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Di Fiore R, Drago-Ferrante R, Suleiman S, Veronese N, Pegreffi F, Calleja-Agius J. Sarcopenia in gynaecological cancers. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2025; 51:108403. [PMID: 38760237 DOI: 10.1016/j.ejso.2024.108403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 04/26/2024] [Accepted: 05/07/2024] [Indexed: 05/19/2024]
Abstract
Gynaecological cancers (GCs) comprise a group of cancers that originate in the female reproductive organs. Each GC is unique, with different signs and symptoms, risk factors and therapeutic strategies. Worldwide, the majority of GCs are still associated with high mortality rates, especially ovarian, due to difficulty in early detection. Despite numerous studies on the underlying pathophysiology, research in the field of GCs poses unique scientific and technological challenges. These challenges require a concerted multi- and inter-disciplinary effort by the clinical, scientific and research communities to accelerate the advancement of prognostic, diagnostic, and therapeutic approaches. Sarcopenia is a multifactorial disease which leads to the systemic loss of skeletal muscle mass and function. It can be caused by malignancies, as well as due to malnutrition, physical inactivity, ageing and neuromuscular, inflammatory, and/or endocrine diseases. Anorexia and systemic inflammation can shift the metabolic balance of patients with cancer cachexia towards catabolism of skeletal muscle, and hence sarcopenia. Therefore, sarcopenia is considered as an indicator of poor general health status, as well as the possible indicator of advanced cancer. There is a growing body of evidence showing the prognostic significance of sarcopenia in various cancers, including GCs. This review will outline the clinical importance of sarcopenia in patients with GCs.
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Affiliation(s)
- Riccardo Di Fiore
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, MSD 2080, Msida, Malta; Sbarro Institute for Cancer Research and Molecular Medicine, Center for Biotechnology, College of Science and Technology, Temple University, Philadelphia, PA, 19122, USA.
| | - Rosa Drago-Ferrante
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, MSD 2080, Msida, Malta; BioDNA Laboratories, Malta Life Sciences Park, SGN 3000, San Gwann, Malta.
| | - Sherif Suleiman
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, MSD 2080, Msida, Malta.
| | - Nicola Veronese
- Department of Internal Medicine, Geriatrics Section, University of Palermo, 90128, Palermo, Italy.
| | - Francesco Pegreffi
- Department of Medicine and Surgery, Kore University of Enna, 94100, Enna, Italy.
| | - Jean Calleja-Agius
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, MSD 2080, Msida, Malta.
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Horisaki K, Yoshikawa S, Mori S, Omata W, Tsutsumida A, Kiyohara Y. Prognostic value of the CONUT score with immune checkpoint inhibitors as first-line therapy for metastatic malignant melanoma. J Dermatol 2025; 52:615-623. [PMID: 39916640 PMCID: PMC11975212 DOI: 10.1111/1346-8138.17613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2024] [Revised: 12/13/2024] [Accepted: 12/20/2024] [Indexed: 04/08/2025]
Abstract
The recent availability of immune checkpoint inhibitors (ICIs) has revolutionized the treatment of advanced malignant melanoma (MM). However, many patients with MM do not benefit from ICI treatment. As immunotherapy is associated with significant toxicity and high treatment costs despite its excellent efficacy, it is pertinent to select patients who are likely to respond to ICIs. In this single-center, retrospective study we investigated whether the controlling nutritional status (CONUT) score is a useful prognostic marker in Japanese patients with advanced-stage cancer. We analyzed 123 patients with stage IV MM treated with ICIs as first-line systemic treatment at our hospital between February 2012 and July 2024. Receiver operating characteristic curve analysis was used to calculate the CONUT cut-off value and CONUT into two groups of ≥3 and ≤2. Progression-free survival (PFS) and overall survival (OS) were determined using the Kaplan-Meier method, and differences in survival were assessed using the log-rank test. The Cox proportional hazard regression model was used to evaluate independent prognostic factors. Objective response rate (ORR), PFS, and OS were significantly low in the CONUT ≥3 group, characterized by low nutritional status and high inflammation. Multivariate analysis identified the CONUT score as an independent prognostic factor for both PFS and OS. The CONUT score was not significantly associated with the development of serious immune-related adverse events. The simplicity of the CONUT score may aid in identifying patients with MM who are suitable candidates for ICI treatment.
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Affiliation(s)
- Ken Horisaki
- Department of DermatologyShizuoka Cancer CenterShizuokaJapan
- Department of DermatologyNagoya University Graduate School of MedicineNagoyaJapan
| | | | - Shoichiro Mori
- Department of DermatologyNagoya University Graduate School of MedicineNagoyaJapan
| | - Wataru Omata
- Department of DermatologyShizuoka Cancer CenterShizuokaJapan
| | | | - Yoshio Kiyohara
- Department of DermatologyShizuoka Cancer CenterShizuokaJapan
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Acar C, Yüksel HÇ, Şahin G, Açar FP, Gunenc D, Karaca B. Prognostic utility of the CALLY index in metastatic melanoma: building a nomogram for Patients on Anti-PD-1 therapy. Clin Transl Oncol 2025:10.1007/s12094-025-03888-z. [PMID: 40091005 DOI: 10.1007/s12094-025-03888-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2024] [Accepted: 02/25/2025] [Indexed: 03/19/2025]
Abstract
BACKGROUND Despite the success of immune checkpoint inhibitors (ICIs) in metastatic melanoma, many patients fail to derive meaningful benefit, underscoring the urgent need for accessible prognostic biomarkers. The C-reactive protein (CRP)-albumin-lymphocyte (CALLY) index, an immunonutritional index, has shown prognostic value in various cancers. Previous studies indicate that systemic inflammation and nutritional status influence ICI efficacy, suggesting the potential relevance of the CALLY index in metastatic melanoma. This study evaluates the CALLY index's role in metastatic melanoma patients treated with anti-PD-1 therapy. METHODS This retrospective study analysed 92 patients with metastatic melanoma who were treated with anti-PD-1 monotherapy at Ege University's Faculty of Medicine between 2015 and 2023. The CALLY index was calculated using the pre-treatment CRP, albumin and lymphocyte levels. Kaplan-Meier analysis was used to estimate survival outcomes, and univariate and multivariate Cox regression models were employed to identify independent prognostic factors. A predictive nomogram incorporating the CALLY index and other significant variables was then developed. RESULTS The optimal CALLY index cutoff was determined to be 2. Patients with a low CALLY index (≤ 2) had worse median overall survival (OS) and progression-free survival (PFS) when compared with those who had a high CALLY index (> 2) (median OS: 9.6 vs 31.3 months, p < 0.001; median PFS: 3.8 vs 10.6 months, p = 0.001). Multivariate analysis identified the CALLY index, lactate dehydrogenase above the upper limit of normal, Eastern Cooperative Oncology Group score ≥ 2, M1c/M1d staging and acral/mucosal melanoma subtypes to be independent predictors of OS. A nomogram was then constructed based on these factors, yielding a concordance index of 0.705 (95% confidence interval: 0.634-0.776). This model stratified patients into low-, intermediate- and high-risk groups, with the high-risk group showing significantly worse OS than the intermediate- and the low-risk groups (p < 0.001). CONCLUSION The CALLY index is a cost-effective and independent prognostic biomarker that can aid in risk stratification and guide treatment decisions in patients with metastatic melanoma receiving anti-PD-1 therapy.
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Affiliation(s)
- Caner Acar
- Division of Medical Oncology, Department of Internal Medicine, Ege University Medical Faculty, 35100, Izmir, Turkey.
| | - Haydar Çağatay Yüksel
- Division of Medical Oncology, Department of Internal Medicine, Ege University Medical Faculty, 35100, Izmir, Turkey
| | - Gökhan Şahin
- Division of Medical Oncology, Department of Internal Medicine, Ege University Medical Faculty, 35100, Izmir, Turkey
| | - Fatma Pinar Açar
- Division of Medical Oncology, Department of Internal Medicine, Ege University Medical Faculty, 35100, Izmir, Turkey
| | - Damla Gunenc
- Division of Medical Oncology, Hatay Training and Research Hospital, 3100, Hatay, Turkey
| | - Burçak Karaca
- Division of Medical Oncology, Department of Internal Medicine, Ege University Medical Faculty, 35100, Izmir, Turkey
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Song J, Liu T, Huang Q, Lv Y, Wen Y, Wang R, Bie J. Prognostic value of prognostic nutritional index in patients with nasopharyngeal carcinoma treated with endostar and concurrent chemoradiotherapy. Support Care Cancer 2025; 33:226. [PMID: 40011250 DOI: 10.1007/s00520-025-09280-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2024] [Accepted: 02/17/2025] [Indexed: 02/28/2025]
Abstract
PURPOSE This study aimed to evaluate the prognostic value of the pre-treatment prognostic nutritional index (PNI) in patients with locally advanced nasopharyngeal carcinoma (LANPC) treated with endostar combined with concurrent chemoradiotherapy (ECCRT). METHODS Clinical data from 92 patients with LANPC who underwent ECCRT between May 2015 and December 2020 were retrospectively analyzed. The PNI was calculated using peripheral blood samples taken 1 week before treatment. The optimal cut-off value for PNI was determined via receiver operating characteristic (ROC) curve analysis based on overall survival (OS). Patients were categorized into high PNI and low PNI groups. The Kaplan-Meier method assessed the impact of PNI on survival, while univariate and multivariate Cox regression analyses identified independent risk factors affecting patient survival. RESULTS The optimal cut-off value of PNI was 50.05. The 3-year OS, progression-free survival (PFS), distant metastasis-free survival (DMFS), and local recurrence-free survival (LRRFS) rates were 91.07% vs. 75.00% (P = 0.002), 83.93% vs. 66.67% (P = 0.015), 89.29% vs. 69.44% (P = 0.004), and 94.64% vs. 91.67% (P = 0.668) in the high PNI and low PNI groups, respectively. A low PNI was associated with shorter OS (HR = 3.592, P = 0.004), PFS (HR = 2.890, P = 0.017), and DMFS (HR = 3.826, P = 0.008). Multivariate analysis revealed that PNI was an independent prognostic factor for OS, PFS, and DMFS. CONCLUSIONS The PNI may serve as a valuable prognostic predictor for patients with LANPC receiving ECCRT, aiding clinicians in selectively providing multimodal interventions to optimize survival outcomes.
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Affiliation(s)
- JunMei Song
- Department of Oncology, Beijing Anzhen Nanchong Hospital, Capital Medical University (Nanchong Central Hospital), 637000, Nanchong, Sichuan, China
- The Second Clinical Medical College of North, Sichuan Medical College, 637000, Nanchong, Sichuan, China
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, 530021, Nanning, Guangxi, China
| | - Ting Liu
- Second Division of Department of Radiation Oncology, Guangxi Academy of Medical, Sciences & the People's Hospital of Guangxi Zhuang Autonomous Region, 530021, Nanning, Guangxi, China
| | - Qiulin Huang
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, 530021, Nanning, Guangxi, China
| | - YuQing Lv
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, 530021, Nanning, Guangxi, China
| | - YaJing Wen
- Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, 510515, Guangzhou, China
| | - RenSheng Wang
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, 530021, Nanning, Guangxi, China.
| | - Jun Bie
- Department of Oncology, Beijing Anzhen Nanchong Hospital, Capital Medical University (Nanchong Central Hospital), 637000, Nanchong, Sichuan, China.
- The Second Clinical Medical College of North, Sichuan Medical College, 637000, Nanchong, Sichuan, China.
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Wang S, Zhou H, Dong L, Qin W. Prognostic nutritional index as an independent risk factor for disease progression in patients with IgA nephropathy. Front Med (Lausanne) 2025; 12:1530312. [PMID: 40070651 PMCID: PMC11893860 DOI: 10.3389/fmed.2025.1530312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2024] [Accepted: 01/31/2025] [Indexed: 03/14/2025] Open
Abstract
Background Immunoglobulin A nephropathy (IgAN), a common primary glomerulonephritis worldwide, has been investigated, and complex factors are involved in disease progression. A group of evidence emerged that nutrition status plays a nonsubstitutable role in the management of chronic kidney disease. Meanwhile, a novel marker of nutrition and inflammation, the prognostic nutritional index (PNI), has been studied in various diseases. Whether PNI can predict the renal outcome of patients with IgAN remains unclear. Thus, we aimed to evaluate the relationships between PNI and clinicopathologic features, renal progression and renal prognosis in patients with IgAN. Methods A total of 1,377 patients with biopsy-proven IgAN were recruited for this retrospective study. All patients were divided into two groups based on the cutoff value of PNI: the high group (PNI ≥ 47.1, n = 886) and the low group (PNI < 47.1, n = 491). Our study endpoint was end-stage renal disease [estimated glomerular filtration rate (eGFR) < 15 mL/min/1.73 m2 or performance of renal replacement therapy]. A correlation test was conducted to explore the relationship between PNI and other important clinicopathologic parameters. The predictive value was determined by the area under the receiver operating characteristic curve (AUROC). Kaplan-Meier and Cox proportional hazards analyses were performed to assess the value of PNI in predicting renal progression and prognosis. Results The correlation test revealed that PNI was positively associated with eGFR (r = 0.16, p < 0.001) and negatively related to 24-h proteinuria (r = -0.387, p < 0.001). Multivariate Cox regression analysis indicated that low PNI was an independent risk factor for IgAN patients even after adjusting for important clinical and pathological parameters (HR, 0.664; 95% CI, 0.443-0.994; p = 0.047). Kaplan-Meier analysis showed that low PNI was significantly correlated with severe renal outcome in patients with IgAN (p < 0.001). Moreover, the subgroup analyses of Kaplan-Meier survival demonstrated that low PNI predicted severe renal prognosis in different types of IgAN patients when considering the level of glomerular filtration rate, 24 h proteinuria and hemoglobin. Conclusion PNI is associated with renal function and pathologic lesions in IgAN patients and could be a novel marker for the evaluation of renal progression and prognosis.
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Affiliation(s)
- Siqing Wang
- Division of Nephrology, Department of Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Huan Zhou
- Division of Nephrology, Department of Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Lingqiu Dong
- Division of Nephrology, Department of Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Wei Qin
- Division of Nephrology, Department of Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
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Zhang Y, Qu Z, Xuan H, Lu L, Ding C, He Z, Gu K, Zhang Y. Efficacy Assessment and Prognostic Value of Inflammatory Markers in Patients with Stage IV Acral and Cutaneous Melanoma Receiving PD-1 Inhibitors. J Inflamm Res 2025; 18:2531-2544. [PMID: 39995827 PMCID: PMC11849423 DOI: 10.2147/jir.s509928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2024] [Accepted: 02/10/2025] [Indexed: 02/26/2025] Open
Abstract
Background Malignant melanoma (MM) is a highly aggressive cancer. Different subtypes have different sensitivities to immunotherapy and lack peripheral blood markers. Few studies have examined the role of inflammatory markers in predicting the overall survival (OS) in stage IV acral melanoma (AM) and cutaneous melanoma (CM) patients receiving immunotherapy. Purpose This study aimed to investigate the value of inflammatory markers in efficacy and prognosis for stage IV melanoma patients who underwent immunotherapy. Patients and Methods This multicenter study reviewed the clinicopathological characteristics and inflammatory markers of 94 stage IV AM and CM patients receiving PD-1 inhibitors therapy. Pearson's chi-squared test or Fisher's exact test was used to compare baseline characteristics. The optimal cut-off values for these markers were stratified using time-dependent receiver operating characteristic curves (t-ROC). Kaplan-Meier (KM) curves and Log rank test were used to explore the relationship between inflammatory markers and survival outcomes. Cox regression analysis was performed to screen for independent prognostic factors and a nomogram was constructed. The model ability was tested by the C-index, t-ROC, calibration curves, and decision curve analysis curves. Results High NLR level was significantly correlated with lymph node metastasis and 3 or above metastatic sites (P=0.009, P=0.012). High PNI level favored a better ECOG PS (P=0.023). According to the KM curves, patients with baseline NLR>2.37, PNI<=42.65, and RLR>11.08 had worse OS (P<0.001, P<0.001, P<0.001). Cox regression analysis based on P<0.05 showed that M1c/M1d (P<0.001), NLR (P=0.003), and PNI (P<0.001) were significantly correlated with OS, and were visualized in a nomogram. C-index, t-ROC, area under the curve (AUC), and calibration curves revealed promising discrimination and accuracy of the nomogram. Decision curve analysis curves showed good clinical utility. Conclusion We established a prognostic predictive model based on distant metastatic sites, NLR, and PNI, and verified its superior performance and potential for clinical application.
