This study examines the prognostic value of pre-treatment inflammatory biomarkers-neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic inflammatory index (SII) in patients with anal cancer (AC). Blood sample analyses from 340 AC patients treated with curative (chemo)radiotherapy were retrieved from patient records to determine pre-treatment NLR, PLR, and SII values. Using receiver operating characteristic curve (RUC) analysis, the Liu method, optimal cut-offs were calculated to 2.96 for NLR, 145.31 for PLR, and 679.86 for SII. Values above the cut-off were significantly associated with worse disease-free survival (DFS) and overall survival (OS). For DFS, the hazard ratios (HRs) were 2.08 for NLR, 1.85 for PLR, and 2.13 for SII, while for OS, the HRs were 1.73 for NLR, 1.14 for PLR, and 1.76 for SII. In multivariate analyses, NLR, PLR, and SII each remained independently significant predictors of DFS. A comprehensive literature review and meta-analysis further substantiated the association between high pre-treatment NLR and OS in AC, although the findings were marked by considerable heterogeneity. These results suggest that NLR, PLR, and SII are valuable and easily measurable prognostic markers in AC. Integrating these biomarkers into clinical practice could enable more personalized treatment strategies by identifying patients at elevated risk of poorer outcomes. Future research should focus on validating these findings across diverse populations and developing standardized methodologies to optimize the clinical utility of these biomarkers.

Pretreatment neutrophil to lymphocyte ratio (NLR) is a negative prognostic marker for survival in head and neck cancer (HNC). Its association with treatment toxicity and intolerance in patients undergoing curative-intent surgery is unknown.

Ambispective study of patients with operable stage II-IV, HPV-negative HNC treated at two academic hospitals. Multiple logistic regression was performed to evaluate the association between pretreatment NLR and short-term treatment outcomes including treatment toxicity and intolerance.

Among 456 patients, 194 experienced treatment-related toxicity, defined as grade ≥ 3 adverse events, and 200 exhibited treatment intolerance, defined as treatment discontinuation or delay due to poor tolerance. High pretreatment NLR was significantly associated with an increased risk of toxicity (OR 1.04; 95% CI: 1.00-1.09) and intolerance (OR 1.06; 95% CI: 1.01-1.12). Patients with an NLR < 2.5 had significantly lower odds of experiencing toxicity (OR 0.50; 95% CI: 0.26-0.96) and intolerance (OR 0.57; 95% CI: 0.33-0.99) after adjusting for multiple confounders.

Low pretreatment NLR was associated with reduced treatment toxicity and lower rates of intolerance in patients undergoing curative-intent surgery for HNC.

In advanced cancer patients the CYP3A4-mediated clearance of drugs is dependent on the severity of inflammation. In a study in patients with advanced cancer (n = 44) with solid tumors, prior to cancer treatment, high inter-patient variability was observed in the plasma pharmacokinetic (PK) parameters of the CYP3A4 substrate midazolam. The neutrophil-to-lymphocyte ratio (NLR) was used to categorize the degree of inflammation of each patient and in turn to correlate increases in NLR to decreases in CYP3A4 expression.

Patients with NLR ≥ 5 were categorized as having high inflammation, and patients with NLR < 5 as having low-to-moderate inflammation. A physiologically-based PK (PBPK) model of midazolam PK and a top-down approach was used to determine the reductions in CYP3A4 abundance in the liver and gut wall needed to match the PK parameters of midazolam in the NLR ≥ 5 and NLR < 5 groups of patients.

The midazolam mean CL/F was 33 L/h in the NLR < 5 group, and midazolam CL/F was 20 L/h in the NLR ≥ 5 group. To match the PK of midazolam in the NLR < 5 group, the CYP3A4 expression was reduced 40% in both the liver and the gut. In the NLR ≥ 5 group, CYP3A4 expression was reduced approximately 40% in the liver and at least 90% in the gut to produce the best fit.

Overall, these results support that NLR may be used as an inflammatory marker that broadly correlates to inflammation-driven changes in CYP3A4 activity.

The purpose of this study was to analyze the utility of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in pediatric myelin-oligodendrocyte glycoprotein antibody-associated disease (MOGAD).

Retrospective review of medical record was performed to analyze association among complete blood count (CBC) indices and clinical characteristics of pediatric MOGAD patients.

61 patients were included in the analysis. In 24 subjects with matched CBC samples, NLR, PLR, and monocyte-to-lymphocyte ratio (MLR) were higher during disease relapse than in remission. In the receiver operating characteristics (ROC) curve analysis, the optimal cutoff values were 2.55 and 179.4 for NLR and PLR, respectively. The area under curve (AUC) was 0.809 and 0.658 for NLR and PLR, respectively. At disease onset, NLR and PLR were higher in patients in the relapsing group. In the ROC curve analysis, the optimal cutoff values were 3.35 and 183.8 with the AUC of 0.739 and 0.700 for NLR and PLR, respectively. In logistic regression analysis, NLR and PLR elevation were statistically significant after adjusting for age, sex, and phenotype. The pooled analysis of all clinical attacks in the relapsing group revealed that NLR and PLR are lower in the isolated optic neuritis (ON) compared to the other phenotypes.

This study shows that in pediatric MOGAD patients, NLR and PLR are useful for prompt recognition of disease relapse and prediction of relapsing course at disease onset. NLR and PLR are also associated with clinical phenotypes in pediatric MOGAD.

Understanding the causal relationships between immune cell populations and cancer development remains a critical challenge in tumor immunology.

We employed Mendelian Randomization analysis leveraging genome-wide association studies of 612 immune cell traits and 91 cancer types to systematically evaluate causal associations. Single-cell RNA sequencing and computational deconvolution analyses were performed to characterize myeloid cell subpopulations in melanoma samples.

Our analysis revealed significant relationships between specific immune cell subsets and cancer risk, particularly highlighting the role of CD33 + myeloid cells in melanoma pathogenesis. Single-cell RNA sequencing identified distinct CD33high myeloid subpopulations characterized by elevated expression of complement cascade components and chemokine signaling pathways. Through computational deconvolution of The Cancer Genome Atlas melanoma cohort, we demonstrated that elevated CD33high monocyte abundance correlates with increased immune dysfunction scores, reduced CD8 + T cell infiltration, and poor survival outcomes.

Here we delineate the multifaceted mechanisms through which CD33 + myeloid cell populations orchestrate perturbations in the tumor-immune microenvironmental landscape, manifesting in compromised immunosurveillance and enhanced tumor progression. Our findings illuminate novel therapeutic opportunities through targeted modulation of myeloid cell function, while providing a systematic framework for understanding the complex interplay between immune cell populations and oncogenic processes.

Androgen deprivation therapy has long been the first-line treatment for hormone-sensitive prostate cancer (HSPC). After progression to castration-resistant prostate cancer (CRPC), androgen receptor pathway inhibitors (ARPIs) are commonly used. Recently, combined therapy with androgen deprivation and an ARPI has been recommended for metastatic HSPC patients. Novel markers are urgently needed for monitoring this disease and for making therapeutic decisions. Plasma samples were collected from 140 patients with either metastatic HSPC (n = 72) or CRPC (n = 68) before the start of ARPI therapy. Digital PCR was used to assess AR gene amplification, while the expression levels of miR-375 were measured by quantitative PCR. Sixteen other clinical markers were also evaluated, including prostate-specific antigen (PSA), chromogranin A (CGA), alkaline phosphatase (ALP), lactate dehydrogenase (LDH), C-reactive protein (CRP), lymphocyte-to-monocyte ratio, and platelet count. A multivariate analysis, adjusted for age and metastatic dissemination, identified miR-375 expression and lymphocyte-to-monocyte ratio to be the independent negative predictors of ARPI therapy failure in CRPC patients. Regarding the HSPC patients, this article reports the primary finding of the independent negative predictive value of platelet count, CRP, and CGA for the failure of combined androgen deprivation therapy and ARPI.

