Gastric cancer(GC),the fifth most common malignancy worldwide,poses a substantial challenge in clinical oncology,particularly in its advanced stages.Despite advancements in immunotherapy,patient prognosis remains poor...Gastric cancer(GC),the fifth most common malignancy worldwide,poses a substantial challenge in clinical oncology,particularly in its advanced stages.Despite advancements in immunotherapy,patient prognosis remains poor,underscoring the need for reliable prognostic tools to refine treatment strategies.A study by Yao et al explores the role of the triglyceride-glucose(TyG)index as a prognostic marker for advanced GC patients receiving immunotherapy combined with chemotherapy.The results of the study demonstrate that the TyG index correlates with improved survival outcomes,including better progression-free survival and overall survival.This editorial critically evaluates the significance of these findings,discusses their implications for future research,and highlights innovative directions that could drive further breakthroughs in the application of the TyG index to cancer therapy.This editorial also highlights the potential of TyG in advancing precision oncology and advocates for global validation and mechanistic investigations to further solidify its clinical utility.Future research should focus on validating the TyG index across various malignancies,exploring its potential to influence immunotherapy through metabolic interventions,and developing multi-biomarker models that integrate TyG with immune and genomic profiles.展开更多
Serum prealbumin is a recognized marker of malnutrition,but its prognostic role in patients with hemorrhagic stroke remains unclear.In this study,we retrospectively reviewed the records of 105 patients with hemorrhagi...Serum prealbumin is a recognized marker of malnutrition,but its prognostic role in patients with hemorrhagic stroke remains unclear.In this study,we retrospectively reviewed the records of 105 patients with hemorrhagic stroke admitted to Renmin Hospital of Wuhan University,China,from January to December 2015.We collected demographic and radiological data,and recorded serum prealbumin levels at admission and on days 1,3,6,9,and 14-21.The existence of infections and gastrointestinal hemorrhage,and clinical condition at discharge were also recorded.Serum prealbumin levels during hospitalization were significantly lower in patients with infections compared with those without infections,and also significantly lower in patients with gastrointestinal hemorrhage compared with those without.Serum prealbumin levels at discharge were significantly higher in patients with good recovery than in those with poor recovery.We conclude that regular serum prealbumin measurements in patients with hemorrhagic stroke may be a useful indicator for determining clinical status and prognosis,which may therefore help to guide clinical decision-making.展开更多
The aim of this study was to determine the impact that age and comorbidity status have on both overall and bladder cancer-specific survival of bladder cancer patients. We obtained medical information pertaining to a p...The aim of this study was to determine the impact that age and comorbidity status have on both overall and bladder cancer-specific survival of bladder cancer patients. We obtained medical information pertaining to a population of 528 patients with newly diagnosed bladder cancer from Chung-Ang University Hospital cancer registry. The Adult Comorbidity Evaluation-27 （ACE-27） test, which has been previously validated in adult cancer patients, was used to assess comorbidity. We evaluated differences in the demographic and clinical characteristics of included patients, as well as differences in the treatments they received after categorizing them by age. The median age at the time of bladder cancer diagnosis of the entire cohort was 63 years, and the median follow-up time was 97 months. Of the 528 patients who were included in our study, 303 had at least one comorbid condition and 249 died during the follow-up period. When patients were stratified by age, we found that older patients had a higher proportion of severe comorbidities （P 〈 0.01） than younger patients, and that a lower proportion of them underwent radical cystec- tomy for invasive bladder cancer （IBC） （P 〈 0.01）. By multivariate analysis, we found that older age was predictive of lower overall survival （OS） and bladder cancer-specific survival （BCSS） rates among patients with superficial bladder cancer （SBC） and of lower OS rates among patients with IBC. We also found that moderate-severe comorbidity status and treatment through a bladder-conserving approach were predictive of lower OS and cancer-specific survival rates among patients with IBC. The disparity between overall deaths and bladder cancer deaths was shown in SBC and increased along with age and higher comorbidity. Age and comorbidity were found to be independent predictive factors of OS and BCSS among bladder cancer patients, and explained the disparity that we observed between overall bladder cancer-specific mortality rates.展开更多
Cardiovascular diseases(CVDs)remain the leading cause of morbidity and mortality worldwide,necessitating innovative diagnostic and prognostic strategies.Traditional biomarkers like C-reactive protein,uric acid,troponi...Cardiovascular diseases(CVDs)remain the leading cause of morbidity and mortality worldwide,necessitating innovative diagnostic and prognostic strategies.Traditional biomarkers like C-reactive protein,uric acid,troponin,and natriuretic peptides play crucial roles in CVD management,yet they are often limited by sensitivity and specificity constraints.This narrative review critically examines the emerging landscape of cardiac biomarkers and advocates for a multiple-marker approach to enhance early detection,prognosis,and risk stratification of CVD.In recent years,several novel biomarkers have shown promise in revolutionizing CVD diagnostics.Gamma-glutamyltransferase,microRNAs,endothelial microparticles,placental growth factor,trimethylamine N-oxide,retinol-binding protein 4,copeptin,heart-type fatty acid-binding protein,galectin-3,growth differentiation factor-15,soluble