Independent Prognostic Factor In Patients Research Articles

Prognostic value and immunomodulatory role of DNM1L in gastric adenocarcinoma.

Mitochondrial fusion and fission are critical for the morphology and function of cells. DNM1L encodes dynamin-related protein 1 (DRP1), a key protein mediating mitochondrial fission, which is upregulated in a variety of cancers and is strongly associated with tumorigenesis. We aim to investigate the relationship between DNM1L and the prognosis of gastric cancer, as well as to explore the function and mechanism of DNM1L in gastric cancer (GC). In this study, we analyzed the expression differences of DNM1L in gastric cancer tissues and paracancerous tissues using The Cancer Genome Atlas (TCGA) and the Gene Expression Omnibus (GEO) database. This was followed by validation through tissue microarrays. We then utilized the cohort information from these microarrays to explore the relationship between DNM1L expression and gastric cancer prognosis. Furthermore, we conducted enrichment analysis to investigate the function and mechanisms of DNM1L in gastric cancer, and lastly, we performed immune cell infiltration analysis using the CIBERSORT algorithm. We discovered that the expression of DNM1L is elevated in GC tissues. TCGA data showed that the overexpression of DNM1L was positively correlated with the T-stage of GC but not with lymph node metastasis, which was also corroborated by our immunohistochemistry experiments. Based on the Kaplan-Meier curves, the high DNM1L expression was remarkably correlated with poor overall survival in patients with GC. In addition, results of COX regression analysis indicated that high DNM1L expression was an independent prognostic factor in patients with GC. Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and Gene set enrichment analysis (GSEA) showed that DNM1L was closely associated with multiple signaling pathways and immune responses. CIBERSORT analysis indicated that increased DNM1L expression may affect the infiltration of immune cells in the tumor microenvironment. The results of this study indicate that DNM1L is upregulated in gastric cancer (GC) and positively correlates with the T-stage and poor prognosis of GC patients, and it plays an important role in tumor immune infiltration.

Peripheral Monocyte Count as an Independent Prognostic Factor for Patients with Locally Advanced Esophageal Squamous Cell Carcinoma

There is no accurate clinicopathological risk model for localized advanced esophageal squamous cell carcinoma (LA-ESCC) that can be used to guide treatment by predicting prognosis. This study aimed to investigate the use of the novel biomarker peripheral absolute monocyte count (AMC) as independent prognostic factor for LA-ESCC with esophagectomy.

Prognostic value of a novel index combining the prognostic nutritional index and D-dimer levels for gastric cancer after gastrectomy.

The prognostic nutritional index and D-dimer level are two useful measures for gastric cancer prognosis. Since they each comprise different factors, it is possible to employ a more useful combined indicator. This study therefore aimed to establish a prognostic nutritional index-D score-which combines the prognostic nutritional index and D-dimer level-and validate its usefulness as a prognostic marker. We collected data from 1,218 patients with gastric cancer who had undergone radical gastrectomy (R0) between January 2004 and December 2015. Patients were divided into three prognostic nutritional index-D score groups based on the following criteria: score 2, low prognostic nutritional index (≤46) and high D-dimer levels (>1.0 µg/ml); score 1, either a low prognostic nutritional index or high D-dimer levels; and score 0, no abnormality. We then defined the PNI-D score as low (score 0 or 1) and high (score 2). The prognostic nutritional index-D score was significantly associated with overall, recurrence-free, and disease-specific survival (all log-rank P<0.0001). The 5-year overall survival rates of the patients with prognostic nutritional index-D scores of low and high were 88.1% and 64.7%, respectively; their 5-year recurrence-free survival rates were 86.7% and 61.3%, respectively; and their 5-year disease-specific survival rates were 99.3% and 76.5%, respectively. Cox multivariate analysis revealed that a high prognostic nutritional index-D score was an independent, statistically significant prognostic factor for poor overall (P=0.01) survival in the patients with gastric cancer. The prognostic nutritional index-D is an independent prognostic factor for patients with gastric cancer.

