment response, PFS, and OS. Results: Between April 2020 and May 2022, after completing recruitment, 80 lung cancer patients were randomized: 43 to dietary counseling and 37 to routine care. The dietary counseling group showed significant benefits, with smaller decreases in body weight at 3-4 weeks (-0.8% vs. -2.6%, p = 0.05) and 12 weeks (-1.1% vs. -4.3%, p = 0.05). They also had higher energy and protein intake levels and better treatment response rates. The secondary outcomes and significant adverse events did not differ significantly between the groups. Conclusions: Dietary counseling helps to maintain body weight, maintain dietary intake, and enhance treatment responses in lung cancer patients. Although not all nutritional markers or survival outcomes were affected, these findings highlight the importance of early nutritional interventions.

The objective of this study was to investigate the relationship between mortality and the prognostic nutritional index (PNI) in the pediatric patient group with ventriculoperitoneal shunt (VPS) infection. A total of 63 pediatric patients with a VPS infection and positive cerebrospinal fluid (CSF) culture were retrospectively registered. The CSF specimens were analyzed to conduct culture and microscopic evaluation. A total of 44.4% of the cases were men and 55.6% of the cases were women. Patients were divided into 2 groups (survivor and non-survivor patients). When survivor and non-survivor patients were compared, it was found that CSF leukocytes, CSF glucose, CSF protein, CSF/blood glucose ratio, lymphocyte, albumin, and PNI levels were lower in the non-survivor patients' group. Nevertheless, blood glucose and CRP (C-reactive protein) were significantly higher in the non-survivor patients' group than in the survivor patients' group. In our investigation, we suggested that low PNI was related to high mortality in cases of VPS infection.

The prognostic value of the pretreatment prognostic nutritional index (PNI) for gynaecological malignancies remain unclear. This meta-analysis aimed to explore the predictive significance of the PNI for gynaecological tumours.

The PubMed, Embase, Web of Science, and Cochrane Library databases were searched up to January 30, 2024, to identify relevant studies. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated to assess the associations of the PNI with overall survival (OS), progression-free survival (PFS), and disease-free survival (DFS) in patients with gynaecological tumours. We examined the correlation of the PNI with clinicopathological parameters of patients with gynaecological carcinoma by utilizing pooled odds ratios (ORs) and 95% CIs.

A total of 28 articles involving 9,428 patients were included in the meta-analysis. The results revealed that a low PNI significantly predicted worse OS (HR = 1.60, 95% CI: 1.39-1.84, P < 0.001), PFS (HR = 1.63, 95% CI: 1.20-2.23, P = 0.002), and DFS (HR = 1.73, 95% CI: 1.19-2.52, P = 0.004). In addition, the subgroup analysis confirmed that the PNI had a prognostic effect on OS for all cancer types, but a significant association with PFS was not observed in patients with cervical cancer. A low PNI was significantly associated with FIGO stages III‒IV (OR = 2.30, 95% CI: 1.89‒2.80, P < 0.001) and LN metastasis (OR = 2.76, 95% CI: 2. 05‒3.73, P < 0.001).

The PNI may be noninvasive and promising biomarker for predicting the prognosis of patients with gynaecological tumours.