AIM To assess the utility of NLR,PLR,IMT and contrast-enhanced ultrasound(CEUS)aspredictive markers for monitoring inflammatory responses and the disease activity in cardiac involvementin Takayasu’s arteritis.METHODS...AIM To assess the utility of NLR,PLR,IMT and contrast-enhanced ultrasound(CEUS)aspredictive markers for monitoring inflammatory responses and the disease activity in cardiac involvementin Takayasu’s arteritis.METHODS A cohort retrospective study encompassing 86 patients(43 withcardiac compromise and 43 without)was conducted.A comparative analysis of NLR,PLR,IMT,andCEUS between TA patients with and without cardiac compromise was undertaken.RESULTS The NLR and PLR of the heart damage group were significantly higher than those of the non heart damagegroup(2.9±1.0 vs.2.1±0.8,P<0.01;166±79 vs.117±51,P<0.01).The IMT and CEUS of the heartdamage group were significantly higher than those of the TA non heart damage group(2.6±0.6 vs.1.5±0.4,P<0.01;2.6±0.5 vs.1.6±0.6,P<0.01).The NLR level of the heart damage group was positivelycorrelated with CRP(r=0.42,P<0.01),and PLR was positively correlated with CRP and CEUS(r=0.34,P<0.05;r=0.35,P<0.05).The results of multiple logistic regression analysis showed that NLR,IMT,andCEUS were independent risk factors for TA and cardiac damage.The area under the ROC curve for NLRto determine cardiac damage is 0.865,with a cut-off value of 2.265,a sensitivity of 69.8%,and aspecificity of 90.7%.The area under the ROC curve for determining cardiac damage using PLR is 0.812,with a cut-off value of 111.275,a sensitivity of 76.7%,and a specificity of 79.1%.CONCLUSION NLR and PLR,in conjunction with contrast-enhanced ultrasound,can be employed to assessinflammatory response and the disease activity in cardiac involvement in Takayasu’s arteritis.展开更多
The global incidence of critical illness has been steadily increasing,resulting in higher mortality rates thereby presenting substantial challenges for clinical mana-gement.Among these conditions,sepsis stands out as ...The global incidence of critical illness has been steadily increasing,resulting in higher mortality rates thereby presenting substantial challenges for clinical mana-gement.Among these conditions,sepsis stands out as the leading cause of critical illness,underscoring the urgent need for continued research to enhance patient care and deepen our understanding of its complex pathophysiology.Lympho-cytes play a pivotal role in both innate and adaptive immune responses,acting as key regulators of the balance between pro-inflammatory and anti-inflam-matory processes to preserve immune homeostasis.In the context of sepsis,an impaired immunity has been associated with disrupted lymphocytic metabolic activity,persistent pro-inflammatory state,and subsequent immunosuppression.These disruptions not only impair pathogen clearance but also predispose pati-ents to secondary infections and hinder recovery,highlighting the importance of targeting lymphocyte dysfunction in sepsis management.Moreover,studies have identified absolute lymphocyte counts and derived parameters as promising clinical biomarkers for prognostic assessment and therapeutic decision-making.In particular,neutrophil-to-lymphocyte ratio,and lymphopenia have gained reco-gnition in the literature as a critical prognostic markers and therapeutic target in the management of sepsis.This review aims to elucidate the multifaceted role of lymphocytes in pathophysiology,with a focus on recent advancements in their use as biomarkers and key findings in this evolving field.展开更多
BACKGROUND Depression is a significant psychiatric disorder with particularly high prevalence among adolescents.This mental health condition can have severe consequences,including academic failure,social withdrawal,an...BACKGROUND Depression is a significant psychiatric disorder with particularly high prevalence among adolescents.This mental health condition can have severe consequences,including academic failure,social withdrawal,and suicidal behavior.Given the increasing rate of depression in this age group,understanding the underlying biological mechanisms is essential for early detection and intervention.Recent studies have suggested that immune markers play a role in the pathophysiology of depression,prompting further investigation of their potential association with depressive symptoms in adolescents.AIM To investigate the relationship between immune markers(monocytes,lymphocytes,and direct bilirubin)and the incidence and severity of depression among adolescents.METHODS This cross-sectional study recruited 145 adolescent patients with depression[male(M)/female(F)=38/107]from Jiangbin Hospital in Guangxi,Zhuang and 163 healthy controls(M/F=77/86)from routine health check-ups.Blood samples were collected after an overnight fast.Depression severity was measured using the Zung Self-Rating Depression Scale.The inclusion criteria were age 12-24 years,diagnosis of depressive disorder(ICD-10),and no recent antidepressant use.The exclusion criteria included psychiatric comorbidities and serious somatic diseases.Key statistical methods included group comparisons and correlation analyses.RESULTS There was a higher prevalence of females in the depression group(P<0.001).Significant age differences were observed between the groups(Z=9.43,P<0.001).The depression group had higher monocyte(Z=3.43,P<0.001)and lymphocyte(t=2.29,P<0.05)counts,and higher serum direct bilirubin levels(Z=4.72,P<0.001).Monocyte count varied significantly according to depression severity,with lower counts in the mild group(Z=-2.90,P<0.05).A negative correlation between age and lymphocyte counts was observed(ρ=-0.22,P<0.01).Logistic regression analysis showed that serum direct bilirubin levels significantly predicted depression.CONCLUSION The potential role of elevated levels of immune markers in the early detection of depression in adolescents has been highlighted.Therefore,it is necessary to explore further the relationships between these immune markers and depression.展开更多
BACKGROUND Osteoarthritis(OA)involves low-grade inflammation.The neutrophil-to-lym-phocyte ratio(NLR)may serve as a simple biomarker,but its role in OA remains unclear.AIM To review the existing scientific literature ...BACKGROUND Osteoarthritis(OA)involves low-grade inflammation.The neutrophil-to-lym-phocyte ratio(NLR)may serve as a simple biomarker,but its role in OA remains unclear.AIM To review the existing scientific literature on the role of NLR in OA,a classic age-related disorder,to perform a meta-analysis of the available data.METHODS The electronic databases PubMed,ProQuest,and Scopus were systematically searched from inception to March 1,2024.The inclusion criteria were retro-spective and prospective case-control studies involving human subjects with OA and healthy controls.The included studies needed to provide NLR levels for both OA patients and healthy controls and perform a comparative analysis of NLR levels between these groups.RESULTS According to the PRISMA guidelines,fifteen articles were included in the meta-analysis after multiple screenings.The pooled results demonstrated a significant overall elevation of NLR in OA patients compared to healthy controls.(standardized mean difference=0.39,95%confidence interval:0.03-0.75,P=0.03).However,the subgroup analysis shows no significant differences in NLR levels when considering study design(retrospective vs prospective)and OA severity(severe vs mild-moderate).This suggests variability and potential limitations in using NLR as a consistent marker across different study types and OA severity.CONCLUSION Our study found that OA patients have higher NLR than healthy individuals.However,NLR did not significantly differ by study type or disease severity,suggesting its limited use in indicating OA severity.展开更多