Active surveillance (AS) strategy aims to avoid unnecessary or excessive early treatment in patients at a low risk for prostate cancer (PCa). However, a biomarker that can predict the need for early curative treatment in patients under AS has not been identified to date. In this study, we aimed to investigate the potential of inflammatory biomarkers in predicting the requirement of curative treatment in the early period in patients under AS.

This study included a total of 83 patients with the diagnosis of PCa and under AS. Patient age, prostate-specific antigen (PSA) level, prostate volume (PV), PSA density (PSAD), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), systemic immune-inflammation index (SII) and follow-up period were compared between the groups.

There was a significant difference between the two groups in terms of PSAD, NLR, PLR and SII (p = 0.037, p = 0.046, p = 0.008, p = 0.004 and p = 0.005, respectively). The cut-off value determined by performing ROC analysis to evaluate the levels that predict the need for curative treatment before AS was 0.125 for PSAD (sensitivity: 61.8%, specificity: 61.2%), 2.01 for NLR (sensitivity: 67.6%, specificity: 55.1%), 115.49 for PLR (sensitivity: 73.5%, specificity: 59.2%) and 465.40 for SII (sensitivity: 70.6%, specificity: 59.2%).

The analysis of PSAD, NLR, PLR and SII before making the decision to conduct AS can guide clinicians regarding curative treatment in the early period.

Existing studies have explored the association between immune-inflammatory indices and inflammatory bowel disease (IBD), but there is a lack of comprehensive evidence. This meta-analysis and systematic review seeks to synthesize the data of available clinical research and offer the latest and comprehensive evidence-based conclusions regarding whether these immune-inflammatory indices can effectively predict the severity, activity, and prognosis of IBD.

Seven databases were comprehensively retrieved from their establishment to March 23, 2025. The combined results were described through standardized mean differences (SMD) or odds ratios (OR) with 95% confidence intervals (CI). Review Manager 5.4 and STATA 15.0 were leveraged for data analysis.

Our analysis included 35 studies involving 5,870 patients. The aggregated data revealed that the neutrophil-to-lymphocyte ratio (NLR) (OR = 1.18, 95% CI:1.04 to 1.34; P = 0.001) (SMD = 1.01, 95%CI = 0.73 to 1.29, P < 0.001), platelet-to-lymphocyte ratio (PLR) (SMD = 0.60, 95%CI = 0.46 to 0.74, P < 0.001), neutrophil-to-platelet ratio (NPR) (OR = 1.20, 95% CI:1.08 to 1.32, P < 0.001), and C-reactive protein to albumin ratio (CRP/ALB) (OR = 1.50, 95% CI:1.38 to 1.65, P < 0.001) were potentially linked to disease activity in IBD patients. PLR (SMD = 1.08, 95%CI = 0.60 to 1.55, P < 0.001) showed potential associations with disease severity in IBD patients. Additionally, NLR (SMD = 0.43, 95%CI = 0.15 to 0.70, P = 0.002) and eosinophil-to-lymphocyte ratio (ELR) (SMD = 0.63, 95%CI = 0.26 to 1.00, P < 0.001) had potential associations with endoscopic response in IBD patients. Moreover, NLR was potentially associated with disease relapse(OR = 1.35, 95% CI:1.09 to 1.68; P = 0.006) and steroid responsiveness (SMD = 0.50, 95%CI = 0.15 to 0.85, P = 0.005).

NLR, PLR, NPR, and CRP/ALB are potential predictors of disease activity in IBD patients. PLR shows the potential to predict disease severity, while NLR and ELR are potential indicators of endoscopic response. Furthermore, NLR is also a potential predictor of relapse and steroid responsiveness. Currently, there is insufficient evidence to support an association between NLR and the severity of IBD, whereas lymphocyte-to-monocyte ratio (LMR) appears to be associated with both the severity and activity of IBD and PLR and eosinophil*neutrophil-to-lymphocytes ratio (ENLR) are associated with endoscopic response in IBD.

CRD 42024609659.

Alpha-fetoprotein-producing gastric cancer (AFPGC) is a rare but highly aggressive subtype of gastric cancer. Patients with AFPGC are at high risk of liver metastasis, and the tumor microenvironment (TME) is complex. A multicenter retrospective study is conducted from January 2011 to December 2021 and included 317 AFPGC patients. Using a multivariable logistic regression model, a nomogram for predicting liver metastasis is built. By combining AFP and the neutrophil-lymphocyte ratio (NLR), we developed a novel and easily applicable predictive indicator, termed ANLiM score, for liver metastasis in AFPGC. An integrated multi-omics analysis, including whole-exome sequencing and proteomic analysis, is conducted and revealed an immunosuppressive TME in AFPGC with liver metastasis. Single-cell RNA sequencing and multiplex immunofluorescence identified the potential roles of tumor-associated neutrophils and tertiary lymphoid structures in shaping the immune microenvironment. These findings are validated in a real-world cohort receiving anti-programmed cell death 1 (anti-PD-1) therapy, which showed concordant effectiveness. In addition, the ANLiM score is also identified as a promising biomarker for predicting immunotherapy efficacy. Overall, a blood biomarker-based predictive indicator is developed for liver metastasis and immunotherapy response in AFPGC. The findings on immune microenvironmental alterations for AFPGC with liver metastasis provide new insights for optimizing immunotherapy strategies.

Neutrophils are among the most abundant immune cell types in the tumour microenvironment and have been associated with poor outcomes across multiple cancer types. Yet despite mounting evidence of their role in tumour progression, therapeutic strategies targeting neutrophils have only recently gained attention and remain limited in scope. This is probably due to the increasing number of distinct neutrophil subtypes identified in cancer and the limited understanding of the mechanisms by which these subsets influence tumour progression and immune evasion. In this Review, we discuss the spectrum of neutrophil subtypes - including those with antitumour activity - and their potential to polarize towards tumour-suppressive phenotypes. We explore the molecular pathways and effector functions by which neutrophils modulate cancer progression, with an emphasis on identifying tractable therapeutic targets. Finally, we examine emerging clinical trials aimed at modulating neutrophil lineages and consider their implications for patient outcomes.

Systemic inflammatory response (SIR) indicators serve as predictive factors for lymph node metastasis (LNM) in various cancers. This study aimed to investigate the association of platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) with LNM in rectal cancer and to identify clinicopathological factors linked to LNM.

We retrospectively analyzed 181 rectal cancer patients who underwent surgical resection. Preoperative NLR and PLR were calculated from blood samples, with optimal cutoff values determined by receiver operating characteristic (ROC) analysis. Associations between NLR/PLR and clinicopathological features were evaluated, risk factors for LNM were analyzed via univariate and multivariate logistic regression.