suppression of tumorigenicity 2,fibroblast growth factor 23,and adrenomedullin have emerged as significant indicators of CV health.These biomarkers provide insights into various pathophysiological processes,such as oxidative stress,endothelial dysfunction,inflammation,metabolic disturbances,and myocardial injury.The integration of these novel biomarkers with traditional ones offers a more comprehensive understanding of CVD mechanisms.This multiple-marker approach can improve diagnostic accuracy,allowing for better risk stratification and more personalized treatment strategies.This review underscores the need for continued research to validate the clinical utility of these biomarkers and their potential incorporation into routine clinical practice.By leveraging the strengths of both traditional and novel biomarkers,precise therapeutic plans can be developed,thereby improving the management and prognosis of patients with CVDs.The ongoing exploration and validation of these biomarkers are crucial for advancing CV care and addressing the limitations of current diagnostic tools.展开更多
In this letter,we discuss the article by Li et al published in the World Journal of Gastrointestinal Surgery.Gallbladder cancer is a rare but fatal cancer that is often detected unexpectedly and at an advanced stage f...In this letter,we discuss the article by Li et al published in the World Journal of Gastrointestinal Surgery.Gallbladder cancer is a rare but fatal cancer that is often detected unexpectedly and at an advanced stage following routine cholecystectomy.Although the prognosis is poor,curative resections often combined with postoperative chemotherapy and/or radiation therapy can improve survival.However,targeted patient selection for the appropriate therapeutic approach is critical to minimize unnecessary morbidity.Using advanced statistical techniques,the authors developed a nomogram with the potential to predict survival after gallbladder cancer resection,identifying factors associated with long-and shortterm survival.This tool could improve patient selection for surgery and postoperative treatment.In this letter,we provide background on survival nomograms including an in-depth discussion of statistical methods employed in this study,the use of nomograms in other forms of cancer,limitations to the model,and directions for future research.展开更多
Objective:While albumin and the weight-standardized hand grip strength(HGS/W)serve as valuable prognostic indicators for cancer patients,their correlation with the prognosis in frail cancer patients remains inadequate...Objective:While albumin and the weight-standardized hand grip strength(HGS/W)serve as valuable prognostic indicators for cancer patients,their correlation with the prognosis in frail cancer patients remains inadequately explored.This study aimed to investigate the prognostic importance of the albumin level and HGS/W in cancer patients with frailty and to further investigate their combined prognostic value.Moreover,this comprehensive evaluation aimed to facilitate timely intervention and treatment for frail patients.Methods:The research enrolled 5,794 cancer patients identified with frailty from a multicenter research database.The diagnosis of frailty was based on the FRAIL scale.An Albumin-HGS/W score was constructed by combining the albumin and HGS/W values.Cox proportional hazard regression was utilized to examine the association between the albumin level and HGS/W and patient outcomes.Results:Among these patients,2,543 were females and 3,251 were males,with a median age of 60.0 years.Optimal stratification based on patient survival revealed the ideal threshold for HGS/W to be 0.48 for males and 0.39 for females,and for albumin to be 38 for both sexes.The fully adjusted model revealed that higher Albumin-HGS/W scores were correlated with a poorer patient prognosis.Notably,an Albumin-HGS/W score of 2 was associated with a higher risk of mortality compared with a score of 0 in the total population(HR:1.813,95%CI:1.580-2.080,P<0.001).Conclusions:Low albumin or HGS/W values are associated with low survival in cancer patients with frailty.Elevated Albumin-HGS/W scores were linked to decreased survival rates in cancer patients with frailty.展开更多
Hepatocellular carcinoma(HCC)is a primary malignancy of the liver with hepatocellular differentiation.The diagnosis and prognosis of HCC are significantly influenced by tumor markers.Ki-67 as an immunohistochemical ma...Hepatocellular carcinoma(HCC)is a primary malignancy of the liver with hepatocellular differentiation.The diagnosis and prognosis of HCC are significantly influenced by tumor markers.Ki-67 as an immunohistochemical marker is a nuclear antigen related to the level of cell proliferation activity.Ki-67 is an important prognostic markers of HCC.In order to help clinicians assess patient outcomes,Ki67 can function as an independent prognostic indicator.In HCC,elevated Ki67 expression is linked to a worse prognosis and a higher chance of recurrence.It is considered a significant marker of clinical,histopathological,and immunological status and prognosis in HCC.Preoperative evaluation and prediction of Ki-67 expression in HCC with machine learning models based on intratumoral and peritumoral radiomic features now have a significant role in patient management and care and will provide a more definite direction for subsequent research.This article aims to evaluate the role of Ki-67 and various other biomarkers in HCC.展开更多
AIM: To elucidate the immunologic parameters for the outcome of patients with malignant tumors, especially esophageal squamous cell carcinoma (ESCC) associated with high malignant potential. METHODS: Clinicopathologic...AIM: To elucidate the immunologic parameters for the outcome of patients with malignant tumors, especially esophageal squamous cell carcinoma (ESCC) associated with high malignant potential. METHODS: Clinicopathologic features were compared between patients with lower and higher CD4 and CD8 values as well as CD4/CD8 ratio in peripheral blood. RESULTS: The survival rate of patients with higher CD4 value was significantly better than that in patients with lower CD4 value (P = 0.039). The survival rate of patients with higher CD8 value was significantly worse than that of patients with lower CD8 value (P = 0.026). Similarly, the survival rate of patients with higher CD4/ CD8 ratio was significantly better than that of patients with lower CD4/CD8 ratio (P = 0.042). Additionally, multivariate analysis demonstrated that lower CD8 and lower CD4/CD8 ratio were factors independently associated with worse prognosis of patients. CONCLUSION: All the immunologic parameters can predict the outcome of patients with ESCC.展开更多
