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BMC Gastroenterology Jul 2023Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related deaths worldwide, and is characterized by insidious onset, rapid progression, and poor...
BACKGROUND
Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related deaths worldwide, and is characterized by insidious onset, rapid progression, and poor prognosis. Immunotherapy is a first-line treatment for advanced HCC. The identification of immune-related prognostic markers may be an effective strategy to predict and improve clinical response rate of immunotherapy.
METHODS
The DESeq2, edgeR, and limma R packages were used to compare the transcriptomes of HCC with different prognoses. Cancer-related databases such as UALCAN, TNMplot, GEPIA, muttarget and Human Protein Atlas (HPA), and the Kaplan-Meier Plotter platform were used to analyze the relationship between CLDN18 and the clinical characteristics, as well as prognosis of HCC. The co-expressed genes of CLDN18 were obtained from LinkedOmics platform, and GO functional enrichment and KEGG pathway analysis were performed. The CIBERSORT, TIMER, Timer 2.0 and TISIDB algorithms were used to analyze immune infiltration.
RESULTS
CLDN18 was differentially expressed in HCC patients with different prognoses, and its expression level in PBMC was positively correlated with the stage of BCLC. In addition, CLDN18 was significantly overexpressed in HCC tumor tissues compared to adjacent non-tumor tissues, which was consistent with PBMC sequencing results and immunohistochemical data from human protein profiles. CLDN18 was also positively correlated with HCC staging and grading, and high expression levels of CLDN18 predicted shorter overall survival. Functional annotation of CLDN18 in HCC revealed enrichment of the cellular senescence and protein activation cascade, along with biological processes such as cell cycle, inflammatory response, and cellular ketone metabolism. In addition, CLDN18 was also associated with tumor infiltrating immune cells, suppressive immune cell markers, T lymphocyte depletion and activation of HCC, and low expression of CLDN18 was associated with higher CD8 + T cell infiltration and better survival rates.
CONCLUSIONS
CLDN18 is a potential prognostic marker and immunotherapeutic target for HCC.
Topics: Humans; Prognosis; Carcinoma, Hepatocellular; Leukocytes, Mononuclear; Liver Neoplasms; Algorithms; Claudins
PubMed: 37438735
DOI: 10.1186/s12876-023-02843-y -
International Journal of Medical... 2015During the onset of Moyamoya disease (MMD), progressive occlusion occurs at the end of the intracranial internal carotid artery, and compensatory net-like abnormal... (Review)
Review
During the onset of Moyamoya disease (MMD), progressive occlusion occurs at the end of the intracranial internal carotid artery, and compensatory net-like abnormal vessels develop in the skull base, generating the corresponding clinical symptoms. MMD can affect both children and adults, but MMD in pediatric patients exhibits distinct clinical features, and the treatment prognoses are different from adult patients. Children are the group at highest risk for MMD. In children, the disease mainly manifests as ischemia, while bleeding is the primary symptom in adults. The pathogenesis of MMD in children is still unknown, and some factors are distinct from those in adults. MMD in children could result in progressive, irreversible nerve functional impairment, and an earlier the onset corresponds to a worse prognosis. Therefore, active treatment at an early stage is highly recommended. The treatment methods for MMD in children mainly include indirect and direct surgeries. Indirect surgeries mainly include multiple burr-hole surgery (MBHS), encephalomyosynangiosis (EMS), and encephaloduroarteriosynangiosis (EDAS); direct surgeries mainly include intra- and extracranial vascular reconstructions that primarily consist of superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis. Indirect surgery, as a treatment for MMD in children, has shown a certain level of efficacy. However, a standard treatment approach should combine both indirect and direct procedures. Compared to MMD in adults, the treatment and prognosis of MMD in children has higher clinical significance. If the treatment is adequate, a satisfactory outcome is often achieved.
Topics: Adult; Cerebral Revascularization; Child; Hemorrhage; Humans; Moyamoya Disease; Prognosis; Research
PubMed: 26180513
DOI: 10.7150/ijms.11719 -
Therapeutic Advances in Respiratory... 2023The central role of inflammatory progression in the development of Coronavirus disease 2019 (COVID-19), especially in severe cases, is indisputable. However, the role of... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The central role of inflammatory progression in the development of Coronavirus disease 2019 (COVID-19), especially in severe cases, is indisputable. However, the role of some novel inflammatory biomarkers in the prognosis of COVID-19 remains controversial.
OBJECTIVE
To assess the effect of some novel inflammatory biomarkers in the occurrence and prognosis of COVID-19.
METHODS
We systematically retrieved the studies related to COVID-19 and the inflammatory biomarkers of interest. The data of each biomarker in different groups were extracted, then were categorized and pooled. The standardized mean difference was chosen as an effect size measure to compare the difference between groups.
