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Oral Oncology Nov 2017The hepatocyte growth factor (HGF)/mesenchymal-epithelial transition factor (c-MET) ligand/receptor axis has been implicated in pathogenesis of malignant diseases... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
The hepatocyte growth factor (HGF)/mesenchymal-epithelial transition factor (c-MET) ligand/receptor axis has been implicated in pathogenesis of malignant diseases including squamous cell carcinoma of the head and neck (SCCHN). Overexpression of c-MET has been reported as a common molecular abnormality in SCCHN, although its prognostic and predictive value remains to be validated.
METHODS
We systematically searched literature for studies evaluating c-MET expression on immunohistochemistry in newly diagnosed, non-metastatic SCCHN. The c-MET expressing cases were classified into three categories according to predefined cut-off values for positivity. Our aim was to assess the prevalence of c-MET expression and its relationship with selected clinicopathological variables.
RESULTS
Twenty-eight studies with 2019 cases were included. Relative frequencies of c-MET expression above cut-off levels I, II, and III were 81.8%, 63.8%, and 46.2%, respectively. Differences between these three values were statistically significant (p<1.0×10). Above cut-off level II, c-MET positivity was associated with worse overall survival (p=4.0×10), positive nodal status (p=1.0×10), higher disease stage (p=7.0×10), older age (p=2.1×10), disease recurrence (p=2.0×10), and primary tumour localization in the oral cavity (p=2.3×10). Above cut-off level III, c-MET positivity was associated with worse disease-free or progression-free survival (p=9.0×10), p16 negativity (p=2.4×10), worse overall survival (p=4.0×10), positive epidermal growth factor receptor (EGFR) status (p=7.2×10), and larger primary tumours (p=4.6×10).
CONCLUSION
In SCCHN, immunohistochemical overexpression of c-MET above cut-off levels III and particularly II was associated with inferior survival outcomes and advanced disease. Moreover, it represents a promising predictive biomarker for c-MET targeting, yet the optimal scoring method remains to be defined.
Topics: Carcinoma, Squamous Cell; Epithelial-Mesenchymal Transition; Female; Head and Neck Neoplasms; Humans; Immunohistochemistry; Male; Middle Aged; Prognosis; Proto-Oncogene Proteins c-met; Squamous Cell Carcinoma of Head and Neck; Survival Analysis
PubMed: 29103754
DOI: 10.1016/j.oraloncology.2017.09.009 -
Kardiologia Polska 2017The aim of this study was to investigate whether the platelet-to-lymphocyte ratio (PLR) is an independent predictor of all-cause mortality and cardiovascular (CV) events... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND AND AIM
The aim of this study was to investigate whether the platelet-to-lymphocyte ratio (PLR) is an independent predictor of all-cause mortality and cardiovascular (CV) events in patients with acute coronary syndrome (ACS).
METHODS
PubMed, Embase, and the Cochrane Library were searched for relevant cohort studies regarding the association between PLR and outcomes of patients with ACS. Either a random- or a fixed-effect model was used for pooling data.
RESULTS
Eight studies involving 6627 patients with ACS were included. The cut-off PLR value for defining risk groups was 150, and patients were assigned to the low (≤ 150) or high (> 150) PLR groups. The pooled relative risk (RR) values of in-hospital and long-term mortality were 2.15 (95% CI [confidence interval] 1.73-2.67; p < 0.00001) and 2.27 (95% CI 1.35-3.80; p = 0.002), respectively, comparing the high and the low PLR groups. Compared with the low PLR group, the high PLR group had a significantly increased risk of in-hospital (RR 1.95; 95% CI 1.30-2.91; p = 0.001) and long-term (RR 1.50; 95% CI 1.08-2.09; p = 0.01) major adverse CV events.
CONCLUSIONS
Elevated PLR was found to be a predictor of all-cause mortality and CV events.