BACKGROUND Several genes,important for development,are reduced or silenced in adulthood,and their abnormal expression has been related to the occurrence and development of malignant tumors.Human sine oculis homeobox h...BACKGROUND Several genes,important for development,are reduced or silenced in adulthood,and their abnormal expression has been related to the occurrence and development of malignant tumors.Human sine oculis homeobox homolog(SIX)proteins belong to the homeobox family and play important roles in the development of different organs.Importantly,SIXs are predicted to have chromatin-binding and DNA-binding transcription factor activity with reported roles in cancers.However,a comprehensive analysis of SIXs in colorectal cancers(CRCs)has not been performed.AIM To explore the expression pattern of six SIX proteins in CRCs and their relationship with the clinicopathological parameters of CRC patients as well as investigate the potential utilization of SIXs as novel prognostic indicators in CRCs.METHODS The expression level of SIXs in normal tissues of different organs and related cancerous tissues was analyzed in the Human Protein Atlas.Kaplan-Meier Plotter and GEPIA2 were used to analyze the prognostic values of SIXs.To analyze the potential signaling pathways with SIX family involvement,LinkedOmics was used to perform Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analyses of SIX4-related genes.Subsequently,immunohistochemical experiments were performed on CRC tissues and adjacent normal tissues,and we examined the SIX4 expression level in 87 pairs of patients with tissue microarray.The relationship between SIX4 and clinicopathological parameters in CRC patients was tested using theχ2 test and Fisher’s exact probability to verify the results of the database analysis.RESULTS The RNA levels of SIX1-4 and SIX6 were relatively low in normal human tissues,while SIX5 was highly expressed at both the RNA and protein levels.However,the protein level of SIX4 was found to be elevated in various malignancies.In CRC tissues,SIX1,SIX2 and SIX4 were elevated in cancer tissues compared with adjacent normal tissue.Among all SIXs,a high level of SIX4 was found to be associated with poor overall and disease-free survival in patients with CRC.For different clinicopathological parameters,increased SIX4 expression was positively correlated with advanced CRC.The top 50 SIX4-related genes were involved with oxidative phosphorylation and the respiratory chain signaling pathways.CONCLUSION The current results provided a comprehensive analysis of the expression and prognostic values of SIX family members in CRC.Among different SIXs,SIX4 plays an oncogenic role in CRC to promote the development of malignancy.In CRC,SIX4 mRNA and protein expression is higher than that in normal tissues and associated with shorter CRC patient survival,suggesting that SIX4 may be a potential therapeutic target for treatment of CRC patients.展开更多
AIM: To analyze the related indices about the prognoses of chronic liver failure caused by hepatitis virus. METHODS: Retrospectively reviewed 320 cases of chronic liver failure caused by hepatitis viruses. An improved...AIM: To analyze the related indices about the prognoses of chronic liver failure caused by hepatitis virus. METHODS: Retrospectively reviewed 320 cases of chronic liver failure caused by hepatitis viruses. An improved group and an ineffective group (IG) were made to compare and analyze their clinical manifestations, laboratory examination indices and complications. Logistic regression was also carried out. RESULTS: There were significant differences (P<0.05) between the improved group and the IG upon such indices as age, bilirubin, prothrombin time, albumin, alpha fetoprotein, the size of liver and complications (P<0.05). The regression formula was as follows: P=1/(1+e^(-y)) (y=1.7262-0.0948X_1+2.9846X_2+0.6992X_3+1.6019X_4+2.0398X_5). (Note: X_1-Prothrombin activity; X_2-digestive tract hemorrhage; X_3-hepatic encephalopathy; A_4-hepatorenal syndrome; X_5-pulmonary infection.). CONCLUSION: Laboratory examination such as bilirubin, prothrombin time and alpha fetoprotein can be regarded as indices of the prognoses of chronic liver failure caused by hepatitis. Moreover, the regression equation can evaluate prognoses more comprehensively and direct our treatments.展开更多
AIMTo compare predictive ability of Budd-Chiari syndrome (BCS) prognostic indices (PIs) for one-year survival and Transjugular intrahepatic portosystemic shunt (TIPS) patency.METHODSThis retrospective study enrolled 1...AIMTo compare predictive ability of Budd-Chiari syndrome (BCS) prognostic indices (PIs) for one-year survival and Transjugular intrahepatic portosystemic shunt (TIPS) patency.METHODSThis retrospective study enrolled 194 Egyptian patients with primary BCS who presented to the Budd-Chiari Study Group of Ain Shams University Hospital. Calculation of the available PIs was performed using Child-Pugh and model for end-stage liver disease scores, BCS-specific PIs (Clichy, New Clichy and Rotterdam) for all patients, and BCS-TIPS PI only for patients who underwent TIPS. The overall one-year survival rate and the one-year shunt patency rate for TIPS were reported.RESULTSThe overall one-year survival rate was 69.6%, and the New Clichy PI revealed the best validity for its prediction at a cut-off value of 3.75, with sensitivity and specificity of 78% and 73.3%, respectively [area under receiver operating characteristic curve (AUC) = 0.806]. The one-year survival rate post-TIPS was 89.7%, and the BCS-TIPS score demonstrated validity for its prediction at a cut-off value of 3.92 (sensitivity and specificity were 71.4% and 64.5%, respectively) (AUC = 0.715). Logistic regression analysis revealed that the New Clichy PI (P = 0.030), high serum total bilirubin (P = 0.047) and low albumin (P < 0.001) were independent factors for predicting mortality within one year. The one-year shunt patency rate in TIPS was 80.2%, and none of the PIs exhibited significant validity for its prediction.CONCLUSIONThe New Clichy score could independently predict the one-year survival in Egyptian BCS patients.展开更多