Background:Transcription factor Krüppel-like factor 3(KLF3)may be involved in regulating inflammation and lymphocyte function.Immune dysfunction in sepsis involves both hyper-inflammation and immunosuppression.Ho...Background:Transcription factor Krüppel-like factor 3(KLF3)may be involved in regulating inflammation and lymphocyte function.Immune dysfunction in sepsis involves both hyper-inflammation and immunosuppression.However,studies on T-lymphocyte KLF3 expression in sepsis are lacking.Methods:We induced sepsis in mice via cecal ligation and puncture(CLP),and their survival rate over 7 days was evaluated.To identify the immune status of these mice,we assessed their cytokine levels,organ damage scores,and splenic T-lymphocyte phenotype.Finally,T-lymphocyte KLF3 expression was detected through flow cytometry.Results:Over the 7 days of observation,septic mice demonstrated 64.7%mortality.In the early stages after CLP,the proinflammatory and anti-inflammatory cytokine levels increased rapidly,multiple organ damage occurred,and splenic T lymphocytes became activated.However,the proportion of KLF3+T lymphocytes decreased.Subsequently,cytokine levels and lymphocyte activation decreased.An increase in cell apoptosis led to a substantial loss of T lymphocytes.Combined with the continual elevations in serum interleukin levels and worsening severe organ damage,septic mice may have entered a state of persistent inflammation and immunosuppression,with a simultaneous increase in KLF3 expression in T lymphocytes.Notably,KLF3 expression was negatively correlated with T-lymphocyte activation and apoptosis.Conclusions:In our septic mice,splenic T-lymphocyte KLF3 expression decreased in the early stage when the mice exhibited a systemic inflammatory response and T-lymphocyte activation.In contrast,it increased in the later stage,when persistent inflammation and immunosuppression occurred.Dynamic monitoring of KLF3 expression levels may provide aid in identifying the immune status of sepsis.展开更多
BACKGROUND Patients with acute-on-chronic liver failure(ACLF)experience severe immune dysfunction.Liver transplantation(LT)significantly improves survival outcomes.However,the characteristics of peripheral blood lymph...BACKGROUND Patients with acute-on-chronic liver failure(ACLF)experience severe immune dysfunction.Liver transplantation(LT)significantly improves survival outcomes.However,the characteristics of peripheral blood lymphocyte subsets(PBLSs)in this patient population are not well defined,and the dynamics of immune reconstitution post-LT are insufficiently understood.AIM To characterize PBLSs in patients with ACLF prior to LT and to evaluate PBLS reconstitution after LT.METHODS Clinical data from patients undergoing LT in the Transplantation Center,The Third Xiangya Hospital from January 2022 to December 2023 were analyzed retrospectively.Our cohort comprised 44 patients with ACLF,16 patients with acute decompensation of cirrhosis,and 23 patients with compensated cirrhosis.Twenty healthy volunteers were included as controls.PBLSs were evaluated across all groups.The relationship between PBLSs and post-LT prognosis was assessed,and dynamic changes in PBLSs among patients with ACLF were analyzed at different time points.RESULTS Patients with ACLF exhibited a marked reduction in PBLSs compared with healthy volunteers.Natural killer(NK)cell counts were further reduced in patients with ACLF when compared with patients with compensated cirrhosis.PBLSs did not correlate with the etiology or severity of ACLF or with established liver failure scores.Following LT,a rapid restoration of NK cells and B cells was observed in patients with ACLF.However,the cluster of differentiation(CD)3+T cell and CD4+T cell counts decreased 14 days post-LT and subsequently returned to preoperative levels by day 21.CONCLUSION Patients with ACLF exhibited markedly reduced PBLSs,with decreased NK cells potentially linked to progression from compensated cirrhosis to liver failure.NK and B cell were rapidly restored after LT.展开更多
Objective:Xuebijing injection has been recommended as a therapeutic approach for individuals with severe and critical COVID-19.This study aims to explore the correlation of neutrophil to lymphocyte platelet ratio(NLPR...Objective:Xuebijing injection has been recommended as a therapeutic approach for individuals with severe and critical COVID-19.This study aims to explore the correlation of neutrophil to lymphocyte platelet ratio(NLPR)with the severity and prognosis of COVID-19,and the effect of XBJ on the prognosis of patients with COVID-19 in different inflammatory states.Methods:This was a retrospective study conducted at Wuhan Union Hospital in China.COVID-19patients admitted between November 1,2022 and February 1,2023 were included.In predicting prognosis for individuals with COVID-19,new inflammatory indicators were used,and their prognostic value was assessed by using Cox regression models and receiver operating characteristic curves.Furthermore,a calculation was made to determine the cutoff value for NLPR.Relative risk and Cox regression models were used to examine the effects of Xuebijing injection on prognosis in patient cohorts that had been stratified by the NLPR cutoff.Results:This research included 455 participants with COVID-19,with a mean age of 72 years.Several inflammatory indicators were found to be strongly correlated with prognosis,and NLPR shows the greatest predictive power.Patients with NLPR>3.29 exhibited a mortality rate of 17.3%,which was 6.2 times higher than in patients with NLPR≤3.29.Importantly,providing Xuebijing injection to patients with NLPR>3.29 was associated with a lower risk of 60-day all-cause mortality.However,there was no discernible improvement in survival among patients with NLPR≤3.29 who received Xuebijing injection.Conclusion:NLPR is the most reliable inflammatory marker for predicting prognosis among individuals with COVID-19,and can accurately identify individuals who may benefit from Xuebijing injection.展开更多
Objective:To investigate the diagnostic value of the neutrophil/lymphocyte ratio,which has not been studied sufficiently to determine the cause of acute gastroenteritis worldwide.Methods:The prospective,observational ...Objective:To investigate the diagnostic value of the neutrophil/lymphocyte ratio,which has not been studied sufficiently to determine the cause of acute gastroenteritis worldwide.Methods:The prospective,observational study included patients diagnosed with acute gastroenteritis who were treated at DışkapıYıldırım Beyazıt Application and Research Center,Emergency Medicine Clinic between 1 September 2020 and 31 May 2021.Demographic characteristics,as well as neutrophil count,lymphocyte count,white blood cell count,and the neutrophil-to-lymphocyte ratio,were compared across the viral,bacterial,and parasitic acute gastroenteritis groups.Results:A total of 168 acute gastroenteritis patients,31 of whom had parasitic,39 bacterial and 98 viral etiologies,were included in this study.Neutrophil/lymphocyte ratio was 2.73(4.03)in the viral acute gastroenteritis group,4.58(8.61)in the bacterial acute gastroenteritis group,and 4.52(5.49)in the parasite acute gastroenteritis group.A statistically significant difference was found among the groups regarding neutrophil/lymphocyte ratio(P=0.022).However,post-hoc analysis revealed no statistically significant differences in the neutrophil-to-lymphocyte ratio among the groups(P>0.05).Conclusions:Neutrophil/lymphocyte ratio alone cannot distinguish etiological causes in patients admitted to the Emergency Medicine Clinic diagnosed with acute gastroenteritis.展开更多
Bai et al investigate the predictive value of T lymphocyte proportion in Alzheimer's disease(AD)prognosis.Through a retrospective study involving 62 AD patients,they found that a decrease in T lymphocyte proportio...Bai et al investigate the predictive value of T lymphocyte proportion in Alzheimer's disease(AD)prognosis.Through a retrospective study involving 62 AD patients,they found that a decrease in T lymphocyte proportion correlated with a poorer prognosis,as indicated by higher modified Rankin scale scores.While the study highlights the potential of T lymphocyte proportion as a prognostic marker,it suggests the need for larger,multicenter studies to enhance generalizability and validity.Additionally,future research could use cognitive exams when evaluating prognosis and delve into immune mechanisms underlying AD progression.Despite limitations inherent in retrospective designs,Bai et al's work contributes to understanding the immune system's role in AD prognosis,paving the way for further exploration in this under-researched area.展开更多
Background With the continuous exploration of cardiovascular diseases,research has found that inflammatory reactions play an important role in the pathogenesis of cardiovascular diseases.In recent years,the ratio of m...Background With the continuous exploration of cardiovascular diseases,research has found that inflammatory reactions play an important role in the pathogenesis of cardiovascular diseases.In recent years,the ratio of monocyte to lymphocyte counts(MLR)has attracted widespread attention as a novel inflammatory marker.Therefore,this article will focus on the value of MLR in terms of prevalence risk,severity and prognosis in common cardiovascular diseases.[S Chin J Cardiol 2024;25(3):200-206]展开更多