Topics: Acute Coronary Syndrome; Adult; Aged; Female; Humans; Lymphocyte Count; Male; Middle Aged; Platelet Count; Prognosis; Risk
PubMed: 28394006
DOI: 10.5603/KP.a2017.0068 -
PloS One 2015Procalcitonin (PCT) has been widely investigated for its prognostic value in septic patients. However, studies have produced conflicting results. The purpose of the... (Meta-Analysis)
Meta-Analysis Review
Procalcitonin (PCT) has been widely investigated for its prognostic value in septic patients. However, studies have produced conflicting results. The purpose of the present meta-analysis is to explore the diagnostic accuracy of a single PCT concentration and PCT non-clearance in predicting all-cause sepsis mortality. We searched PubMed, Embase, Web of Knowledge and the Cochrane Library. Articles written in English were included. A 2 × 2 contingency table was constructed based on all-cause mortality and PCT level or PCT non-clearance in septic patients. Two authors independently evaluated study eligibility and extracted data. The diagnostic value of PCT in predicting prognosis was determined using a bivariate meta-analysis model. We used the Q-test and I2 index to test heterogeneity. Twenty-three studies with 3,994 patients were included. An elevated PCT level was associated with a higher risk of death. The pooled relative risk (RR) was 2.60 (95% confidence interval (CI), 2.05-3.30) using a random-effects model (I(2) = 63.5%). The overall area under the summary receiver operator characteristic (SROC) curve was 0.77 (95% CI, 0.73-0.80), with a sensitivity and specificity of 0.76 (95% CI, 0.67-0.82) and 0.64 (95% CI, 0.52-0.74), respectively. There was significant evidence of heterogeneity for the PCT testing time (P = 0.020). Initial PCT values were of limited prognostic value in patients with sepsis. PCT non-clearance was a prognostic factor of death in patients with sepsis. The pooled RR was 3.05 (95% CI, 2.35-3.95) using a fixed-effects model (I(2) = 37.9%). The overall area under the SROC curve was 0.79 (95% CI, 0.75-0.83), with a sensitivity and specificity of 0.72 (95% CI, 0.58-0.82) and 0.77 (95% CI, 0.55-0.90), respectively. Elevated PCT concentrations and PCT non-clearance are strongly associated with all-cause mortality in septic patients. Further studies are needed to define the optimal cut-off point and the optimal definition of PCT non-clearance for accurate risk assessment.
Topics: Biomarkers; Calcitonin; Calcitonin Gene-Related Peptide; Emergency Service, Hospital; Humans; Intensive Care Units; Mortality; Odds Ratio; Protein Precursors; Sepsis
PubMed: 26076027
DOI: 10.1371/journal.pone.0129450 -
Heliyon May 2022The albumin-to-globulin ratio (AGR) has been used to predict severity and mortality in infectious diseases. The aim of this study is to evaluate the prognostic value of... (Review)
Review
BACKGROUND AND AIMS
The albumin-to-globulin ratio (AGR) has been used to predict severity and mortality in infectious diseases. The aim of this study is to evaluate the prognostic value of the AGR in COVID-19 patients.
METHODS
A systematic review and meta-analysis were conducted. We included observational studies assessing the association between the AGR values upon hospital admission and severity or all-cause mortality in COVID-19 patients. In the meta-analyses we used random effect models. Risk of bias was assessed using the Newcastle-Ottawa Scale (NOS). The effect measures were expressed as mean difference (MD) and their 95% confidence intervals (CI). We performed Egger's test and funnel plots to assess the publication bias.
RESULTS
The included studies had a total of 11356 patients corresponding to 31 cohort studies. Severe COVID-19 patients had lower AGR values than non-severe COVID-19 patients (mean difference (MD), -0.27; 95% IC, -0.32 to -0.22; p < 0.001; I = 88%). Non-survivor patients with COVID-19 had lower AGR values than survivor patients (MD, -0.29; 95% IC, -0.35 to -0.24; p < 0.001; I = 79%). In the sensitivity analysis, we only included studies with low risk of bias, which decreased the heterogeneity for both outcomes (severity, I = 20%; mortality, I = 5%).
CONCLUSIONS
Low AGR values upon hospital admission were found in COVID-19 patients with a worse prognosis.