RESULTS
A total of 90 studies with 12,059 participants were included in this study. We found higher levels of endocan, PTX3, suPAR, sRAGE, galectin-3, and monocyte distribution width (MDW) in the COVID-19 positive groups compared to the COVID-19 negative groups. No significant differences for suPAR and galectin-3 were detected between the severe group and mild/moderate group of COVID-19. In addition, the deaths usually had higher levels of PTX3, sCD14-ST, suPAR, and MDW at admission compared to the survivors. Furthermore, patients with higher levels of endocan, galectin-3, sCD14-ST, suPAR, and MDW usually developed poorer comprehensive clinical prognoses.
CONCLUSIONS
In summary, this meta-analysis provides the most up-to-date and comprehensive evidence for the role of the mentioned novel inflammatory biomarkers in the prognosis of COVID-19, especially in evaluating death and other poor prognoses, with most biomarkers showing a better discriminatory ability.
Topics: Humans; Receptors, Urokinase Plasminogen Activator; Galectin 3; Lipopolysaccharide Receptors; COVID-19; Biomarkers; Prognosis
PubMed: 37727063
DOI: 10.1177/17534666231199679 -
Annals of Medicine Dec 2023Epstein-Barr virus (EBV)-associated hemophagocytic lymphohistiocytosis (EBV-HLH) is a common subtype of HLH with heterogeneous clinical presentations from self-limited...
BACKGROUND
Epstein-Barr virus (EBV)-associated hemophagocytic lymphohistiocytosis (EBV-HLH) is a common subtype of HLH with heterogeneous clinical presentations from self-limited to death, of which adults are worse than children.
OBJECTIVE
To establish predictors of mortality risk in adult EBV-HLH patients for timely and appropriate treatment.
METHODS
Patients with confirmed EBV-HLH admitted to Beijing Friendship Hospital from January 2015 to December 2019 were enrolled and statistical analysis of their laboratory test results was performed.
RESULTS
Among 246 adult patients with EBV-HLH, the deceased were older ( < 0.05), with fewer blood cells ( < 0.05), poorer renal function ( < 0.01), higher levels of procalcitonin (PCT) ( < 0.01), as well as soluble interleukin-2 receptor (sCD25) ( < 0.01). The overall median survival time of patients was 135 days, 87 days for patients without transplantation and 294 days with transplantation ( < 0.001). A combined index of sCD25, PCT, and estimated glomerular filtration rate (eGFR) was obtained to predict prognosis, named the Improved HLH index (IH index), and patients were divided into three groups meeting IH- (i.e. sCD25 ≤ 18,000 pg/mL, PCT ≤ 1.8 ng/mL, eGFR ≥ 90 mL/min/1.73m), IH1+ (i.e. only sCD25 > 18,000 pg/mL or only eGFR < 90 mL/min/1.73m), and IH2+ (i.e. the rest), respectively. In patients with the HScore ≥ 169 or meeting HLH-04, those meeting IH2+ had significantly worse prognoses than those who met IH1+ or IH- ( < 0.001). In the group meeting IH + or IH2+, patients who received allo-HSCT had better prognoses than those who did not ( < 0.05), but there was still a significant difference in prognosis among the three groups in transplanted patients ( < 0.001).
CONCLUSION
The IH index can early identify adult patients with a poor prognosis of EBV-HLH, initiating timely and appropriate treatment.KEY MESSAGESA combined index of sCD25, PCT, and eGFR was obtained to predict prognosis, named the Improved Hemophagocytic Lymphohistiocytosis index (IH index).IH index can early identify adult patients with a poor prognosis of EBV-HLH, initiating timely and appropriate treatment.
Topics: Child; Humans; Adult; Lymphohistiocytosis, Hemophagocytic; Herpesvirus 4, Human; Epstein-Barr Virus Infections; Retrospective Studies; Prognosis
PubMed: 36533966
DOI: 10.1080/07853890.2022.2149850 -
The Journal of International Medical... Feb 2021To investigate the clinical characteristics and prognoses of patients with postpartum acute kidney injury (PPAKI).
OBJECTIVE
To investigate the clinical characteristics and prognoses of patients with postpartum acute kidney injury (PPAKI).
METHODS
We retrospectively reviewed the clinical presentations, laboratory examinations, treatments, and outcomes of patients with PPAKI admitted to our hospital from January 2013 to December 2017. We then analyzed the clinical characteristics and prognoses of the mothers and their infants.
RESULTS
Of 37 patients diagnosed with PPAKI, 26 (70.3%) received treatment in the intensive care unit, mainly for hemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome (28/37, 75.7%), pre-eclampsia (26/37, 70.3%), and postpartum hemorrhage (22/37, 59.5%). Twenty patients required renal replacement treatment (RRT), but renal recovery times were similar in the RRT and non-RRT groups. Renal function recovered completely in 30 patients (81.1%) and partially in one patient (2.7%), and was not re-examined in two patients (5.4%). Three patients (8.1%) were lost to follow-up. Only one patient (2.7%) remained dialysis-dependent, and no maternal deaths occurred. The preterm birth, low birth weight, and infant survival rates were 70.7% (29/41), 68.3% (28/41), and 78.0% (32/41), respectively.