Background:Visceral adipose tissue(VAT)has been linked to the severe acute pancreatitis(SAP)prognosis,although the underlying mechanism remains unclear.It has been reported that pyroptosis worsens SAP.The present stud...Background:Visceral adipose tissue(VAT)has been linked to the severe acute pancreatitis(SAP)prognosis,although the underlying mechanism remains unclear.It has been reported that pyroptosis worsens SAP.The present study aimed to verify whether mesenteric adipose tissue(MAT,a component of VAT)can cause secondary intestinal injury through the pyroptotic pathway.Methods:Thirty-six male Sprague Dawley(SD)rats were divided into six different groups.Twelve rats were randomly divided into the SAP and control groups.We monitored the changes of MAT and B lymphocytes infiltration in MAT of SAP rats.Twelve SAP rats were injected with MAT B lymphocytes or phosphate buffer solution(PBS).The remaining twelve SAP rats were first injected with MAT B lymphocytes,and then with MCC950(NLRP3 inhibitor)or PBS.We collected blood and tissue samples from pancreas,gut and MAT for analysis.Results:Compared to the control rats,the SAP group showed inflammation in MAT,including higher expression of tumor necrosis factor(TNF-α)and interleukin-6(IL-6),lower expression of IL-10,and histological changes.Flow cytometry analysis revealed B lymphocytes infiltration in MAT but not T lymphocytes and macrophages.The SAP rats also exhibited intestinal injury,characterized by lower expression of zonula occludens-1(ZO-1)and occludin,higher levels of lipopolysaccharide and diamine oxidase,and pathological changes.The expression of NLRP3 and n-GSDMD,which are responsible for pyroptosis,was increased in the intestine of SAP rats.The injection of MAT B lymphocytes into SAP rats exacerbated the inflammation in MAT.The upregulation of pyroptosis reduced tight junction in the intestine,which contributed to the SAP progression,including higher inflammatory indicators and worse histological changes.The administration of MCC950 to SAP+MAT B rats downregulated pyroptosis,which subsequently improved the intestinal barrier and ameliorated inflammatory response of SAP.Conclusions:In SAP,MAT B lymphocytes aggravated local inflammation,and promoted the injury to the intestine through the enteric pyroptotic pathway.展开更多
BACKGROUND Advanced gastric cancer(AGC)remains a challenging malignancy with poor prognosis.The combination of oxaliplatin and trastuzumab has shown promising results in AGC treatment.This study aimed to investigate t...BACKGROUND Advanced gastric cancer(AGC)remains a challenging malignancy with poor prognosis.The combination of oxaliplatin and trastuzumab has shown promising results in AGC treatment.This study aimed to investigate the effects of oxaliplatin and trastuzumab combination therapy on serum tumor markers and T lymphocyte subsets in patients with AGC and to explore their potential as predictive biomarkers for treatment response.AIM To investigate the impact of oxaliplatin and trastuzumab combination therapy on serum markers and T cell subsets in patients with AGC.METHODS This prospective study enrolled 60 patients with AGC.All patients received oxaliplatin(130 mg/m^(2),every 3 weeks)and trastuzumab(8 mg/kg loading dose,followed by 6 mg/kg every 3 weeks)for six cycles.Serum carcinoembryonic antigen(CEA),cancer antigen 19-9(CA19-9),and cancer antigen 72-4(CA72-4)were measured before and after treatment.T-lymphocyte subsets,including CD3+,CD4+,CD8+,and CD4+/CD8+ratios,were also evaluated.The clinical response was assessed using the Response Evaluation Criteria in Solid Tumors version 1.1.RESULTS After six cycles of treatment,the CEA,CA19-9,and CA72-4 serum levels significantly decreased compared to baseline levels(P<0.001).The percentages of CD3+and CD4+T lymphocytes increased significantly(P<0.05),whereas the percentage of CD8+T lymphocytes decreased(P<0.05).The CD4+/CD8+ratio also significantly increased after treatment(P<0.05).Patients with a higher decrease in serum tumor markers(≥50%reduction)and a higher increase in CD4+/CD8+ratio(≥1.5-fold)showed better clinical response rates(P<0.05).CONCLUSION Oxaliplatin and trastuzumab combination therapy effectively reduced serum tumor marker levels and modulated T lymphocyte subsets in patients with AGC.Combination therapy not only has a direct antitumor effect,but also enhances the immune response in patients with AGC.Serum tumor markers and T lymphocyte subsets may serve as potential predictive biomarkers for treatment response in patients with AGC receiving combination therapy.展开更多
BACKGROUND Circulating tumor cell(CTC)count and neutrophil-to-lymphocyte ratio(NLR)are both closely associated with the prognosis of hepatocellular carcinoma(HCC).AIM To investigate the prognostic value of combining t...BACKGROUND Circulating tumor cell(CTC)count and neutrophil-to-lymphocyte ratio(NLR)are both closely associated with the prognosis of hepatocellular carcinoma(HCC).AIM To investigate the prognostic value of combining these two indicators in HCC.METHODS Clinical data were collected from patients with advanced HCC who received im-mune therapy combined with targeted therapy at the Department of Oncology,the Affiliated Hospital of Southwest Medical University,Sichuan,China,from 2021 to 2023.The optimal cutoff values for CTC programmed death-ligand 1(PD-L1)(+)>1 or CTC PD-L1(+)≤1 and NLR>3.89 or NLR≤3.89 were evaluated using X-Tile software.Patients were categorized into three groups based on CTC PD-L1(+)counts and NLR:CTC-NLR(0),CTC-NLR(1),and CTC-NLR(2).The relationship between CTC-NLR and clinical variables as well as survival rates was assessed.RESULTS Patients with high CTC PD-L1(+)expression or NLR at baseline had shorter median progression-free survival(m-PFS)and median overall survival(mOS)than those with low levels of CTC PD-L1(+)or NLR(P<0.001).Mean-while,patients in the CTC-NLR(2)group showed a significant decrease in mPFS and mOS.Cox regression analysis revealed that alpha-fetoprotein(AFP),CTC PD-L1(+),and CTC-NLR were independent predictors of OS.The time-dependent receiver operating characteristic curve showed that the area under the curve of CTC-NLR at 12 months(0.821)and 18 months(0.821)was superior to that of AFP and CTC PD-L1(+).CONCLUSION HCC patients with high CTC PD-L1(+)or NLR expression tend to exhibit poor prognosis,and a high baseline CTC-NLR score may indicate low survival.CTC-NLR may serve as an effective prognostic indicator for patients with advanced HCC receiving immunotherapy combined with targeted therapy.展开更多
Systemic therapy has become the standard treatment for patients with advanced hepatocellular carcinoma(HCC)whose treatment options are limited.However,the long-term patient response to drugs and the survival outcomes ...Systemic therapy has become the standard treatment for patients with advanced hepatocellular carcinoma(HCC)whose treatment options are limited.However,the long-term patient response to drugs and the survival outcomes remain a concern.With increasing exploration of the HCC microenvironment,particularly in terms of T lymphocyte immunity,a new era of immunomolecular targeted therapy,based on molecular signaling,has arrived for advanced HCC.In the study of immune tolerance of the intrinsic HCC microenvironment,we found that multiple immunosuppressive mechanisms and immune checkpoint inhibitors,such as anti–programmed cell death protein 1/ligand of programmed cell death protein 1 therapy,have improved clinical outcomes in some patients with advanced HCC.Furthermore,various combination therapies have been investigated,and HCC types have been categorized into different types based on anti–programmed cell death protein 1(PD-1)/ligand of programmed cell death protein 1(PD-L1)treatment.In this paper,we first discuss the tumor-infiltrating T lymphocyte immunity and immune tolerance of HCC.We then clarify the basic mechanism of anti–PD-1/PD-L1 therapy and discuss the types of HCC based on anti–PD-1/PD-L1 therapy.Thereafter,we explain the relevant studies and mechanisms of combination therapy of anti–PD-1/PD-L1 with antiangiogenesis drugs or multikinase kinase inhibitors,anti–T lymphocyte–related signaling pathways in HCC,and other anti-CD8+T cell immune checkpoints.In this way,this review offers a deeper understanding of anti–PD-1/PD-L1 immunotherapy for advanced HCC,in order to provide better individualized treatments for patients with advanced HCC.展开更多