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Affiliation(s)
- Yan Zhang
- Department of Oncology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, People’s Republic of China
| | - Ziting Qu
- Department of Oncology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, People’s Republic of China
| | - Han Xuan
- Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, People’s Republic of China
| | - Lili Lu
- Department of Oncology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, People’s Republic of China
| | - Cuicui Ding
- Department of Oncology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, People’s Republic of China
| | - Ziran He
- Department of Oncology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, People’s Republic of China
| | - Kangsheng Gu
- Department of Oncology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, People’s Republic of China
| | - Yiyin Zhang
- Department of Oncology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, People’s Republic of China
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Kundi F, Paksoy ZB. The Value of Prognostic Nutritional Index in Patients with Deep Neck Space Infection. Niger J Clin Pract 2025; 28:237-242. [PMID: 40326907 DOI: 10.4103/njcp.njcp_34_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 12/27/2024] [Indexed: 05/07/2025]
Abstract
BACKGROUND Antibiotic therapy is pivotal in deep neck space infections, yet inappropriate use and antibiotic resistance impact patient outcomes. AIM This study aimed to evaluate the clinical significance of admission prognostic nutritional index (PNI) as a prognostic marker. METHODS Data from 81 hospitalized patients (mean age 33.9 years) with deep neck space infections confirmed by CT scans were analyzed (Nov 2020 - Sep 2023). PNI, derived from serum albumin and lymphocyte count, was calculated. Primary outcome was antibiotic resistance; secondary outcome was length-of-stay. RESULTS Patients with antibiotic resistance (n = 24) had significantly lower PNI (mean 47.3, SD = 9.2) compared to the non-resistant group (n = 57, mean 57.5, SD = 12.2), P < 0.001. Adjusted multivariable analysis showed PNI as a significant predictor of antibiotic resistance (OR = 0.908, 95% CI 0.837-0.984, P = 0.004). ROC analysis established a PNI cut-off of 51.5 with 59% sensitivity and 80% specificity. Linear regression revealed decreasing PNI associated with prolonged length-of-hospital stays (adjusted R-squared = 0.40, P = 0.010). CONCLUSIONS The study underscores PNI's potential as a prognostic marker for deep neck space infections, particularly in predicting antibiotic resistance and length of hospital stay. Lower PNI values correlate with compromised nutritional and immune status, suggesting its clinical relevance for personalized treatment strategies.
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Affiliation(s)
- Fcs Kundi
- Department of Otorhinolaryngology, Ankara Yildirim Beyazit University, Çankaya, Ankara, Turkey
- Department of Otorhinolaryngology, Ankara City Hospital, Çankaya, Ankara, Turkey
| | - Z B Paksoy
- Department of Otorhinolaryngology, Ankara City Hospital, Çankaya, Ankara, Turkey
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Zhang F, Xie Y, Liu L, Liu H, Feng O, Li Y, Dang Y. Association of Immune Nutrition Indices with the Risk of All-Cause Mortality and Cardiovascular Mortality in Patients with Heart Failure in the NHANES (1999-2018). Rev Cardiovasc Med 2025; 26:25055. [PMID: 39867204 PMCID: PMC11759971 DOI: 10.31083/rcm25055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Revised: 07/02/2024] [Accepted: 07/09/2024] [Indexed: 01/28/2025] Open
Abstract
Background Heart failure (HF) remains a global challenge with disappointing long-term outcomes. Malnutrition is prevalent in patients with HF and disrupts the equilibrium of immune and inflammatory responses, resulting in further deterioration of the HF. Novel indicators emerge as immune nutrition indices, including the prognostic nutritional index (PNI), neutrophil-to-lymphocyte ratio (NLR), Controlling Nutritional Status (CONUT) score, and cholesterol-modified prognostic nutritional index (CPNI). This study examines the correlation between immune nutrition indices and all-cause and cardiovascular mortality in patients with HF. Methods The data source for this study was the National Health and Nutrition Examination Survey (NHANES). A total of 1232 participants with HF were included. Weighted Cox proportional hazards models were employed to assess the independent association of different immune nutrition indices with mortality risk, alongside subgroup analyses and Kaplan-Meier survival curves. Restricted cubic spline analysis was utilized to clarify the detailed association between immune nutrition indices and hazard ratio (HR). A time-dependent receiver operating characteristic curve analysis was conducted to assess the predictive ability. Results After full adjustments, PNI is independently related to all-cause mortality (HR = 0.94, 95% CI: 0.92-0.97) and cardiovascular mortality (HR = 0.94, 95% CI: 0.90-0.99). CPNI, CONUT, and NLR also showed an independent association with the prognosis of HF. Time-dependent receiver operating characteristic curve analysis indicated that PNI exhibited the highest predictive power for mortality among the CPNI, CONUT, and NLR indexes. Conclusions Our study revealed that immune nutrition indicators, including CPNI, could predict all-cause mortality and cardiovascular mortality in the HF population. Compared with other indicators, PNI is the most effective predictor.
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Affiliation(s)
- Feifei Zhang
- Department of Cardiology Center, Hebei General Hospital, 050051 Shijiazhuang, Hebei, China
| | - Yuetao Xie
- Department of Cardiology Center, Hebei General Hospital, 050051 Shijiazhuang, Hebei, China
| | - Litian Liu
- Department of Cardiology Center, Hebei General Hospital, 050051 Shijiazhuang, Hebei, China
| | - Huiliang Liu
- Department of Cardiology Center, Hebei General Hospital, 050051 Shijiazhuang, Hebei, China
| | - Ohua Feng
- Department of Cardiology, Jingxing County Hospital, 050051 Shijiazhuang, Hebei, China
| | - Yingxiao Li
- Department of Cardiology Center, Hebei General Hospital, 050051 Shijiazhuang, Hebei, China
| | - Yi Dang
- Department of Cardiology Center, Hebei General Hospital, 050051 Shijiazhuang, Hebei, China
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Wei J, Xiang W, Wei H, Hu X, Lu Y, Dong X. Impact of nutrition risk index, prognostic nutritional index and skeletal muscle index on early myelosuppression of first-line chemotherapy in stage IV gastric cancer patients. BMC Gastroenterol 2024; 24:452. [PMID: 39695992 DOI: 10.1186/s12876-024-03548-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Accepted: 12/02/2024] [Indexed: 12/20/2024] Open
Abstract
BACKGROUND In gastric cancer (GC) patients, malnutrition is common and has a negative impact on treatment tolerance, survival, and prognosis. The purpose of this study was to explore the relationship between prechemotherapy nutritional state and early myelosuppression in stage IV GC patients treated with first-line chemotherapy. METHODS This retrospective study included patients with stage IV GC who received first-line chemotherapy between July 2012 and December 2021. Clinical and laboratory data were collected within 1 week before chemotherapy to calculate nutrition risk index, prognostic nutritional index. Pretreatment abdominal computed tomography scans were used to quantify skeletal muscle index (SMI). The main measurable outcome was the incidence of grade ≥ 2 early myelosuppression after chemotherapy. RESULTS Among 102 patients eligible for analysis, 50% were malnourished, 50% were poor prognoses and 49% were sarcopenic at baseline.The side effects were generally well managed, with a 26.5% occurrence of grade 3/4 side effects. Pre-chemotherapy patients with low Nutrition Risk Index (NRI) (p = 0.002), low prognostic nutritional index (PNI) (p = 0.001), and low SMI (p = 0.001) had significantly higher incidences of grade ≥ 2 myelosuppression occurred after the first cycle of chemotherapy. Moreover, the high level of PNI was associated with higher completion rate of chemotherapy (p = 0.01). Multivariate logistic regression analysis revealed that SMI at baseline (p = 0.006) and hemoglobin level (p = < 0.001) were prognostic factors for grade ≥ 2 early myelosuppression. CONCLUSION Stage IV GC patients with low NRI, low PNI and low SMI experienced significantly more grade ≥ 2 early myelosuppression during the first line of chemotherapy.
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Affiliation(s)
- Juan Wei
- Department of Medical Oncology, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang, China
| | - WeiFeng Xiang
- Department of Medical Oncology, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang, China
| | - HangPing Wei
- Department of Medical Oncology, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang, China
| | - XiaoYan Hu
- Department of Medical Oncology, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang, China
| | - YiFang Lu
- Department of Medical Oncology, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang, China
| | - XiaoFang Dong
- Department of Medical Oncology, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang, China.
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Ge Y, Liu X, Xu Y, Su Y, Li Y, Wang L. Combined systemic immune-inflammatory index and prognostic nutritional index predicts the efficacy and prognosis of ES-SCLC patients receiving PD-L1 inhibitors combined with first-line chemotherapy. Front Oncol 2024; 14:1485849. [PMID: 39697233 PMCID: PMC11652344 DOI: 10.3389/fonc.2024.1485849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2024] [Accepted: 11/12/2024] [Indexed: 12/20/2024] Open
Abstract
Background There is a strong association between inflammation and the formation, progression, and metastasis of malignant tumors, according to earlier studies. Some composite inflammation-nutritional indicators, such as the systemic immune-inflammation index (SII) and the prognostic nutritional index (PNI), have a certain predictive effect on the prognosis of patients with small cell lung cancer (SCLC). However, the relationship between these indicators and the efficacy of immunotherapy in SCLC patients is still not well understood. Therefore, the purpose of this study was to explore how the pre-treatment SII-PNI score can predict the tumor response and prognosis of extensive-stage SCLC patients treated with PD-L1 inhibitors and first-line chemotherapy. Methods This research conducted a retrospective review of 70 ES- SCLC patients from December 2019 to January 2023. According to the SII-PNI score, all patients were categorized into three groups. Overall survival (OS) was assessed by implementing the Kaplan Meier and Cox regression models. In addition, we devised a nomogram and scrutinized its accuracy in prediction through receiver operating characteristic (ROC) curve analysis and visualized it by calibration plots. Subsequently, a risk classification system was established. Results Patients with higher SII-PNI scores exhibited notably poorer survival outcomes compared to their counterpart with low SII-PNI score (p=0.008), as well as poorer short-term curative effects (p=0.004). The results of the multivariate analysis revealed that the SII-PNI score (p=0.036) had an independent association with a less favorable OS. The nomogram has been demonstrated to be a reliable prognostic tool for ES-SCLC patients. A notable difference was identified between the two different levels of risk. Conclusion The baseline SII-PNI score can serve as a reliable prognostic indicator for ES-SCLC patients receiving immunotherapy. Higher SII-PNI scores imply a worse prognosis.
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Affiliation(s)
- Yi Ge
- Department of Oncology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiaoyu Liu
- Department of Oncology, Luohe Central Hospital, Luohe, China
| | - Yishi Xu
- Department of Oncology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yanwei Su
- Department of Oncology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yixin Li
- Department of Oncology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Liping Wang
- Department of Oncology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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11
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Kaya MN, Kılıç Ö, Güneş EÇ, Tecer D, Yılmaz S. Indices and ferritin level that predict organ involvement in adult-onset Still's disease. Biomark Med 2024; 18:899-906. [PMID: 39317410 PMCID: PMC11508950 DOI: 10.1080/17520363.2024.2403330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Accepted: 09/09/2024] [Indexed: 09/26/2024] Open
Abstract
Aim: The aim of the study is to evaluate whether C-reactive protein to albumin ratio (CAR), lactate dehydrogenase to albumin ratio (LAR), ferritin to erythrocyte sedimentation rate ratio (FER), systemic immune-inflammation index (SII), prognostic nutritional index (PNI) indices and ferritin level can predict organ involvement in adult-onset Still's disease (AOSD) patients.Methods: This study was planned as a cross-sectional study. Univariate and multivariate logistic regression analyses were performed to evaluate the usefulness of ferritin level and inflammatory indices in defining organ involvement.Results: Sixty-one patients diagnosed with AOSD were included in this study. Multivariate logistic regression analyzes showed that LAR (OR 1.028, 95% CI: 1.011-1.044) (p = 0.001) index predicted lymphadenopathy involvement, CAR (OR 1.249, 95% CI: 1.087-1.435) (p = 0.002) index predicted hepatomegaly involvement, ferritin level (OR 1.004, 95% CI: 1.001-1.008) (p = 0.007) predicted splenomegaly involvement, FER (OR 1.085, 95% CI: 1.012-1.164) (p = 0.021) and PNI (OR 0.271, 95% CI: 1.132-0.553) (p < 0.001) index predicted the occurrence of serositis.Conclusion: This study showed that ferritin level, CAR, FER, PNI and LAR markers may predict organ involvement at diagnosis in AOSD patients.
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Affiliation(s)
- Mehmet Nur Kaya
- University of Health Sciences Turkey, Gülhane Training & Research Hospital, Rheumatology Department, Ankara, 38100, Turkey
| | - Özlem Kılıç
- University of Health Sciences Turkey, Gülhane Training & Research Hospital, Rheumatology Department, Ankara, 38100, Turkey
| | - Ezgi Çimen Güneş
- University of Health Sciences Turkey, Gülhane Training & Research Hospital, Rheumatology Department, Ankara, 38100, Turkey
| | - Duygu Tecer
- University of Health Sciences Turkey, Gülhane Training & Research Hospital, Rheumatology Department, Ankara, 38100, Turkey
| | - Sedat Yılmaz
- University of Health Sciences Turkey, Gülhane Training & Research Hospital, Rheumatology Department, Ankara, 38100, Turkey
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Endo S, Imai H, Shiono A, Hashimoto K, Miura Y, Okazaki S, Abe T, Mouri A, Kaira K, Masubuchi K, Masubuchi T, Kobayashi K, Minato K, Kato S, Kagamu H. The Glasgow Prognostic Score as a Predictor of Survival after Chemoradiotherapy for Limited-Disease Small Cell Lung Cancer. Oncology 2024; 103:83-93. [PMID: 39102792 DOI: 10.1159/000540651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Accepted: 07/26/2024] [Indexed: 08/07/2024]
Abstract
INTRODUCTION Established biomarkers for predicting chemoradiotherapy efficacy for limited-disease small cell lung cancer (LD-SCLC) are lacking. The inflammation-based Glasgow Prognostic Score (GPS), comprising serum C-reactive protein (CRP) and albumin levels, can predict survival in advanced cancer. This study investigated whether metabolic and inflammatory markers, including the GPS, can predict the efficacy of chemoradiotherapy in patients with LD-SCLC. METHODS We retrospectively analyzed 124 patients who underwent chemoradiotherapy for LD-SCLC at two institutions between April 2007 and June 2021, and assessed the prognostic significance of various metabolic and inflammatory markers. The GPS was calculated using the CRP and albumin concentrations, and categorized as follows: 0, CRP <1.0 mg/dL and albumin ≥3.5 mg/dL; 1, elevated CRP or decreased albumin; and 2, CRP ≥1.0 mg/dL and albumin<3.5 mg/dL. Differences in progression-free survival (PFS) and overall survival (OS) were examined using Kaplan-Meier curves and Cox proportional-hazard models. RESULTS The overall response rate was 95.1% (95% confidence interval [CI]: 89.6-97.9%). The median PFS and OS from chemoradiotherapy initiation were 12.6 (95% CI: 9.9-15.4) and 29.0 (95% CI: 24.8-45.5) months, respectively. The GPS demonstrated independent predictive ability for the effectiveness of chemoradiotherapy, wherein favorable scores (GPS 0-1) were significantly correlated with superior PFS and OS compared to unfavorable scores (GPS 2: PFS: 14.8 vs. 6.7 months, p = 0.0001; OS: 35.4 vs. 11.0 months, p < 0.0001). CONCLUSION This preliminary examination revealed that the GPS was significantly associated with PFS and OS in patients undergoing chemoradiotherapy for LD-SCLC, indicating its potential utility in assessing the therapeutic outcomes in LD-SCLC.