Geriatric Nutritional Risk Index Is an Independent Prognostic Factor for Patients With Esophageal Cancer Who Receive Curative Treatment.

The perioperative nutritional status has recently been reported to influence the prognosis of various types of cancer. We investigated the relationship between the Geriatric Nutritional Risk Index (GNRI) and overall survival (OS) and recurrence-free survival (RFS) in patients with esophageal cancer who received radical and adjuvant therapy. Patients who underwent radical resection for esophageal cancer at our hospital (n=187) were included. Background characteristics, surgical factors, and OS were examined retrospectively. The GNRI was calculated using preoperative values, with GNRI <98 classified as low-GNRI. Seventy-five and 112 patients were classified into the GNRI-low and -high groups, respectively. The 3- and 5-year OS rates were 75.7% and 66.7%, respectively, in the GNRI-high group and 43.2% and 36.7% in the GNRI-low group; the difference was statistically significant (p<0.001). In the univariate and multivariate analyses, low-GNRI was selected as a risk factor for OS. The hazard ratio for low-GNRI was 2.184 (95% confidence interval=1.361-3.508, p=0.001). The 5-year RFS rate in the high- and low-GNRI groups was 54.6% and 25.0%, respectively (p=0.001). In the univariate and multivariate analyses, low-GNRI was a risk factor for RFS. The hazard ratio for low-GNRI was 1.704 (95%CI=1.121-2.590, p=0.013). Regarding the type of recurrence, lymph node recurrence was significantly more common in the low-GNRI group (p=0.008). Low-GNRI was an independent risk factor for OS and RFS after radical resection of esophageal cancer. The preoperative GNRI may be a useful prognostic factor after esophageal cancer surgery.

Lymphocyte to Monocyte Ratio Is an Independent Prognostic Factor in Patients With Esophageal Cancer Who Receive Curative Treatment.

This study evaluated the clinical impact of the lymphocyte-to-monocyte ratio (LMR) in patients with esophageal cancer who received curative treatment and perioperative adjuvant treatment. The association between LMR and the clinicopathological characteristics of patients with esophageal cancer was also investigated. This study included 181 patients who underwent curative treatment for esophageal cancer between 2005 and 2020. The prognosis and clinicopathological parameters of patients with high and low LMR statuses were analyzed. The OS rates at 3 and 5 years after surgery were significantly lower (40.6% and 33.8%, respectively) in the low-LMR group than in the high-LMR group (67.1% and 58.4%, respectively). The pretreatment LMR was selected as an independent prognostic factor in the multivariate analysis model [hazard ratio (HR)=2.606; 95%CI=1.504-4.516, p<0.001]. Similar results were observed for RFS. Furthermore, LMR was associated with the occurrence of postoperative surgical complications and hematological recurrence. The incidence of anastomotic leakage was 63.3% in the low-LMR group and 27.2% in the high-LMR group (p<0.001). Moreover, the hematologic recurrence rate in the low-LMR group was significantly higher than that in the high-LMR group (46.7% vs. 23.8%, p=0.011). The LMR may be a promising prognostic and predictive factor for esophageal cancer, and may be used to select optimal treatment strategies in the future.

Oncological outcomes of conversion therapy in gastric cancer patients with peritoneal metastasis: a large-scale retrospective cohort study