CONCLUSION
RRT does not reduce renal recovery time compared with non-RRT. Overall, the prognoses of both mothers and their fetuses are good following treatment for PPAKI.
Topics: Acute Kidney Injury; Female; Humans; Infant; Infant, Newborn; Postpartum Period; Pregnancy; Premature Birth; Prognosis; Renal Replacement Therapy; Retrospective Studies
PubMed: 33583276
DOI: 10.1177/0300060520988388 -
European Annals of Otorhinolaryngology,... Feb 2016Adult soft-tissue sarcoma is rare but aggressive, with incidence around 5 per 100,000 per year. Head and neck locations are infrequent. Genetic disease and irradiation... (Review)
Review
Adult soft-tissue sarcoma is rare but aggressive, with incidence around 5 per 100,000 per year. Head and neck locations are infrequent. Genetic disease and irradiation are risk factors. The diagnosis needs to be known in order to avoid treatment delay. There are about 50 histologic subtypes, with different patterns and prognoses. Pathologic review and the development of molecular techniques are therefore essential. Prognosis in adult head and neck soft-tissue sarcoma (HNSTS) is poor: 5-year overall survival, about 60%. Recurrence is most often local. Prognostic factors are: tumor size and local extension, histologic grade and margin status. There are few targeted management guidelines. Surgical resection with negative margins is the primary treatment. Postoperative radiation therapy can improve prognosis. The role of chemotherapy is not well established. HNSTS should be treated in a reference center, with multidisciplinary staff following national network guidelines. Several factors are still unknown. The purpose of this article is to summarize the state of knowledge in adult HNSTS.
Topics: Adult; Head and Neck Neoplasms; Humans; Practice Guidelines as Topic; Prognosis; Risk Factors; Sarcoma
PubMed: 26403655
DOI: 10.1016/j.anorl.2015.09.003 -
Annals of Surgery Feb 2021This review assimilates and critically evaluates available literature regarding the use of metabolomic profiling in surgical decision-making. (Review)
Review
OBJECTIVE
This review assimilates and critically evaluates available literature regarding the use of metabolomic profiling in surgical decision-making.
BACKGROUND
Metabolomic profiling is performed by nuclear magnetic resonance spectroscopy or mass spectrometry of biofluids and tissues to quantify biomarkers (ie, sugars, amino acids, and lipids), producing diagnostic and prognostic information that has been applied among patients with cardiovascular disease, inflammatory bowel disease, cancer, and solid organ transplants.
METHODS
PubMed was searched from 1995 to 2019 to identify studies investigating metabolomic profiling of surgical patients. Articles were included and assimilated into relevant categories per PRISMA-ScR guidelines. Results were summarized with descriptive analytical methods.
RESULTS
Forty-seven studies were included, most of which were retrospective studies with small sample sizes using various combinations of analytic techniques and types of biofluids and tissues. Results suggest that metabolomic profiling has the potential to effectively screen for surgical diseases, suggest diagnoses, and predict outcomes such as postoperative complications and disease recurrence. Major barriers to clinical adoption include a lack of high-level evidence from prospective studies, heterogeneity in study design regarding tissue and biofluid procurement and analytical methods, and the absence of large, multicenter metabolome databases to facilitate systematic investigation of the efficacy, reproducibility, and generalizability of metabolomic profiling diagnoses and prognoses.
CONCLUSIONS
Metabolomic profiling research would benefit from standardization of study design and analytic approaches. As technologies improve and knowledge garnered from research accumulates, metabolomic profiling has the potential to provide personalized diagnostic and prognostic information to support surgical decision-making from preoperative to postdischarge phases of care.
Topics: Clinical Decision-Making; Humans; Magnetic Resonance Spectroscopy; Mass Spectrometry; Metabolomics; Prognosis; Surgical Procedures, Operative
PubMed: 32482979
DOI: 10.1097/SLA.0000000000003935 -
Frontiers in Immunology 2022Osteosarcoma is a malignant bone tumor with poor outcomes affecting the adolescents and elderly. In this study, we comprehensively assessed the metabolic characteristics...
OBJECTIVES
Osteosarcoma is a malignant bone tumor with poor outcomes affecting the adolescents and elderly. In this study, we comprehensively assessed the metabolic characteristics of osteosarcoma patients and constructed a hexosamine biosynthesis pathway (HBP)-based risk score model to predict the prognosis and tumor immune infiltration in patients with osteosarcoma.