Objective:To explore correlation of neutrophil-to-lymphocyte ratio(NLR)to severity of coronary artery disease(CAD)and in-hospital clinical outcomes in patients with acute coronary syndrome(ACS).Methods:In this prospec...Objective:To explore correlation of neutrophil-to-lymphocyte ratio(NLR)to severity of coronary artery disease(CAD)and in-hospital clinical outcomes in patients with acute coronary syndrome(ACS).Methods:In this prospective and observational study,we recruited 500 patients with ACS.For all the eligible patients,demographic details were collected,and laboratory parameters were evaluated.The CAD severity was evaluated in terms of the number of involved vessels.The NLR was calculated based on neutrophils and lymphocytes and the correlation of various risk factors and severity and outcome of CAD was performed.Results:77.2%of Patients was male,and 52%of the patients aged between 55-70 years.Based on the type of ACS,396 out of 500 patients had ST-elevation myocardial infarction.An ascending trend in the white blood cell levels and NLR value was noted as the severity of the ACS increased and the highest white blood cell levels and NLR was noted among classⅣpatients.The mean NLR value among the non-survivors were higher compared to the survivors(9.52±5.72 vs.4.76±2.36;P<0.01).Receiver operating curve showed that the cut-off NLR value was 5.76 with a sensitivity of 75.0%and a specificity of 77.3%.Conclusions:The NLR can be used as an independent prognostic marker in ACS.An elevated NLR value serves as a reliable predictor for short-term complications,notably in-hospital mortality.展开更多
BACKGROUND The influence of Helicobacter-pylori(H.pylori)infection and the characteristics of gastric cancer(GC)on tumor-infiltrating lymphocyte(TIL)levels has not been extensively studied.Analysis of infiltrating-imm...BACKGROUND The influence of Helicobacter-pylori(H.pylori)infection and the characteristics of gastric cancer(GC)on tumor-infiltrating lymphocyte(TIL)levels has not been extensively studied.Analysis of infiltrating-immune-cell subtypes as well as survival is necessary to obtain comprehensive information.AIM To determine the rates of deficient mismatch-repair(dMMR),HER2-status and H.pylori infection and their association with TIL levels in GC.METHODS Samples from 503 resected GC tumors were included and TIL levels were evaluated following the international-TILs-working-group recommendations with assessment of the intratumoral(IT),stromal(ST)and invasive-border(IB)compartments.The density of CD3,CD8 and CD163 immune cells,and dMMR and HER2-status were determined by immunohistochemistry(IHC).H.pylori infection was evaluated by routine histology and quantitative PCR(qPCR)in a subset of samples.RESULTS dMMR was found in 34.4%,HER2+in 5%and H.pylori-positive in 55.7%of samples.High IT-TIL was associated with grade-3(P=0.038),while ST-TIL with grade-1(P<0.001),intestinal-histology(P<0.001)and no-recurrence(P=0.003).dMMR was associated with high TIL levels in the ST(P=0.019)and IB(P=0.01)compartments,and STCD3(P=0.049)and ST-CD8(P=0.05)densities.HER2-was associated with high IT-CD8(P=0.009).H.pylorinegative was associated with high IT-TIL levels(P=0.009)when assessed by routine-histology,and with high TIL levels in the 3 compartments(P=0.002-0.047)and CD8 density in the IT and ST compartments(P=0.001)when assessed by qPCR.A longer overall survival was associated with low IT-CD163(P=0.003)and CD8/CD3(P=0.001 in IT and P=0.002 in ST)and high IT-CD3(P=0.021),ST-CD3(P=0.003)and CD3/CD163(P=0.002).CONCLUSION TIL levels were related to dMMR and H.pylori-negativity.Low CD8/CD3 and high CD163/CD3 were associated with lower recurrence and longer survival.展开更多
BACKGROUND The association between tumor-infiltrating lymphocyte(TIL)levels and the res-ponse to neoadjuvant therapy(NAT)in patients with triple-negative breast cancer(TNBC)remains unclear.AIM To investigate the predi...BACKGROUND The association between tumor-infiltrating lymphocyte(TIL)levels and the res-ponse to neoadjuvant therapy(NAT)in patients with triple-negative breast cancer(TNBC)remains unclear.AIM To investigate the predictive potential of TIL levels for the response to NAT in TNBC patients.METHODS A systematic search of the National Center for Biotechnology Information PubMed database was performed to collect relevant published literature prior to August 31,2023.The correlation between TIL levels and the NAT pathologic com-plete response(pCR)in TNBC patients was assessed using a systematic review and meta-analysis.Subgroup analysis,sensitivity analysis,and publication bias analysis were also conducted.RESULTS A total of 32 studies were included in this meta-analysis.The overall meta-ana-lysis results indicated that the pCR rate after NAT treatment in TNBC patients in the high TIL subgroup was significantly greater than that in patients in the low TIL subgroup(48.0%vs 27.7%)(risk ratio 2.01;95%confidence interval 1.77-2.29;P<0.001,I2=56%).Subgroup analysis revealed that the between-study hetero-geneity originated from differences in study design,TIL level cutoffs,and study populations.Publication bias could have existed in the included studies.The meta-analysis based on different NAT protocols revealed that all TNBC patients with high levels of TILs had a greater rate of pCR after NAT treatment in all protocols(all P≤0.01),and there was no significant between-protocol difference in the statistics among the different NAT protocols(P=0.29).Additionally,sensitivity analysis demonstrated that the overall results of the meta-analysis remained consistent when the included studies were individually excluded.CONCLUSION TILs can serve as a predictor of the response to NAT treatment in TNBC patients.TNBC patients with high levels of TILs exhibit a greater NAT pCR rate than those with low levels of TILs,and this predictive capability is con-sistent across different NAT regimens.展开更多
This editorial will focus on tumor immunity and the factors that alter the tumor immune micro-environment.The role of tumor infiltrating lymphocytes(TILs)will also be discussed in detail,including the types,mechanism ...This editorial will focus on tumor immunity and the factors that alter the tumor immune micro-environment.The role of tumor infiltrating lymphocytes(TILs)will also be discussed in detail,including the types,mechanism of action,and role.Gastric cancer(GC)often presents in the advanced stage and has various factors predicting the outcomes.The interplay of these factors and their correlation with the TILs is discussed.A literature review revealed high intratumoral TILs associated with higher grade,HER2-,and Helicobacter pylori negativity.Moreover,stromal(ST)TILs correlated with lower grade and lesser recurrence risk in GC.High TILs in ST and invasive border also correlated with mismatch repair deficiency status.Further characterization of the CD3+,CD8+,and other cells is also warranted.In the future,this complex correlation of cancer cells with the immune system can be explored for therapeutic avenues.展开更多
BACKGROUND The lymphocyte to monocyte ratio(LMR)is considered a marker of systemic inflammation in cardiovascular disease and acts as predictor of mortality in coronary artery disease.AIM To investigate the predictive...BACKGROUND The lymphocyte to monocyte ratio(LMR)is considered a marker of systemic inflammation in cardiovascular disease and acts as predictor of mortality in coronary artery disease.AIM To investigate the predictive role of LMR in diabetic coronary artery disease patients.METHODS This cross-sectional study was conducted at tertiary care super-specialty hospital at New Delhi,India.A total of 200 angiography-proven coronary artery disease(CAD)patients were enrolled and grouped into two categories:Group I[CAD patients with type 2 diabetes mellitus(T2DM)and glycated hemoglobin(HbA1c)levels≥6.5%],and Group II(CAD patients without T2DM and HbA1c levels<6.5%).Serum lipoproteins,HbA1c,and complete blood count of enrolled patients were analyzed using fully automatic analyzers.RESULTS The logistic regression analysis showed an odds ratio of 1.48(95%CI:1.28-1.72,P<0.05)for diabetic coronary artery disease patients(Group I)in unadjusted model.After adjusting for age,gender,diet,smoking,and hypertension history,the odds ratio increased to 1.49(95%CI:1.29-1.74,P<0.01)in close association with LMR.Further adjustment for high cholesterol and triglycerides yielded the same odds ratio of 1.49(95%CI:1.27-1.75,P<0.01).Receiver operating characteristic curve analysis revealed 74%sensitivity,64%specificity,and 0.74 area under the curve(95%CI:0.67-0.80,P<0.001),suggesting moderate predictive accuracy for diabetic CAD patients.CONCLUSION LMR showed positive association with diabetic coronary artery disease,with moderate predictive accuracy.These findings have implications for improving CAD management in diabetics,necessitating further research and targeted interventions.展开更多