BackgroundData on the long-term oncological outcomes of patients who undergo conversion surgery (CS) in gastric cancer (GC) patients with peritoneal metastasis (PM) are limited.MethodsGC patients with PM who received intraperitoneal (ip) and systemic chemotherapy between April 2015 and January 2021 were enrolled. Multivariate analysis was performed to identify risk factors associated with survival. Clinicopathological and survival outcomes were compared between those with CS and those without CS (NCS). The paclitaxel (PTX) plus tegafur–gimeracil–oteracil potassium capsules (S-1) (PS) + ip PTX and oxaliplatin plus S-1 (SOX) + ip PTX groups were matched in a 1:1 ratio using propensity score matching. Oncological and survival data were collected and analyzed.ResultsA total of 540 patients who received ip chemotherapy via subcutaneous port and systemic chemotherapy were analyzed and 268 patients were enrolled, including 113 who underwent CS and 155 who did not. Overall survival (OS) were 27.0 months and 11.8 months in the CS and NCS groups (P < 0.0001), respectively. R0 resection was an independent prognostic factor for patients who underwent CS. The OS of patients with or without ovariectomy was 21.3 or 12.0 months (P < 0.0001). No difference of clinicopathological and survival outcomes was found between the PS + ip PTX and SOX + ip PTX groups.ConclusionConversion therapy is safe and adverse events were manageable. CS improves the survival of GC patients with PM after ip and systemic chemotherapy. R0 is an important prognostic factor. Furthermore, outcomes are comparable between the PS + ip PTX and SOX + ip PTX groups.

Does sex influence the prognosis of laryngeal cancer? A systematic review and a meta-analysis

PurposeLaryngeal cancer (LC) represents the tumor with the highest male-to-female sex ratio, yet the prognostic significance of sex remains uncertain. This study aimed to assess whether sex serves as an independent predictor of tumor control and survival in patients with laryngeal cancer. MethodsA systematic review and a meta-analysis of the literature was performed by querying the PubMed, Scopus, and Google Scholar databases. Outcome measures were overall survival (OS), disease-specific survival (DSS), and disease-free survival (DFS). Cumulative hazard ratios (HRs) with 95 % CI are presented for the reported outcomes. QUIPS tool was used for evaluating biases. ResultsOut of a total of 16,592 retrieved articles, a total of 19 articles were included for quantitative analyses. A total of 1195 women affected by LC were analyzed, and compared to 7966 male patients: pooled analysis for survival revealed no significant sex-based differences (OS: HR = 0.786, 95 % CI: 0.590–1.047; DFS: HR = 0.465, 95 % CI 0.150–1.437; DSS: HR = 0.152, 95 % CI 0.01–12.82). All the included studies showed a low to moderate overall risk of bias. ConclusionsThis meta-analysis suggests that sex does not represent a significant independent prognostic factor for patients affected by laryngeal cancer.

Comprehensive analysis of thirteen-gene panel with prognosis value in Multiple Myeloma.

Although there are many treatments for Multiple myeloma (MM), patients with MM still unable to escape the recurrence and aggravation of the disease. We constructed a risk model based on genes closely associated with MM prognosis to predict its prognostic value. Gene function enrichment and signal pathway enrichment analysis, Least Absolute Shrinkage and Selection Operator (LASSO) regression analysis, univariate and multivariate Cox regression analysis, Kaplan-Meier (KM) survival analysis and Receiver Operating Characteristic (ROC) analysis were used to identify the prognostic gene signature for MM. Finally, the prognostic gene signature was validated using the Gene Expression Omnibus (GEO) database. Thirteen prognostic genes were screened by univariate Cox analysis and LASSO regression analysis. Multivariate Cox analysis revealed risk score to be an independent prognostic factor for patients with MM [Hazard Ratio (HR) = 2.564, 95% Confidence Interval (CI) = 2.223-2.958, P< 0.001]. The risk score had a high level of predictive value according to ROC analysis, with an area under the curve (AUC) of 0.744. The potential prognostic signature of thirteen genes were assessed and a risk model was constructed that significantly correlated with prognosis in MM patients.

Combined inflammatory parameters and tertiary lymphoid structure predict prognosis in patients with resectable non-small cell lung cancer treated with neoadjuvant chemoimmunotherapy.