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Affiliation(s)
- Satoshi Endo
- Division of Respiratory Medicine, Gunma Prefectural Cancer Center, Ota, Japan
| | - Hisao Imai
- Division of Respiratory Medicine, Gunma Prefectural Cancer Center, Ota, Japan
- Department of Respiratory Medicine, International Medical Center, Saitama Medical University, Saitama, Japan
| | - Ayako Shiono
- Department of Respiratory Medicine, International Medical Center, Saitama Medical University, Saitama, Japan
| | - Kosuke Hashimoto
- Department of Respiratory Medicine, International Medical Center, Saitama Medical University, Saitama, Japan
| | - Yu Miura
- Department of Respiratory Medicine, International Medical Center, Saitama Medical University, Saitama, Japan
| | - Shohei Okazaki
- Division of Radiation Oncology, Gunma Prefectural Cancer Center, Ota, Japan
| | - Takanori Abe
- Department of Radiation Oncology, International Medical Center, Saitama Medical University, Saitama, Japan
| | - Atsuto Mouri
- Department of Respiratory Medicine, International Medical Center, Saitama Medical University, Saitama, Japan
| | - Kyoichi Kaira
- Department of Respiratory Medicine, International Medical Center, Saitama Medical University, Saitama, Japan
| | - Ken Masubuchi
- Division of Respiratory Medicine, Gunma Prefectural Cancer Center, Ota, Japan
| | - Takeshi Masubuchi
- Division of Respiratory Medicine, Gunma Prefectural Cancer Center, Ota, Japan
| | - Kunihiko Kobayashi
- Department of Respiratory Medicine, International Medical Center, Saitama Medical University, Saitama, Japan
| | - Koichi Minato
- Division of Respiratory Medicine, Gunma Prefectural Cancer Center, Ota, Japan
- Division of Health Evaluation and Promotion, SUBARU Health Insurance Society, Ota Memorial Hospital, Ota, Japan
| | - Shingo Kato
- Department of Radiation Oncology, International Medical Center, Saitama Medical University, Saitama, Japan
| | - Hiroshi Kagamu
- Department of Respiratory Medicine, International Medical Center, Saitama Medical University, Saitama, Japan
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Thompson JJ, McGovern J, Roxburgh CSD, Edwards J, Dolan RD, McMillan DC. The relationship between LDH and GLIM criteria for cancer cachexia: Systematic review and meta-analysis. Crit Rev Oncol Hematol 2024; 199:104378. [PMID: 38754770 DOI: 10.1016/j.critrevonc.2024.104378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 04/02/2024] [Accepted: 04/30/2024] [Indexed: 05/18/2024] Open
Abstract
INTRODUCTION Cancer cachexia is a clinical condition characterized by recognizable "sickness behaviors" accompanied by loss of lean body tissue. The Global Leadership on Malnutrition (GLIM) has proposed phenotypic (unintentional weight loss, low body mass index and low muscle mass) and aetiologic (reduced food intake and inflammation or disease burden) diagnostic criteria. Recent work has suggested serum lactate dehydrogenase (LDH) might represent a 3rd aetiologic criteria. Little is known of its relationship with GLIM. A systematic review and meta-analysis of their comparative prognostic value and association was performed. METHODS A search of electronic databases (PubMed, Medline, Ovid, Cochrane) up to February 2023 was used to identify studies that compared the prognostic value of LDH and components of the GLIM criteria in cancer. An analysis of the relationship between LDH and the components of GLIM was undertaken where this data was available. RevMan 5.4.1 was used to perform a meta-analysis for each diagnostic criteria that had 3 or more studies which reported hazard ratios with a 95 per cent confidence interval for overall survival (OS). RESULTS A total of 119 studies were reviewed. Advanced lung cancer was the most studied population. Included in the meta-analysis were 6 studies (n=2165) on LDH and weight loss, 17 studies (n=7540) on LDH and low BMI, 5 studies (n=758) on LDH and low muscle mass, 0 studies on LDH and food intake and 93 studies (n=32,190) on LDH and inflammation. There was a significant association between elevated serum LDH and each of low BMI (OR 1.39, 1.09 - 1.77; p=0.008), elevated NLR (OR 2.04, 1.57 - 2.65; p<0.00001) and elevated CRP (OR 2.58, 1.81 - 3.67; p<0.00001). There was no association between elevated serum LDH and low muscle mass. Only one study presented data on the association between LDH and unintentional weight loss. Elevated LDH showed a comparative OS (HR 1.86, 1.57 - 2.07; p<0.00001) to unintentional weight loss (HR 1.57, 1.23 - 1.99; p=0.0002) and had a similar OS (HR 2.00, 1.70 - 2.34; p<0.00001) to low BMI (HR 1.57, 1.29-2.90; p<0.0001). LDH also showed an OS (HR 2.25, 1.76 - 2.87; p<0.00001) congruous with low muscle mass (HR 1.93, 1.14 - 3.27; p=0.01) and again, LDH conferred as poor an OS (HR 1.77, 1.64-1.90; p<0.00001) as elevated NLR (HR 1.61, 1.48 - 1.77; p<0.00001) or CRP (HR 1.55, 1.43 - 1.69; p<0.00001). CONCLUSION Current literature suggests elevated serum LDH is associated with inflammation in cancer (an aetiologic GLIM criterion), however more work is required to establish the relationship between LDH and the phenotypic components of GLIM. Additionally, elevated serum LDH appears to be a comparative prognosticator of overall survival in cancer when compared to the GLIM criteria.
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Affiliation(s)
- Joshua J Thompson
- Academic Unit of Surgery, School of Medicine, University of Glasgow, Glasgow Royal Infirmary, Glasgow, UK.
| | - Josh McGovern
- Academic Unit of Surgery, School of Medicine, University of Glasgow, Glasgow Royal Infirmary, Glasgow, UK
| | - Campbell S D Roxburgh
- Academic Unit of Surgery, School of Medicine, University of Glasgow, Glasgow Royal Infirmary, Glasgow, UK
| | - Joanne Edwards
- Wolfson Wohl Cancer Research Centre, School of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - Ross D Dolan
- Academic Unit of Surgery, School of Medicine, University of Glasgow, Glasgow Royal Infirmary, Glasgow, UK
| | - Donald C McMillan
- Academic Unit of Surgery, School of Medicine, University of Glasgow, Glasgow Royal Infirmary, Glasgow, UK
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Katipoğlu Z, Abay RN. May the prognostic nutritional index (PNI) play a role in predicting age-related macular degeneration? Int Ophthalmol 2024; 44:228. [PMID: 38780873 DOI: 10.1007/s10792-024-03059-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 02/16/2024] [Indexed: 05/25/2024]
Abstract
AIM It is known that a healthy and balanced diet plays an important role in the etiopathogenesis of age-related macular degeneration (AMD). The aim of this study is to show the possible relationship between the prognostic nutritional index (PNI) and AMD. METHODS This observational longitudinal study included 50 patients who were diagnosed with AMD and 100 participants as control group in the Ophthalmology Polyclinic of Kırşehir Ahi Evran Training and Research Hospital between December 2022 and February 2023. The PNI scores of the patients were calculated with the formula (10 × albumin (g/L) + (0.005 × total lymphocyte count), using routine hemogram and biochemical assays. RESULTS One hundred fifty participants were included in the study (average age: 73.7 ± 8.6 years, male: 53.3%). When adjusted for age, sex, and total comorbidity index score via multivariate logistic regression analysis, the association between AMD and PNI scores (OR = 0.3; CI: 0.2-0.4; p = 0.01) and Charlson Comorbidity Index (CCI) scores (OR = 6.8; CI: 2.8-16.6; p = 0.01) was statistically significant. CONCLUSION The use of PNI scores may be practical and useful in routine clinical practice for predicting AMD.
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Affiliation(s)
- Zeynep Katipoğlu
- Department of Ophtalmatology, Balıkesir Atatürk City Hospital, Altıeylül, Balıkesir, Turkey.
| | - Rafiye Nur Abay
- Kırşehir Ahi Evran Training and Research Hospital, Kırşehir, Turkey
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Ye M, Zhang L. Correlation of Prognostic Nutritional Index and Systemic Immune-Inflammation Index with the Recurrence and Prognosis in Oral Squamous Cell Carcinoma with the Stage of III/IV. Int J Gen Med 2024; 17:2289-2297. [PMID: 38799199 PMCID: PMC11122246 DOI: 10.2147/ijgm.s458666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 05/08/2024] [Indexed: 05/29/2024] Open
Abstract
Introduction This study aimed to explore the correlation of systemic immune-inflammation index (SII) and prognostic nutritional index (PNI) with the recurrence and prognosis in patients with advanced oral squamous cell carcinoma (OSCC). Methods A total of 298 OSCC patients with the stage of III/IV were finally included in the study. SII = neutrophil count (109/L) × platelet count (109/L)/lymphocyte count (109/L). PNI = serum albumin (g/L) + 5 × total lymphocyte count (109/L). Results High preoperative SII and low preoperative PNI were independent risk factors for tumor recurrence in OSCC patients of the stage of III/IV. The area under the curves (AUC) for SII was 0.69 (0.63 to 0.76), for PNI was 0.72 (0.67 to 0.78), and for joint model was 0.81 (0.76 to 0.85). Patients with low level of joint model had significantly higher overall survival rate for 5 years follow-up than those with high level. Discussion Both preoperative SII and PNI are valuable independent tumor recurrence prediction index in patients with advanced OSCC. Meanwhile, the combination of preoperative SII and PNI is also valuable on OSCC recurrence and prognosis prediction.
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Affiliation(s)
- Manjun Ye
- Department of Oral Surgery, Daqing Oilfield General Hospital, Daqing, Heilongjiang, 163000, People’s Republic of China
| | - Lixia Zhang
- Department of Oral Surgery, Daqing Oilfield General Hospital, Daqing, Heilongjiang, 163000, People’s Republic of China
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Chen JJ, Lee TH, Lai PC, Chang CH, Wu CH, Huang YT. Prognostic nutritional index as a predictive marker for acute kidney injury in adult critical illness population: a systematic review and diagnostic test accuracy meta-analysis. J Intensive Care 2024; 12:16. [PMID: 38671543 PMCID: PMC11046764 DOI: 10.1186/s40560-024-00729-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Accepted: 04/06/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND The prognostic nutritional index (PNI), integrating nutrition and inflammation markers, has been increasingly recognized as a prognostic predictor in diverse patient cohorts. Recently, its effectiveness as a predictive marker for acute kidney injury (AKI) in various clinical settings has gained attention. This study aims to assess the predictive accuracy of the PNI for AKI in critically ill populations through systematic review and meta-analysis. METHODS A systematic review was conducted using the databases MEDLINE, EMBASE, PubMed, and China National Knowledge Infrastructure up to August 2023. The included trials reported the PNI assessment in adult population with critical illness and its predictive capacity for AKI. Data on study characteristics, subgroup covariates, and diagnostic performance of PNI, including sensitivity, specificity, and event rates, were extracted. A diagnostic test accuracy meta-analysis was performed. Subgroup analyses and meta-regression were utilized to investigate the sources of heterogeneity. The GRADE framework evaluated the confidence in the meta-analysis's evidence. RESULTS The analysis encompassed 16 studies with 17 separate cohorts, totaling 21,239 patients. The pooled sensitivity and specificity of PNI for AKI prediction were 0.67 (95% CI 0.58-0.74) and 0.74 (95% CI 0.67-0.80), respectively. The pooled positive likelihood ratio was 2.49 (95% CI 1.99-3.11; low certainty), and the negative likelihood ratio was 0.46 (95% CI 0.37-0.56; low certainty). The pooled diagnostic odds ratio was 5.54 (95% CI 3.80-8.07), with an area under curve of summary receiver operating characteristics of 0.76. Subgroup analysis showed that PNI's sensitivity was higher in medical populations than in surgical populations (0.72 vs. 0.55; p < 0.05) and in studies excluding patients with chronic kidney disease (CKD) than in those including them (0.75 vs. 0.56; p < 0.01). Overall, diagnostic performance was superior in the non-chronic kidney disease group. CONCLUSION Our study demonstrated that PNI has practical accuracy for predicting the development of AKI in critically ill populations, with superior diagnostic performance observed in medical and non-CKD populations. However, the diagnostic efficacy of the PNI has significant heterogeneity with different cutoff value, indicating the need for further research.
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Affiliation(s)
- Jia-Jin Chen
- Kidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Linkou Branch, Chang Gung university, Taoyuan, 33305, Taiwan
| | - Tao-Han Lee
- Department of Nephrology, Chansn Hospital, Taoyuan City, 33305, Taiwan
| | - Pei-Chun Lai
- Education Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chih-Hsiang Chang
- Kidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Linkou Branch, Chang Gung university, Taoyuan, 33305, Taiwan
| | - Che-Hsiung Wu
- Division of Nephrology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, 231, Taiwan.
- School of Medicine, Tzu Chi University, Hualien, 970, Taiwan.
| | - Yen-Ta Huang
- Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No. 138, Shengli Road, Tainan, 701, Taiwan.
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Ye J, Zheng L, Chen Z, Wang Q, Liao X, Wang X, Wei Q, Bao Y. Serum α-hydroxybutyrate dehydrogenase as a biomarker for predicting survival outcomes in patients with UTUC after radical nephroureterectomy. BMC Urol 2024; 24:62. [PMID: 38509518 PMCID: PMC10953183 DOI: 10.1186/s12894-024-01439-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 02/26/2024] [Indexed: 03/22/2024] Open
Abstract
PURPOSE We aimed to determine the prognostic value of α-hydroxybutyrate dehydrogenase (α-HBDH) in upper tract urothelial carcinoma (UTUC) patients after radical nephroureterectomy (RNU). MATERIALS AND METHODS We retrospectively enrolled the data of 544 UTUC patients at West China Hospital from May 2003 to June 2019. Cancer-specific survival (CSS) was the endpoint of interest. The optimal cutoff value of α-HBDH was identified by X-Tile program. After propensity score matching (PSM), we utilized Kaplan‒Meier curves to estimate survival and Cox proportional hazard model for risk assessment. A nomogram was built based on the results of multivariate analysis, and calibration curve, time-dependent receiver operating characteristic (ROC) curves and decision curve analysis were also performed to evaluate the predictive accuracy. RESULTS Overall, 394 and 150 patients were divided into the α-HBDH-low group and α-HBDH -high group at the cutoff value of 158 U/L, respectively. After PSM, the two groups were well matched for all confounding factors. High α-HBDH was associated with inferior CSS (P = 0.006), and preoperative α-HBDH was an independent predictor for CSS (HR: 1.36; 95% CI:1.08, 1.80), especially in localized UTUC patients (HR: 2.04; 95% CI:1.11, 3.74). Furthermore, the nomogram based on α-HBDH achieved great predictive ability for CSS with areas under the curves of 0.800 and 0.778 for 3-year and 5-year CSS, respectively. CONCLUSION Serum α-HBDH was a novel and reliable biomarker for predicting survival outcomes in UTUC patients after RNU but should be further explored.
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Affiliation(s)
- Jianjun Ye
- Department of Urology and Institute of Urology, West China Hospital, Sichuan University, Chengdu, 610041, China
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Lei Zheng
- Department of Urology and Institute of Urology, West China Hospital, Sichuan University, Chengdu, 610041, China
- West China School of Medicine, Sichuan University, Chengdu, China
- Department of Urology, People's Hospital of Tibet Autonomous Region, Lhasa, China
| | - Zeyu Chen
- Department of Urology and Institute of Urology, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Qihao Wang
- Department of Urology and Institute of Urology, West China Hospital, Sichuan University, Chengdu, 610041, China
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Xinyang Liao
- Department of Urology and Institute of Urology, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Xingyuan Wang
- Department of Urology and Institute of Urology, West China Hospital, Sichuan University, Chengdu, 610041, China
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Qiang Wei
- Department of Urology and Institute of Urology, West China Hospital, Sichuan University, Chengdu, 610041, China.
| | - Yige Bao
- Department of Urology and Institute of Urology, West China Hospital, Sichuan University, Chengdu, 610041, China.
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Tian Y, Li R, Wang G, Xu K, Li H, He L. Prediction of postoperative infectious complications in elderly patients with colorectal cancer: a study based on improved machine learning. BMC Med Inform Decis Mak 2024; 24:11. [PMID: 38184556 PMCID: PMC10770876 DOI: 10.1186/s12911-023-02411-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 12/18/2023] [Indexed: 01/08/2024] Open
Abstract
BACKGROUND Infectious complications after colorectal cancer (CRC) surgery increase perioperative mortality and are significantly associated with poor prognosis. We aimed to develop a model for predicting infectious complications after colorectal cancer surgery in elderly patients based on improved machine learning (ML) using inflammatory and nutritional indicators. METHODS The data of 512 elderly patients with colorectal cancer in the Third Affiliated Hospital of Anhui Medical University from March 2018 to April 2022 were retrospectively collected and randomly divided into a training set and validation set. The optimal cutoff values of NLR (3.80), PLR (238.50), PNI (48.48), LCR (0.52), and LMR (2.46) were determined by receiver operating characteristic (ROC) curve; Six conventional machine learning models were constructed using patient data in the training set: Linear Regression, Random Forest, Support Vector Machine (SVM), BP Neural Network (BP), Light Gradient Boosting Machine (LGBM), Extreme Gradient Boosting (XGBoost) and an improved moderately greedy XGBoost (MGA-XGBoost) model. The performance of the seven models was evaluated by area under the receiver operator characteristic curve, accuracy (ACC), precision, recall, and F1-score of the validation set. RESULTS Five hundred twelve cases were included in this study; 125 cases (24%) had postoperative infectious complications. Postoperative infectious complications were notably associated with 10 items features: American Society of Anesthesiologists scores (ASA), operation time, diabetes, presence of stomy, tumor location, NLR, PLR, PNI, LCR, and LMR. MGA-XGBoost reached the highest AUC (0.862) on the validation set, which was the best model for predicting postoperative infectious complications in elderly patients with colorectal cancer. Among the importance of the internal characteristics of the model, LCR accounted for the highest proportion. CONCLUSIONS This study demonstrates for the first time that the MGA-XGBoost model with 10 risk factors might predict postoperative infectious complications in elderly CRC patients.
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Affiliation(s)
- Yuan Tian
- Department of Gastrointestinal Surgery, The Third Affiliated Hospital of Anhui Medical University (The first people's Hospital of Hefei), Hefei, Anhui, China
| | - Rui Li
- Department of Gastrointestinal Surgery, The Third Affiliated Hospital of Anhui Medical University (The first people's Hospital of Hefei), Hefei, Anhui, China
| | - Guanlong Wang
- Department of Gastrointestinal Surgery, The Third Affiliated Hospital of Anhui Medical University (The first people's Hospital of Hefei), Hefei, Anhui, China
| | - Kai Xu
- Department of Gastrointestinal Surgery, The Third Affiliated Hospital of Anhui Medical University (The first people's Hospital of Hefei), Hefei, Anhui, China
| | - Hongxia Li
- Department of Oncology, The Third Affiliated Hospital of Anhui Medical University (The first people's Hospital of Hefei), Hefei, Anhui, China
| | - Lei He
- Department of Gastrointestinal Surgery, The Third Affiliated Hospital of Anhui Medical University (The first people's Hospital of Hefei), Hefei, Anhui, China.