BACKGROUND The prognosis of critically ill patients is closely linked to their gastrointestinal(GI)function.The acute GI injury(AGI)grading system,established in 2012,is extensively utilized to evaluate GI dysfunction...BACKGROUND The prognosis of critically ill patients is closely linked to their gastrointestinal(GI)function.The acute GI injury(AGI)grading system,established in 2012,is extensively utilized to evaluate GI dysfunction and forecast outcomes in clinical settings.In 2021,the GI dysfunction score(GIDS)was developed,building on the AGI grading system,to enhance the accuracy of GI dysfunction severity assessment,improve prognostic predictions,reduce subjectivity,and increase reproducibility.AIM To compare the predictive capabilities of GIDS and the AGI grading system for 28-day mortality in critically ill patients.METHODS A retrospective study was conducted at the general intensive care unit(ICU)of a regional university hospital.All data were collected during the first week of ICU admission.The primary outcome was 28-day mortality.Multivariable logistic regression analyzed whether GIDS and AGI grade were independent risk factors for 28-day mortality.The predictive abilities of GIDS and AGI grade were compared using the receiver operating characteristic curve,with DeLong’s test assessing differences between the curves’areas.RESULTS The incidence of AGI in the first week of ICU admission was 92.13%.There were 85 deaths(47.75%)within 28 days of ICU admission.There was no initial 24-hour difference in GIDS between the non-survival and survival groups.Both GIDS(OR 2.01,95%CI:1.25-3.24;P=0.004)and AGI grade(OR 1.94,95%CI:1.12-3.38;P=0.019)were independent predictors of 28-day mortality.No significant difference was found between the predictive accuracy of GIDS and AGI grade for 28-day mortality during the first week of ICU admission(Z=-0.26,P=0.794).CONCLUSION GIDS within the first 24 hours was an unreliable predictor of 28-day mortality.The predictive accuracy for 28-day mortality from both systems during the first week was comparable.展开更多
BACKGROUND Endoscopic resection,especially endoscopic submucosal dissection(ESD),is increasingly performed in elderly patients with early gastric cancer,and lesions beyond the expanded indications are also resected en...BACKGROUND Endoscopic resection,especially endoscopic submucosal dissection(ESD),is increasingly performed in elderly patients with early gastric cancer,and lesions beyond the expanded indications are also resected endoscopically in some patients.It is essential to assess whether gastric ESD is safe and suitable for elderly patients and investigate what type of lesions carry an increased risk of ESD-related complications.AIM To assess the efficacy and feasibility of gastric ESD for elderly patients,and define high-risk lesions and prognostic indicators.METHODS Among a total of 1169 sessions of gastric ESD performed in Kanagawa Cancer Center Hospital from 2006 to 2014,179 sessions(15.3%)were performed in patients aged≥80 years,and 172 of these sessions were done in patients with a final diagnosis of gastric cancer.These patients were studied retrospectively to evaluate short-term outcomes and survival.The short-term outcomes included the rates of en bloc resection and curative resection,complications,and procedurerelated mortality.Curability was assessed according to the Japanese Gastric Cancer Treatment Guidelines 2010.Fisher’s exact test was used to statistically analyze risk factors.Clinical characteristics of each group were compared using Fisher’s exact test and Mann-Whitney U test.Survival rates at each time point were based on Kaplan-Meier estimation.Overall survival rates were compared between patients with gastric cancer in each group with use of the log-rank test.To identify prognostic factors that jointly predict the hazard of death while controlling for model overfitting,we used the least absolute shrinkage and selection operator(LASSO)Cox regression model including factors curative/noncurative,age,gender,body mass index,prognostic nutritional index,Charlson comorbidity index(CCI),Glasgow prognostic score,neutrophil-to-lymphocyte ratio,and antithrombotic agent use.We selected the LASSO Cox regression model that resulted in minimal prediction error in 10-fold cross-validation.P<0.05 was considered statistically significant.RESULTS The en bloc dissection rate was 97.1%,indicating that a high quality of treatment was achieved even in elderly patients.As for complications,the rates of bleeding,perforation and aspiration pneumonitis were 3.4%,1.1%and 0.6%,respectively.These complication rates indicated that ESD was not associated with a particularly higher risk in elderly patients than in nonelderly patients.A dissection incision>40 mm,lesions associated with depressions,and lesions with ulcers were risk factors for post-ESD bleeding,and location of the lesion in the upper third of the stomach was a risk factor for perforation in elderly patients(P<0.05).Location of the lesion in the lower third of the stomach tended to be associated with a higher risk of bleeding.The overall survival(OS)did not differ significantly between curative and noncurative ESD(P=0.69).In patients without additional surgery,OS rate was significantly lower in patients with a high CCI(≥2)than in those with a low CCI(≤1)(P<0.001).CONCLUSION Gastric ESD is feasible even in patients aged≥80 years.Observation without additional surgery after noncurative ESD is reasonable,especially in elderly patients with CCI≥2.展开更多
基金Supported by the Natural Science Foundation of Fujian Province,No.2023J01160Scientific Research Project of Putian University,No.2022059Special Project for Outstanding Young Talents of Putian University,No.2024072.