Neoadjuvant chemoimmunotherapy shows great potential for patients with non-small cell lung cancer (NSCLC), but no clear prognostic markers have been identified. This study investigates the correlation between inflammatory parameters and the expression of tertiary lymphoid structures (TLS) and the predictive ability of inflammatory parameters combined with TLS for disease-free survival (DFS) in patients with resectable NSCLC receiving neoadjuvant chemotherapy. We retrospectively analyzed the clinical data and hematological parameters of 117 patients with NSCLC who underwent neoadjuvant chemoimmunotherapy and radical surgery. TLS were evaluated by observing H&E stained and immunohistochemically stained tissue sections. Univariate chi-square and multifactor logistic analyses were used to determine the correlation between hematological parameters and TLS. The Kaplan-Meier method, univariate and multivariate Cox regression analysis and constructed nomogram models were used to assess the prognostic value of the investigated parameters on DFS. Receiver operating characteristic (ROC) curves analyses were used to compare the performances of the three models. After logistic analysis, it was found that platelet-to-lymphocyte ratio (PLR) ≤288.78 (odds ratio OR=0.122, P=0.009) was an independent predictor of high TLS expression. The Cox regression analyses showed that Histology (HR=0.205, P=0.002), systemic immune inflammation index (SII) (HR=2.758, P=0.042) and TLS (HR=0.057, P<0.05) were independent prognostic factors in patients with NSCLC. The combined SII-TLS model was better than the single-indicator model in assessing the 1-year and 18-months DFS rates in patients with NSCLC. Our study showed that PLR was an independent predictor of TLS and that both TLS and SII predicted prognosis in patients with neoadjuvant chemoimmunotherapy-resectable NSCLC; however, combining SII and TLS to assess DFS was more accurate than using either parameter alone.

Value of adjuvant chemotherapy for patients with pT2N0M0 non-small cell lung cancer receiving radical resection.

Associations between adjuvant chemotherapy (ACT) and the improvement in survival for patients with pT2N0M0 non-small cell lung cancer (NSCLC) who received R0 resection remain controversial. This study aimed to evaluate the value of ACT for patients with pT2N0M0 NSCLCs, and to identify the subgroups who could benefit from ACT. Multivariable Cox proportional hazards regression models were used to estimate independent prognostic factors. High-risk factor (HRF) included visceral pleural invasion (VPI), lymphovascular invasion (LVI) and poor differentiation/undifferentiated tumors. Of the 899 patients, 277 (30.8%) patients received ACT. More younger patients (p < 0.001) and male patients (p = 0.007) received ACT. With the increase of pathological tumor size (p < 0.001) and the number of HRFs (p < 0.001), there was a significant rise in the proportion of patients receiving ACT. For all patients, ACT could not improve recurrence-free survival (RFS) (p = 0.672) and overall survival (OS) (p = 0.306). For patients with pathological stage IIA or radiological pure-solid tumors, ACT could significantly improve the OS (p = 0.011 and p = 0.037, respectively), and multivariate analysis revealed that ACT was an independent prognostic factor for patients with pathological stage IIA (p = 0.005). ACT could improve the OS significantly in patients with pathological stage IB pure-solid lung adenocarcinoma (LUAD) (p = 0.043). ACT was valuable for patients with pathological stage IIA (pT2bN0M0) and patients with radiological pure-solid LUAD of pathological stage IB. A combination of radiological features and pathological subtypes could be helpful when selecting patients with pT2N0M0 NSCLCs for ACT.