Introduction: Hypertensive disorder in pregnancy affects 4 to 6 percent of all pregnancies and carries risks for the both baby and the mother. Only a few groups of women who are at high-risk pregnancies are received p...Introduction: Hypertensive disorder in pregnancy affects 4 to 6 percent of all pregnancies and carries risks for the both baby and the mother. Only a few groups of women who are at high-risk pregnancies are received prophylaxis Aspirin, more than 15 percent of women develop pre-eclampsia with a single minor risk factor. Methods: This descriptive cross-sectional study was conducted to compare the 1<sup>st</sup> trimester NLR value of normotensive, pregnancy induced hypertensive and pre-eclamptic pregnant women. The study was conducted with a sample of 416, antenatal patients who were admitted to ward 25, at Colombo North Teaching Hospital Ragama. Data was collected as separated three groups. NLR value was calculated separately and ANOVA test was used to analyze the 3 categorical data. Post HOC test was done to assess the multiple comparison. Results: The prevalence rates of pregnancy induced hypertension and pre-eclampsia among the pregnant women were 8.6% and 5.7%. The mean NLR values of normotensive group was 2.708, pregnancy induced hypertensive group was 2.650 and pre eclamptic group was 3.789. There was a significant difference in NLR value between pre eclamptic group and other two groups with P value of Conclusion: The 1<sup>st</sup> trimester NLR value of pre eclamptic patients significantly increased compared to normotensive women.展开更多
文摘AIM To assess the utility of NLR,PLR,IMT and contrast-enhanced ultrasound(CEUS)aspredictive markers for monitoring inflammatory responses and the disease activity in cardiac involvementin Takayasu’s arteritis.METHODS A cohort retrospective study encompassing 86 patients(43 withcardiac compromise and 43 without)was conducted.A comparative analysis of NLR,PLR,IMT,andCEUS between TA patients with and without cardiac compromise was undertaken.RESULTS The NLR and PLR of the heart damage group were significantly higher than those of the non heart damagegroup(2.9±1.0 vs.2.1±0.8,P<0.01;166±79 vs.117±51,P<0.01).The IMT and CEUS of the heartdamage group were significantly higher than those of the TA non heart damage group(2.6±0.6 vs.1.5±0.4,P<0.01;2.6±0.5 vs.1.6±0.6,P<0.01).The NLR level of the heart damage group was positivelycorrelated with CRP(r=0.42,P<0.01),and PLR was positively correlated with CRP and CEUS(r=0.34,P<0.05;r=0.35,P<0.05).The results of multiple logistic regression analysis showed that NLR,IMT,andCEUS were independent risk factors for TA and cardiac damage.The area under the ROC curve for NLRto determine cardiac damage is 0.865,with a cut-off value of 2.265,a sensitivity of 69.8%,and aspecificity of 90.7%.The area under the ROC curve for determining cardiac damage using PLR is 0.812,with a cut-off value of 111.275,a sensitivity of 76.7%,and a specificity of 79.1%.CONCLUSION NLR and PLR,in conjunction with contrast-enhanced ultrasound,can be employed to assessinflammatory response and the disease activity in cardiac involvement in Takayasu’s arteritis.
文摘The global incidence of critical illness has been steadily increasing,resulting in higher mortality rates thereby presenting substantial challenges for clinical mana-gement.Among these conditions,sepsis stands out as the leading cause of critical illness,underscoring the urgent need for continued research to enhance patient care and deepen our understanding of its complex pathophysiology.Lympho-cytes play a pivotal role in both innate and adaptive immune responses,acting as key regulators of the balance between pro-inflammatory and anti-inflam-matory processes to preserve immune homeostasis.In the context of sepsis,an impaired immunity has been associated with disrupted lymphocytic metabolic activity,persistent pro-inflammatory state,and subsequent immunosuppression.These disruptions not only impair pathogen clearance but also predispose pati-ents to secondary infections and hinder recovery,highlighting the importance of targeting lymphocyte dysfunction in sepsis management.Moreover,studies have identified absolute lymphocyte counts and derived parameters as promising clinical biomarkers for prognostic assessment and therapeutic decision-making.In particular,neutrophil-to-lymphocyte ratio,and lymphopenia have gained reco-gnition in the literature as a critical prognostic markers and therapeutic target in the management of sepsis.This review aims to elucidate the multifaceted role of lymphocytes in pathophysiology,with a focus on recent advancements in their use as biomarkers and key findings in this evolving field.
基金Supported by the Medical Discipline Construction Project of Pudong Health Committee of Shanghai,No.PWZzb2022-09Nanning City Science Research and Technology Development Program,No.ZC20233017and Guangxi Medical and Health Appropriate Technology Development and Promotion Project,No.S2021061.
文摘BACKGROUND Depression is a significant psychiatric disorder with particularly high prevalence among adolescents.This mental health condition can have severe consequences,including academic failure,social withdrawal,and suicidal behavior.Given the increasing rate of depression in this age group,understanding the underlying biological mechanisms is essential for early detection and intervention.Recent studies have suggested that immune markers play a role in the pathophysiology of depression,prompting further investigation of their potential association with depressive symptoms in adolescents.AIM To investigate the relationship between immune markers(monocytes,lymphocytes,and direct bilirubin)and the incidence and severity of depression among adolescents.METHODS This cross-sectional study recruited 145 adolescent patients with depression[male(M)/female(F)=38/107]from Jiangbin Hospital in Guangxi,Zhuang and 163 healthy controls(M/F=77/86)from routine health check-ups.Blood samples were collected after an overnight fast.Depression severity was measured using the Zung Self-Rating Depression Scale.The inclusion criteria were age 12-24 years,diagnosis of depressive disorder(ICD-10),and no recent antidepressant use.The exclusion criteria included psychiatric comorbidities and serious somatic diseases.Key statistical methods included group comparisons and correlation analyses.RESULTS There was a higher prevalence of females in the depression group(P<0.001).Significant age differences were observed between the groups(Z=9.43,P<0.001).The depression group had higher monocyte(Z=3.43,P<0.001)and lymphocyte(t=2.29,P<0.05)counts,and higher serum direct bilirubin levels(Z=4.72,P<0.001).Monocyte count varied significantly according to depression severity,with lower counts in the mild group(Z=-2.90,P<0.05).A negative correlation between age and lymphocyte counts was observed(ρ=-0.22,P<0.01).Logistic regression analysis showed that serum direct bilirubin levels significantly predicted depression.CONCLUSION The potential role of elevated levels of immune markers in the early detection of depression in adolescents has been highlighted.Therefore,it is necessary to explore further the relationships between these immune markers and depression.
文摘BACKGROUND Osteoarthritis(OA)involves low-grade inflammation.The neutrophil-to-lym-phocyte ratio(NLR)may serve as a simple biomarker,but its role in OA remains unclear.AIM To review the existing scientific literature on the role of NLR in OA,a classic age-related disorder,to perform a meta-analysis of the available data.METHODS The electronic databases PubMed,ProQuest,and Scopus were systematically searched from inception to March 1,2024.The inclusion criteria were retro-spective and prospective case-control studies involving human subjects with OA and healthy controls.The included studies needed to provide NLR levels for both OA patients and healthy controls and perform a comparative analysis of NLR levels between these groups.RESULTS According to the PRISMA guidelines,fifteen articles were included in the meta-analysis after multiple screenings.The pooled results demonstrated a significant overall elevation of NLR in OA patients compared to healthy controls.(standardized mean difference=0.39,95%confidence interval:0.03-0.75,P=0.03).However,the subgroup analysis shows no significant differences in NLR levels when considering study design(retrospective vs prospective)and OA severity(severe vs mild-moderate).This suggests variability and potential limitations in using NLR as a consistent marker across different study types and OA severity.CONCLUSION Our study found that OA patients have higher NLR than healthy individuals.However,NLR did not significantly differ by study type or disease severity,suggesting its limited use in indicating OA severity.
基金supported by grants from theNational Key Specialty Construction Project of China[grant number 2023-141]the National High Level Hospital Clinical Research Funding(Scientific Research Feed Fund of Peking University First Hospital)[grant number 2022SF23].