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Xie N, Lin J, Yu H, Liu L, Deng S, Liu L, Sun Y. A Diagnostic Nomogram Incorporating Prognostic Nutritional Index for Predicting Vaginal Invasion in Stage IB - IIA Cervical Cancer. Cancer Control 2024; 31:10732748241278479. [PMID: 39171582 PMCID: PMC11342438 DOI: 10.1177/10732748241278479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 08/07/2024] [Accepted: 08/12/2024] [Indexed: 08/23/2024] Open
Abstract
INTRODUCTION With the advancements in cancer prevention and diagnosis, the proportion of newly diagnosed early-stage cervical cancers has increased. Adjuvant therapies based on high-risk postoperative histopathological factors significantly increase the morbidity of treatment complications and seriously affect patients' quality of life. OBJECTIVES Our study aimed to establish a diagnostic nomogram for vaginal invasion (VI) among early-stage cervical cancer (CC) that can be used to reduce the occurrence of positive or close vaginal surgical margins. METHODS We assembled the medical data of early-stage CC patients between January 2013 and December 2021 from the Fujian Cancer Hospital. Data on demographics, laboratory tests, MRI features, physical examination (PE), and pathological outcomes were collected. Univariate and multivariate logistic regression analyses were employed to estimate the diagnostic variables for VI in the training set. Finally, the statistically significant factors were used to construct an integrated nomogram. RESULTS In this retrospective study, 540 CC patients were randomly divided into training and validation cohorts according to a 7:3 ratio. Multivariate logistic analyses showed that age [odds ratio (OR) = 2.41, 95% confidence interval (CI), 1.29-4.50, P = 0.006], prognostic nutritional index (OR = 0.18, 95% CI, 0.04-0.77, P = 0.021), histological type (OR = 0.28, 95% CI, 0.08-0.94, P = 0.039), and VI based on PE (OR = 3.12, 95% CI, 1.52-6.45, P = 0.002) were independent diagnostic factors of VI. The diagnostic nomogram had a robust ability to predict VI in the training [area under the receiver operating characteristic curve (AUC) = 0.76, 95% CI: 0.70-0.82] and validation (AUC = 0.70, 95% CI: 0.58-0.83) cohorts, and the calibration curves, decision curve analysis, and confusion matrix showed good prediction power. CONCLUSION Our diagnostic nomograms could help gynaecologists quantify individual preoperative VI risk, thereby optimizing treatment options, and minimizing the incidence of multimodality treatment-related complications and the economic burden.
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Affiliation(s)
- Ning Xie
- Department of Gynecology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian Province, China
| | - Jie Lin
- Department of Gynecology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian Province, China
| | - Haijuan Yu
- Department of Gynecology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian Province, China
| | - Li Liu
- Department of Gynecology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian Province, China
| | - Sufang Deng
- Department of Gynecology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian Province, China
| | - Linying Liu
- Department of Gynecology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian Province, China
| | - Yang Sun
- Department of Gynecology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian Province, China
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Zhang J, Xiao X, Han T, Liu Y, Shuai P. Relationship between immune nutrition index and all-cause and cause-specific mortality in U.S. adults with chronic kidney disease. Front Nutr 2023; 10:1264618. [PMID: 38156280 PMCID: PMC10752924 DOI: 10.3389/fnut.2023.1264618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 10/27/2023] [Indexed: 12/30/2023] Open
Abstract
Objective The available evidence regarding the association of immune nutrition status with chronic kidney disease (CKD) is limited. Thus, the present study examined whether immunonutrition indices were associated with renal function and mortality among CKD individuals. Research design and methods This study enrolled 6,099 U.S. adults with CKD from the NHANES 2005-2018 database. Participants were matched with National Death Index records until 31 December 2019 to determine mortality outcomes. The time-dependent receiver operating characteristic was utilized to identify the most effective index among the prognostic nutritional index (PNI), system inflammation score (SIS), Naples prognostic score (NPS), and controlling nutritional status (CONUT) for predicting mortality. Cox regression models were employed to evaluate the associations of immunonutrition indices with mortality in participants with CKD. Results The PNI exhibited the strongest predictive power among the four indices evaluated and the restricted cubic spline analysis revealed a cutoff value of 51 for the PNI in predicting mortality. During a median follow-up of 72 months (39-115 months), a total of 1,762 (weighted 24.26%) CKD participants died from all causes. The Kaplan-Meier curve demonstrated a reduced risk of death for the subjects with a higher PNI compared to those in the lower group. Besides, after adjusting for multiple potential confounders, a higher PNI remained an independent predictor for lower risks of all-cause mortality (HR 0.80, 95%CI: 0.71-0.91, p < 0.001) and cardiovascular disease (CVD) mortality (HR 0.69, 95%CI: 0.55-0.88, p = 0.002) in individuals with CKD. Conclusion In CKD, a higher PNI level was significantly associated with lower mortality from all causes and CVD. Thus, the clinical utility of this immunonutrition indicator may facilitate risk stratification and prevent premature death among patients with CKD.
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Affiliation(s)
- Junlin Zhang
- Department of Health Management and Institute of Health Management, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
- Department of Nephrology, The Third People’s Hospital of Chengdu, Southwest Jiaotong University, Chengdu, China
| | - Xiang Xiao
- Department of Nephrology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Tianzhao Han
- Department of Nephrology, The Third People’s Hospital of Chengdu, Southwest Jiaotong University, Chengdu, China
| | - Yuping Liu
- Department of Health Management and Institute of Health Management, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Ping Shuai
- Department of Health Management and Institute of Health Management, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
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Feng L, Chen W, Yang T, Liu Q, Zhao Y, Song Q, Ping P, Fu S. Malnutrition significantly affected centenarian prognoses: A prospective study with 5-year follow-up. Clin Nutr ESPEN 2023; 58:117-121. [PMID: 38056994 DOI: 10.1016/j.clnesp.2023.09.921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 05/22/2023] [Accepted: 09/22/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND The world is currently facing a much-needed conundrum, and population aging has become an important worldwide problem. Appropriate nutritional intervention could prolong survival time and reduce mortality rate. However, scarce study has involved the effects of nutrition on survival time in centenarians and evaluated the malnutrition with prognostic nutritional index (PNI) in relation to healthy aging. This prospective study was designed to investigate the effects of malnutrition through PNI assessment on mortality rate and survival time with 5-year follow-up in Chinese centenarians. METHODS A household survey was conducted on the centenarians in 18 cities and counties of Hainan province, and malnutrition was evaluated by PNI as an effective tool in 423 centenarians followed up for 5-year. RESULTS Prevalence of malnutrition was 19.4%. Body mass index (BMI) was significantly lower and malnutrition was significantly more in the dead group than those in the survival group (all P < 0.05). Multivariate Cox regression analysis indicated that BMI [Hazard ratio (HR): 0.913; 95%CI: 0.854-0.977] negatively affected mortality rate, whereas malnutrition (HR: 2.630; 95%CI:1.474-4.695) positively affected mortality rate in centenarians (all P < 0.05). When BMI was <18.5 kg/m2, malnutrition (HR: 4.401; 95%CI: 1.948-9.943) also positively affected mortality rate (P < 0.05). CONCLUSIONS This prospective study with 5-year follow-up demonstrated that malnutrition had positive effect on mortality rate, especially when BMI was lower than 18.5 kg/m2, in Chinese centenarians. In order to reduce mortality rate and prolong survival time, it is essential to pay attention to malnutrition in elderly population.
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Affiliation(s)
- Long Feng
- Department of Anesthesiology, Hainan Hospital of Chinese People's Liberation Army General Hospital, Sanya, China.
| | - Wenji Chen
- Department of Rheumatology, Hainan Hospital of Chinese People's Liberation Army General Hospital, Sanya, China.
| | - Ting Yang
- Central Laboratory, Hainan Hospital of Chinese People's Liberation Army General Hospital, Sanya, China.
| | - Qiong Liu
- Medical Care Center, Hainan Hospital of Chinese People's Liberation Army General Hospital, Sanya, China.
| | - Yali Zhao
- Central Laboratory, Hainan Hospital of Chinese People's Liberation Army General Hospital, Sanya, China.
| | - Qing Song
- Heatstroke Treatment and Research Center of Chinese People's Liberation Army, Sanya, China.
| | - Ping Ping
- General Station for Drug and Instrument Supervision and Inspection, Joint Logistic Support Force of Chinese People's Liberation Army, Beijing, China.
| | - Shihui Fu
- Department of Cardiology, Hainan Hospital of Chinese People's Liberation Army General Hospital, Sanya, China; Department of Geriatric Cardiology, Chinese People's Liberation Army General Hospital, Beijing, China.
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Sun B, Chen Y, Man Y, Fu Y, Lin J, Chen Z. Clinical value of neutrophil-to-lymphocyte ratio and prognostic nutritional index on prediction of occurrence and development of diabetic foot-induced sepsis. Front Public Health 2023; 11:1181880. [PMID: 38026334 PMCID: PMC10630165 DOI: 10.3389/fpubh.2023.1181880] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 10/05/2023] [Indexed: 12/01/2023] Open
Abstract
Background Diabetic foot-induced sepsis is a serious complication associated with increased disability and mortality in hospitalized patients. Early prediction of admission and detection effectively improve treatment options and prevent further deterioration. This study aims to evaluate the clinical value of the neutrophil-to-lymphocyte ratio (NLR) and prognostic nutritional index (PNI) to predict the risk of sepsis in patients with diabetic foot ulcers (DFU). Methods Retrospective analysis was performed on 216 patients who were admitted to the Fujian Medical University Union Hospital between January 2015 and December 2022. Patients with DFU were divided into the non-sepsis (n = 166) and the DFU-induced sepsis (n = 50) groups. The independent factors of DFU-induced sepsis were determined by univariate and multivariate logistic regression analyses. A receiver operating characteristic (ROC) curve was performed to compare the area under the curves (AUC) of PNI and NLR. Results Multivariate logistic regression analysis revealed that the PNI, NLR, international normalized ratio (INR), thrombin time (PT), and C-reactive protein (CRP) were independent prognostic factors for DFU-induced sepsis. After adjusting for potential confounders, the adjusted odds ratios of NLR for DFU-induced sepsis were 1.121 (1.072-1.172), 1.132 (1.077-1.189), and 1.080 (1.022-1.142), while those of PNI were 0.912 (0.873-0.953), 0.902 (0.856-0.950), and 1.004 (1.001-1.006). Moreover, the AUC of NLR was significantly greater than that of CRP (0.790, 95% CI: 0.689-0.891, p < 0.001 vs. 0.780, 95% CI: 0.686-0.873, p < 0.001). Conclusion NLR and PNI have been regarded as readily and independently predictive markers in patients with DFU-induced sepsis. NLR is critical for the early detection and effective treatment of DFU-induced sepsis and is superior to CRP.
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Affiliation(s)
- Bing Sun
- Burn & Wound Repair Department, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Burn Institute, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Burn Medical Center, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Provincial Key Laboratory of Burn and Trauma, Fujian Medical University Union Hospital, Fuzhou, China
| | - Yimin Chen
- Burn & Wound Repair Department, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Burn Institute, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Burn Medical Center, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Provincial Key Laboratory of Burn and Trauma, Fujian Medical University Union Hospital, Fuzhou, China
| | - Yulin Man
- Burn & Wound Repair Department, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Burn Institute, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Burn Medical Center, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Provincial Key Laboratory of Burn and Trauma, Fujian Medical University Union Hospital, Fuzhou, China
| | - Yu Fu
- Burn & Wound Repair Department, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Burn Institute, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Burn Medical Center, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Provincial Key Laboratory of Burn and Trauma, Fujian Medical University Union Hospital, Fuzhou, China
| | - Jianchang Lin
- Burn & Wound Repair Department, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Burn Institute, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Burn Medical Center, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Provincial Key Laboratory of Burn and Trauma, Fujian Medical University Union Hospital, Fuzhou, China
| | - Zhaohong Chen
- Burn & Wound Repair Department, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Burn Institute, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Burn Medical Center, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Provincial Key Laboratory of Burn and Trauma, Fujian Medical University Union Hospital, Fuzhou, China
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Nishihara-Kato F, Imai H, Tsuda T, Wasamoto S, Nagai Y, Kishikawa T, Miura Y, Ono A, Yamada Y, Masubuchi K, Osaki T, Nakagawa J, Umeda Y, Minemura H, Kozu Y, Taniguchi H, Ohta H, Kaira K, Kagamu H. Prognostic Potential of the Prognostic Nutritional Index in Non-Small Cell Lung Cancer Patients Receiving Pembrolizumab Combination Therapy with Carboplatin and Paclitaxel/Nab-Paclitaxel. Oncology 2023; 102:30-42. [PMID: 37598676 DOI: 10.1159/000533604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 07/12/2023] [Indexed: 08/22/2023]
Abstract
INTRODUCTION Pembrolizumab (Pemb) therapy in conjunction with carboplatin and paclitaxel (PTX)/nab-PTX has been efficacious in treating non-small cell lung cancer (NSCLC). However, the response predictors of this combination therapy (Pemb-combination) remain undetermined. We aimed to evaluate whether Glasgow prognostic score (GPS), neutrophil-to-lymphocyte ratio (NLR), body mass index (BMI), platelet-to-lymphocyte ratio (PLR), and prognostic nutritional index (PNI) are potential factors in prognosticating the response to Pemb-combination therapy in advanced NSCLC patients. METHODS We retrospectively recruited 144 NSCLC patients receiving first-line treatment with Pemb-combination therapy from 13 institutions between December 1, 2018, and December 31, 2020. GPS, NLR, BMI, PLR, and PNI were assessed for their efficacy as prognostic indicators. Cox proportional hazard models and the Kaplan-Meier method were used to compare the progression-free survival (PFS) and overall survival (OS) of the patients. RESULTS The treatment exhibited a response rate of 63.1% (95% confidence interval [CI]: 55.0-70.6%). Following Pemb-combination administration, the median PFS and OS were 7.3 (95% CI: 5.3-9.4) and 16.5 (95% CI: 13.9-22.1) months, respectively. Contrary to PNI, NLR, GPS, BMI, and PLR did not display substantially different PFS in univariate analysis. However, multivariate analysis did not identify PNI as an independent prognostic factor for PFS. Furthermore, univariate analysis revealed that GPS, BMI, and PLR exhibited similar values for OS but not NLR and PNI. Patients with PNI ≥45 were predicted to have better OS than those with PNI <45 (OS: 23.4 and 13.9 months, respectively, p = 0.0028). Multivariate analysis did not establish NLR as an independent prognostic factor for OS. CONCLUSION The PNI evidently predicted OS in NSCLC patients treated with Pemb-combination as first-line therapy, thereby validating its efficiency as a prognostic indicator of NSCLC.
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Affiliation(s)
- Fuyumi Nishihara-Kato
- Department of Respiratory Medicine, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Saitama, Japan
| | - Hisao Imai
- Department of Respiratory Medicine, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Saitama, Japan
- Division of Respiratory Medicine, Gunma Prefectural Cancer Center, Ota, Japan
| | - Takeshi Tsuda
- Division of Respiratory Medicine, Toyama Prefectural Central Hospital, Toyama, Japan
| | - Satoshi Wasamoto
- Division of Respiratory Medicine, Saku Central Hospital Advanced Care Center, Saku, Japan
| | - Yoshiaki Nagai
- Department of Respiratory Medicine, Jichi Medical University, Saitama Medical Center, Saitama, Japan
| | | | - Yosuke Miura
- Division of Allergy and Respiratory Medicine, Integrative Center of Internal Medicine, Gunma University Hospital, Maebashi, Japan
| | - Akihiro Ono
- Division of Internal Medicine, Kiryu Kosei General Hospital, Kiryu, Japan
| | - Yutaka Yamada
- Division of Respiratory Medicine, Ibaraki Prefectural Central Hospital, Kasama, Japan
| | - Ken Masubuchi
- Division of Respiratory Medicine, Gunma Prefectural Cancer Center, Ota, Japan
| | - Takashi Osaki
- Division of Respiratory Medicine, National Hospital Organization Shibukawa Medical Center, Shibukawa, Japan
| | - Junichi Nakagawa
- Division of Respiratory Medicine, National Hospital Organization Takasaki General Medical Center, Takasaki, Japan
| | - Yukihiro Umeda
- Third Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Hiroyuki Minemura
- Department of Pulmonary Medicine, Fukushima Medical University, Fukushima, Japan
| | - Yuki Kozu
- Division of Respiratory Medicine, Saku Central Hospital Advanced Care Center, Saku, Japan
| | - Hirokazu Taniguchi
- Division of Respiratory Medicine, Toyama Prefectural Central Hospital, Toyama, Japan
| | - Hiromitsu Ohta
- Department of Respiratory Medicine, Jichi Medical University, Saitama Medical Center, Saitama, Japan
| | - Kyoichi Kaira
- Department of Respiratory Medicine, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Saitama, Japan
| | - Hiroshi Kagamu
- Department of Respiratory Medicine, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Saitama, Japan
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Suzuki E, Kawata N, Shimada A, Sato H, Anazawa R, Suzuki M, Shiko Y, Yamamoto M, Ikari J, Tatsumi K, Suzuki T. Prognostic Nutritional Index (PNI) as a Potential Prognostic Tool for Exacerbation of COPD in Elderly Patients. Int J Chron Obstruct Pulmon Dis 2023; 18:1077-1090. [PMID: 37309393 PMCID: PMC10257926 DOI: 10.2147/copd.s385374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 04/28/2023] [Indexed: 06/14/2023] Open
Abstract
Purpose In COPD, exacerbation of the disorder causes a deterioration in the quality-of-life and worsens respiratory dysfunction, leading to a poor prognosis. In recent years, nutritional indices have been reported as significant prognostic factors in various chronic diseases. However, the relationship between nutritional indicators and prognosis in elderly subjects with COPD has not been investigated. Patients and methods We enrolled 91 subjects who received COPD assessment tests (CAT), spirometry, blood tests, and multidetector computed tomography (MDCT). We divided the subjects into two groups according to age (<75 years (n=57) and ≥ 75 years (n=34)). The prognostic nutritional index (PNI) was used to assess immune-nutritional status and was calculated as 10 x serum albumin + 0.005 x total lymphocyte count. We then examined the relationship between PNI and clinical parameters, including exacerbation events. Results There was no significant correlation between the PNI and CAT, the FEV1%pred, or low attenuation volume percentage (LAV%). In the elderly group, there were significant differences between the groups with or without exacerbation in the CAT and PNI (p=0.008, p=0.004, respectively). FEV1%pred, neutrophil-to-lymphocyte ratio (NLR) and LAV% did not differ between the two groups. The analytical model combining CAT and PNI improved the prediction of exacerbations in the elderly subjects (p=0.0068). Conclusion In elderly subjects with COPD, CAT were associated significantly with the risk of COPD exacerbation, with PNI also a potential predictor. The combined assessment of CAT and PNI may be a useful prognostic tool in subjects with COPD.