No significant differences were observed between the high NLR (H-NLR) and low NLR (L-NLR) groups in terms of clinicopathological characteristics, including TNM stage, perineural invasion (PNI), lymphovascular invasion (LVI), or serum levels of CEA and CA19-9 respectively (p > 0.05).In contrast, the high PLR (H-PLR) group showed significantly higher prevalence of several adverse pathological features: The H-PLR group had a higher positive PNI (54.2% vs.25.0%,p = 0.04), greater positive LVI(51.6% vs.28.6%,p = 0.025),and more positive TDs (14.4% vs.0,p = 0.028), increased lymph node metastasis (52.9% vs.17.9%,p < 0.001), more elevated CEA (43.1% vs.14.3%,p = 0.005) and more advanced tumor stage (stage II + stage III,81% vs.67.9%,p = 0.003).Univariate analysis identified several factors significantly associated with LNM: T stage (OR = 3.156, 95%CI:1.580-6.303),positive PNI (OR = 6.182,95%CI:3.242-11.787),positive LVI (OR = 10.271,95%CI:5.177-20.375),H-PLR(OR = 5.175,95%CI:1.870-14.321),positive TDs (OR = 3.390,95%CI:1.261-9.117),TLN(OR = 1.053,95%CI:1.005-1.103),elevated CEA(OR = 3.313,95%CI:1.655-5.920) and elevated CA199 (OR = 2.248,95%CI:1.012-4.992) were correlated with LNM using univariate analysis, but only positive LVI(adjusted OR = 6.203,95%CI:2.892-13.303,p < 0.001) and positive PNI (adjusted OR = 3.086,95%CI:1.341-7.102,p = 0.008) were the independent risk factors for LNM using multivariate analysis.

H-PLR but not H-NLR may be associated with LNM, positive LVI and PNI were independent risk factors for LNM in RC.

Tumor-induced systemic accumulation and polarization of neutrophils to an immunosuppressive phenotype is a potent driver of metastasis formation. Yet, how mammary tumors reprogram granulopoiesis at the molecular level and when tumor imprinting occurs during neutrophil development remains underexplored. Here, we combined single-cell, chromatin and functional analyses to unravel the tumor-driven reprogramming of granulopoiesis in the bone marrow, along with intervention studies aimed at reversing this process. We observe that mammary tumors accelerate commitment to the neutrophil lineage at the expense of lymphopoiesis and erythropoiesis without stimulating the development of a novel myeloid lineage. Moreover, tumor-directed immunosuppressive imprinting of neutrophils starts early in hematopoiesis. Treatment with anti-IL-1β normalizes tumor-induced granulopoiesis, reducing neutrophil immunosuppressive phenotype and mitigating metastatic spread. Together, these data provide molecular insights into the aberrant, tumor-driven neutrophil differentiation pathway leading to metastasis-promoting chronic inflammation and how it can be reversed to reduce metastatic spread.

Associations between scores on the advanced lung cancer inflammation index (ALI) and mortality among sarcopenic adults remains unknown. This study investigates the relationship between ALI and both all-cause and cardiovascular mortality among adults with sarcopenia.

The study involved sarcopenic adults from the National Health and Nutrition Examination Survey (NHANES), conducted between 1999 and 2006 and 2011-2018. Mortality information was acquired from the National Death Index, which tracks deaths through to December 31, 2019. Weighted multivariable Cox proportional hazards regression was employed to calculate hazard ratios (HRs) for mortality in different models. Additionally, the restricted cubic spline (RCS) method was used to investigate non-linear associations. Subgroup analyses and sensitivity analyses were conducted to detect differences and examine the reliability of the findings.

This study included 2074 American adults with sarcopenia categorized into quartiles. 701 deaths occurred from all causes, with 236 linked to cardiovascular issues. Multivariate Cox regression models showed that those in the highest ALI quartile had a lower all-cause mortality rate than those in the lowest quartile (model 1: HR = 0.69, 95 % CI 0.55-0.87, P = 0.002; model 2: HR = 0.73, 95 % CI 0.56-0.94, P = 0.017). Likewise, those in the highest ALI quartile had a lower risk of death from cardiovascular causes (model 1: HR = 0.55, 95 % CI 0.36-0.85, P = 0.007; model 2: HR = 0.59, 95 % CI 0.37-0.95, P = 0.031). RCS results revealed an L-shaped correlation between ALI score and all-cause mortality.

A higher ALI score was strongly associated with lower rates of both all-cause and cardiovascular mortality among sarcopenic adults, particularly in the older population, males, smokers, and those with hypertension. This suggests that ALI may serve as a risk stratification tool.

The neutrophil-to-lymphocyte ratio (NLR) not only indicates the inflammatory response within the tumor microenvironment but may also correlate with tumor biological behavior (such as aggressiveness). The present study aimed to systematically review and conduct a meta-analysis on the impact of the NLR on the prognosis of patients with renal cell carcinoma (RCC). To this aim, a comprehensive search of multiple relevant databases, including PubMed, Embase and the Cochrane Library, was conducted to identify literature related to NLR and RCC prognosis. Following rigorous literature screening and quality assessment, a systematic quantitative analysis was ultimately performed on several studies that met the inclusion criteria. The results indicated a significant association between elevated NLR levels and poor prognosis in patients with RCC, suggesting that high NLR levels may serve as an independent predictor of unfavorable outcomes. Therefore, the present study provides important evidence for clinical decision-making, further demonstrating that NLR can serve as an independent prognostic indicator for patients with RCC, aiding healthcare professionals in making more precise judgments in patient management and treatment strategy formulation.

The role of systemic inflammation, a significant prognostic factor in various malignancies, is underexplored in mucinous appendix cancer (MAC). We assessed how inflammation, expressed by preoperative serum C-reactive protein (CRP), correlates with survival across MAC histopathologies managed with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC).

This retrospective cohort study included MAC patients with peritoneal dissemination, who had complete CRS/HIPEC (CC-0/1) (1998-2023). Preoperative serum CRP cut-off was defined with the minimum p-value approach and time-dependent receiver operating characteristic analysis. Survival was analyzed using the Kaplan-Meier method and Cox regression.

Of 273 patients, 163 had low-grade and 110 had high-grade MAC. CRP cut-off was 2.00 mg/dL. Among low-grade, 132 patients had CRP<2 and 31 had CRP≥2. In high-grade, 87 patients had CRP<2 and 23 had CRP≥2. Median follow-up was 86 (95%CI: 48-124) months. In low-grade MAC, 5-year progression-free survival (PFS) was 88.5 % in CRP<2 and 53.9 % in CRP≥2 (p < 0.001), while 5-year overall survival (OS) was 89.2 % and 85.4 %, respectively (p = 0.018). In high-grade tumors, 5-year PFS was 46.5 % in CRP<2 and 19.3 % in CRP≥2 (p = 0.011), while 5-year OS was 56.5 % and 45.3 %, respectively (p = 0.291). Multivariate Cox regression showed a strong association of CRP≥2 with worse PFS (HR 5.10; 95%CI: 2.46-10.58) and OS (HR 3.18; 95%CI: 1.22-8.28) in low-grade MAC only.

Elevated pre-CRS/HIPEC serum CRP was associated with worse PFS and OS in low-grade, but not in high-grade MAC. These findings highlight CRP's utility in prognosis assessment and can be useful in identifying target MAC subgroups for studying anti-inflammatory agents.

Before the twentieth century, patients with advanced lung cancer had limited treatment options and chemotherapy was the primary form of treatment, with an overall survival often <0.5 years. However, with advances in society and medical technology, the treatment approaches for advanced non-small cell lung cancer (NSCLC) have markedly changed. Traditional chemotherapy has been gradually replaced by targeted therapy and immunotherapy, leading to the emergence of various new therapeutic options that offer patients more personalized and precise care. This raises the question of what the future holds for the treatment of NSCLC. This review provides a comprehensive analysis of the latest breakthroughs in targeted therapies, immunotherapies, and drugs for antibody-drug conjugates (ADCs), highlights advances in multimodal combination therapy strategies, and explores the causes of resistance and the challenges that exist in overcoming it. In particular, this review provides unique insights into key directions for future research in NSCLC, such as personalised treatment strategies and biomarker exploration based on multi-omics data, aiming to provide new inspiration for clinical decision-making and research.