文摘Background:Transcription factor Krüppel-like factor 3(KLF3)may be involved in regulating inflammation and lymphocyte function.Immune dysfunction in sepsis involves both hyper-inflammation and immunosuppression.However,studies on T-lymphocyte KLF3 expression in sepsis are lacking.Methods:We induced sepsis in mice via cecal ligation and puncture(CLP),and their survival rate over 7 days was evaluated.To identify the immune status of these mice,we assessed their cytokine levels,organ damage scores,and splenic T-lymphocyte phenotype.Finally,T-lymphocyte KLF3 expression was detected through flow cytometry.Results:Over the 7 days of observation,septic mice demonstrated 64.7%mortality.In the early stages after CLP,the proinflammatory and anti-inflammatory cytokine levels increased rapidly,multiple organ damage occurred,and splenic T lymphocytes became activated.However,the proportion of KLF3+T lymphocytes decreased.Subsequently,cytokine levels and lymphocyte activation decreased.An increase in cell apoptosis led to a substantial loss of T lymphocytes.Combined with the continual elevations in serum interleukin levels and worsening severe organ damage,septic mice may have entered a state of persistent inflammation and immunosuppression,with a simultaneous increase in KLF3 expression in T lymphocytes.Notably,KLF3 expression was negatively correlated with T-lymphocyte activation and apoptosis.Conclusions:In our septic mice,splenic T-lymphocyte KLF3 expression decreased in the early stage when the mice exhibited a systemic inflammatory response and T-lymphocyte activation.In contrast,it increased in the later stage,when persistent inflammation and immunosuppression occurred.Dynamic monitoring of KLF3 expression levels may provide aid in identifying the immune status of sepsis.
基金Supported by the National Natural Science Foundation of China,No.82300857.
文摘BACKGROUND Patients with acute-on-chronic liver failure(ACLF)experience severe immune dysfunction.Liver transplantation(LT)significantly improves survival outcomes.However,the characteristics of peripheral blood lymphocyte subsets(PBLSs)in this patient population are not well defined,and the dynamics of immune reconstitution post-LT are insufficiently understood.AIM To characterize PBLSs in patients with ACLF prior to LT and to evaluate PBLS reconstitution after LT.METHODS Clinical data from patients undergoing LT in the Transplantation Center,The Third Xiangya Hospital from January 2022 to December 2023 were analyzed retrospectively.Our cohort comprised 44 patients with ACLF,16 patients with acute decompensation of cirrhosis,and 23 patients with compensated cirrhosis.Twenty healthy volunteers were included as controls.PBLSs were evaluated across all groups.The relationship between PBLSs and post-LT prognosis was assessed,and dynamic changes in PBLSs among patients with ACLF were analyzed at different time points.RESULTS Patients with ACLF exhibited a marked reduction in PBLSs compared with healthy volunteers.Natural killer(NK)cell counts were further reduced in patients with ACLF when compared with patients with compensated cirrhosis.PBLSs did not correlate with the etiology or severity of ACLF or with established liver failure scores.Following LT,a rapid restoration of NK cells and B cells was observed in patients with ACLF.However,the cluster of differentiation(CD)3+T cell and CD4+T cell counts decreased 14 days post-LT and subsequently returned to preoperative levels by day 21.CONCLUSION Patients with ACLF exhibited markedly reduced PBLSs,with decreased NK cells potentially linked to progression from compensated cirrhosis to liver failure.NK and B cell were rapidly restored after LT.
基金supported by the National Natural Science Foundation of China(No.81571373,No.81601217 and No.82001491)Natural Science Foundation of Hubei Province of China(No.2017CFB627)+1 种基金Health Commission of Hubei Province Scientific Research Project(No.WJ2021M247)Scientific Research Fund of Wuhan Union Hospital(No.2019)。
文摘Objective:Xuebijing injection has been recommended as a therapeutic approach for individuals with severe and critical COVID-19.This study aims to explore the correlation of neutrophil to lymphocyte platelet ratio(NLPR)with the severity and prognosis of COVID-19,and the effect of XBJ on the prognosis of patients with COVID-19 in different inflammatory states.Methods:This was a retrospective study conducted at Wuhan Union Hospital in China.COVID-19patients admitted between November 1,2022 and February 1,2023 were included.In predicting prognosis for individuals with COVID-19,new inflammatory indicators were used,and their prognostic value was assessed by using Cox regression models and receiver operating characteristic curves.Furthermore,a calculation was made to determine the cutoff value for NLPR.Relative risk and Cox regression models were used to examine the effects of Xuebijing injection on prognosis in patient cohorts that had been stratified by the NLPR cutoff.Results:This research included 455 participants with COVID-19,with a mean age of 72 years.Several inflammatory indicators were found to be strongly correlated with prognosis,and NLPR shows the greatest predictive power.Patients with NLPR>3.29 exhibited a mortality rate of 17.3%,which was 6.2 times higher than in patients with NLPR≤3.29.Importantly,providing Xuebijing injection to patients with NLPR>3.29 was associated with a lower risk of 60-day all-cause mortality.However,there was no discernible improvement in survival among patients with NLPR≤3.29 who received Xuebijing injection.Conclusion:NLPR is the most reliable inflammatory marker for predicting prognosis among individuals with COVID-19,and can accurately identify individuals who may benefit from Xuebijing injection.
文摘Objective:To investigate the diagnostic value of the neutrophil/lymphocyte ratio,which has not been studied sufficiently to determine the cause of acute gastroenteritis worldwide.Methods:The prospective,observational study included patients diagnosed with acute gastroenteritis who were treated at DışkapıYıldırım Beyazıt Application and Research Center,Emergency Medicine Clinic between 1 September 2020 and 31 May 2021.Demographic characteristics,as well as neutrophil count,lymphocyte count,white blood cell count,and the neutrophil-to-lymphocyte ratio,were compared across the viral,bacterial,and parasitic acute gastroenteritis groups.Results:A total of 168 acute gastroenteritis patients,31 of whom had parasitic,39 bacterial and 98 viral etiologies,were included in this study.Neutrophil/lymphocyte ratio was 2.73(4.03)in the viral acute gastroenteritis group,4.58(8.61)in the bacterial acute gastroenteritis group,and 4.52(5.49)in the parasite acute gastroenteritis group.A statistically significant difference was found among the groups regarding neutrophil/lymphocyte ratio(P=0.022).However,post-hoc analysis revealed no statistically significant differences in the neutrophil-to-lymphocyte ratio among the groups(P>0.05).Conclusions:Neutrophil/lymphocyte ratio alone cannot distinguish etiological causes in patients admitted to the Emergency Medicine Clinic diagnosed with acute gastroenteritis.
文摘Bai et al investigate the predictive value of T lymphocyte proportion in Alzheimer's disease(AD)prognosis.Through a retrospective study involving 62 AD patients,they found that a decrease in T lymphocyte proportion correlated with a poorer prognosis,as indicated by higher modified Rankin scale scores.While the study highlights the potential of T lymphocyte proportion as a prognostic marker,it suggests the need for larger,multicenter studies to enhance generalizability and validity.Additionally,future research could use cognitive exams when evaluating prognosis and delve into immune mechanisms underlying AD progression.Despite limitations inherent in retrospective designs,Bai et al's work contributes to understanding the immune system's role in AD prognosis,paving the way for further exploration in this under-researched area.
文摘Background With the continuous exploration of cardiovascular diseases,research has found that inflammatory reactions play an important role in the pathogenesis of cardiovascular diseases.In recent years,the ratio of monocyte to lymphocyte counts(MLR)has attracted widespread attention as a novel inflammatory marker.Therefore,this article will focus on the value of MLR in terms of prevalence risk,severity and prognosis in common cardiovascular diseases.[S Chin J Cardiol 2024;25(3):200-206]
基金This study was supported by a grant from Beijing Natural Science Foundation(7234399).