Construction and evaluation of a column chart model and a random forest model for predicting the prognosis of hydrodistention surgery in BPS/IC patients based on preoperative CD117, P2X3R, NGF, and TrkA levels

ObjectiveThis study seeks to investigate independent risk factors affecting the prognoses of patients with bladder pain syndrome/interstitial cystitis (BPS/IC) following hydrodistention surgery and to develop a column chart model and a random forest model to help predict clinical outcomes.MethodA retrospective analysis was conducted on the clinical data of 1006 BPS/IC patients who visited the urology department of the Fifth Hospital of Shanxi Medical University (Shanxi Provincial People's Hospital) between June 2012 and June 2022. The patients were randomly divided into a model group (n = 704) and a validation group (n = 302). In the model group, logistic regression analysis was used to identify independent risk factors, which were used to construct a prognostic nomogram. The nomogram was evaluated by analyzing the area under the curve (AUC), calibration curve, and decision curve. These results were subsequently validated via consistency analysis (n = 302). And based on the random forest algorithm, we calculate the same data and construct a random forest model.ResultMultivariate logistic regression analysis revealed that age and the expression of the biomarkers CD117, P2X3R, NGF, and TrkA were independent prognostic factors for patients with BPS/IC (P < 0.05). Using these five indicators, a nomogram was developed to predict the risk factors for BPS/IC (scores ranged from 0 to 400). Based on the indicators, the nomogram demonstrated good prognostic performance (AUC = 0.982 and 95% confidence interva is 0.960–0.100). The correction curve indicated a high level of differentiation in the model, and the decision curve suggested positive clinical benefits. The random forest model has high accuracy and good calibration in predicting the prognosis of patients with interstitial cystitis after hydrodistention surgery.ConclusionAge, CD117, P2X3R, NGF, and TrkA are independent prognostic factors for bladder pain syndrome/interstitial cystitis. The column chart model and random forest model constructed based on these indicators have good predictive performance for patient prognosis.

Prognostic Impact of Primary Tumor Sidedness in Stage III Colorectal Cancer: Real-World Evidence from a Brazilian Cohort

BackgroundPrimary tumor sidedness (PTS) is an independent prognostic factor in patients with metastatic colorectal cancer (CRC), with a worse prognosis for right-sided tumors. There are limited data on the prognostic impact of PTS in stage III CRC. The main objective of this study was to analyze the prognostic impact of PTS in stage III CRC. Patients and MethodsA retrospective and uni-institutional cohort study was performed in an oncology reference center. Patients with stage III CRC treated with a 5-fluorouracil and oxaliplatin-based chemotherapy regimen (mFLOX regimen) from October 2007 to February 2013 were included. The primary outcome was the probability of overall survival (OS) at 5 years stratified by PTS. Secondary outcomes were the probability of disease-free survival (DFS) at 5 years and an analysis of the prognostic impact of clinical and molecular biomarkers. Kaplan‒Meier curves were used, and Cox models were used to evaluate prognostic factors associated with OS and DFS. ResultsOverall, 265 patients were evaluated. Transverse colon tumors, multicentric tumors, and undetermined primary subsites were excluded, resulting in 234 patients classified according to PTS: 95 with right sidedness (40.6%) and 139 with left sidedness (59.4%). The median follow-up time was 66 months [interquartile range (IQR): 39-81]. The 5-year OS probabilities for right-sided and left-sided tumors were 67% (95% CI: 58%-77%) and 82% (75%-89%), respectively [hazard ratio (HR): 2.02, 95% CI: 1.18-3.46; P = .010]. The 5-year probabilities of DFS for right-sided and left-sided tumors were 58% (49%-69%) and 65% (58%-74%), respectively (HR: 1.29, 0.84-1.97; P = 0.248). ConclusionThese data suggest that there may be a worse prognosis (inferior OS at 5 years) for resected right-sided stage III CRC patients treated in the real world. However, these data need to be confirmed by prospective studies with a larger number of participants.