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Affiliation(s)
- Eiko Suzuki
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba-shi, Chiba, 260-8677, Japan
| | - Naoko Kawata
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba-shi, Chiba, 260-8677, Japan
| | - Ayako Shimada
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba-shi, Chiba, 260-8677, Japan
- Department of Respirology, Shin-yurigaoka General Hospital, Kawasaki, Kanagawa, 215-0026, Japan
| | - Hirotaka Sato
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba-shi, Chiba, 260-8677, Japan
- Department of Radiology, Soka Municipal Hospital, Souka-shi, Saitama, 340-8560, Japan
| | - Rie Anazawa
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba-shi, Chiba, 260-8677, Japan
- Department of Infectious Diseases, NTT Medical Center Tokyo, Tokyo, 141-8625, Japan
| | - Masaki Suzuki
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba-shi, Chiba, 260-8677, Japan
- Department of Respirology, Kashiwa Kousei General Hospital, Kashiwa-shi, Chiba-ken, 277-8551, Japan
| | - Yuki Shiko
- Biostatistics Section, Clinical Research Center, Chiba University Hospital, Chiba-shi, 260-8670, Japan
| | - Mayumi Yamamoto
- Department of Palliative Care Medicine, Chiba Rosai Hospital, Chiba-shi, Chiba, 290-0003, Japan
| | - Jun Ikari
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba-shi, Chiba, 260-8677, Japan
| | - Koichiro Tatsumi
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba-shi, Chiba, 260-8677, Japan
| | - Takuji Suzuki
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba-shi, Chiba, 260-8677, Japan
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Kocak MZ, Coban S, Araz M, Eryilmaz MK, Artac M. Prognostic biomarkers in metastatic colorectal cancer: delta prognostic nutritional index, delta neutrophil to lymphocyte ratio, and delta platelet to lymphocyte ratio. Support Care Cancer 2023; 31:357. [PMID: 37246994 DOI: 10.1007/s00520-023-07829-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 05/22/2023] [Indexed: 05/30/2023]
Abstract
BACKGROUND The aim of this study is to determine the prognostic value of the prognostic nutritional index (PNI), the neutrophil to lymphocyte ratio (NLR), and the platelet to lymphocyte ratio (PLR) and their dynamic changes on survival outcomes in metastatic colorectal cancers (mCRC). METHODS The data of 199 patients with mCRC were retrospectively analyzed. To evaluate the temporal relation between the PNI, NLR, and PLR values and survival, pre-chemotherapy PNI, NLR, and PLR levels were assessed from peripheral blood cell counts on admission; post-chemotherapy PNI, NLR, and PLR levels were assessed with follow-up blood cell counts within two weeks after chemotherapy; and the difference between pre-chemotherapy PNI, NLR, and PLR levels and post-chemotherapy PNI, NLR, and PLR levels was evaluated as delta PNI, delta NLR, and delta PLR. RESULTS The median PNI, PLR, and NLR were 39.01, 150.2 and 2.53 before chemotherapy and 38.2, 146.6, and 3.31 after chemotherapy, respectively. The median OS was 23.7 months (95%CI:17.8-29.7) and 28.9 months (95%CI:24.8-33.08) for pre-chemotherapy PNI level < 39.01 vs. PNI level ≥ 39.01, respectively(p = 0.035) The positive delta PNI was significantly higher for OS than the negative delta PNI(p < 0.009). Delta PLR and delta NLR were not significant for OS and PFS(p > 0.05 for all). CONCLUSIONS The results of this study clearly show that the negative delta PNI to be an independent predictor of poor OS and poor PFS in patients with colon cancer who received first line treatment. In addition, delta NLR and delta PLR were shown not to predict survival outcomes.
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Affiliation(s)
- Mehmet Zahid Kocak
- Department of Medical Oncology, Necmettin Erbakan University, Konya, Turkey.
| | - Seda Coban
- Department of Internal Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Murat Araz
- Department of Medical Oncology, Necmettin Erbakan University, Konya, Turkey
| | | | - Mehmet Artac
- Department of Medical Oncology, Necmettin Erbakan University, Konya, Turkey
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Fan R, Chen Y, Xu G, Pan W, Lv Y, Zhang Z. Combined systemic immune-inflammatory index and prognostic nutritional index predict outcomes in advanced non-small cell lung cancer patients receiving platinum-doublet chemotherapy. Front Oncol 2023; 13:996312. [PMID: 37077828 PMCID: PMC10106714 DOI: 10.3389/fonc.2023.996312] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 03/15/2023] [Indexed: 04/05/2023] Open
Abstract
Background Systemic immune-inflammatory index (SII) and prognostic nutritional index (PNI) could evaluate the therapeutic efficacy and prognosis in different tumors. However, no studies investigated the SII-PNI score to predict outcomes in non-small cell lung cancer (NSCLC) patients treated with platinum-doublet chemotherapy. The aim of this study was to investigate the SII-PNI score in predicting outcomes in non-small cell lung cancer (NSCLC) patients treated with platinum-doublet chemotherapy. Materials and methods Our study retrospectively analyzed clinical data from 124 patients with advanced NSCLC receiving platinum-doublet chemotherapy. The SII and PNI were calculated based on peripheral blood cell counts and serum albumin, and the optimal cut-off values were determined using receiver operating characteristic (ROC). All patients were divided into three groups according to the SII-PNI score. The association between the SII-PNI score and the clinicopathological characteristics of the patients was examined. The Kaplan-Meier and Cox regression models were used to assess progression-free survival (PFS)and overall survival (OS). Results There was no significant correlation between SII, PNI at baseline and chemotherapy response in patients with advanced NSCLC (p>0.05). However, after receiving 4 cycles of platinum-doublet chemotherapy, the SII of the SD group (p=0.0369) and PD group (p=0.0286) was significantly higher than that of the PR group. At the same time, the PNI of the SD group (p=0.0112) and the PD group (p=0.0007) was significantly lower than that of the PR group. The PFS of patients with SII-PNI scores of 0, 1, and 2 were 12.0, 7.0, and 5.0 months, and the OS of patients with SII-PNI scores of 0, 1, and 2 were 34.0, 17.0, and 10.5 months, respectively. There was statistical significance among the three groups (all p <0.001). Multivariate analyses showed that the chemotherapy response of progressive disease (PD) (HR, 3.508; 95% CI, 1.546-7.960; p=0.003) and SII-PNI score of 2 (HR, 4.732; 95% CI, 2.561-8.743; p < 0.001) were independently associated with a shorter OS. The uses of targeted drugs (HR, 0.543; 95% CI, 0.329-0.898; p=0.017) and immune checkpoint inhibitors (HR, 0.218; 95% CI, 0.081-0.584; p=0.002) were protective factors for OS in patients with NSCLC. Conclusion Compared with baseline parameters, the correlation between SII, PNI after 4 cycles of chemotherapy and the chemotherapy effect was more significant. The SII-PNI score after 4 cycles of chemotherapy is an effective prognostic biomarker for advanced NSCLC patients treated with platinum-doublet chemotherapy. Patients with a higher SII-PNI score had a worse prognosis.
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Affiliation(s)
| | | | | | | | | | - Zhongwei Zhang
- Department of Pulmonary and Critical Care, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China
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Biomarkers for Outcome in Metastatic Melanoma in First Line Treatment with Immune Checkpoint Inhibitors. Biomedicines 2023; 11:biomedicines11030749. [PMID: 36979727 PMCID: PMC10044937 DOI: 10.3390/biomedicines11030749] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 02/26/2023] [Accepted: 02/27/2023] [Indexed: 03/06/2023] Open
Abstract
Introduction: A high proportion of metastatic melanoma patients do not respond to immune checkpoint inhibitors (ICI), and until now, no validated biomarkers for response and survival have been known. Methods: We performed a retrospective analysis of outcomes in patients with metastatic melanoma treated with first-line ICI at the Institute of Oncology Ljubljana from January 2018 to December 2020. The immune-related adverse events (irAEs) and serum immune-inflammation parameters (neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (LR), systemic immune-inflammation index (SII) and pan-immune-inflammation value (PIV)) were analyzed as potential biomarkers for response and survival. Survival rates were calculated using the Kaplan–Meier method and then compared with the log-rank test. Multivariate regression Cox analysis was used to determine independent prognostic factors for progression-free survival (PFS) and overall survival (OS). Results: Median follow-up was 22.5 months. The estimated median progression-free survival (PFS) was 15 months (95% CI 3.3–26.2). The two-year survival rate (OS) was 66.6%. Among 129 treated patients, 24 (18.6%) achieved complete response, 28 (21.7%) achieved partial response, 26 (20.2%) had stable disease and 51 (39.5%) patients experienced a progressive disease. There was a higher response rate in patients with irAEs (p < 0.001) and high NLR before the second cycle of ICI (p = 0.052). Independent prognostic factors for PFS were irAE (HR 0.41 (95% CI 0.23–0.71)), SII before the first cycle of ICI (HR 1.94 (95% CI 1.09–3.45)) and PLR before the second cycle of ICI (HR 1.71 (95% CI 1.03–2.83)). The only independent prognostic factor for OS was SII before the first cycle of ICI (HR 2.60 (95% CI 0.91–7.50)). Conclusions: Patients with high pre-treatment levels of SII had a higher risk of progression and death; however, patients with irAEs in the high-SII group might respond well to ICI. Patients who develop irAEs and have high NLRs before the second ICI application have higher rates of CR and PR, which implicates their use as early biomarkers for responsiveness to ICI.
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Zhang J, Chen Y, Zou L, Gong R. Prognostic nutritional index as a risk factor for diabetic kidney disease and mortality in patients with type 2 diabetes mellitus. Acta Diabetol 2023; 60:235-245. [PMID: 36324018 PMCID: PMC9629877 DOI: 10.1007/s00592-022-01985-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 09/28/2022] [Indexed: 11/10/2022]
Abstract
AIMS Microinflammation and malnutrition are common in individuals with type 2 diabetes mellitus (T2DM). We aimed to validate whether prognostic nutritional index (PNI) may increase the risk of diabetic kidney disease (DKD) and all-cause mortality in T2DM patients. METHODS This retrospective cohort study was based on the National Health and Nutrition Examination Survey (NHANES) and National Death Index (NDI) 2013-2018 database. A total of 14,349 eligible subjects were included, and 2720 of them were with T2DM. PNI was assessed by the 5 × lymphocyte count (109/L) + serum albumin (g/L). The Logistic and Cox regression analyses were conducted to investigate the risk factors of DKD and mortality in T2DM patients. RESULTS For 14,349 participants represented 224.7 million noninstitutionalized residents of the United State, the average PNI was 53.72 ± 0.12, and the prevalence of T2DM was 14.89%. T2DM patients had a lower level of PNI and dietary protein intake, a higher risk of mortality, kidney injury, anemia, arterial hypertension and hyperuricemia, compared with non-T2DM subjects. DKD occurred in 35.06% of diabetic participants and a higher PNI was independently related with a lower risk of DKD (OR 0.64, 95% CI 0.459-0.892, p = 0.01) in T2DM after multivariate adjustment. During a median follow-up of 46 person-months (29-66 months), a total of 233 T2DM individuals died from all causes (mortality rate = 8.17%). Subjects with T2DM who had a higher PNI showed a lower risk of all-cause mortality (HR 0.60, 95% CI 0.37-0.97, p = 0.036). CONCLUSIONS PNI, as a marker of immunonutrition, correlated with the incidence of DKD, and was an independent predictor for all-cause mortality in participants with T2DM. Thus, PNI may conduce to the risk stratification and timely intervention of T2DM patients.
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Affiliation(s)
- Junlin Zhang
- Department of Nephrology, The Third People's Hospital of Chengdu, Southwest Jiaotong University, No. 37, Qinglong Street, Chengdu, 610014, Sichuan Province, China
| | - Yao Chen
- Department of Breast Surgery, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Liang Zou
- Department of Nephrology, The Third People's Hospital of Chengdu, Southwest Jiaotong University, No. 37, Qinglong Street, Chengdu, 610014, Sichuan Province, China
| | - Rong Gong
- Department of Nephrology, The Third People's Hospital of Chengdu, Southwest Jiaotong University, No. 37, Qinglong Street, Chengdu, 610014, Sichuan Province, China.
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C-Reactive Protein and Lymphocyte-to-Monocyte Ratio Predict Recurrence in Stage III Melanoma Patients with Microscopic Sentinel Lymph Node Metastasis. Cancers (Basel) 2023; 15:cancers15030702. [PMID: 36765660 PMCID: PMC9913855 DOI: 10.3390/cancers15030702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/16/2023] [Accepted: 01/18/2023] [Indexed: 01/25/2023] Open
Abstract
Although adjuvant therapies with immune checkpoint inhibitors (ICI) and BRAF/MEK inhibitors improve recurrence-free survival (RFS) in stage III melanoma patients significantly, prognostic factors are needed to identify patients with a high risk of disease recurrence. Therefore, the aim of our study was to investigate the prognostic potential of routinely collected blood parameters for stage III melanoma patients with microscopic sentinel lymph node (SLN) metastasis. Altogether, we retrospectively analyzed 138 stage III melanoma patients who were diagnosed with microscopic SLN metastasis at the skin cancer center of the University Hospital Cologne between 2011 and 2020 and who did not receive prior adjuvant therapy with ICI or BRAF/MEK-inhibitors. Univariate and multivariate Cox regression analyses, Kaplan-Meier survival analyses and receiver operating characteristic (ROC) curves were performed to assess the impact of preoperatively collected blood parameters and blood ratios on recurrence-free survival (RFS; primary endpoint) and overall survival (OS). A high neutrophil-to-lymphocyte ratio (NLR), low lymphocyte-to-monocyte ratio (LMR) and high C-reactive protein (CRP) value were significantly associated with shorter RFS in multivariate analysis. For LMR (cut-off 3.5) and for CRP (cut-off 3.0) this effect remained after dichotomization. CRP showed a stronger association with RFS than NLR or LMR, with the highest association being detected for the combination of low LMR and high CRP. Additionally, derived NLR ≥ 2.0 was significantly associated with shorter OS in multivariate analysis. In summary, our data suggest that CRP in combination with LMR should be considered as a marker for melanoma recurrence in stage III melanoma patients with microscopic SLN metastasis.
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Matsubara K, Otani S, Yamamoto H, Tomioka Y, Shiotani T, Miyoshi K, Okazaki M, Sugimoto S, Yamane M, Toyooka S. The impact of prognostic nutrition index on the waitlist mortality of lung transplantation. Gen Thorac Cardiovasc Surg 2022; 71:306-312. [PMID: 36495468 DOI: 10.1007/s11748-022-01895-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 11/23/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The prognostic nutrition index (PNI), calculated using serum albumin and total lymphocyte count, is a recent topical index related to inflammation. Preoperative PNI is regarded as a new preoperative prognostic score in lung transplantation (LTx). This study aimed to investigate the impact of PNI at the time of registration as a prognostic parameter of mortality on the waiting list for LTx. METHODS A retrospective review was conducted on the data of 132 adult patients registered for LTx in our department between January 2013 and June 2020. Patients who finally received LTx were analyzed as censored data. The overall survival was evaluated using the Kaplan-Meier method for pre-registered clinical factors including the PNI at the time of registration. Overall survival was calculated from the date of listing to the Japan Organ Transplant Network to the date of death. RESULTS The low-PNI group had a significantly worse prognosis. Multivariate analysis demonstrated that age (p = 0.023), idiopathic interstitial pneumonia (p < 0.001), lung allocation score (LAS) (p < 0.001), and PNI (p < 0.001) were independent prognostic factors for waitlist mortality. CONCLUSIONS PNI at the time of registration can be an independent prognostic parameter in registered candidates for LTx.
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Susok L, Said S, Reinert D, Mansour R, Scheel CH, Becker JC, Gambichler T. The pan-immune-inflammation value and systemic immune-inflammation index in advanced melanoma patients under immunotherapy. J Cancer Res Clin Oncol 2022; 148:3103-3108. [PMID: 35006344 PMCID: PMC9508007 DOI: 10.1007/s00432-021-03878-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 12/01/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate the pan-immune-inflammation value (PIV) and systemic immune-inflammation index (SII) in patients with cutaneous melanoma (CM) under immune checkpoint inhibitor (ICI) therapy. METHODS PIV and SII were calculated before the start of ICI therapy and at time of progression/death in patients with metastatic CM (stage III/IV). Sex-age-matched CM patients in stage I/II and healthy subjects (HC) served as controls. RESULTS The median PIV of stage III/IV patients was significantly (P = 0.0011) higher than in stage I/II patients and HC. SII was significantly (P = 0.00044) lower in HC than in CM patients. At baseline, PIV and SII did significantly correlate with lactate dehydrogenase (P = 0.045/0.017). However, ROC curve statistics revealed that SII and PIV were not significantly associated with clinical parameters, including best response to ICI treatment (P = 0.87/0.64), progression-free survival (P = 0.73/0.91), and melanoma-specific survival (P = 0.13/0.17). Moreover, there were no significant changes of PIV and SII from baseline to progression/death (P = 0.38/0.52). CONCLUSIONS Even though both immune-inflammation biomarkers showed some power to differentiate between CM stages and HC, respectively, PIV and SII seem not to be significant predictors for clinical outcome measures of CM patients under ICI therapy.