文摘Background:Visceral adipose tissue(VAT)has been linked to the severe acute pancreatitis(SAP)prognosis,although the underlying mechanism remains unclear.It has been reported that pyroptosis worsens SAP.The present study aimed to verify whether mesenteric adipose tissue(MAT,a component of VAT)can cause secondary intestinal injury through the pyroptotic pathway.Methods:Thirty-six male Sprague Dawley(SD)rats were divided into six different groups.Twelve rats were randomly divided into the SAP and control groups.We monitored the changes of MAT and B lymphocytes infiltration in MAT of SAP rats.Twelve SAP rats were injected with MAT B lymphocytes or phosphate buffer solution(PBS).The remaining twelve SAP rats were first injected with MAT B lymphocytes,and then with MCC950(NLRP3 inhibitor)or PBS.We collected blood and tissue samples from pancreas,gut and MAT for analysis.Results:Compared to the control rats,the SAP group showed inflammation in MAT,including higher expression of tumor necrosis factor(TNF-α)and interleukin-6(IL-6),lower expression of IL-10,and histological changes.Flow cytometry analysis revealed B lymphocytes infiltration in MAT but not T lymphocytes and macrophages.The SAP rats also exhibited intestinal injury,characterized by lower expression of zonula occludens-1(ZO-1)and occludin,higher levels of lipopolysaccharide and diamine oxidase,and pathological changes.The expression of NLRP3 and n-GSDMD,which are responsible for pyroptosis,was increased in the intestine of SAP rats.The injection of MAT B lymphocytes into SAP rats exacerbated the inflammation in MAT.The upregulation of pyroptosis reduced tight junction in the intestine,which contributed to the SAP progression,including higher inflammatory indicators and worse histological changes.The administration of MCC950 to SAP+MAT B rats downregulated pyroptosis,which subsequently improved the intestinal barrier and ameliorated inflammatory response of SAP.Conclusions:In SAP,MAT B lymphocytes aggravated local inflammation,and promoted the injury to the intestine through the enteric pyroptotic pathway.
文摘BACKGROUND Advanced gastric cancer(AGC)remains a challenging malignancy with poor prognosis.The combination of oxaliplatin and trastuzumab has shown promising results in AGC treatment.This study aimed to investigate the effects of oxaliplatin and trastuzumab combination therapy on serum tumor markers and T lymphocyte subsets in patients with AGC and to explore their potential as predictive biomarkers for treatment response.AIM To investigate the impact of oxaliplatin and trastuzumab combination therapy on serum markers and T cell subsets in patients with AGC.METHODS This prospective study enrolled 60 patients with AGC.All patients received oxaliplatin(130 mg/m^(2),every 3 weeks)and trastuzumab(8 mg/kg loading dose,followed by 6 mg/kg every 3 weeks)for six cycles.Serum carcinoembryonic antigen(CEA),cancer antigen 19-9(CA19-9),and cancer antigen 72-4(CA72-4)were measured before and after treatment.T-lymphocyte subsets,including CD3+,CD4+,CD8+,and CD4+/CD8+ratios,were also evaluated.The clinical response was assessed using the Response Evaluation Criteria in Solid Tumors version 1.1.RESULTS After six cycles of treatment,the CEA,CA19-9,and CA72-4 serum levels significantly decreased compared to baseline levels(P<0.001).The percentages of CD3+and CD4+T lymphocytes increased significantly(P<0.05),whereas the percentage of CD8+T lymphocytes decreased(P<0.05).The CD4+/CD8+ratio also significantly increased after treatment(P<0.05).Patients with a higher decrease in serum tumor markers(≥50%reduction)and a higher increase in CD4+/CD8+ratio(≥1.5-fold)showed better clinical response rates(P<0.05).CONCLUSION Oxaliplatin and trastuzumab combination therapy effectively reduced serum tumor marker levels and modulated T lymphocyte subsets in patients with AGC.Combination therapy not only has a direct antitumor effect,but also enhances the immune response in patients with AGC.Serum tumor markers and T lymphocyte subsets may serve as potential predictive biomarkers for treatment response in patients with AGC receiving combination therapy.
基金The research protocol was approved by the Clinical Trial Ethics Committee of the Affiliated Hospital of Southwest Medical University(approval number:KY2021063)registered in the Chinese Clinical Trial Registry(registration number:ChiCTR2100044198).
文摘BACKGROUND Circulating tumor cell(CTC)count and neutrophil-to-lymphocyte ratio(NLR)are both closely associated with the prognosis of hepatocellular carcinoma(HCC).AIM To investigate the prognostic value of combining these two indicators in HCC.METHODS Clinical data were collected from patients with advanced HCC who received im-mune therapy combined with targeted therapy at the Department of Oncology,the Affiliated Hospital of Southwest Medical University,Sichuan,China,from 2021 to 2023.The optimal cutoff values for CTC programmed death-ligand 1(PD-L1)(+)>1 or CTC PD-L1(+)≤1 and NLR>3.89 or NLR≤3.89 were evaluated using X-Tile software.Patients were categorized into three groups based on CTC PD-L1(+)counts and NLR:CTC-NLR(0),CTC-NLR(1),and CTC-NLR(2).The relationship between CTC-NLR and clinical variables as well as survival rates was assessed.RESULTS Patients with high CTC PD-L1(+)expression or NLR at baseline had shorter median progression-free survival(m-PFS)and median overall survival(mOS)than those with low levels of CTC PD-L1(+)or NLR(P<0.001).Mean-while,patients in the CTC-NLR(2)group showed a significant decrease in mPFS and mOS.Cox regression analysis revealed that alpha-fetoprotein(AFP),CTC PD-L1(+),and CTC-NLR were independent predictors of OS.The time-dependent receiver operating characteristic curve showed that the area under the curve of CTC-NLR at 12 months(0.821)and 18 months(0.821)was superior to that of AFP and CTC PD-L1(+).CONCLUSION HCC patients with high CTC PD-L1(+)or NLR expression tend to exhibit poor prognosis,and a high baseline CTC-NLR score may indicate low survival.CTC-NLR may serve as an effective prognostic indicator for patients with advanced HCC receiving immunotherapy combined with targeted therapy.
文摘Systemic therapy has become the standard treatment for patients with advanced hepatocellular carcinoma(HCC)whose treatment options are limited.However,the long-term patient response to drugs and the survival outcomes remain a concern.With increasing exploration of the HCC microenvironment,particularly in terms of T lymphocyte immunity,a new era of immunomolecular targeted therapy,based on molecular signaling,has arrived for advanced HCC.In the study of immune tolerance of the intrinsic HCC microenvironment,we found that multiple immunosuppressive mechanisms and immune checkpoint inhibitors,such as anti–programmed cell death protein 1/ligand of programmed cell death protein 1 therapy,have improved clinical outcomes in some patients with advanced HCC.Furthermore,various combination therapies have been investigated,and HCC types have been categorized into different types based on anti–programmed cell death protein 1(PD-1)/ligand of programmed cell death protein 1(PD-L1)treatment.In this paper,we first discuss the tumor-infiltrating T lymphocyte immunity and immune tolerance of HCC.We then clarify the basic mechanism of anti–PD-1/PD-L1 therapy and discuss the types of HCC based on anti–PD-1/PD-L1 therapy.Thereafter,we explain the relevant studies and mechanisms of combination therapy of anti–PD-1/PD-L1 with antiangiogenesis drugs or multikinase kinase inhibitors,anti–T lymphocyte–related signaling pathways in HCC,and other anti-CD8+T cell immune checkpoints.In this way,this review offers a deeper understanding of anti–PD-1/PD-L1 immunotherapy for advanced HCC,in order to provide better individualized treatments for patients with advanced HCC.
文摘Objective:To explore correlation of neutrophil-to-lymphocyte ratio(NLR)to severity of coronary artery disease(CAD)and in-hospital clinical outcomes in patients with acute coronary syndrome(ACS).Methods:In this prospective and observational study,we recruited 500 patients with ACS.For all the eligible patients,demographic details were collected,and laboratory parameters were evaluated.The CAD severity was evaluated in terms of the number of involved vessels.The NLR was calculated based on neutrophils and lymphocytes and the correlation of various risk factors and severity and outcome of CAD was performed.Results:77.2%of Patients was male,and 52%of the patients aged between 55-70 years.Based on the type of ACS,396 out of 500 patients had ST-elevation myocardial infarction.An ascending trend in the white blood cell levels and NLR value was noted as the severity of the ACS increased and the highest white blood cell levels and NLR was noted among classⅣpatients.The mean NLR value among the non-survivors were higher compared to the survivors(9.52±5.72 vs.4.76±2.36;P<0.01).Receiver operating curve showed that the cut-off NLR value was 5.76 with a sensitivity of 75.0%and a specificity of 77.3%.Conclusions:The NLR can be used as an independent prognostic marker in ACS.An elevated NLR value serves as a reliable predictor for short-term complications,notably in-hospital mortality.