Marital Status as an Independent Prognostic Factor in Patients with Glioblastoma: A Population-Based Study

BackgroundThis study was aimed to investigate the effects of marital status on overall survival (OS) and cancer-specific survival (CSS) in patients with glioblastoma (GBM) and to develop nomograms for predicting prognosis in GBM patients. MethodsAll patients were selected from the Surveillance, Epidemiology, and End Results (SEER) cancer registry program. We used propensity score matching to balance the baseline characteristics of married and unmarried patients. The effects of marital status on OS and CSS were then assessed using Kaplan-Meier curves and Cox proportional hazard regression, and the magnitude of each factor was visualized in the form of forest maps. The impact of marriage on the survival of GBM patients was further explored by stratifying several demographic factors. Finally, the nomograms were constructed and verified based on Cox proportional risk regression model. Results17,517 patients with GBM (11,818 married patients, 67.5%) were enrolled in the study cohort. After PSM, there were 5699 patients in both the married and unmarried groups. Multivariate Cox regression analysis showed that both married and single patients had better OS (Married: HR 0.824, 95% CI: 0.788-0.862, P <0.001; Single: HR 0.764, 95% CI: 0.722-0.808, P <0.001) and CSS (Married: HR 0.833, 95% CI: 0.796-0.872, P <0.001; Single: HR 0.761, 95% CI: 0.718-0.806, P <0.001) than divorced, separated, and widowed (DSW) patients. ConclusionsMarital status was an independent prognostic factor in patients with GBM. The nomograms constructed in this study could help medical professionals to provide personalized prognostic assessment and treatment decisions for patients with GBM.

The place of initial serum sodium and globulin ratio in the prognosis estimation of patients with lung cancer

Aims: Since lung cancer is a disease with a high mortality and morbidity rate, determining its prognosis has a very important place. Studies in the literature have shown that electrolyte disturbance and inflammation may be associated with a poor prognosis in lung cancer, however, further studies are needed on this subject. In this study, it was planned to investigate the role of the sodium and globulin ratio measured at the time of diagnosis in the prognosis prediction of patients with lung cancer diagnosis. Methods: The study was carried out retrospectively from the patient files and hospital records of 165 patients who were followed up with the diagnosis of lung cancer between January 1, 2015 and January 1, 2021 in XXXX University (KKU) Faculty of Medicine, Department of Internal Medicine, and Medical Oncology Department. Patients with achievable sodium, albumin, and total protein values at the time of diagnosis were included in the study. The hemogram parameters of the patients included in the study were creatinine and estimated glomerular filtration rate (eGFR), alanine aminotransferase (ALT) level, albumin level, total protein level and globulin level, C-reactive protein (CRP) level, CEA, and TSH levels. In addition, the sodium/globulin ratio (SGR) and the CRP/albumin ratio (CAR) were evaluated. Results: 87.3% of the patients were male, and 12.7% were female. The mean age at presentation was 62.5 ± 9.1 years. Adenocancer accounts for 46.1% of cancers with 76 patients, squamous cell carcinoma for 41.8% with 69 patients, and small cell carcinoma for 12.1% with 20 patients. 11 (6.7%) of the patients were stage 1, 25 (15.2%) stage 2, 58 (35.2%) stage 3, and 71 (43%) stage 4 patients. 111 (67.3%) of the patients died. The average follow-up time is 16.6 months. In the regression analyzes performed in our study, mortality and sodium/globulin ratio (SGR) and progression-free survival and sodium/globulin ratio (SGR) were found to be unrelated. There was a weak negative correlation between the sodium/globulin ratio (SGR) and the CRP/albumin ratio (CAR). In the multivariate regression analysis, the stage of the disease, diabetes, and CRP level were found to be the independent variables affecting mortality and the stage of the disease affecting progression-free survival. (p&lt;0.001). Conclusion: Independent prognostic factors in patients with lung cancer; stage of disease for mortality, diabetes, and CRP level were found to be stages for progression-free survival. Considering the weak relationship between sodium/globulin ratio (SGR) and CRP/albumin ratio (CAR), SGR can be used as a future biomarker to predict prognosis in cancer patients. Further studies are needed to learn more about the relationship between SGR and lung cancer.