METHODS
Gene expression matrices of osteosarcoma were downloaded from the Therapeutically Applicable Research to Generate Effective Treatments (TARGET) and Gene Expression Omnibus (GEO) databases. GSVA and univariate Cox regression analysis were performed to screen the metabolic features associated with prognoses. LASSO regression analysis was conducted to construct the metabolism-related risk model. Differentially expressed genes (DEGs) were identified and enrichment analysis was performed based on the risk model. CIBERSORT and ESTIMATE algorithms were executed to evaluate the characteristics of tumor immune infiltration. Comparative analyses for immune checkpoints were performed and the Tumor Immune Dysfunction and Exclusion (TIDE) algorithm was used to predict immunotherapeutic response. Finally, hub genes with good prognostic value were comprehensive analyzed including drug sensitivity screening and immunohistochemistry (IHC) experiments.
RESULTS
Through GSVA and survival analysis, the HBP pathway was identified as the significant prognostic related metabolism feature. Five genes in the HBP pathway including GPI, PGM3, UAP1, OGT and MGEA5 were used to construct the HBP-related risk model. Subsequent DEGs and enrichment analyses showed a strong correlation with immunity. Further, CIBERSORT and ESTIMATE algorithms showed differential immune infiltration characteristics correlated with the HBP-related risk model. TIDE algorithms and immune checkpoint analyses suggested poor immunotherapeutic responses with low expression of immune checkpoints in the high-risk group. Further analysis revealed that the UAP1 gene can predict metastasis. IHC experiments suggested that UAP1 expression correlated significantly with the prognosis and metastasis of osteosarcoma patients. When screening for drug sensitivity, high UAP1 expression was suggestive of great sensitivity to antineoplastic drugs including cobimetinib and selumetinib.
CONCLUSION
We constructed an HBP-related gene signature containing five key genes (GPI, PGM3, UAP1, OGT, MGEA5) which showed a remarkable prognostic value for predicting prognosis and can guide immunotherapy and targeted therapy for osteosarcoma.
Topics: Adolescent; Humans; Aged; Hexosamines; Osteosarcoma; Prognosis; Bone Neoplasms; Survival Analysis
PubMed: 36275679
DOI: 10.3389/fimmu.2022.1028263 -
Chinese Clinical Oncology Aug 2018Patient outcomes following surgical resection of retroperitoneal sarcomas (RPSs) are variable and therefore predicting prognosis is challenging. The risk of recurrence... (Review)
Review
Patient outcomes following surgical resection of retroperitoneal sarcomas (RPSs) are variable and therefore predicting prognosis is challenging. The risk of recurrence varies according to several patient- tumour- and treatment-related characteristics, including histological subtype and tumour grade. In an era of increased movement towards individualised patient care, the ability to predict prognosis following surgery for RPS is essential. The accurate prediction of an individual patient's outcome is important to allow adequate patient counselling and to ensure the optimal therapeutic strategy is selected. The outcomes of patients who have undergone resection for RPS can be predicted using tools such as nomograms. Nomograms take into account the relative contribution of each variable by giving them different weights and then combining them. This review aims to discuss current staging systems available for RPS and to critically appraise predictive tools that are currently available for use in clinical practice.
Topics: Female; Humans; Male; Neoplasm Staging; Nomograms; Prognosis; Sarcoma; Treatment Outcome
PubMed: 30173527
DOI: 10.21037/cco.2018.08.01 -
Current Oncology (Toronto, Ont.) Mar 2023Reliable tools for prognosis prediction are crucially needed by oncologists so they can tailor individual treatments. However, the wide spectrum of histologies and... (Review)
Review
Reliable tools for prognosis prediction are crucially needed by oncologists so they can tailor individual treatments. However, the wide spectrum of histologies and prognostic behaviors of sarcomas challenges their development. In this field, nomograms could definitely better account for their granularity compared to the more widely used AJCC/UICC TNM staging system. Nomograms are predictive tools that incorporate multiple risk factors and return a numerical probability of a clinical event. Since the development of the first nomogram in 2002, several other nomograms have been built, either general, site-specific, histology-specific, or both. Recently, some new "dynamic" nomograms and prognostic tools have been developed, allowing doctors to "recalculate" a patient's prognosis by taking into account the time since primary surgery, the event history, and the potential time-dependent effect of covariates. Due to these new tools, prognosis prediction is no longer limited to the time of the first computation but can be adapted and recalculated based on the occurrence (or not) of any event as time passes from the first computation. In this review, we aimed to give an overview of the available nomograms for STS and to help clinicians in the process of selecting the best tool for each patient.
Topics: Humans; Nomograms; Prognosis; Neoplasm Staging; Sarcoma; Soft Tissue Neoplasms
PubMed: 37185391
DOI: 10.3390/curroncol30040278