Neutrophils are important components of the immune system and play a key role in defending against pathogenic infections and responding to inflammatory cues, including cancer. Their dysregulation indicates potential disease risk factors. However, their functional importance in disease progression has often been underestimated due to their short half-life, especially as there is limited information on the role of intratumoral neutrophils. Recent studies on their prominent role in cancer have led to a paradigm shift in our understanding of the functional diversity of neutrophils. These studies highlight that neutrophils have emerged as key components of the tumor microenvironment, where they can play a dual role in promoting and suppressing cancer. Moreover, several approaches to therapeutically target neutrophils have emerged, and clinical trials are investigating their efficacy. In this review, we discussed the involvement of neutrophils in cancer initiation and progression. We summarized recent advances in therapeutic strategies targeting neutrophils and, most importantly, suggested future research directions that could facilitate the manipulation of neutrophils for therapeutic purposes in cancer patients.

Cancer is a leading cause of death, especially among women, with cancers like breast, ovarian, and cervical cancer presenting unique diagnostic and treatment challenges. Systemic inflammation plays a significant role in cancer progression, affecting both tumor development and therapeutic outcomes. Despite the established link between inflammation and cancer, comprehensive studies on the prognostic value of the Aggregate Index of Systemic Inflammation (AISI) in female cancer patients are lacking. This study explores the association between AISI and mortality outcomes, including all-cause and cardiovascular mortality, in female cancer patients.

This study analyzes data from the NHANES database and Dandong Central Hospital. Kaplan-Meier survival curves and multivariable Cox proportional hazards regression analyses were used to assess the relationship between AISI and all-cause and cardiovascular mortality. Restricted cubic spline plots and subgroup analyses were applied to explore potential interactions.

Elevated AISI levels were strongly associated with increased all-cause and cardiovascular mortality. Patients in the highest AISI quartile demonstrated significantly higher mortality risks compared to those in the lowest quartile. ROC curve analysis indicated superior predictive performance of AISI over SII. Restricted cubic spline plots revealed a linear relationship, with mortality risk notably increasing when AISI levels were elevated.

AISI is a robust predictor of all-cause and cardiovascular mortality in female cancer patients. Its ease of measurement and strong prognostic value make it a valuable tool for risk assessment and management in this population.

Cancer cells are often described as voracious consumers of nutrients, with glucose frequently cited as a key energy source; however, their metabolic plasticity allows them to adapt and utilize various substrates, including lipids and amino acids, to sustain growth and survival. However, the metabolic demands of immune cells within the tumor microenvironment (TME) are less commonly discussed despite their critical role in shaping the immune response. In this review, we explored the intricate interplay between immunometabolism and innate immunity cells in gastrointestinal cancers. We focused on how metabolic pathways, including glycolysis, fatty acid oxidation, and amino acid metabolism, drive the immunosuppressive functions of myeloid-derived suppressor cells (MDSCs) and tumor-associated neutrophils (TANs), tumor-associated macrophages (TAMs) and innate lymphocyte subsets such as NK cells. These cells contribute to a hostile immune landscape, supporting tumor growth and evasion from immune surveillance in a phenomenon of tumor-derived immunosuppression. Additionally, we investigated the influence of dietary interventions on the metabolic reprogramming of these immune cells, highlighting how nutrition can modulate the TME. Finally, we discussed emerging therapeutic strategies that target metabolic vulnerabilities in MDSCs, TANs, NK cells, and monocytes, offering a novel avenue for enhancing antitumor immunity. By dissecting these mechanisms, we aim to provide insights into how metabolic pathways can be harnessed to improve cancer treatment outcomes. This review underscores the importance of understanding immunometabolism not only as a driver of immune suppression but also as a potential therapeutic target in gastrointestinal cancer.

Anastomotic leakage (AL) is a serious complication following rectal cancer surgery and is associated with increased recurrence, mortality, extended hospital stays, and delayed chemotherapy. The Onodera prognostic nutritional index (OPNI) and inflammation-related biomarkers, such as the neutrophil-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), have been studied in the context of cancer prognosis, but their combined efficacy in predicting AL remains unclear.

To investigate the relationships between AL and these markers and developed a predictive model for AL.

A retrospective cohort study analyzed the outcomes of 434 patients who had undergone surgery for rectal cancer at a tertiary cancer center from 2016 to 2023. The patients were divided into two groups on the basis of the occurrence of AL: One group consisted of patients who experienced AL (n = 49), and the other group did not (n = 385). The investigation applied logistic regression to develop a risk prediction model utilizing clinical, pathological, and laboratory data. The efficacy of this model was then evaluated through receiver operating characteristic curve analysis.

In the present study, 11.28% of the participants (49 out of 434 participants) suffered from AL. Multivariate analysis revealed that preoperative levels of the OPNI, NLR, and PLR emerged as independent risk factors for AL, with odds ratios of 0.705 (95%CI: 0.641-0.775, P = 0.012), 1.628 (95%CI: 1.221-2.172, P = 0.024), and 0.994 (95%CI: 0.989-0.999, P = 0.031), respectively. These findings suggest that these biomarkers could effectively predict AL risk. Furthermore, the proposed predictive model has superior discriminative ability, as demonstrated by an area under the curve of 0.910, a sensitivity of 0.898, and a specificity of 0.826, reflecting its high level of accuracy.

The risk of AL in rectal cancer surgery patients can be effectively predicted by assessing the preoperative levels of serum nutritional biomarkers and inflammatory indicators, emphasizing their importance in the preoperative evaluation process.

Introduction: The Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) is widely used to assess patient status but relies on subjective judgment and may not fully reflect their physical reserve. While studies have shown that skeletal muscle quality and quantity are associated with patient prognosis, their role in cancers of unknown primary (CUP) remains unclear. Therefore, this study aimed to investigate whether computed tomography (CT)-based skeletal muscle indicators reflect physical reserve and their prognostic value in patients with CUP. Methods: This study enrolled 184 patients with CUP, comprising both inpatients and outpatients, who were diagnosed at Seoul St. Mary's Hospital between 1 January 2008, and 30 June 2024. Overall survival (OS) was evaluated using the Kaplan-Meier method and analyzed using the log-rank test. Univariate and multivariate analyses were performed using Cox proportional hazard models. Statistical significance was defined as p < 0.05. Correlation analyses were conducted to evaluate the relationships between skeletal muscle density (SMD), skeletal muscle index (SMI), and other prognostic factors. Results: SMD was positively correlated with SMI and negatively correlated with age, neutrophil-to-lymphocyte ratio, Charlson Comorbidity Index (CCI), and ECOG-PS. Jonckheere's trend test revealed that SMD decreased significantly as CCI and ECOG-PS increased (p < 0.001), indicating that a higher comorbidity burden and poorer performance status were associated with lower SMD. Both ECOG-PS and SMD were identified as prognostic factors in the univariate analysis of survival; however, only SMD demonstrated statistical significance regarding prognostic value in the multivariate analysis (p = 0.004) Conclusions: SMD, as a measure of muscle quality, demonstrates superior prognostic value compared to the subjective ECOG-PS and may serve as a reliable objective tool for assessing physical reserve in patients with CUP.

Increasingly, the immune system is implicated in the aetiology and progression of Parkinson's disease (PD). Immune activation is seen both peripherally in the blood, with a tendency towards a pro-inflammatory profile, and centrally in the cerebrospinal fluid and brain parenchyma, with microglial activation and increased numbers of immune cells in the central nervous system. However, the relationship between this peripheral and central immune profile, as well as the association with clinical measures of disease severity is not clear.