文摘Gastric cancer(GC),the fifth most common malignancy worldwide,poses a substantial challenge in clinical oncology,particularly in its advanced stages.Despite advancements in immunotherapy,patient prognosis remains poor,underscoring the need for reliable prognostic tools to refine treatment strategies.A study by Yao et al explores the role of the triglyceride-glucose(TyG)index as a prognostic marker for advanced GC patients receiving immunotherapy combined with chemotherapy.The results of the study demonstrate that the TyG index correlates with improved survival outcomes,including better progression-free survival and overall survival.This editorial critically evaluates the significance of these findings,discusses their implications for future research,and highlights innovative directions that could drive further breakthroughs in the application of the TyG index to cancer therapy.This editorial also highlights the potential of TyG in advancing precision oncology and advocates for global validation and mechanistic investigations to further solidify its clinical utility.Future research should focus on validating the TyG index across various malignancies,exploring its potential to influence immunotherapy through metabolic interventions,and developing multi-biomarker models that integrate TyG with immune and genomic profiles.
基金supported by the National Natural Science Foundation of China,No.81571147an American Heart Association Award,No.14FTF19970029
文摘Serum prealbumin is a recognized marker of malnutrition,but its prognostic role in patients with hemorrhagic stroke remains unclear.In this study,we retrospectively reviewed the records of 105 patients with hemorrhagic stroke admitted to Renmin Hospital of Wuhan University,China,from January to December 2015.We collected demographic and radiological data,and recorded serum prealbumin levels at admission and on days 1,3,6,9,and 14-21.The existence of infections and gastrointestinal hemorrhage,and clinical condition at discharge were also recorded.Serum prealbumin levels during hospitalization were significantly lower in patients with infections compared with those without infections,and also significantly lower in patients with gastrointestinal hemorrhage compared with those without.Serum prealbumin levels at discharge were significantly higher in patients with good recovery than in those with poor recovery.We conclude that regular serum prealbumin measurements in patients with hemorrhagic stroke may be a useful indicator for determining clinical status and prognosis,which may therefore help to guide clinical decision-making.
文摘The aim of this study was to determine the impact that age and comorbidity status have on both overall and bladder cancer-specific survival of bladder cancer patients. We obtained medical information pertaining to a population of 528 patients with newly diagnosed bladder cancer from Chung-Ang University Hospital cancer registry. The Adult Comorbidity Evaluation-27 （ACE-27） test, which has been previously validated in adult cancer patients, was used to assess comorbidity. We evaluated differences in the demographic and clinical characteristics of included patients, as well as differences in the treatments they received after categorizing them by age. The median age at the time of bladder cancer diagnosis of the entire cohort was 63 years, and the median follow-up time was 97 months. Of the 528 patients who were included in our study, 303 had at least one comorbid condition and 249 died during the follow-up period. When patients were stratified by age, we found that older patients had a higher proportion of severe comorbidities （P 〈 0.01） than younger patients, and that a lower proportion of them underwent radical cystec- tomy for invasive bladder cancer （IBC） （P 〈 0.01）. By multivariate analysis, we found that older age was predictive of lower overall survival （OS） and bladder cancer-specific survival （BCSS） rates among patients with superficial bladder cancer （SBC） and of lower OS rates among patients with IBC. We also found that moderate-severe comorbidity status and treatment through a bladder-conserving approach were predictive of lower OS and cancer-specific survival rates among patients with IBC. The disparity between overall deaths and bladder cancer deaths was shown in SBC and increased along with age and higher comorbidity. Age and comorbidity were found to be independent predictive factors of OS and BCSS among bladder cancer patients, and explained the disparity that we observed between overall bladder cancer-specific mortality rates.