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Affiliation(s)
- L Susok
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - S Said
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - D Reinert
- Department of Radiology, Ruhr-University Bochum, Bochum, Germany
| | - R Mansour
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | | | - J C Becker
- Translational Skin Cancer Research, DKTK Partner Site Essen/Düsseldorf, West German Cancer Center, Dermatology, University Duisburg-Essen, Essen, Germany
- German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - T Gambichler
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany.
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Fan S, Liu X, Wu Y, Li K, Zhao X, Lin W, Liu J. Prognostic Value of Lactate Dehydrogenase, Melanoma Inhibitory Protein, and S-100B Protein in Patients with Malignant Melanoma. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2022; 2022:9086540. [PMID: 36248431 PMCID: PMC9553451 DOI: 10.1155/2022/9086540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/11/2022] [Accepted: 08/30/2022] [Indexed: 11/17/2022]
Abstract
Objective This investigation probed the prognostic potential for lactate dehydrogenase (LDH), melanoma inhibitory activity protein (MIA), and S-100B protein in cases of malignant melanoma. Methods 84 cases were segregated into effective cohort (n = 64) and ineffective cohort (n = 20) depending on clinical efficacy. The cases were followed up for three years and segregated into mortality cohort (n = 29) and survival cohort (n = 55) depending upon 3-year survival. Serum LDH, MIA, and S-100B levels were compared across the effective and ineffective cohorts. Serum LDH, MIA, and S-100B levels in cases of different clinical stages were comparatively analyzed, with correlations of these indicators with the clinical stage being evaluated. ROC evaluated the prognostic potential of serum LDH, MIA, and S-100B. Cases were segregated into the high-level and low-level cohorts according to serum LDH, MIA, and S-100B levels, and the survival rates of cases were compared. Results The levels of LDH, MIA, and S-100B in the effective cohort were significantly lower than those in the ineffective cohort. The AUC value of the composite indicator of serum LDH, MIA, and S-100B for effectiveness evaluation was (0.839). Serum LDH, MIA, and S-100B levels were positively linked to the clinical stage. AUC value of the composite indicator of serum LDH, MIA, and S-100B for prognosis evaluation prediction (0.942) was elevated compared to LDH (0.632), MIA (0.732), or S-100B (0.828) alone. Survival rate of cases of LDH ≥30.56 mg/L (57.14%, 32/56) was lower than that of cases of LDH <30.56 mg/L (82.14%, 23/28) (log-rank χ 2 = 4.672, P < 0.05). The survival rate of MIA ≥5.34 ng/mL cases was lower than that of MIA <5.34 ng/mL cases. The survival rate of cases of S-100B ≥ 1.03ug/L was lower than that of S-100B < 1.03ug/L. Conclusion Serum LDH, MIA, and S-100B protein levels are linked to the clinical stage. The lactate dehydrogenase, melanoma inhibitory protein, and S-100B protein are of good clinical effectiveness and have the prognostic potential for cases of malignant melanoma.
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Affiliation(s)
- Shuwen Fan
- Department of Burn and Plastic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215000, China
| | - Xiao Liu
- Department of Burn and Plastic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215000, China
| | - Yizhu Wu
- Department of Burn and Plastic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215000, China
| | - Ke Li
- Department of Burn and Plastic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215000, China
| | - Xiaoyu Zhao
- Department of Burn and Plastic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215000, China
| | - Wei Lin
- Department of Burn and Plastic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215000, China
| | - Jianjiang Liu
- Department of Burn and Plastic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215000, China
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Prognostic Potential of the Baseline Pan-Immune-Inflammation Value and Neutrophil/Lymphocyte Ratio in Stage I to III Melanoma Patients. Cancers (Basel) 2022; 14:cancers14184410. [PMID: 36139570 PMCID: PMC9496745 DOI: 10.3390/cancers14184410] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 08/24/2022] [Accepted: 09/05/2022] [Indexed: 11/17/2022] Open
Abstract
Prognostic biomarkers derived from complete blood count (CBC) have received marked interest as an indirect measure of the inflammatory pressure in cancers such as metastatic melanoma. Here, we evaluated the novel pan-immune-inflammation value (PIV) and the frequently assessed neutrophil/lymphocyte ratio (NLR) in a large cohort of patients with cutaneous melanoma (CM) without distant metastases (stages I to III). PIV and NLR were calculated at CM diagnosis. Healthy controls were also included. We used the Kaplan-Meier method to estimate crude survival probabilities and used Cox proportional hazards regression for multiple adjustment of hazard ratios. We observed that higher PIV (HR: 1.72, 95% CI 1.14 to 2.58 and HR: 1.696, 95% CI 1.029 to 2.795, respectively) and NLR (HR: 1.70, 95% CI 1.10 to 2.62) values were associated with CM relapse and CM-specific death in the crude analysis. However, when adjusting for potential confounders, in particular age and tumor thickness, the total effect of PIV and NLR on CM-relapse-free (HR: 1.28, 95% CI 0.83 to 1.98 and HR: 1.26, 95% CI 0.80 to 1.98, respectively) and CM-specific survival (HR: 1.36, 95% CI 0.80 to 2.30 and HR: 1.37, 95% CI 0.80 to 2.33, respectively) was substantially reduced. However, both PIV and NLR were positively correlated with age and tumor thickness, which are important independent predictors for CM relapse and CM-specific death. In conclusion, in stage I to III CM patients PIV as well as NLR appear to be confounded by age and tumor thickness and probably have no potential to further improve the prediction of survival of stage I to III CM patients beyond standard prognostic factors.
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Fu M, Yu L, Yang L, Chen Y, Chen X, Hu Q, Sun H. Predictive value of the preoperative prognostic nutritional index for postoperative progression in patients with pancreatic neuroendocrine neoplasms. Front Nutr 2022; 9:945833. [PMID: 36159473 PMCID: PMC9493178 DOI: 10.3389/fnut.2022.945833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 08/23/2022] [Indexed: 11/13/2022] Open
Abstract
Objective The preoperative nutritional status of cancer patients is closely related to prognosis. The prognostic nutritional index (PNI) has been shown to predict the prognosis of a variety of tumors, but its study in pancreatic neuroendocrine neoplasms (pNENs) is lacking. The aim of the present study is to investigate the predictive value of the preoperative PNI for postoperative progression in patients with pNENs. Methods The medical records of 181 patients with pNENs, who underwent surgery, were retrospectively analyzed. A time-dependent receiver operating characteristic (ROC) curve was plotted to determine the optimal cut-off value of the preoperative PNI. Correlations between the preoperative PNI and clinicopathological parameters were analyzed using multiple linear regression. A Kaplan-Meier curve was applied to assess the progression-free survival (PFS) rate, which was tested using a log rank. Univariate and multivariate Cox proportional risk regression models were used to analyze the predictive value of the preoperative PNI on prognosis. Results The optimal cut-off value of the preoperative PNI was 48.275. The patients were divided into a high PNI group (PNI > 48.275, n = 92) and a low PNI group (PNI ≤ 48.275, n = 89). The proportion of patients with tumor progression after surgery was significantly higher in the low PNI group compared with that in the high PNI group (P = 0.004). The Kaplan-Meier curve showed that the PFS rate after surgery was significantly lower in the low PNI group compared with that in the high PNI group (P = 0.026). The preoperative PNI was an independent predictor of PFS (HR: 2.727, 95% CI: 1.174∼6.333, P = 0.020). Conclusion The preoperative PNI has a predictive value for postoperative progression in patients with pNENs.
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Affiliation(s)
- Mengfei Fu
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, China
| | - Li Yu
- Department of Emergency Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liu Yang
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, China
| | - Yang Chen
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, China
| | - Xiao Chen
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, China
| | - Qinyu Hu
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, China
| | - Hui Sun
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, China
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Yang F, Pan M, Nie J, Xiao F, Zhang Y. Evaluation of the prognostic nutritional index for the prognosis of Chinese patients with high/extremely high-risk prostate cancer after radical prostatectomy. World J Clin Cases 2022; 10:8863-8871. [PMID: 36157668 PMCID: PMC9477051 DOI: 10.12998/wjcc.v10.i25.8863] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/22/2022] [Accepted: 07/29/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The incidence of prostate cancer (PCa) is on the rise in China. The risk level of patients with PCa is associated with disease-free survival rate at 10 years after radical prostatectomy. Predicting prognosis in advance according to the degree of risk can provide a reference for patients, especially treatment options and postoperative adjuvant treatment measures for high-risk/extremely high-risk patients.
AIM To explore the predictive value of the prognostic nutritional index (PNI) for biological recurrence in Chinese patients with high/extremely high-risk PCa after radical prostatectomy.
METHODS The biochemical test results and clinical data of 193 patients who underwent radical prostatectomy for the first time from January 2015 to December 2020 were retrospectively collected. The PNI value of peripheral blood within 1 wk before surgery was calculated, and during the follow-up period, prostate-specific antigen ≥ 0.2 ng/mL was considered to have biological recurrence. The receiver operating characteristic (ROC) curve was used to calculate the optimal critical value and area under the curve (AUC) of the patients. According to the critical value, the progression-free survival of the high PNI group and low PNI group was compared. The independent influencing factors of the patients' prognosis were obtained by the Cox proportional hazards regression model.
RESULTS The non-biological recurrence rates at 1, 3, and 5 years were 92.02%, 84.05%, and 74.85%, respectively. The optimal critical value for PNI to predict biological recurrence was 46.23, and the AUC was 0.789 (95% confidence interval: 0.651-0.860; P < 0.001). The sensitivity and specificity were 82.93% and 62.30%, respectively. In accordance with the optimal critical value of the ROC curve (46.23), 193 patients were further divided into a high PNI group (PNI ≤ 46.23, n = 108) and low PNI group (PNI > 46.23, n = 85). The incidence of postoperative complications in the high PNI group was lower than that in the low PNI group (21.18% vs 38.96%). Kaplan-Meier survival analysis showed that the overall survival rate at 5 years in the low PNI group was 87.96% (13/108), which was lower than that in the high PNI group (61.18%, 33/85; P < 0.05). Low PNI [hazard ratio (HR) = 1.74; P = 0.003] and positive incisal margin status (HR = 2.14; P = 0.001) were independent predictors of biological recurrence in patients with high/extremely high-risk PCa.
CONCLUSION The PNI has predictive value for the prognosis of patients with high/extremely high-risk PCa, and is an independent prognostic factor. Patients with low PNI value have a shorter time of non-biological recurrence after prostatectomy. It is expected that the combined prediction of other clinicopathological data will further improve the accuracy and guide postoperative adjuvant therapy to improve the quality of prognosis.
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Affiliation(s)
- Fan Yang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Min Pan
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Jin Nie
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Fan Xiao
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Yuan Zhang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
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Yuksel Y, Kose S. Prognostic Nutritional Index Predicts Contrast-Induced Nephropathy in Patients with Acute Coronary Syndrome. Angiology 2022:33197221116203. [DOI: 10.1177/00033197221116203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study evaluated the effectiveness of prognostic nutritional index (PNI) in predicting contrast induced nephropathy (CIN) in patients with acute coronary syndrome (ACS). This study included 925 ACS patients (mean age 62.5 ± 12.4 years, 73.5% male); 604 were diagnosed as unstable angina pectoris/non–ST-elevation myocardial infarction (USAP/NSTEMI) and 321 as ST-elevation myocardial infarction (STEMI). The PNI formula was: 10 × serum albumin (g/dL) + .005 × total lymphocyte count (/mm3). The patients were divided into two groups: CIN (n = 232) and non-CIN (n = 693). Patients without CIN had a significantly lower PNI than patients with CIN (44.3 ± 6.9 vs 54.7 ± 7.4; P < .001). In the receiver operating characteristic (ROC) curve analysis, the cut-off value for PNI of 48.6 has 80% specificity and 81% sensitivity in predicting CIN (area under the ROC curve (AUC): .87, 95% CI [.84–.89]). PNI <48.6 (odds ratio (OR): 6.765, P < .001), pre-procedural creatinine levels (OR: 6.223, P < .001), left ventricular ejection fraction (LVEF) (OR: .960, P < .001), age (OR: 1.025, P = .005), diabetes mellitus (DM) (0R: 1.768, P = .006), contrast amount (OR: 1.003, P = .038), and having STEMI (OR: .594, P = .029) were found independently associated with CIN. PNI is a strong independent predictor of CIN in ACS patients.
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Affiliation(s)
- Yasin Yuksel
- Department of Cardiology, Saglik Bilimleri University, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Sennur Kose
- Department of Nephrology, Saglik Bilimleri University, Istanbul Training and Research Hospital, Istanbul, Turkey
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Yang M, Zhang Q, Ge Y, Tang M, Hu C, Wang Z, Zhang X, Song M, Ruan G, Zhang X, Liu T, Xie H, Zhang H, Zhang K, Li Q, Li X, Liu X, Lin S, Shi H. Prognostic Roles of Inflammation- and Nutrition-Based Indicators for Female Patients with Cancer. J Inflamm Res 2022; 15:3573-3586. [PMID: 35747251 PMCID: PMC9211802 DOI: 10.2147/jir.s361300] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 06/08/2022] [Indexed: 12/04/2022] Open
Abstract
Purpose The incidence, progression, and prognosis of cancer could be affected by inflammation and nutrition. Female patients have different inflammatory and nutritional states depending on their age and tumor types. It is important to screen for suitable prognostic indicators in female patients with cancer of different ages and tumor types. Patients and Methods Baseline clinicopathologic and laboratory characteristics of 1502 female patients with cancer were obtained from a multicenter cohort study. Concordance indices (C-indices) were used to evaluate the prediction accuracy of following inflammation- and nutrition-based indicators: advanced lung cancer inflammation index (ALI), systemic immune inflammation index (SII), modified geriatric nutritional risk index (mGNRI), albumin-to-globulin ratio (AGR), prognostic nutritional index (PNI), lymphocyte-to-C-reactive protein ratio (LCR), controlling nutritional status score (CONUT), modified Glasgow prognostic score (mGPS), and lymphocyte-to-C-reactive protein score (LCS). Results The most suitable indicators in different female populations with cancer had C-indices as follows: LCR (0.668; 95% CI, 0.644–0.693) for all females; AGR (0.681; 95% CI, 0.619–0.743) for young females; LCR (0.667; 95% CI, 0.628–0.706) for middle-aged females; ALI (0.597; 95% CI, 0.574–0.620) for elderly females; LCR (0.684; 95% CI, 0.621–0.747) for females with reproductive system cancer; and ALI (0.652; 95% CI, 0.624–0.680) for females with non-reproductive system cancer. Conclusion The most suitable indicators for the different female populations with cancer are summarized as follows: LCR for all females, AGR for young females, LCR for middle-aged females, ALI for elderly females, LCR for females with reproductive system cancer, and ALI for females with non-reproductive system cancer.