PubMed: 35601226
DOI: 10.1016/j.heliyon.2022.e09457 -
Archives of Academic Emergency Medicine 2023The Corticosteroid Randomization After Significant Head injury (CRASH) and the International Mission for Prognosis and Analysis of Clinical Trials (IMPACT) are two... (Review)
Review
INTRODUCTION
The Corticosteroid Randomization After Significant Head injury (CRASH) and the International Mission for Prognosis and Analysis of Clinical Trials (IMPACT) are two prognostic models frequently used in predicting the outcome of patients with traumatic brain injury. There are ongoing debates about which of the two models has a better prognostic value. This study aims to compare the CRASH and IMPACT in predicting mortality and unfavorable outcome of patients with traumatic brain injury.
METHOD
We performed a literature search using Medline (via PubMed), Embase, Scopus, and Web of Science databases until August 17, 2022. After two independent researchers screened the articles, we included all the original articles comparing the prognostic value of IMPACT and CRASH models in patients with traumatic brain injury. The outcomes evaluated were mortality and unfavorable outcome. The data of the included articles were analyzed using STATA 17.0 statistical program, and we reported an odds ratio (OR) with a 95% confidence interval (95% CI) for comparison.
RESULTS
We included the data from 16 studies. The analysis showed that the areas under the curve of the IMPACT core model and CRASH basic model do not differ in predicting the mortality of patients (OR=0.99; p=0.905) and their six-month unfavorable outcome (OR=1.01; p=0.719). Additionally, the CRASH CT model showed no difference from the IMPACT extended (OR=0.98; p=0.507) and IMPACT Lab (OR=1.00; p=0.298) models in predicting the mortality of patients with traumatic brain injury. We also observed similar findings in the six-month unfavorable outcome, showing that the CRASH CT model does not differ from the IMPACT extended (OR=1.00; p=0.990) and IMPACT Lab (OR=1.00; p=0.570) in predicting the unfavorable outcome in head trauma patients.
CONCLUSION
Low to very low level of evidence shows that IMPACT and CRASH models have similar values in predicting mortality and unfavorable outcome in patients with traumatic brain injury. Since the discriminative power of the IMPACT Core and CRASH basic models is not different from the IMPACT extended, IMPACT Lab, and CRASH CT models, it may be possible to only use the core and basic models in examining the prognosis of patients with traumatic injuries to the brain.
PubMed: 36919143
DOI: 10.22037/aaem.v11i1.1885 -
Annals of Medicine and Surgery (2012) Sep 2022Penile cancer is rare among male malignancies. Various biomarkers have been used to predict the prognosis of cancer, one of which is the neutrophil to lymphocyte ratio... (Review)
Review
BACKGROUND
Penile cancer is rare among male malignancies. Various biomarkers have been used to predict the prognosis of cancer, one of which is the neutrophil to lymphocyte ratio (NLR). Therefore, we conducted this systematic review and meta-analysis to evaluate the prognostic value of NLR in penile cancer.
METHODS
This review was conducted following the PRISMA guideline. Several databases, including Scopus, Science-direct, and PubMed, were systematically searched. The primary outcomes were lymph node metastasis (LNM), cancer-specific survival (CSS), and overall survival (OS). All statistical analyses were processed using Review Manager (RevMan) version 5.4.
RESULTS
A total of six retrospective studies were included in the analysis. The cut-off values of NLR in the included studies ranged from 2.6 to 3.59. Meta-analysis showed that penile cancer patients with high NLR had worse LNM and CSS based on the univariate analysis (OR 3.56, 95% CI 2.38, 5.32, p < 0.01; HR 4.19, 95% CI 2.19, 8.01, p = 0.0; respectively). Furthermore, the meta-analysis revealed that NLR is an independent predictor of LNM and CSS (OR 6.67, 95% CI 2.44, 18.22, p < 0.01; HR 2.15, 95% CI 1.23, 3.73, p < 0.01; respectively). However, NLR failed to show as independent predictor for OS (HR 1.69,95% CI 0.95,3.00, p = 0.07).
CONCLUSION
NLR is an independent predictor of LNM and CSS. However, NLR is not proven to be an independent predictor of OS in this study.