文摘Cardiovascular diseases(CVDs)remain the leading cause of morbidity and mortality worldwide,necessitating innovative diagnostic and prognostic strategies.Traditional biomarkers like C-reactive protein,uric acid,troponin,and natriuretic peptides play crucial roles in CVD management,yet they are often limited by sensitivity and specificity constraints.This narrative review critically examines the emerging landscape of cardiac biomarkers and advocates for a multiple-marker approach to enhance early detection,prognosis,and risk stratification of CVD.In recent years,several novel biomarkers have shown promise in revolutionizing CVD diagnostics.Gamma-glutamyltransferase,microRNAs,endothelial microparticles,placental growth factor,trimethylamine N-oxide,retinol-binding protein 4,copeptin,heart-type fatty acid-binding protein,galectin-3,growth differentiation factor-15,soluble suppression of tumorigenicity 2,fibroblast growth factor 23,and adrenomedullin have emerged as significant indicators of CV health.These biomarkers provide insights into various pathophysiological processes,such as oxidative stress,endothelial dysfunction,inflammation,metabolic disturbances,and myocardial injury.The integration of these novel biomarkers with traditional ones offers a more comprehensive understanding of CVD mechanisms.This multiple-marker approach can improve diagnostic accuracy,allowing for better risk stratification and more personalized treatment strategies.This review underscores the need for continued research to validate the clinical utility of these biomarkers and their potential incorporation into routine clinical practice.By leveraging the strengths of both traditional and novel biomarkers,precise therapeutic plans can be developed,thereby improving the management and prognosis of patients with CVDs.The ongoing exploration and validation of these biomarkers are crucial for advancing CV care and addressing the limitations of current diagnostic tools.
文摘In this letter,we discuss the article by Li et al published in the World Journal of Gastrointestinal Surgery.Gallbladder cancer is a rare but fatal cancer that is often detected unexpectedly and at an advanced stage following routine cholecystectomy.Although the prognosis is poor,curative resections often combined with postoperative chemotherapy and/or radiation therapy can improve survival.However,targeted patient selection for the appropriate therapeutic approach is critical to minimize unnecessary morbidity.Using advanced statistical techniques,the authors developed a nomogram with the potential to predict survival after gallbladder cancer resection,identifying factors associated with long-and shortterm survival.This tool could improve patient selection for surgery and postoperative treatment.In this letter,we provide background on survival nomograms including an in-depth discussion of statistical methods employed in this study,the use of nomograms in other forms of cancer,limitations to the model,and directions for future research.
基金supported by a Henan Province Science and Technology Research Project(No.252102311033)the National Key Research and Development Program(No.2022YFC2009600 and No.2022YFC2009601).
文摘Objective:While albumin and the weight-standardized hand grip strength(HGS/W)serve as valuable prognostic indicators for cancer patients,their correlation with the prognosis in frail cancer patients remains inadequately explored.This study aimed to investigate the prognostic importance of the albumin level and HGS/W in cancer patients with frailty and to further investigate their combined prognostic value.Moreover,this comprehensive evaluation aimed to facilitate timely intervention and treatment for frail patients.Methods:The research enrolled 5,794 cancer patients identified with frailty from a multicenter research database.The diagnosis of frailty was based on the FRAIL scale.An Albumin-HGS/W score was constructed by combining the albumin and HGS/W values.Cox proportional hazard regression was utilized to examine the association between the albumin level and HGS/W and patient outcomes.Results:Among these patients,2,543 were females and 3,251 were males,with a median age of 60.0 years.Optimal stratification based on patient survival revealed the ideal threshold for HGS/W to be 0.48 for males and 0.39 for females,and for albumin to be 38 for both sexes.The fully adjusted model revealed that higher Albumin-HGS/W scores were correlated with a poorer patient prognosis.Notably,an Albumin-HGS/W score of 2 was associated with a higher risk of mortality compared with a score of 0 in the total population(HR:1.813,95%CI:1.580-2.080,P<0.001).Conclusions:Low albumin or HGS/W values are associated with low survival in cancer patients with frailty.Elevated Albumin-HGS/W scores were linked to decreased survival rates in cancer patients with frailty.
文摘Hepatocellular carcinoma(HCC)is a primary malignancy of the liver with hepatocellular differentiation.The diagnosis and prognosis of HCC are significantly influenced by tumor markers.Ki-67 as an immunohistochemical marker is a nuclear antigen related to the level of cell proliferation activity.Ki-67 is an important prognostic markers of HCC.In order to help clinicians assess patient outcomes,Ki67 can function as an independent prognostic indicator.In HCC,elevated Ki67 expression is linked to a worse prognosis and a higher chance of recurrence.It is considered a significant marker of clinical,histopathological,and immunological status and prognosis in HCC.Preoperative evaluation and prediction of Ki-67 expression in HCC with machine learning models based on intratumoral and peritumoral radiomic features now have a significant role in patient management and care and will provide a more definite direction for subsequent research.This article aims to evaluate the role of Ki-67 and various other biomarkers in HCC.
文摘AIM: To elucidate the immunologic parameters for the outcome of patients with malignant tumors, especially esophageal squamous cell carcinoma (ESCC) associated with high malignant potential. METHODS: Clinicopathologic features were compared between patients with lower and higher CD4 and CD8 values as well as CD4/CD8 ratio in peripheral blood. RESULTS: The survival rate of patients with higher CD4 value was significantly better than that in patients with lower CD4 value (P = 0.039). The survival rate of patients with higher CD8 value was significantly worse than that of patients with lower CD8 value (P = 0.026). Similarly, the survival rate of patients with higher CD4/ CD8 ratio was significantly better than that of patients with lower CD4/CD8 ratio (P = 0.042). Additionally, multivariate analysis demonstrated that lower CD8 and lower CD4/CD8 ratio were factors independently associated with worse prognosis of patients. CONCLUSION: All the immunologic parameters can predict the outcome of patients with ESCC.