61 people with PD, within three years of diagnosis and no immune comorbidities, and 51 matched controls underwent detailed blood immunophenotyping using a flow cytometry panel with markers to characterise adaptive and innate immune populations. In the PD cohort, 35 also had cerebrospinal fluid (CSF) immune cell analysis and 31 underwent positron emission tomography (PET) brain imaging with the radioligand [11C]-PK11195 to assess microglial activation. PD participants were assessed with the Movement Disorder Society-Unified Parkinson's disease rating Scale (MDS-UPDRS) and the Addenbrooke's Cognitive Examination (ACE-III). The immune profiles of PD and control participants were compared. In the PD group, relationships between peripheral and CSF immune cell populations, [11C]-PK11195 binding, and clinical measures were investigated in exploratory analyses using multiple linear regression.

Compared to controls, PD participants had a pro-inflammatory profile in the blood with an elevated Systemic Inflammatory Index (SII) (p = 0.049), a higher percentage of classical monocytes (p = 0.046), and decreased expression of functional markers of T regulatory cells (FoxP3 (p = 0.030) and Helios (p = 0.015)) and B regulatory cells (CD1d (p = 0.031)). Immune cell subset numbers in blood and CSF were correlated for CD8+ cells (rho = 0.42, p = 0.011), CD16+ NK cells (rho = 0.49, p = 0.004) and classical monocytes (rho = -0.38, p = 0.028). CSF immune populations were also correlated with [11C]-PK11195 binding in disease-relevant regions of interest. Several blood and CSF immune cell subsets and regional [11C]-PK11195 binding showed relationships with motor and cognitive scores, with a consistent trend of pro-inflammatory markers being related to a more severe disease phenotype. Increased Toll-like receptor 2 expression on classical monocytes in the CSF and [11C]-PK11195 binding in the substantia nigra independently predicted motor score (MDS-UPDRS-III).

This exploratory study suggests that peripheral and central immune changes are closely linked in PD, and relevant to clinical disease severity. These findings warrant further validation and exploration to identify immune biomarkers linked to disease state, as well as candidate therapeutic targets.

This research investigates the relationships between the composite dietary antioxidant index (CDAI) and the likelihood of cardiovascular disease (CVD) and mortality in older adults with hypertension. Utilized data from the National Health and Nutrition Examination Survey (NHANES) to investigate the potential mediating role of the triglyceride-glucose (TyG) index in these relationships.

A cohort of 5,276 participants, aged 65 years or older and diagnosed with hypertension, was extracted from the NHANES database. The main outcomes examined were the odds of CVD and mortality, utilizing data from the National Center for Health Statistics (NCHS). Multivariate logistic regression models were utilized to evaluate the relationship between CDAI and CVD. Cox proportional hazards regression models and Kaplan-Meier survival curves were utilized to analyze the relationship between CDAI and mortality. Mediation analysis was conducted to assess the potential intermediary role of TyG-related indicators-specifically TyG, TyG-BMI, TyG-WC, and TyG-WHtR- in the connection between CDAI and mortality.

The mean CDAI for the study participants was 1.88 ± 3.90, and the average age was 74.15 ± 5.96 years. During an average follow-up duration of 109.51 months, 4,712 cases of CVD and 725 recorded deaths were observed. In the fully adjusted models, CDAI showed a negative association with both CVD (Odds Ratio [OR] = 0.94, 95% Confidence Interval [CI] = 0.92-0.97) and mortality (Hazard Ratio [HR] = 0.95, 95% CI = 0.93-0.97). Mediation analysis indicated that the TyG-BMI, TyG-WC, and TyG-WHtR indices accounted for 33.1%, 34.3%, and 19.1% of the relationship between CDAI and mortality, respectively.

A higher CDAI demonstrated an inverse association with both CVD and mortality in elderly hypertensive individuals. The relationship was partially mediated by TyG-related indices, indicating that increased antioxidant intake may lead to improved health outcomes and a decreased risk of poor prognosis in this population.

To develop the PRIMAL (Prognostic Risk stratification for Integrating Manifestations of symptoms and Abnormal Labs) score to predict prognosis in renal cell carcinoma (RCC) by integrating clinical presentation, paraneoplastic syndromes (PNS), and abnormal laboratory values at diagnosis.

5256 T1-T4, N0/1, M0/1 RCC surgical patients from 4 institutions were analyzed retrospectively. Preoperative variables included hematuria, visceral pain, nausea/vomiting, thrombocytopenia (<100 × 109/L), hypoalbuminemia (<3.5 g/dL), anemia (<11.5 mg/dL for women, <12.5 mg/dL for men), elevated De Ritis Ratio (AST/ALT > 1.25), elevated neutrophil-to-lymphocyte-ratio (NLR > 2.27). Patients were stratified into 4 PRIMAL categories (Low = 0, Favorable-intermediate = 1-2, Unfavorable-intermediate = 1-2+anemia, High ≥ 3). Multivariable Cox regression and Kaplan-Meier analyses assessed association with overall survival (OS) and cancer-specific survival (CSS). C-indexes, Receiver operating characteristic curves and Area under curve assessed accuracy of the model towards OS and CSS individually and in combination with the Leibovich score.

2513 (48%) patients had low, 1532 (29%) favorable-intermediate, 909 (17%) unfavorable-intermediate, 302 (6%) high PRIMAL score. High score patients exhibited highest hazard ratios (HR) for all-cause mortality (ACM) (HR = 7.71, 95% CI = 5.98-9.93) and cancer-specific mortality (CSM) (HR = 8.54, 95% CI = 5.96-12.24). Five-year OS rates were 91%, 82%, 65% and 46%, while CSS rates were 95%, 90%, 76% and 60% for Low, Favorable-Intermediate, Unfavorable-Intermediate and High groups, respectively. PRIMAL achieved C-indexes of 0.70 for OS and 0.74 for CSS prediction. The combined CSS PRIMAL-Leibovich model yielded an AUC of 0.76 (P = 0.02), outperforming individual scores.

PRIMAL is a valuable tool for RCC prognostication, enabling assessment of disease aggressiveness at diagnosis. Including PRIMAL score during initial evaluations enhances stratification, identifying patients with a higher risk disease and aids clinical decision-making.

In the treatment of non-small cell lung cancer (NSCLC), immune checkpoint inhibitors (ICIs) have markedly improved patient survival, yet some patients do not benefit. The existing prognostic factors are limited, highlighting the development of reliable and convenient predictive indicators.

A retrospective analysis was performed on 219 NSCLC patients treated with ICIs from June 2019 to January 2024. The nutritional risk screening (NRS 2002) and the neutrophil-to-lymphocyte ratio (NLR) were employed to evaluate the patients' nutritional status and inflammatory response, aiming to investigate the correlation between these markers and treatment outcomes.

The median follow-up duration for the overall population was 29 (IQR: 25.96-32.04) months. The analysis showed that the median progression-free survival (mPFS) and median overall survival (mOS) in the high nutritional risk group (NRS2002 ≥ 3, accounting for 23.74%) were significantly lower than those in the low nutritional risk group (NRS2002 < 3, accounting for 76.26%) (mPFS: 2.5 vs 16 months; mOS: 8 vs 16 months, both P < 0.001). Similarly, patients with high NLR values (> 4.92) had significantly shorter OS and PFS than those with low NLR (≤ 4.92) values (mOS: 7 vs 18 months; mPFS: 3 vs 17 months, both P < 0.001). Multivariate Cox analysis revealed that a high NRS 2002 score (HR = 2.76, 95% CI 1.68-4.54, P < 0.001) and high NLR (HR = 2.77, 95% CI 1.65-4.64, P < 0.001) were independent predictors of poor prognosis. Risk stratification was performed using a combined scoring system of NRS 2002 and NLR (0 points-low risk, 1 point-moderate risk, 2 points-high risk), and it was found that as the risk score increased, OS and PFS significantly decreased (mOS: 8 [2.61-13.39] vs 16 [13.04-18.96] vs NA [NA-NA] months; mPFS: 2.5 [0.99-4.02] vs 8.5 [5.47-11.53] vs 16 [11.41-20.59] months, respectively, both P < 0.001). The utility of the combined NLR and NRS2002 scoring model was assessed using a time-dependent receiver operating characteristic (ROC) curve, with results indicating that at 12 months, the AUC value of the combined scoring model was 0.81 (CI 0.72-0.90). At 24 and 36 months, the AUC values were 0.73 (CI 0.66-0.80) and 0.70 (CI 0.64-0.76), respectively. Moreover, the nomogram model exhibited high predictive accuracy in predicting survival prognosis, with AUC values of 0.84 (CI 0.77-0.91), 0.85 (CI 0.79-0.91), and 0.78 (CI 0.69-0.88) at 12, 24, and 36 months, respectively.