PubMed: 36147188
DOI: 10.1016/j.amsu.2022.104335 -
Journal of Interventional Cardiac... Dec 2022To investigate the changes of P wave indices in atrial fibrillation (AF) patients after catheter ablation and the association between P wave indices and AF recurrence. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
To investigate the changes of P wave indices in atrial fibrillation (AF) patients after catheter ablation and the association between P wave indices and AF recurrence.
METHODS
PubMed, Embase, and Cochrane Database were searched through September 15th 2021 for studies on the association between P wave indices and AF with catheter ablation. Heterogeneity was estimated using the I statistic, the random effects model was used to calculate the pooled results, and summary receiver operating characteristic curve (SROC) was used to evaluate the predictive value.
RESULTS
Among included fourteen studies with 1674 AF patients, we found significantly decreased P wave dispersion (P) (mean difference [MD]: - 6.5 ms, 95% confidence interval [95% CI]: - 11.81 to - 1.18, P = 0.02) after cryoballoon ablation (CBA) or radiofrequency ablation (RFA), and maximum P wave (P) (MD: - 8.57 ms, 95% CI: - 17.03 to - 0.10, P = 0.05) after RFA only, but increased minimum P wave (P) (MD: 3.43 ms, 95% CI: 1.07 to 5.79, P < 0.01) after CBA only. P measured before ablation was remarkably higher (MD: 5.79 ms, 95% CI: 2.23 to 9.36, P < 0.01) in patients with recurrence than without; meanwhile, P was higher measured both before and after ablation (MD: 6.49 ms, 95% CI: 2.30 to 10.69, P < 0.01 and MD: 11.2 ms, 95% CI: 2.88 to 19.52, P < 0.01). Furthermore, SROC analysis showed acceptable predictive efficiencies of P (AUC = 0.776) and P (AUC = 0.759) for AF recurrence.
CONCLUSION
P was significantly decreased after AF catheter ablation. Higher P and P may have predictive values for AF recurrence.
Topics: Humans; Atrial Fibrillation
PubMed: 35488962
DOI: 10.1007/s10840-022-01147-7 -
International Journal of Clinical... Nov 2021Neutrophil-to-lymphocyte ratio (NLR) is an accessible and widely used biomarker. NLR may be used as an early marker of poor prognosis in patients with COVID-19. (Meta-Analysis)
Meta-Analysis
BACKGROUND
Neutrophil-to-lymphocyte ratio (NLR) is an accessible and widely used biomarker. NLR may be used as an early marker of poor prognosis in patients with COVID-19.
OBJECTIVE
To evaluate the prognostic value of the NLR in patients diagnosed with COVID-19.
METHODS
We conducted a systematic review and meta-analysis. Observational studies that reported the association between baseline NLR values (ie, at hospital admission) and severity or all-cause mortality in COVID-19 patients were included. The quality of the studies was assessed using the Newcastle-Ottawa Scale (NOS). Random effects models and inverse variance method were used for meta-analyses. The effects were expressed as odds ratios (ORs) and their 95% confidence intervals (CIs). Small study effects were assessed with the Egger's test.
RESULTS
We analysed 61 studies (n = 15 522 patients), 58 cohorts, and 3 case-control studies. An increase of one unit of NLR was associated with higher odds of severity (OR 6.22; 95%CI 4.93 to 7.84; P < .001) and higher odds of all-cause mortality (OR 12.6; 95%CI 6.88 to 23.06; P < .001). In our sensitivity analysis, we found that 41 studies with low risk of bias and moderate heterogeneity (I = 53% and 58%) maintained strong association between NLR values and both outcomes (severity: OR 5.36; 95% CI 4.45 to 6.45; P < .001; mortality: OR 10.42 95% CI 7.73 to 14.06; P = .005).
CONCLUSIONS
Higher values of NLR were associated with severity and all-cause mortality in hospitalised COVID-19 patients.