基金Supported by the National Natural Science Foundation of China,No.81501539the Natural Science Foundation of Guangdong Province,No.2021A1515012180 and 2016A030312008+2 种基金Special Grant for Key Area Programs of Guangdong Department of Education,No.2021ZDZX2004Science and Technology Special Project of Guangdong Province,No.210715216902829“Dengfeng Project”for the construction of high-level hospitals in Guangdong Province-First Affiliated Hospital of Shantou University College Supporting Funding,No.202003-10.
文摘BACKGROUND Several genes,important for development,are reduced or silenced in adulthood,and their abnormal expression has been related to the occurrence and development of malignant tumors.Human sine oculis homeobox homolog(SIX)proteins belong to the homeobox family and play important roles in the development of different organs.Importantly,SIXs are predicted to have chromatin-binding and DNA-binding transcription factor activity with reported roles in cancers.However,a comprehensive analysis of SIXs in colorectal cancers(CRCs)has not been performed.AIM To explore the expression pattern of six SIX proteins in CRCs and their relationship with the clinicopathological parameters of CRC patients as well as investigate the potential utilization of SIXs as novel prognostic indicators in CRCs.METHODS The expression level of SIXs in normal tissues of different organs and related cancerous tissues was analyzed in the Human Protein Atlas.Kaplan-Meier Plotter and GEPIA2 were used to analyze the prognostic values of SIXs.To analyze the potential signaling pathways with SIX family involvement,LinkedOmics was used to perform Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analyses of SIX4-related genes.Subsequently,immunohistochemical experiments were performed on CRC tissues and adjacent normal tissues,and we examined the SIX4 expression level in 87 pairs of patients with tissue microarray.The relationship between SIX4 and clinicopathological parameters in CRC patients was tested using theχ2 test and Fisher’s exact probability to verify the results of the database analysis.RESULTS The RNA levels of SIX1-4 and SIX6 were relatively low in normal human tissues,while SIX5 was highly expressed at both the RNA and protein levels.However,the protein level of SIX4 was found to be elevated in various malignancies.In CRC tissues,SIX1,SIX2 and SIX4 were elevated in cancer tissues compared with adjacent normal tissue.Among all SIXs,a high level of SIX4 was found to be associated with poor overall and disease-free survival in patients with CRC.For different clinicopathological parameters,increased SIX4 expression was positively correlated with advanced CRC.The top 50 SIX4-related genes were involved with oxidative phosphorylation and the respiratory chain signaling pathways.CONCLUSION The current results provided a comprehensive analysis of the expression and prognostic values of SIX family members in CRC.Among different SIXs,SIX4 plays an oncogenic role in CRC to promote the development of malignancy.In CRC,SIX4 mRNA and protein expression is higher than that in normal tissues and associated with shorter CRC patient survival,suggesting that SIX4 may be a potential therapeutic target for treatment of CRC patients.
文摘AIM: To analyze the related indices about the prognoses of chronic liver failure caused by hepatitis virus. METHODS: Retrospectively reviewed 320 cases of chronic liver failure caused by hepatitis viruses. An improved group and an ineffective group (IG) were made to compare and analyze their clinical manifestations, laboratory examination indices and complications. Logistic regression was also carried out. RESULTS: There were significant differences (P<0.05) between the improved group and the IG upon such indices as age, bilirubin, prothrombin time, albumin, alpha fetoprotein, the size of liver and complications (P<0.05). The regression formula was as follows: P=1/(1+e^(-y)) (y=1.7262-0.0948X_1+2.9846X_2+0.6992X_3+1.6019X_4+2.0398X_5). (Note: X_1-Prothrombin activity; X_2-digestive tract hemorrhage; X_3-hepatic encephalopathy; A_4-hepatorenal syndrome; X_5-pulmonary infection.). CONCLUSION: Laboratory examination such as bilirubin, prothrombin time and alpha fetoprotein can be regarded as indices of the prognoses of chronic liver failure caused by hepatitis. Moreover, the regression equation can evaluate prognoses more comprehensively and direct our treatments.
文摘AIMTo compare predictive ability of Budd-Chiari syndrome (BCS) prognostic indices (PIs) for one-year survival and Transjugular intrahepatic portosystemic shunt (TIPS) patency.METHODSThis retrospective study enrolled 194 Egyptian patients with primary BCS who presented to the Budd-Chiari Study Group of Ain Shams University Hospital. Calculation of the available PIs was performed using Child-Pugh and model for end-stage liver disease scores, BCS-specific PIs (Clichy, New Clichy and Rotterdam) for all patients, and BCS-TIPS PI only for patients who underwent TIPS. The overall one-year survival rate and the one-year shunt patency rate for TIPS were reported.RESULTSThe overall one-year survival rate was 69.6%, and the New Clichy PI revealed the best validity for its prediction at a cut-off value of 3.75, with sensitivity and specificity of 78% and 73.3%, respectively [area under receiver operating characteristic curve (AUC) = 0.806]. The one-year survival rate post-TIPS was 89.7%, and the BCS-TIPS score demonstrated validity for its prediction at a cut-off value of 3.92 (sensitivity and specificity were 71.4% and 64.5%, respectively) (AUC = 0.715). Logistic regression analysis revealed that the New Clichy PI (P = 0.030), high serum total bilirubin (P = 0.047) and low albumin (P < 0.001) were independent factors for predicting mortality within one year. The one-year shunt patency rate in TIPS was 80.2%, and none of the PIs exhibited significant validity for its prediction.CONCLUSIONThe New Clichy score could independently predict the one-year survival in Egyptian BCS patients.