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Affiliation(s)
- Ming Yang
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, People's Republic of China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, People's Republic of China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, People's Republic of China
| | - Qi Zhang
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, People's Republic of China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, People's Republic of China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, People's Republic of China
| | - Yizhong Ge
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, People's Republic of China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, People's Republic of China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, People's Republic of China.,The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325000, People's Republic of China
| | - Meng Tang
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, People's Republic of China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, People's Republic of China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, People's Republic of China
| | - Chunlei Hu
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, People's Republic of China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, People's Republic of China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, People's Republic of China
| | - Ziwen Wang
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, People's Republic of China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, People's Republic of China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, People's Republic of China
| | - Xi Zhang
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, People's Republic of China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, People's Republic of China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, People's Republic of China
| | - Mengmeng Song
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, People's Republic of China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, People's Republic of China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, People's Republic of China
| | - Guotian Ruan
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, People's Republic of China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, People's Republic of China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, People's Republic of China
| | - Xiaowei Zhang
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, People's Republic of China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, People's Republic of China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, People's Republic of China
| | - Tong Liu
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, People's Republic of China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, People's Republic of China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, People's Republic of China
| | - Hailun Xie
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, People's Republic of China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, People's Republic of China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, People's Republic of China
| | - Heyang Zhang
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, People's Republic of China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, People's Republic of China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, People's Republic of China
| | - Kangping Zhang
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, People's Republic of China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, People's Republic of China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, People's Republic of China
| | - Qinqin Li
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, People's Republic of China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, People's Republic of China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, People's Republic of China
| | - Xiangrui Li
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, People's Republic of China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, People's Republic of China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, People's Republic of China
| | - Xiaoyue Liu
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, People's Republic of China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, People's Republic of China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, People's Republic of China
| | - Shiqi Lin
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, People's Republic of China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, People's Republic of China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, People's Republic of China.,The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325000, People's Republic of China
| | - Hanping Shi
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, People's Republic of China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, People's Republic of China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, People's Republic of China
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Sakane T, Okuda K, Matsui T, Oda R, Tatematsu T, Yokota K, Nakanishi R. Prognostic value of systemic inflammatory markers and the nutrition status in thymic epithelial tumors with complete resection. Thorac Cancer 2022; 13:2127-2133. [PMID: 35715991 PMCID: PMC9346175 DOI: 10.1111/1759-7714.14485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 05/04/2022] [Accepted: 05/05/2022] [Indexed: 11/29/2022] Open
Abstract
Background Recent studies have shown that several systemic inflammatory markers and the nutrition status, including the neutrophil‐to‐lymphocyte ratio (NLR), monocyte‐to‐lymphocyte ratio (MLR), platelet‐to‐lymphocyte ratio (PLR), and prognostic nutritional index (PNI), are useful prognostic factors in several malignant tumors. The present study explored the prognostic value of the NLR, MLR, PLR, and PNI in thymic epithelial tumor (TET) patients who underwent complete resection. Methods A total of 158 TET patients who underwent complete resection were involved in the analysis. Their NLR, MLR, PLR, and PNI values were obtained from a blood examination within one month before the initiation of treatment. A receiver operating characteristic curve analysis was conducted to determine the optimal cutoff values. Results The enrolled patients were stratified by cutoffs of 4.35 for the NLR, 0.22 for the MLR, 130.18 for the PLR, and 44.02 for the PNI. A univariate analysis revealed that high‐grade malignant TET, including type B2 and B3 thymoma, thymic carcinoma, and thymic neuroendocrine tumor; an advanced Masaoka stage; a high NLR; a high MLR; and a low PNI were significant predictors of a poor disease‐free survival (DFS). A multivariate analysis confirmed that an advanced Masaoka stage (HR = 5.5557, p = 0.0007) and a high MLR (HR = 3.3371, p = 0.0264) were independent predictors of a poor DFS. Conclusions Our study demonstrated that the pretreatment MLR was an independent predictor of the DFS in patients with TETs who underwent complete resection.
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Affiliation(s)
- Tadashi Sakane
- Department of Oncology, Immunology and Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Katsuhiro Okuda
- Department of Oncology, Immunology and Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Takuya Matsui
- Department of Oncology, Immunology and Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Risa Oda
- Department of Oncology, Immunology and Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Tsutomu Tatematsu
- Department of Oncology, Immunology and Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Keisuke Yokota
- Department of Oncology, Immunology and Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Ryoichi Nakanishi
- Department of Oncology, Immunology and Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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Xing L, Chen R, Qian J, Ren J, Deng X. A comparison of three preoperative nutritional assessment methods for predicting ovarian cancer patient prognosis: which is better? Support Care Cancer 2022; 30:5221-5229. [PMID: 35260921 DOI: 10.1007/s00520-022-06941-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 02/27/2022] [Indexed: 02/08/2023]
Abstract
BACKGROUND The study aimed to compare the predictive values of three widely used nutritional assessment methods, body mass index (BMI), Nutritional Risk Screening 2002 (NRS 2002), and the prognostic nutritional index (PNI), for different clinical prognostic indicators of ovarian cancer patients. METHODS Patients diagnosed with ovarian cancer treated in our hospital between January 2017 and March 2019 were retrospectively included. The three nutritional assessment methods were assessed, and multivariable analysis was conducted to explore predictive factors for clinical prognoses. Receiver operating characteristic (ROC) curves and the area under the ROC curve (AUROC) were generated to evaluate the discriminative abilities of the three nutritional assessment tools. RESULTS A total of 442 patients were recruited. Multivariable analysis revealed that the PNI value predicted 1-year death and 1-year recurrence and that both the NRS 2002 score and the PNI value predicted 30-day readmission (P < 0.05). For PNI, AUROCs were 0.834 for predicting 1-year death and 0.719 for 1-year recurrence prediction; for NRS, the AUROC was 0.820 2002 for predicting 30-day readmission. The optimal cutoff values that maximized the prognostic prediction ability were PNI values of 47.75 g/L and 50.40 g/L for 1-year death and 1-year recurrence, respectively, and an NRS 2002 score of 3 points for 30-day readmission following discharge. CONCLUSION For ovarian cancer patients, the PNI is better at predicting 1-year death and 30-day readmission after discharge, and the NRS 2002 is superior for predicting 1-year recurrence.
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Affiliation(s)
- Lu Xing
- Department of Gynecological Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan Province, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan Province, China
| | - Ruiqi Chen
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
| | - Jiahui Qian
- West China School of Public Health, Sichuan University, Chengdu, Sichuan Province, China
| | - Jianhua Ren
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan Province, China. .,Department of Gynecological and Obstetric Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan Province, China.
| | - Xue Deng
- Department of Gynecological Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan Province, China. .,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan Province, China.
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40
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Han S, Qu FW, Wang PF, Liu YX, Li SW, Yan CX. Development and Validation of a Nomogram Model Based on Hematological Indicators for Predicting the Prognosis of Diffused Gliomas. Front Surg 2022; 9:803237. [PMID: 35495765 PMCID: PMC9043458 DOI: 10.3389/fsurg.2022.803237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 03/08/2022] [Indexed: 01/23/2023] Open
Abstract
Background Diffused gliomas are aggressive malignant brain tumors. Various hematological factors have been proven to predict the prognosis of patients with gliomas. The aim of this study is to integrate these hematological markers and develop a comprehensive system for predicting the prognosis of patients with gliomas. Method This retrospective study included 723 patients pathologically diagnosed with diffused gliomas. Hematological indicators were collected preoperatively, including neutrophil-to-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), albumin globulin ratio (AGR), platelet distribution width (PDW), red blood cell distribution width (RDW), fibrinogen (FIB), and prognostic nutritional index (PNI). Least absolute shrinkage and selection operator (LASSO) Cox was applied to screen the hematological indicators for a better prediction of patients' prognosis and to build an inflammation-nutrition score. A nomogram model was developed to predict the overall survival (OS), which included age, tumor grade, IDH-1 mutations, and inflammation-nutrition score. Result Patients were randomly divided into a primary cohort (n = 509) and a validation cohort (n = 214). There was no difference in age and IDH-1 mutation frequency between the cohorts. In the primary cohort, NLR, LMR, AGR, FIB, and PNI were selected to build an inflammation nutrition score. Patients with a high-risk inflammation-nutrition score had a short median OS of 17.40 months compared with 27.43 months in the low-risk group [HR 2.54; 95% CI (1.91–3.37); p < 0.001]. Moreover, age, tumor grade, IDH-1 mutations, and inflammation-nutrition score were independent prognostic factors in the multivariate analysis and thus were included in the nomogram model. The nomogram model showed a high prediction value with a Harrell's concordance index (C-index) of 0.75 [95% CI (0.72–0.77)]. The validation cohort supported these results. Conclusion The prognostic nomogram model provided a high prognostic predictive power for patients with gliomas.
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Affiliation(s)
- Song Han
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijing, China
| | - Fang-wen Qu
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijing, China
- Grade 2018, Medical College, Qingdao University, Qingdao, China
| | - Peng-fei Wang
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijing, China
| | - Ying-xin Liu
- Grade 2018, Medical College, Qingdao University, Qingdao, China
| | - Shou-wei Li
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijing, China
| | - Chang-xiang Yan
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijing, China
- *Correspondence: Chang-xiang Yan
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Kudou K, Kusumoto T, Nambara S, Tsuda Y, Kusumoto E, Yoshida R, Sakaguchi Y, Ikejiri K. New index combining multiple
inflammation‐based
prognostic scores for predicting the prognosis of gastric cancer patients. JGH Open 2022; 6:171-178. [PMID: 35355677 PMCID: PMC8938759 DOI: 10.1002/jgh3.12723] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 11/26/2021] [Accepted: 02/19/2022] [Indexed: 12/04/2022]
Abstract
Background and Aim Several inflammation‐based scores have prognostic value for patients diagnosed with various cancers. However, using only a single inflammation‐based prognostic score may be unreliable, as the cut‐off values and relative usefulness among various inflammation‐based prognostic scores vary. We established a new combined index of four inflammation‐based prognostic scores, namely the neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, prognostic index, and prognostic nutritional index, and assessed its usefulness to predict the prognosis of gastric cancer. Methods and Results We reviewed the data of 635 patients who underwent surgical resection for gastric cancer. We calculated the combined index as the total value of each of the four included inflammation‐based prognostic scores and analyzed the relationship between the combined index and postoperative prognosis of gastric cancer. The new combined index was represented as a value between 0 and 6 in each patient. The Kaplan–Meier survival curves showed that patients whose combined index was 0 had good long‐term outcomes, while the prognosis of patients whose combined index ranged from 4 to 6 was poor. Conclusion This new combined index was strongly associated with poor prognosis in patients who underwent surgery for gastric cancer. It is inferred that it can predict patient prognosis after surgical resection for gastric cancer with a stronger correlation and clearer stratification than a single inflammation‐based prognostic score.
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Affiliation(s)
- Kensuke Kudou
- Department of Gastroenterological Surgery, Clinical Research Institute Cancer Research Division National Hospital Organization Kyushu Medical Center Fukuoka Japan
| | - Tetsuya Kusumoto
- Department of Gastroenterological Surgery, Clinical Research Institute Cancer Research Division National Hospital Organization Kyushu Medical Center Fukuoka Japan
| | - Sho Nambara
- Department of Gastroenterological Surgery, Clinical Research Institute Cancer Research Division National Hospital Organization Kyushu Medical Center Fukuoka Japan
| | - Yasuo Tsuda
- Department of Gastroenterological Surgery, Clinical Research Institute Cancer Research Division National Hospital Organization Kyushu Medical Center Fukuoka Japan
| | - Eiji Kusumoto
- Department of Gastroenterological Surgery, Clinical Research Institute Cancer Research Division National Hospital Organization Kyushu Medical Center Fukuoka Japan
| | - Rintaro Yoshida
- Department of Gastroenterological Surgery, Clinical Research Institute Cancer Research Division National Hospital Organization Kyushu Medical Center Fukuoka Japan
| | - Yoshihisa Sakaguchi
- Department of Gastroenterological Surgery, Clinical Research Institute Cancer Research Division National Hospital Organization Kyushu Medical Center Fukuoka Japan
| | - Koji Ikejiri
- Department of Gastroenterological Surgery, Clinical Research Institute Cancer Research Division National Hospital Organization Kyushu Medical Center Fukuoka Japan
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Xie Z, Zhou H, Wang L, Wu Y. The Significance of the preoperative lactate dehydrogenase/albumin Ratio in the Prognosis of Colon Cancer: a retrospective study. PeerJ 2022; 10:e13091. [PMID: 35295561 PMCID: PMC8919845 DOI: 10.7717/peerj.13091] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 02/18/2022] [Indexed: 01/12/2023] Open
Abstract
Background We explored the relationship between the platelet-lymphocyte ratio (PLR), the prognostic nutritional index (PNI), the lactate dehydrogenase-albumin ratio (LDH/albumin ratio; LAR), the controlling nutritional status (CONUT) score, and the long-term survival of colon cancer patients. Methods We conducted a retrospective analysis of the clinical data and follow-up materials of 126 patients with colon cancer who underwent surgical treatment in the Department of Gastrointestinal Surgery of Jiangnan University Affiliated Hospital from June 2012 to December 2015. The receiver operating characteristic curve (ROC) was used to distinguish the high ratio group from the low ratio group. The Kaplan Meier method was used to draw the survival curve in our survival analysis. The log rank test was used for the univariate analysis and the Cox multivariate regression analysis was used to analyze the correlation between preoperative PLR, PNI, LAR, conut scores, and overall survival (OS) and progression free survival (PFS) of patients with colon cancer. Results The median follow-up time was 72 months. The OS rates at 3 and 5 years were 83.3% and 78.5%, respectively. The PFS rates at 3 and 5 years were 79.3% and 77.6%, respectively. The 3-year and 5-year OS rates in the low LAR group (≤4.91) were 90.9% and 87.1%, respectively, and were 56.0% and 44.0% in the high LAR group (>4.91) respectively. Univariate and multivariate analyses showed that the LAR value was correlated with OS and PFS (P < 0.05). Conclusion A high preoperative LAR is an independent predictor of the prognosis of colon cancer patients.
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Affiliation(s)
- Zhihui Xie
- Department of General Surgery, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China
| | - Hui Zhou
- Human Reproductive Medicine Center, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China
| | - Lei Wang
- Department of General Surgery, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China
| | - Yibo Wu
- Human Reproductive Medicine Center, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China
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Li F, Li C, Sun Y, Bao Y, Jiang W, Song Z, Wang Y, Liu M, Wang W, Li T, Li L. Cerebral Ischemic Complications After Surgical Revascularization for Moyamoya Disease: Risk Factors and Development of a Predictive Model Based on Preoperative Nutritional Blood Parameters. Front Nutr 2022; 9:842838. [PMID: 35360692 PMCID: PMC8960452 DOI: 10.3389/fnut.2022.842838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 02/02/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives Cerebral ischemic complications are common after revascularization in patients with moyamoya disease (MMD). Risk factors from specific laboratory variables have only been assessed by limited research. This study was to investigate the association between postoperative cerebral ischemia and nutritional blood parameters and examine predictive values of such risk factors in adults. Methods Preoperative demographics and nutritional blood parameters of patients with MMD who received revascularization at our institution from 2012 to 2021 were retrospectively reviewed. Univariate analysis and multivariable logistic regression were used to identify independent risk factors for the onset of postoperative cerebral ischemic complications. Predictive values were tested and a model incorporating these independent risk factors was created using the R program. Area under the receiver operating characteristic curve (AUC) was used for testing its discriminability. Results Postoperative cerebral ischemic complications occurred in 32 patients of 100 included procedures. Surgery on the left hemisphere, lower admission modified Rankin Scale (mRS) score, aberrant nutritional parameters including low white blood cell (WBC), and high total cholesterol (TC) were significantly associated with cerebral ischemic complications after revascularization. The intriguing role of WBC might be explained by altered immunomodulation. The AUC of this model with novel nutritional parameters yielded a value of 0.811, presenting better predictive accuracy. Additionally, the model was visualized in the form of a nomogram and translated into a user-friendly calculator to generate individual risk. Conclusions Surgical side, admission mRS score, WBC, and TC were independent risk factors for postoperative cerebral ischemic complications. The model composed of these four parameters was promising to be adopted in clinical practice.
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Affiliation(s)
- Fangbao Li
- Department of Neurosurgery, Qingdao Municipal Hospital, Qingdao, China
- School of Medicine, Dalian Medical University, Dalian, China
| | - Chuanfeng Li
- Department of Neurosurgery, Qingdao Municipal Hospital, Qingdao, China
| | - Yunwei Sun
- Department of Neurosurgery, Qingdao Municipal Hospital, Qingdao, China
| | - Yue Bao
- Department of Neurosurgery, Qingdao Municipal Hospital, Qingdao, China
| | - Wenbo Jiang
- Department of Neurosurgery, Qingdao Municipal Hospital, Qingdao, China
| | - Zuoyan Song
- Department of Anesthesiology, Qingdao Municipal Hospital, Qingdao, China
| | - Yongyi Wang
- Department of Neurosurgery, Qingdao Municipal Hospital, Qingdao, China
| | - Mingxing Liu
- Department of Neurosurgery, Qingdao Municipal Hospital, Qingdao, China
| | - Weimin Wang
- Department of Neurosurgery, Qingdao Municipal Hospital, Qingdao, China
| | - Tong Li
- Department of Neurosurgery, Qingdao Municipal Hospital, Qingdao, China
- *Correspondence: Tong Li
| | - Luo Li
- Department of Neurosurgery, Qingdao Municipal Hospital, Qingdao, China
- Luo Li
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Qi M, Xu D, Wang S, Li B, Peng S, Li Q, Zhang H, Fan R, Chen H, Kong MG. In Vivo Metabolic Analysis of the Anticancer Effects of Plasma-Activated Saline in Three Tumor Animal Models. Biomedicines 2022; 10:biomedicines10030528. [PMID: 35327329 PMCID: PMC8945198 DOI: 10.3390/biomedicines10030528] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 02/12/2022] [Accepted: 02/20/2022] [Indexed: 02/04/2023] Open
Abstract
In recent years, the emerging technology of cold atmospheric pressure plasma (CAP) has grown rapidly along with the many medical applications of cold plasma (e.g., cancer, skin disease, tissue repair, etc.). Plasma-activated liquids (e.g., culture media, water, or normal saline, previously exposed to plasma) are being studied as cancer treatments, and due to their advantages, many researchers prefer plasma-activated liquids as an alternative to CAP in the treatment of cancer. In this study, we showed that plasma-activated-saline (PAS) treatment significantly inhibited tumor growth, as compared with saline, in melanoma, and a low-pH environment had little effect on tumor growth in vivo. In addition, based on an ultra-high-performance liquid tandem chromatography-quadrupole time-of-flight mass spectrometry (UHPLC-QTOF-MS) analysis of tumor cell metabolism, the glycerophospholipid metabolic pathway was the most susceptible metabolic pathway to PAS treatment in melanoma in vitro and in vivo. Furthermore, PAS also inhibited cell proliferation in vivo in oral tongue squamous-cell cancer and non-small-cell lung cancer. There were few toxic side effects in the three animal models, and the treatment was deemed safe to use. In the future, plasma-activated liquids may serve as a potential therapeutic approach in the treatment of cancer.