Topics: COVID-19; Humans; Lymphocytes; Neutrophils; Prognosis; SARS-CoV-2
PubMed: 34228867
DOI: 10.1111/ijcp.14596 -
International Journal of Molecular... Sep 2022The aim of our meta-analysis is to analyze data available in the literature regarding a possible prognostic value of the albumin to globulin ratio (AGR) in prostate... (Meta-Analysis)
Meta-Analysis Review
The aim of our meta-analysis is to analyze data available in the literature regarding a possible prognostic value of the albumin to globulin ratio (AGR) in prostate cancer (PC) patients. We distinguished our analysis in terms of PC staging, histologic aggressiveness, and risk of progression after treatments. A literature search process was performed (“prostatic cancer”, “albumin”, “globulin”, “albumin to globulin ratio”) following the PRISMA guidelines. In our meta-analysis, the pooled Event Rate (ER) estimate for each group of interest was calculated using a random effect model. Cases were distinguished in Low and High AGR groups based on an optimal cut-off value defined at ROC analysis. Four clinical trials were enclosed (sample size range from 214 to 6041 cases). The pooled Risk Difference for a non-organ confined PC between High AGR and Low AGR cases was −0.05 (95%CI: −0.12−0.01) with a very low rate of heterogeneity (I2 < 0.15%; p = 0.43) among studies (test of group differences p = 0.21). In non-metastatic PC cases, the pooled Risk Difference for biochemical progression (BCP) between High AGR and Low AGR cases was −0.05 (95%CI: −0.12−0.01) (I2 = 0.01%; p = 0.69) (test of group differences p = 0.12). In metastatic PC cases, AGR showed an independent significant (p < 0.01) predictive value either in terms of progression free survival (PFS) (Odds Ratio (OR): 0.642 (0.430−0.957)) or cancer specific survival (CSS) (OR: 0.412 (0.259−0.654)). Our meta-analysis showed homogeneous results supporting no significant predictive values for AGR in terms of staging, grading and biochemical progression in non-metastatic PC.
Topics: Disease-Free Survival; Globulins; Humans; Male; Prognosis; Prostatic Neoplasms; Retrospective Studies; Serum Albumin
PubMed: 36232828
DOI: 10.3390/ijms231911501 -
Journal of Orthopaedic Surgery and... Nov 2023The OPG/RANKL signal pathway was important regulation mechanism of bone remodeling cycle, but the effect of osteoprotegerin (OPG) and RANKL in osteoporosis was... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
The OPG/RANKL signal pathway was important regulation mechanism of bone remodeling cycle, but the effect of osteoprotegerin (OPG) and RANKL in osteoporosis was uncertain. We did a systematic review with meta-analysis to assess the association between serum OPG/RANKL and osteoporosis.
METHODS
The systematic search, data extraction, critical appraisal, and meta-analysis were performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Randomized controlled studies were searched in PubMed, OvidMedline, Embase (1946 to present). Standard mean difference (SMD), and associated credible interval (CI) were calculated using RevMan statistical software to assess the continuous data. Heterogeneity in studies was measured by I values. Subgroup analysis was performed based on different bone turnover.
RESULTS
A total of 5 randomized controlled studies met the inclusion criteria. Both OPG and RANKL had no significant differences between the osteoporosis and control group, and the statistical heterogeneity was high in meta-analysis. However, RANKL had significant differences between the osteoporosis group with low bone turnover and control group (SMD = - 1.17; 95% CI - 1.77 to 0.57; P value < 0.01) in subanalysis. Furthermore, the OPG/RANKL ratio was significant lower in the osteoporosis group than in the control group (SMD = - 0.29; 95% CI - 0.57 to - 0.02; P value < 0.05), and the statistical heterogeneity was very low (Chi = 0.20, P = 0.66, I = 0%).
CONCLUSIONS
Our meta-analysis study supported OPG and RANKL were important modulatory factors of bone formation and resorption in bone turnover, respectively. Although the serum level of both OPG and RANKL were not associated with osteoporosis, but the OPG/RANKL ratio was associated with osteoporosis. In future, standardizing the test method and unit was good to clinical application.
Topics: Humans; Osteoprotegerin; Osteoporosis; Bone Remodeling; Osteogenesis; RANK Ligand; Bone Density
PubMed: 37932757
DOI: 10.1186/s13018-023-04179-5