基金approved by the Ethics Committee of the First Affiliated Hospital of Zhejiang Chinese Medical University(No.2024-KLS-369-02).
文摘BACKGROUND The prognosis of critically ill patients is closely linked to their gastrointestinal(GI)function.The acute GI injury(AGI)grading system,established in 2012,is extensively utilized to evaluate GI dysfunction and forecast outcomes in clinical settings.In 2021,the GI dysfunction score(GIDS)was developed,building on the AGI grading system,to enhance the accuracy of GI dysfunction severity assessment,improve prognostic predictions,reduce subjectivity,and increase reproducibility.AIM To compare the predictive capabilities of GIDS and the AGI grading system for 28-day mortality in critically ill patients.METHODS A retrospective study was conducted at the general intensive care unit(ICU)of a regional university hospital.All data were collected during the first week of ICU admission.The primary outcome was 28-day mortality.Multivariable logistic regression analyzed whether GIDS and AGI grade were independent risk factors for 28-day mortality.The predictive abilities of GIDS and AGI grade were compared using the receiver operating characteristic curve,with DeLong’s test assessing differences between the curves’areas.RESULTS The incidence of AGI in the first week of ICU admission was 92.13%.There were 85 deaths(47.75%)within 28 days of ICU admission.There was no initial 24-hour difference in GIDS between the non-survival and survival groups.Both GIDS(OR 2.01,95%CI:1.25-3.24;P=0.004)and AGI grade(OR 1.94,95%CI:1.12-3.38;P=0.019)were independent predictors of 28-day mortality.No significant difference was found between the predictive accuracy of GIDS and AGI grade for 28-day mortality during the first week of ICU admission(Z=-0.26,P=0.794).CONCLUSION GIDS within the first 24 hours was an unreliable predictor of 28-day mortality.The predictive accuracy for 28-day mortality from both systems during the first week was comparable.
文摘BACKGROUND Endoscopic resection,especially endoscopic submucosal dissection(ESD),is increasingly performed in elderly patients with early gastric cancer,and lesions beyond the expanded indications are also resected endoscopically in some patients.It is essential to assess whether gastric ESD is safe and suitable for elderly patients and investigate what type of lesions carry an increased risk of ESD-related complications.AIM To assess the efficacy and feasibility of gastric ESD for elderly patients,and define high-risk lesions and prognostic indicators.METHODS Among a total of 1169 sessions of gastric ESD performed in Kanagawa Cancer Center Hospital from 2006 to 2014,179 sessions(15.3%)were performed in patients aged≥80 years,and 172 of these sessions were done in patients with a final diagnosis of gastric cancer.These patients were studied retrospectively to evaluate short-term outcomes and survival.The short-term outcomes included the rates of en bloc resection and curative resection,complications,and procedurerelated mortality.Curability was assessed according to the Japanese Gastric Cancer Treatment Guidelines 2010.Fisher’s exact test was used to statistically analyze risk factors.Clinical characteristics of each group were compared using Fisher’s exact test and Mann-Whitney U test.Survival rates at each time point were based on Kaplan-Meier estimation.Overall survival rates were compared between patients with gastric cancer in each group with use of the log-rank test.To identify prognostic factors that jointly predict the hazard of death while controlling for model overfitting,we used the least absolute shrinkage and selection operator(LASSO)Cox regression model including factors curative/noncurative,age,gender,body mass index,prognostic nutritional index,Charlson comorbidity index(CCI),Glasgow prognostic score,neutrophil-to-lymphocyte ratio,and antithrombotic agent use.We selected the LASSO Cox regression model that resulted in minimal prediction error in 10-fold cross-validation.P<0.05 was considered statistically significant.RESULTS The en bloc dissection rate was 97.1%,indicating that a high quality of treatment was achieved even in elderly patients.As for complications,the rates of bleeding,perforation and aspiration pneumonitis were 3.4%,1.1%and 0.6%,respectively.These complication rates indicated that ESD was not associated with a particularly higher risk in elderly patients than in nonelderly patients.A dissection incision>40 mm,lesions associated with depressions,and lesions with ulcers were risk factors for post-ESD bleeding,and location of the lesion in the upper third of the stomach was a risk factor for perforation in elderly patients(P<0.05).Location of the lesion in the lower third of the stomach tended to be associated with a higher risk of bleeding.The overall survival(OS)did not differ significantly between curative and noncurative ESD(P=0.69).In patients without additional surgery,OS rate was significantly lower in patients with a high CCI(≥2)than in those with a low CCI(≤1)(P<0.001).CONCLUSION Gastric ESD is feasible even in patients aged≥80 years.Observation without additional surgery after noncurative ESD is reasonable,especially in elderly patients with CCI≥2.