The combined NRS 2002 and NLR scoring can serve as an effective prognostic tool for NSCLC patients receiving ICIs treatment. This scoring system helps clinicians more accurately identify patients who will benefit from immunotherapy, thereby facilitating more personalized treatment plans. Further validation of this scoring system's applicability and reliability is warranted in future multicenter, large-sample prospective studies.

Intestinal necrosis represents as one of the most severe complications of intussusception. Various markers of systemic inflammation, such as neutrophil counts, CRP levels, albumin concentrations, platelet counts, and lymphocyte counts as well as combined ratios, such as lymphocyte-to-CRP ratio (LCR), platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), and CRP-to-albumin ratio (CAR), have been proposed as valuable predictors for a variety of inflammatory conditions, making them useful biomarkers for inflammation. We investigated the effectiveness of different combinations of inflammatory markers in predicting intestinal necrosis and the need for intestinal resection in cases of intussusception.

This is a retrospective cohort study that included 100 patients diagnosed with intussusception and needed surgical intervention after failed nonoperative reduction of intussusception. The patients were divided into two groups based on whether they had intestinal resection. Analysis was conducted on combinations of inflammatory markers, such as NLR, PLR, LCR, and CAR, to correlate with intraoperative findings for detecting the markers with the highest correlation with intestinal necrosis in intussusception patients.

A statistically significant higher mean CAR was observed among cases with resection (15.27 ± 6.74) compared to the nonresection group (3.56 ± 4.06). Conversely, the mean LCR was significantly lower in the resection group (0.116 ± 0.12) compared to the nonresection group (0.509 ± 0.33). The ROC analysis showed that the area under the curve (AUC) for LCR in differentiating cases requiring resection was excellent, with a best-detected cutoff point of 0.1233, yielding a sensitivity of 85.7% and specificity of 90%. Similarly, the AUC for CAR in differentiating cases needing intestinal resection was excellent, with a best-detected cutoff point of 7.73, yielding a sensitivity of 92.6% and specificity of 90%. Additionally, the CAR was a statistically significant predictor of the need for resection, with each unit increase in CAR increasing the risk by 1.42 (95% CI: 1.25-1.61).

The mean CRP-to-albumin ratio (CAR) is significantly higher in cases requiring intestinal resection compared to those that do not require resection. LCR also provides useful information and should be used alongside the CAR in the decision-making process. If a patient's CAR exceeds 7.73 and if LCR is below 0.1233, they are more likely to need surgery due to necrosis. Given its statistical significance, CAR should be used as a key marker for predicting the need for intestinal resection. For each one-unit increase in CAR, the risk of needing intestinal resection increases by 1.42 times, which can aid in prioritizing patients for surgery, avoiding treatment delays, and enhancing patient outcome.

Background and Objectives: CRC is one of the leading causes of cancer-related deaths worldwide. New biomarkers are needed to identify the high-risk patient population after primary treatment and to personalize and perfect treatment and follow-up. Indicators of cancer-associated systemic inflammatory response, such as the LMR, have been widely investigated and have yielded conflicting results. The aim of this study was to investigate the effect of preoperative LMR on the prognosis of recurrent CRC. Materials and Methods: We included 204 patients admitted to our center for recurrent CRC between January 2010 and January 2015. Retrospectively, we investigated the preoperative LMR data and its effect on RFS and OS. Results: The cut-off value of LMR was 24.72 and, according to this value, we created two groups: LMR-H and LMR-L. There were 104 (50.9%) patients in the H group and 100 (49.1%) patients in the L group. The median OS was 38.0 months (95% confidence interval (CI): 30.66-45.33) for the L group and 49.0 months (95% CI: 44.06-53.94) for the H group. Overall population median OS was calculated as 44.0 months (95% CI: 40.1-47.8, p = 0.004). Median RFS was 21.3 months (95% CI: 18.3-24.2) for the LMR-L group and 28.39 months (95% CI: 24.9-31.8) for the LMR-H group (p = 0.004). Conclusions: The association between the LMR at diagnosis and early recurrence, as well as survival outcomes, was investigated in patients with recurrent CRC. Higher preoperative LMR levels were found to correlate with improved OS and RFS.

Radiation is often used as the primary treatment for a range of cancers. Nonetheless, its ability to trigger secondary tumors has emerged as a significant issue. Therefore, gaining insight into and predicting radiation-induced secondary cancers is essential for enhancing the long-term prognosis of cancer survivors.

Previous studies have identified several factors; however, research on the use of serum-based inflammatory markers as prognostic tools for predicting radiation-induced secondary malignancies is limited. Investigating the potential of serum-based inflammation prognostic scores could provide a minimally invasive and affordable method for the early prediction of secondary malignancies.

We retrospectively analyzed a patient cohort with radiation-induced secondary malignancy from the electronic database MIMIC-IV to investigate whether a serum-based inflammatory marker score can serve as a predictive tool.

This study seeks not only to assess the efficacy of the risk score, but also to develop a clinical utility tool nomogram for predicting the occurrence of radiation-induced secondary cancers. A RISM of 4.28% was observed in a cohort from the MIMIC-IV database using SIRI-RT as a risk index, with the Charlson comorbidity index, chemotherapy, and creatinine levels as significant confounding risk factors.

Our study suggests that elevated serum-based inflammation prognostic scores and the nomogram developed herein can be used to predict a greater likelihood of developing secondary malignancies following radiation therapy.

The stress-associated chaperone system is an actionable target in cancer therapies. It is ubiquitously upregulated in cancer tissues and enables tumorigenicity by stabilizing oncoproteins. Most inhibitors target the key component, heat-shock protein 90 (HSP90). Although HSP90 inhibitors are highly tumor-selective, they fail in clinical trials. These failures are partly due to interference with a negative regulatory feedback loop in the heat-shock response (HSR): in response to HSP90 inhibition, there is compensatory synthesis of stress-inducible chaperones, mediated by the transcription factor heat-shock-factor 1 (HSF1). We recently identified that wild-type p53 reduces the HSR by repressing HSF1 via a p21-CDK4/6-MAPK-HSF1 axis. Here, we test whether in HSP90-based therapies, simultaneous p53 activation or direct cell cycle inhibition interrupts the deleterious HSF1-HSR axis and improves the efficiency of HSP90 inhibitors. We found that the clinically relevant p53 activator Idasanutlin suppresses the HSF1-HSR activity in HSP90 inhibitor-based therapies. This combination synergistically reduces cell viability and accelerates cell death in p53-proficient colorectal cancer (CRC) cells, murine tumor-derived organoids, and patient-derived organoids (PDOs). Mechanistically, upon combination therapy, CRC cells upregulate p53-associated pathways, apoptosis, and inflammatory pathways. Likewise, in a CRC mouse model, dual HSF1-HSP90 inhibition represses tumor growth and remodels immune cell composition. Importantly, inhibition of the cyclin-dependent kinases 4/6 (CDK4/6) under HSP90 inhibition phenocopies synergistic repression of the HSR in p53-proficient CRC cells. Moreover, in p53-deficient CRC cells, HSP90 inhibition in combination with CDK4/6 inhibitors similarly suppresses the HSF1-HSR and reduces cancer growth. Likewise, p53-mutated PDOs respond to dual HSF1-HSP90 inhibition, providing a strategy to target CRC independent of the p53 status. In sum, we provide new options to improve HSP90-based therapies to enhance CRC therapies.