基金Supported by Ministerio de la Produccion de Peru,No.317-PNICP-EC-2014,and No.430-PNICP-PIAP-2014Consejo Nacional de Ciencia Tecnologia e Innovacion Tecnologica,No.196-2015-FONDECYT,No.197-2015-FONDECYT,and No.204-2015-FONDECYT.
文摘BACKGROUND The influence of Helicobacter-pylori(H.pylori)infection and the characteristics of gastric cancer(GC)on tumor-infiltrating lymphocyte(TIL)levels has not been extensively studied.Analysis of infiltrating-immune-cell subtypes as well as survival is necessary to obtain comprehensive information.AIM To determine the rates of deficient mismatch-repair(dMMR),HER2-status and H.pylori infection and their association with TIL levels in GC.METHODS Samples from 503 resected GC tumors were included and TIL levels were evaluated following the international-TILs-working-group recommendations with assessment of the intratumoral(IT),stromal(ST)and invasive-border(IB)compartments.The density of CD3,CD8 and CD163 immune cells,and dMMR and HER2-status were determined by immunohistochemistry(IHC).H.pylori infection was evaluated by routine histology and quantitative PCR(qPCR)in a subset of samples.RESULTS dMMR was found in 34.4%,HER2+in 5%and H.pylori-positive in 55.7%of samples.High IT-TIL was associated with grade-3(P=0.038),while ST-TIL with grade-1(P<0.001),intestinal-histology(P<0.001)and no-recurrence(P=0.003).dMMR was associated with high TIL levels in the ST(P=0.019)and IB(P=0.01)compartments,and STCD3(P=0.049)and ST-CD8(P=0.05)densities.HER2-was associated with high IT-CD8(P=0.009).H.pylorinegative was associated with high IT-TIL levels(P=0.009)when assessed by routine-histology,and with high TIL levels in the 3 compartments(P=0.002-0.047)and CD8 density in the IT and ST compartments(P=0.001)when assessed by qPCR.A longer overall survival was associated with low IT-CD163(P=0.003)and CD8/CD3(P=0.001 in IT and P=0.002 in ST)and high IT-CD3(P=0.021),ST-CD3(P=0.003)and CD3/CD163(P=0.002).CONCLUSION TIL levels were related to dMMR and H.pylori-negativity.Low CD8/CD3 and high CD163/CD3 were associated with lower recurrence and longer survival.
基金Supported by Henan Province Medical Science and Technology Tackling Plan Joint Construction Project,No.LHGJ20220684.
文摘BACKGROUND The association between tumor-infiltrating lymphocyte(TIL)levels and the res-ponse to neoadjuvant therapy(NAT)in patients with triple-negative breast cancer(TNBC)remains unclear.AIM To investigate the predictive potential of TIL levels for the response to NAT in TNBC patients.METHODS A systematic search of the National Center for Biotechnology Information PubMed database was performed to collect relevant published literature prior to August 31,2023.The correlation between TIL levels and the NAT pathologic com-plete response(pCR)in TNBC patients was assessed using a systematic review and meta-analysis.Subgroup analysis,sensitivity analysis,and publication bias analysis were also conducted.RESULTS A total of 32 studies were included in this meta-analysis.The overall meta-ana-lysis results indicated that the pCR rate after NAT treatment in TNBC patients in the high TIL subgroup was significantly greater than that in patients in the low TIL subgroup(48.0%vs 27.7%)(risk ratio 2.01;95%confidence interval 1.77-2.29;P<0.001,I2=56%).Subgroup analysis revealed that the between-study hetero-geneity originated from differences in study design,TIL level cutoffs,and study populations.Publication bias could have existed in the included studies.The meta-analysis based on different NAT protocols revealed that all TNBC patients with high levels of TILs had a greater rate of pCR after NAT treatment in all protocols(all P≤0.01),and there was no significant between-protocol difference in the statistics among the different NAT protocols(P=0.29).Additionally,sensitivity analysis demonstrated that the overall results of the meta-analysis remained consistent when the included studies were individually excluded.CONCLUSION TILs can serve as a predictor of the response to NAT treatment in TNBC patients.TNBC patients with high levels of TILs exhibit a greater NAT pCR rate than those with low levels of TILs,and this predictive capability is con-sistent across different NAT regimens.
文摘This editorial will focus on tumor immunity and the factors that alter the tumor immune micro-environment.The role of tumor infiltrating lymphocytes(TILs)will also be discussed in detail,including the types,mechanism of action,and role.Gastric cancer(GC)often presents in the advanced stage and has various factors predicting the outcomes.The interplay of these factors and their correlation with the TILs is discussed.A literature review revealed high intratumoral TILs associated with higher grade,HER2-,and Helicobacter pylori negativity.Moreover,stromal(ST)TILs correlated with lower grade and lesser recurrence risk in GC.High TILs in ST and invasive border also correlated with mismatch repair deficiency status.Further characterization of the CD3+,CD8+,and other cells is also warranted.In the future,this complex correlation of cancer cells with the immune system can be explored for therapeutic avenues.
文摘BACKGROUND The lymphocyte to monocyte ratio(LMR)is considered a marker of systemic inflammation in cardiovascular disease and acts as predictor of mortality in coronary artery disease.AIM To investigate the predictive role of LMR in diabetic coronary artery disease patients.METHODS This cross-sectional study was conducted at tertiary care super-specialty hospital at New Delhi,India.A total of 200 angiography-proven coronary artery disease(CAD)patients were enrolled and grouped into two categories:Group I[CAD patients with type 2 diabetes mellitus(T2DM)and glycated hemoglobin(HbA1c)levels≥6.5%],and Group II(CAD patients without T2DM and HbA1c levels<6.5%).Serum lipoproteins,HbA1c,and complete blood count of enrolled patients were analyzed using fully automatic analyzers.RESULTS The logistic regression analysis showed an odds ratio of 1.48(95%CI:1.28-1.72,P<0.05)for diabetic coronary artery disease patients(Group I)in unadjusted model.After adjusting for age,gender,diet,smoking,and hypertension history,the odds ratio increased to 1.49(95%CI:1.29-1.74,P<0.01)in close association with LMR.Further adjustment for high cholesterol and triglycerides yielded the same odds ratio of 1.49(95%CI:1.27-1.75,P<0.01).Receiver operating characteristic curve analysis revealed 74%sensitivity,64%specificity,and 0.74 area under the curve(95%CI:0.67-0.80,P<0.001),suggesting moderate predictive accuracy for diabetic CAD patients.CONCLUSION LMR showed positive association with diabetic coronary artery disease,with moderate predictive accuracy.These findings have implications for improving CAD management in diabetics,necessitating further research and targeted interventions.
文摘Introduction: Hypertensive disorder in pregnancy affects 4 to 6 percent of all pregnancies and carries risks for the both baby and the mother. Only a few groups of women who are at high-risk pregnancies are received prophylaxis Aspirin, more than 15 percent of women develop pre-eclampsia with a single minor risk factor. Methods: This descriptive cross-sectional study was conducted to compare the 1<sup>st</sup> trimester NLR value of normotensive, pregnancy induced hypertensive and pre-eclamptic pregnant women. The study was conducted with a sample of 416, antenatal patients who were admitted to ward 25, at Colombo North Teaching Hospital Ragama. Data was collected as separated three groups. NLR value was calculated separately and ANOVA test was used to analyze the 3 categorical data. Post HOC test was done to assess the multiple comparison. Results: The prevalence rates of pregnancy induced hypertension and pre-eclampsia among the pregnant women were 8.6% and 5.7%. The mean NLR values of normotensive group was 2.708, pregnancy induced hypertensive group was 2.650 and pre eclamptic group was 3.789. There was a significant difference in NLR value between pre eclamptic group and other two groups with P value of Conclusion: The 1<sup>st</sup> trimester NLR value of pre eclamptic patients significantly increased compared to normotensive women.