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Affiliation(s)
- Miao Qi
- State Key Laboratory of Electrical Insulation and Power Equipment, Centre for Plasma Biomedicine, Xi’an Jiaotong University, Xi’an 710049, China; (M.Q.); (S.P.); (Q.L.); (H.Z.); (R.F.)
- The School of Life Science and Technology, Xi’an Jiaotong University, Xi’an 710049, China; (S.W.); (B.L.)
| | - Dehui Xu
- State Key Laboratory of Electrical Insulation and Power Equipment, Centre for Plasma Biomedicine, Xi’an Jiaotong University, Xi’an 710049, China; (M.Q.); (S.P.); (Q.L.); (H.Z.); (R.F.)
- Correspondence: (D.X.); (M.G.K.)
| | - Shuai Wang
- The School of Life Science and Technology, Xi’an Jiaotong University, Xi’an 710049, China; (S.W.); (B.L.)
| | - Bing Li
- The School of Life Science and Technology, Xi’an Jiaotong University, Xi’an 710049, China; (S.W.); (B.L.)
| | - Sansan Peng
- State Key Laboratory of Electrical Insulation and Power Equipment, Centre for Plasma Biomedicine, Xi’an Jiaotong University, Xi’an 710049, China; (M.Q.); (S.P.); (Q.L.); (H.Z.); (R.F.)
| | - Qiaosong Li
- State Key Laboratory of Electrical Insulation and Power Equipment, Centre for Plasma Biomedicine, Xi’an Jiaotong University, Xi’an 710049, China; (M.Q.); (S.P.); (Q.L.); (H.Z.); (R.F.)
| | - Hao Zhang
- State Key Laboratory of Electrical Insulation and Power Equipment, Centre for Plasma Biomedicine, Xi’an Jiaotong University, Xi’an 710049, China; (M.Q.); (S.P.); (Q.L.); (H.Z.); (R.F.)
| | - Runze Fan
- State Key Laboratory of Electrical Insulation and Power Equipment, Centre for Plasma Biomedicine, Xi’an Jiaotong University, Xi’an 710049, China; (M.Q.); (S.P.); (Q.L.); (H.Z.); (R.F.)
| | - Hailan Chen
- Frank Reidy Center for Bioelectrics, Old Dominion University, Norfolk, VA 23508, USA;
| | - Michael G. Kong
- Frank Reidy Center for Bioelectrics, Old Dominion University, Norfolk, VA 23508, USA;
- Department of Electrical and Computer Engineering, Old Dominion University, Norfolk, VA 23529, USA
- Correspondence: (D.X.); (M.G.K.)
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Gambichler T, Said S, Abu Rached N, Scheel CH, Susok L, Stranzenbach R, Becker JC. Pan-immune-inflammation value independently predicts disease recurrence in patients with Merkel cell carcinoma. J Cancer Res Clin Oncol 2022; 148:3183-3189. [PMID: 35098389 PMCID: PMC9508022 DOI: 10.1007/s00432-022-03929-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 01/17/2022] [Indexed: 12/25/2022]
Abstract
Purpose We aimed to determine whether the pan-immune-inflammation value (PIV) of patients with Merkel cell carcinoma (MCC) at primary diagnosis differs from controls and whether it is associated with disease stage and outcome. Methods In this retrospective study, we recruited MCC patients with stage I–III. PIV was calculated from absolute complete blood cell counts obtained within one week at MCC diagnosis as follows: [neutrophils (103/mm3) × platelets (103/mm3) × monocytes (103/mm3)]/lymphocytes (103/mm3). As controls, we studied age–gender-matched cutaneous melanoma (CM, stage I–III) patients and healthy controls (HC). Univariate and multivariate statistics were used. Results The median PIV in MCC patients was significantly increased compared to both CM patients as well as healthy controls. PIV of MCC patients in stage II and III was significantly higher compared to stage I patients. ROC analysis revealed that MCC recurrence was significantly associated with a PIV greater than 372 [p < 0.0001, Youden index 0.58; hazard ratio: 4 (95% confidence interval: 1.7 to 9.2)]. In multivariate analysis, only a PIV greater than 372 and higher MCC stage were determined as independent predictors for disease recurrence. Conclusion We determined, for the first time, the prognostic ability of the promising blood-based biomarker PIV in MCC patients and observed that PIV is increased in MCC patients in dependence on disease stage and independently predicts MCC recurrence.
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Affiliation(s)
- T Gambichler
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Gudrunstraße 56, 44791, Bochum, Germany.
| | - S Said
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Gudrunstraße 56, 44791, Bochum, Germany
| | - N Abu Rached
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Gudrunstraße 56, 44791, Bochum, Germany
| | - C H Scheel
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Gudrunstraße 56, 44791, Bochum, Germany
| | - L Susok
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Gudrunstraße 56, 44791, Bochum, Germany
| | - R Stranzenbach
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Gudrunstraße 56, 44791, Bochum, Germany
| | - J C Becker
- Translational Skin Cancer Research, DKTK Partner Site Essen/Düsseldorf, West German Cancer Center, Dermatology, University Duisburg-Essen, Essen, Germany
- German Cancer Research Center (DKFZ), Heidelberg, Germany
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Hirahara N, Matsubara T, Kaji S, Uchida Y, Hyakudomi R, Yamamoto T, Takai K, Sasaki Y, Kawakami K, Tajima Y. Influence of nutrition on stage-stratified survival in gastric cancer patients with postoperative complications. Oncotarget 2022; 13:183-197. [PMID: 35079325 PMCID: PMC8782615 DOI: 10.18632/oncotarget.28179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 01/06/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND We assessed the relationship between preoperative prognostic nutritional index (PNI) and short- and long-term outcomes among gastric cancer patients because the clinical significance of PNI in these patients remains controversial. MATERIALS AND METHODS We retrospectively reviewed the medical records of 434 consecutive patients who underwent curative laparoscopic gastrectomy for gastric cancer. RESULTS Patients with postoperative complications had a significantly poorer overall survival (OS) than those without. On multivariate analyses, postoperative complications were independently associated with PNI value and operative procedure type. In the low PNI group (n = 118), those with postoperative complications experienced significantly poorer OS than those without complications. Among the low PNI group with pTNM stage I and II disease, those with postoperative complications experienced significantly worse OS than those without complications. However, among the high PNI group and patients with stage II and III disease in the low PNI group, OS was similar with respect to postoperative complications. CONCLUSIONS The present study confirmed that long-term prognosis was unaffected by postoperative complications in well-nourished gastric cancer patients. In addition, preoperative nutritional status and postoperative complications, may be crucial in determining the prognosis of gastric cancer, especially in early-stage cancer.
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Affiliation(s)
- Noriyuki Hirahara
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Takeshi Matsubara
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Shunsuke Kaji
- Department of Surgery, Matsue Red Cross Hospital, Shimane, Matsue, Horomachi, Japan
| | - Yuki Uchida
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Ryoji Hyakudomi
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Tetsu Yamamoto
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Kiyoe Takai
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Yohei Sasaki
- Department of Surgery, Masuda Red Cross Hospital, Shimane, Masuda, Otoyoshi-cho, Japan
| | - Koki Kawakami
- Department of Surgery, Matsue Red Cross Hospital, Shimane, Matsue, Horomachi, Japan
| | - Yoshitsugu Tajima
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
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Luo D, Xie N, Yang Z, Zhang C. Association of nutritional status and mortality risk in patients with primary pulmonary hypertension. Pulm Circ 2022; 12:e12018. [PMID: 35506096 PMCID: PMC9052992 DOI: 10.1002/pul2.12018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 11/20/2021] [Accepted: 11/30/2021] [Indexed: 11/10/2022] Open
Abstract
Malnutrition plays a crucial role in pulmonary hypertension (PH). The prognostic nutritional index (PNI) is a reliable indicator for nutritional status assessment. However, its relationship with mortality risk in PH patients has not yet been investigated. This study analyzed data from the Patient Registry for Primary PH. PNI was calculated through albumin and lymphocyte counts. Subjects with missing data for PNI calculation were excluded. The primary endpoint was all‐cause mortality. Cox proportional hazard model was used to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs). Of the 317 patients records available in the registry, we finally included 136 patients. The average age of the included subjects was 40.56 (14.91) years and 63.24% (86/136) were female. In our analysis of Cox regression, per 1‐point increment of PNI was associated with 4% decreased risk of mortality in PH patients (age‐ and sex‐adjusted HR: 0.96, 95% CI: 0.93–0.98, p = 0.002). We further categorized these subjects by quartiles of PNI. Compared to quartile 4, the age‐ and sex‐adjusted HRs of death for quartiles 1, 2, and 3 were 2.39 (95% CI: 1.21–4.72, p = 0.01), 2.25 (95% CI: 1.15–4.39, p = 0.02), and 1.72 (95% CI: 0.84–3.52, p = 0.14). In addition, logistic regression analyses suggested a positive correlation of PNI with total lung capacity (β = 0.98, p = 0.002) and forced expiratory volume in 1 min (β = 1.53, p = 0.03). This study demonstrates that low PNI was associated with an increased risk of death in PH patients. These findings help to enlighten our understanding of the nutritional status and adverse outcomes in PH patients.
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Affiliation(s)
- Dongling Luo
- Department of Cardiology Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences Guangzhou China
| | - Nanshan Xie
- Department of Cardiology Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences Guangzhou China
| | - Ziyang Yang
- Department of Cardiology Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences Guangzhou China
| | - Caojin Zhang
- Department of Cardiology Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences Guangzhou China
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Zhu S, Cheng Z, Hu Y, Chen Z, Zhang J, Ke C, Yang Q, Lin F, Chen Y, Wang J. Prognostic Value of the Systemic Immune-Inflammation Index and Prognostic Nutritional Index in Patients With Medulloblastoma Undergoing Surgical Resection. Front Nutr 2022; 8:754958. [PMID: 34977115 PMCID: PMC8718683 DOI: 10.3389/fnut.2021.754958] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 11/18/2021] [Indexed: 01/19/2023] Open
Abstract
Background: The progression and metastasis of cancers are associated with systematic immune inflammation and nutritional dysfunction. The systemic immune-inflammation index and prognostic nutritional index (PNI) have shown a prognostic impact in several malignancies. Therefore, our study aimed to evaluate immune inflammation and nutritional index prognostic significance in patients with medulloblastoma (MB). Methods: We retrospectively analyzed 111 patients with MB between 2001 and 2021 at our institution. The optimal cutoff values for systemic immune-inflammation index (SII), neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte counts ration (MLR), and PNI were evaluated with receiver operating characteristic (ROC) curve analysis. Clinical characteristics and SII, NLR, MLR, and PNI were tested with the Pearson's chi-squared test. The Kaplan–Meier survival curves and the Cox proportional hazards model were used to evaluate the effects of immune inflammation and nutritional index on overall survival (OS). Results: Receiver operating characteristic curve analysis determined the optimal SII, NLR, MLR, and PNI cutoff values of 2,278, 14.83, 0.219, and 56.5 that significantly interacts with OS and divided the patients into two groups. Comparative survival analysis exhibited that the high-SII cohort had significantly shorter OS (p = 0.0048) than the low-SII cohort. For the univariate analysis, the results revealed that preoperative hydrocephalus (p = 0.01), SII (p = 0.006), albumin–bilirubin score (ALBI) (p = 0.04), and coSII–PNI were predictors of OS. In the multivariate analysis, preoperative hydrocephalus (p < 0.001), ALBI (p = 0.010), SII (p < 0.001), and coSII–PNI as independent prognostic factors were significantly correlated with OS. Conclusion: The preoperative SII, ALBI, and coSII–PNI serve as robust prognostic biomarkers for patients with MB undergoing surgical resection.
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Affiliation(s)
- Sihan Zhu
- Department of Neurosurgery and Neuro-Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Zhuqing Cheng
- Department of Neurosurgery and Neuro-Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Yuanjun Hu
- Department of Neurosurgery and Neuro-Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Zhenghe Chen
- Department of Neurosurgery and Neuro-Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Ji Zhang
- Department of Neurosurgery and Neuro-Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Chao Ke
- Department of Neurosurgery and Neuro-Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Qunying Yang
- Department of Neurosurgery and Neuro-Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Fuhua Lin
- Department of Neurosurgery and Neuro-Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Yinsheng Chen
- Department of Neurosurgery and Neuro-Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Jian Wang
- Department of Neurosurgery and Neuro-Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
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Xue W, Zhang Y, Wang H, Zhang Y, Hu X. Multicenter Study of Controlling Nutritional Status (CONUT) Score as a Prognostic Factor in Patients With HIV-Related Renal Cell Carcinoma. Front Immunol 2021; 12:778746. [PMID: 34917092 PMCID: PMC8669761 DOI: 10.3389/fimmu.2021.778746] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 11/09/2021] [Indexed: 01/06/2023] Open
Abstract
Objective In recent years, the controlled nutritional status (CONUT) score has been widely recognized as a new indicator for assessing survival in patients with urological neoplasms, including renal, ureteral, and bladder cancer. However, the CONUT score has not been analyzed in patients with HIV-related urological neoplasms. Therefore, we aimed to evaluate the prognostic significance of the CONUT score in patients with HIV-related renal cell carcinoma (RCC). Methods A total of 106 patients with HIV-related RCC were recruited from four hospitals between 2012 and 2021, and all included patients received radical nephrectomy or partial nephrectomy. The CONUT score was calculated by serum albumin, total lymphocyte counts, and total cholesterol concentrations. Patients with RCC were divided into two groups according to the optimal cutoff value of the CONUT score. Survival analysis of different CONUT groups was performed by the Kaplan–Meier method and a log rank test. A Cox proportional risk model was used to test for correlations between clinical variables and cancer-specific survival (CSS), overall survival (OS), and disease-free survival (DFS). Clinical variables included age, sex, hypertension, diabetes, tumor grade, Fuhrman grade, histology, surgery, and CD4+ T lymphocyte count. Result The median age was 51 years, with 93 males and 13 females. At a median follow-up of 41 months, 25 patients (23.6%) had died or had tumor recurrence and metastasis. The optimal cutoff value for the CONUT score was 3, and a lower CONUT score was associated with the Fuhrman grade (P=0.024). Patients with lower CONUT scores had better CSS (HR 0.197, 95% CI 0.077-0.502, P=0.001), OS (HR 0.177, 95% CI 0.070-0.446, P<0.001) and DFS (HR 0.176, 95% CI 0.070-0.444, P<0.001). Multivariate Cox regression analysis indicated that a low CONUT score was an independent predictor of CSS, OS and DFS (CSS: HR=0.225, 95% CI 0.067-0.749, P=0.015; OS: HR=0.201, 95% CI 0.061-0.661, P=0.008; DFS: HR=0.227, 95% CI 0.078-0.664, P=0.007). In addition, a low Fuhrman grade was an independent predictor of CSS (HR 0.192, 95% CI 0.045-0.810, P=0.025), OS (HR 0.203, 95% CI 0.049-0.842, P=0.028), and DFS (HR 0.180, 95% CI 0.048-0.669, P=0.010), while other factors, such as age, sex, hypertension, diabetes, tumor grade, histology, surgery, and CD4+ T lymphocyte count, were not associated with survival outcome. Conclusion The CONUT score, an easily measurable immune-nutritional biomarker, may provide useful prognostic information in HIV-related RCC.
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Affiliation(s)
- Wenrui Xue
- Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Yu Zhang
- Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Hua Wang
- Chengdu Public Health Clinical Medical Center, Sichuan, China
| | - Yu Zhang
- Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Xiaopeng Hu
- Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
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Hannarici Z, Yilmaz A, Buyukbayram ME, Tekin SB, Bilici M. A novel prognostic biomarker for cutaneous malignant melanoma: red cell distribution width (RDW) to lymphocyte ratio. Melanoma Res 2021; 31:566-574. [PMID: 34570023 DOI: 10.1097/cmr.0000000000000785] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
It is well-known that inflammation plays a significant role in cancer formation and prognosis. Both lymphocyte count and red cell distribution width (RDW) has been used to predict prognosis in various cancers as an indicator of inflammation. Yet, the role of RDW-lymphocyte ratio (RLR) in determining prognosis is still unknown. We aimed to determine the prognostic role of RLR in cutaneous malignant melanoma (MM). One hundred fifteen patients with MM were included in the study retrospectively. The relationship of the clinical-pathological data with overall survival (OS) and progression-free survival (PFS) was analyzed using Kaplan-Meier curves. The cut-off values of neutrophil to lymphocyte ratio, systemic immune-inflammation index (SII), prognostic nutritional index (PNI) and RLR were determined as 2, 487, 51.5 and 6.52, respectively. OS was significantly longer in the low SII, high PNI, low RLR group, while PFS was longer in groups with high PNI and low RLR. In univariate analysis, it was determined that PFS was significantly correlated with Eastern Cooperative Oncology Group (ECOG) performance, TNM stage, PNI and RLR. Moreover, in univariate analysis, a significant correlation was determined between OS and age, ECOG performance, TNM stage, adjuvant interferon, SII, PNI and RLR. In multivariate analysis, ECOG performance, TNM stage and RLR were determined as independent prognostic factors for PFS, while TNM stage and RLR were found to be independent prognostic factors for OS. RLR could be a novel prognostic marker for both PFS and OS in patients with cutaneous MM.
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Affiliation(s)
- Zekeriya Hannarici
- Department of Medical Oncology, Atatürk University Faculty of Medicine, Erzurum, Turkey
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