Peripheral complete blood cell count (CBC) and blood ratios, including neutrophil-to-lymphocyte ratio (NLR), neutrophil-to-red blood cell ratio (NRR), and platelet-to-lymphocyte ratio (PLR), have been used in the diagnosis and prognosis of several cancers; however, their relevance in canine splenic hemangiosarcoma (HSA) remains to be investigated. This study investigated whether CBC, NLR, NRR, and PLR could be diagnostic and prognostic biomarkers in dogs with splenic HSA. Analyzing medical records of 154 dogs undergoing splenectomy from 2018 to 2022, we found that dogs diagnosed with splenic HSA (n = 63) had significantly higher neutrophil counts (14.9 ± 9.7 vs. 12.6 ± 9.6; p < 0.001), increased NRR (3.7 ± 2.6 vs. 2.7 ± 3.7; p < 0.001), lower platelet counts (145 ± 111 vs. 270 ± 213; p < 0.001), and reduced PLR (139.4 ± 160.0 vs. 259.9 ± 278.0; p < 0.001) compared to dogs with other splenic lesions. This study also identified a higher risk of relapse and mortality associated with increased NRR (p < 0.001 and p = 0.012, respectively) and an inverse relationship with PLR (p = 0.015 and p = 0.033, respectively), whereas NLR showed no significant association. The multivariate survival analysis identified NRR as an independent prognostic factor for DFI [hazard ratio (1.837); 95% confidence interval (1.147-2.942); p = 0.011], while for OS, the association did not reach statistical significance [hazard ratio (1.510); 95% confidence interval (0.985-2.314); p = 0.059]. These findings highlight the potential of NRR and PLR as biomarkers for assessing diagnosis and prognosis in canine splenic HSA, advocating for further validation in the future.

This study investigates the link between inflammatory markers and liver fibrosis in type 2 diabetes mellitus (T2DM) patients with metabolic dysfunction-associated fatty liver disease (MAFLD).

From Oct 2020 to Oct 2024, 769 hospitalized T2DM patients were studied. They were split into Control (n=389) and Experimental groups (T2DM with MAFLD, n=380). The Experimental group was further divided based on FIB-4 scores into non-fibrosis (FIB-4< 1.3, n=267), suspected fibrosis (1.3 ≤ FIB-4 ≤ 2.67, n=99), and advanced fibrosis (FIB-4 > 2.67, n=14). Logistic regression identified factors affecting liver fibrosis, while ROC analysis assessed the predictive value of NLR, SIRI, PLR, and PHR for liver fibrosis in T2DM-MAFLD patients.

The Experimental group showed higher BMI, FPG, TG, TC, LDL-C, ALT, AST, ALB, GGT, and SUA, but lower age, diabetes duration, MPV, and HDL-C (P< 0.05). Compared to non-fibrosis, suspected fibrosis had higher age, diabetes duration, MPV, AST, and NLR, and lower LY, PLR, PHR. Advanced fibrosis featured higher age, AST, NLR, FPG, HbA1c, SIRI, and lower LY, RBC, LDL-C, PLR, PHR, Hb, PLT, and ALB (P< 0.05). Logistic regression identified NLR, SIRI, PLR, and PHR as significant factors for liver fibrosis. ROC analysis showed AUCs of 0.712 (NLR), 0.757 (SIRI), 0.703 (PLR), and 0.806 (PHR) with sensitivities and specificities varying among markers. Optimal cut-offs were 1.573 (NLR), 1.465 (SIRI), 110.819 (PLR), and 185.379 (PHR).

NLR, SIRI, PLR, and PHR significantly influence liver fibrosis in T2DM patients with MAFLD, aiding in its diagnosis and management.

This study aimed to explore the relationship between the systemic immune-inflammatory index (SII) and the probability of in-hospital mortality among acute ischemic stroke (AIS) with atrial fibrillation (AF) patients undergoing intravenous thrombolysis.

This single-center, retrospective observational study included individuals among AIS with AF who received intravenous thrombolysis. The SII is determined by taking the product of the platelet and neutrophil counts, followed by dividing this result by the lymphocyte count. In-hospital mortality was defined as a Modified Rankin Scale (mRS) score of 6 point. The investigation applied logistic regression models, along with subgroup, sensitivity, and receiver operating characteristic (ROC) curve analyses assessments, to explore the relationship between the SII and in-hospital mortality.

541 patients were included in this study, 50 (9.24%) of whom died during their hospital stay. Multifactorial logistic regression analyses using fully adjusted models, demonstrated that the SII is independently associated with the risk of in-hospital death. Patients with elevated SII levels experienced a significantly increased risk of in-hospital mortality, which was found to be 2.557 (95% CI: 1.154-5.665, P = 0.021) times greater compared to those with lower SII levels. Through multivariate logistic regression analyses, a notable correlation between the SII and the probability of death during hospitalization was observed across various subgroups, including individuals aged ≤75 and >75years, women, patients with persistent AF, those receiving thrombolytic therapy, diabetic and nondiabetic patients, individuals with BMI ≥24 kg/m2, and those with an admission National Institutes of Health Stroke Scale score ≤20 (P < 0.05). Two sensitivity analyses confirmed the robustness of this association from multiple perspectives (P < 0.05). ROC analysis demonstrated that the SII, the baseline model, and their combined model all showed strong predictive power for in-hospital mortality. Notably, the combined model outperformed the SII alone (P < 0.05). In addition, the predictive value of SII for in-hospital death was significantly higher than that of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR).

A significant association has been observed between the risk of in-hospital death among AIS with AF individual undergoing intravenous thrombolysis and the SII.

Background/Objectives: Identifying reliable biomarkers for healthy aging and longevity is a fundamental challenge in aging research and medical sciences. The neutrophil-to-lymphocyte ratio (NLR) is a readily measurable indicator of immune balance that reflects the interplay between innate immune activation and adaptive immune suppression. Methods: This study examined NLR values in 204 physically healthy residents (98 men and 106 women) stratified into four lifespan categories based on death certificates. Page's test and ordinal regression (Cumulative Link Model) were used to assess trends with longevity. Results: In men, a downward trend in NLR values was observed. In women, a significant age-related decline in NLR was identified, with longer-lived individuals showing notably lower NLR values compared to their shorter-lived counterparts. The findings suggest that lower NLR is associated with longer survival, particularly in older women, reflecting superior immune regulation and reduced systemic inflammation. Conversely, elevated NLR may indicate immune dysfunction and heightened inflammatory burden. Conclusions: The results of this study complement existing findings, reinforcing the critical importance of immune balance in supporting healthy aging and longevity. These findings also underscore the potential of NLR as a robust biomarker for evaluating immune function and anticipating resilience to age-related decline, offering a practical tool for assessing immune health in the aging population.

Although there are multiple treatment options, oncologists lack appropriate biomarkers for determining the efficacy and toxicity of immunotherapy. In this study, we aimed to use a combination of the clinical parameters of IMDC risk groups at the time of diagnosis to predict the effectiveness of immunotherapy.

This multicenter cross-sectional study retrospectively analyzed non-small cell lung cancer (NSCLC) patients receiving nivolumab for the prognostic effects of clinical factors, including the IMDC score.

Two hundred and five patients were enrolled in this study. There was no favorable group because the TTI was less than 1 year in the entire study group in the IMDC. The IMDC score and IMDC groups showed significant differences in PFS (p < 0.001; p < 0.001, respectively). Intermediate and poor-risk groups had PFS of 8 and 3 months PFS, respectively. The IMDC group showed a significant effect on OS (p = 0.002). The intermediate- and poor-risk groups had 12- and 4-month OS, respectively. The TTI risk factor excluded patient numbers in the favorable, intermediate, and poor risk groups were 47, 129, and 29, respectively, in the revised IMDC group (rIMDC). The prognostic effect of the rIMDC score and groups remained significant (p < 0.001 and p < 0.001, respectively). The classical IMDC had a significant effect on PFS in the multivariate analysis (p = 0.016). Also, rIMDC score in multivariate analysis resulted with significant effect on OS (p = 0.035).

To date, this is the first study to prove that the IMDC may be a valuable option for predicting both prognosis and treatment efficacy in NSCLC patients receiving especially second or further lines nivolumab treatment.

Few studies have examined the prognosis of long-term survivors with gastric cancer (GC) after gastrectomy. This study aimed to identify the prognostic factors for 5-year recurrence-free survivors after gastrectomy for GC.

A total of 721 patients with pathologic stage Ⅰ to Ⅲ GC who underwent gastrectomy between 2005 and 2018 and survived for 5 years without recurrence were enrolled. Conditional overall survival (cOS), conditional disease-specific survival (cDSS), and conditional non-disease-specific survival (cNDSS) of 5-year recurrence-free survivors were calculated. The association between cOS, cDSS, and cNDSS and clinicopathologic factors was evaluated using univariate and multivariate analyses.

The mean age of the patients was 70.5 ± 10.1 years, 68.5% of the patients were male, and 491, 128, and 102 had stage Ⅰ, Ⅱ, and Ⅲ GC, respectively. Of note, 17 patients relapsed, and 65 patients died (disease-specific, non-disease-specific, and unknown: 12, 45, and 6, respectively) during a median follow-up of 36 months. The 5-year cOS, cDSS, and cNDSS rates were 90.3%, 97.3%, and 93.3%, respectively. Multivariate analysis showed that age of ≥80 years and neutrophil-to-lymphocyte ratio (NLR) of ≥2.7 were significantly associated with poorer cOS. Stage Ⅲ GC was associated with decreased cDSS, and age of ≥80 years, NLR of ≥2.7, and mean corpuscular volume (MCV) of ≥93.4 fL were associated with lower cNDSS.

Age of ≥80 years, stage Ⅲ GC, NLR of ≥2.7, and MCV of ≥93.4 fL were unfavorable prognostic factors for 5-year recurrence-free survivors after gastrectomy for GC. Long-term surveillance after gastrectomy could be tailored based on these factors.

Multiple inflammatory and nutritional biomarkers have been established as independent prognostic factors across various solid tumors, but their role in outcomes prediction for glioma is still under investigation. Aim of the present systematic review is to report the available evidence regarding the impact of nutritional assessment and intervention for glioma prognosis and patients' quality of life (QoL).

Our systematic review conformed to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The PubMed and EMBASE databases were searched to identify studies assessing the impact of nutritional status and intervention and hematological biomarkers on survival outcomes and quality of life in patients with newly diagnosed gliomas. In the search strategy Medical Subject Headings (MeSH) terms were used. Search terms included ("nutritional status" or "nutritional assessment" or "nutritional intervention") AND ("glioma" or "glioblastoma" or "high-grade glioma" or "low-grade glioma" or "anaplastic astrocytoma" or "anaplastic oligodendroglioma") AND ("prognosis" or "survival outcomes"). The quality of each study was investigated based on the Newcastle-Ottawa Scale (NOS) criteria. Selected papers were in English and included publications in humans. This study was registered on PROSPERO (Registration No. CRD42024555442).

Our search retrieved 20 papers published between 2015 and 2023, all aiming at investigating correlations between hematological biomarkers (albumin, prealbumin, fibrinogen) and/or nutritional tools (Controlling Nutritional Score, CONUT; Prognostic Nutritional Index, PNI) and survival outcomes and quality of life of glioma patients. Nutritional intervention as well was evaluated for outcomes prediction. Overall, most papers contributed to the evidence of how nutritional assessment and inflammatory biomarkers could play an independent prognostic role also in the management of glioma patients.

PNI, CONUT score and hematological biomarkers (e.g. albumin, globulin, neutrophils, lymphocytes) may serve as useful predictors in patients with gliomas, potentially influencing clinical decisions. Additional large-scale studies are required to validate these findings and determine the mechanisms by which nutritional status, systemic inflammation and immune status affect prognosis in glioma patients.

High neighborhood deprivation is linked to increased cancer and overall mortality. Prior studies demonstrated higher inflammation in people from high deprivation areas. The area deprivation index (ADI) is a composite measure of income, education, employment, and housing, which quantifies neighborhood deprivation. We used the All of Us dataset to test whether inflammation, measured via c-reactive protein (CRP), albumin, and the neutrophil-to-lymphocyte ratio (NLR), differs by ADI in cancer survivors.

Our sample included individuals with a history of lung, breast, prostate, and colorectal cancer, filtered for the presence of the inflammatory biomarkers. We used quartiles of ADI based on 3-digit zip code and biomarkers from electronic health records. We estimated the association between ADI and inflammation using adjusted logistic regression (n = 690 for CRP; n = 4242 for albumin; n = 5183 for NLR).

The sample had a mean age of 66.2 ± 10.1 years, 63.0% were female, and 86.8% were White. Mean CRP (11.5 ± 17.5 mg/L) and NLR (3.6 ± 2.2) indicated moderate to high inflammation. In the fully adjusted model, there were 2.04 (95% CI:1.02, 4.11) and 2.17 higher odds (95% CI:1.16, 4.13) of elevated CRP when comparing quartile 4 and quartile 3, respectively, to the lowest ADI quartile. Regression models were not significant for albumin or NLR.

Area deprivation is associated with CRP, a marker of stress that may lead to a higher risk of chronic diseases among cancer survivors. Future studies using a sample of cancer survivors with a wider range of ADI may help to strengthen this association.

Background/Objectives: To evaluate the prognostic value of easily obtainable biomarkers for patients undergoing percutaneous microwave ablation (MWA) for colorectal liver metastases (CLMs). Prior studies showed that simple biomarkers, such as the lymphocyte-to-monocyte ratio (LMR), albumin-to-globulin ratio (AGR), platelet-to-lymphocyte ratio (PLR), and neutrophil-to-lymphocyte ratio (NLR), as well as cancer-specific markers, like carcinoembryonic antigen (CEA), might have a prognostic role in various malignancies; however, none of these were assessed in patients undergoing MWA for CLMs. Methods: Based on the simple laboratory results, which were determined prior to the ablation, several biomarkers, including the LMR, AGR, PLR, and NLR, were calculated. The log-rank test's optimal cutoff points for continuous variables were determined. Subsequently, univariable and multivariable Cox regression models were utilized to determine the association between various features and overall survival (OS). Results: This study included 57 CLM patients with a mean age of 63 ± 12.5 years at the time of ablation with a mean follow up of 30.9 months. The univariable model demonstrated that a high level of CEA (cutoff: 29.1 ng/mL; HR: 3.70) and a high LMR (cutoff: 5.32; HR: 4.05) were related to worse OS, whereas a high NLR (cutoff: 2.05; HR: 0.31) and primary left-sided colon cancer (HR: 0.36) were positive prognostic factors. The multivariable regression model confirmed these findings, with the exception of the LMR, which was no longer significantly associated with OS. Conclusions: This study demonstrates the feasibility of overall survival prediction and thus patient stratification based on easily obtainable biomarkers and clinicopathological features in CLM patients undergoing MWA.