A Respective Analysis of EBV DNA Status in T/NK Cell Lymphoma Associated-Hemophagocytic Lymphohistiocytosis

Background: To explore the clinical characteristics and prognostic implication of Epstein-Barr virus (EBV) DNA status in patients with T-cell or natural-killer cell lymphoma-associated hemophagocytic lymphohistiocytosis (T/NK-LAHLH). Method: Patients who diagnosed with T/NK-LAHLH in the First Affiliated Hospital of Zhejiang University from January 2017 to August 2022 were included. Baseline characteristics were summarized and compared. Complete response (CR), partial response (PR) and no response (NR) were used to evaluate the 2-week efficacy of HLH treatment. Overall survival (OS) was estimated by Kaplan-Meier method and log-rank test. Cox proportional hazard model for potential factors were conducted. Result: Eight-five T/NK-LAHLH patients were finally enrolled, with a median age of 52 (18-81) years. According to EBV DNA status, sixty-seven were classified as EBV DNA positive group and 18 were EBV DNA negative group. Patients in EBV DNA positive T/NK-LAHLH group displayed significantly lower PLT (P=0.003), and globulin level (P=0.033), higher IL-10 level (P=0.011) and longer activated partial thromboplastin time (APTT, P=0.034) than those of EBV DNA negative T/NK-LAHLH group at HLH diagnosed. For patients received the anti-HLH therapy only, the ORR was 33.9%, patients in the liposomal doxorubicin-etoposide-prednisolone (DEP) group and ruxolitinib combined with corticosteroid (Ru-D) group achieved relatively better efficacy, with ORR 56.3% and 64.3%, respectively. Whereas the ORR in the HLH-94 group was 23.1% and corticosteroid with or without intravenous immunoglobulins (GC±IVIG) regimen had no effect on T/NK-LAHLH, all patients showed no response to GC±IVIG regimen. The difference of ORR was significance among the four anti-HLH regimens (P&amp;lt;0.001). The median period of anti-HLH therapy was 5 days for patients who received anti-HLH therapy and then switched to anti-lymphoma chemotherapy, with ORR 78.3%. There was a significant difference in the efficacy and OS for whether converted to anti-lymphoma therapy within 2 weeks after receiving anti-HLH (P&amp;lt;0.001 and P=0.018, respectively). Patients who obtained HLH control within 2 weeks have a better OS (P&amp;lt;0.0001) than no response to therapy. EBV DNA-positive patients displayed significantly worse OS than EBV DNA-negative patients (P&amp;lt;0.0001). Furthermore, all 5 patients who received allogeneic hematopoietic stem cell transplantation (allo-HSCT) were still alive during the follow-up period and achieved significantly prolonged survival (P=0.013) than those who did not. By multivariate analysis, EBV DNA positive, advanced age, prolonged APTT, elevated fibrinogen level and no response to HLH treatment were independent risk factors of OS. Conclusion: EBV infection, along with coagulation abnormalities, advanced age and no response to HLH therapy were independent prognostic factors for patients with T/NK-LAHLH. Early diagnosis and appropriate chemotherapy plus HSCT are essential to achieve improved outcomes in T/NK-LAHLH patients. Keywords ：hemophagocytic lymphohistiocytosis, T/NK cell lymphoma, EBV, HSCT, treatment, prognosis

The Clinical Significance and Prognostic Value of Serum Beta-2 Microglobulin in Adult Lymphoma-Associated Hemophagocytic Lymphohistiocytosis: A Multicenter Analysis of 326 Patients

Introduction: Hemophagocytic lymphohistiocytosis (HLH) is a rare syndrome characterized by an excessive immune response. Beta-2 microglobulin (B2M) forms the light chain section of the major histocompatibility complex (MHC) class Ⅰ antigen. The prognostic role of B2M in lymphoma-associated HLH remains to be determined. This study was to investigate the prognostic role of serum B2M in adult lymphoma-associated hemophagocytic lymphohistiocytosis (HLH). Methods: The clinical and laboratory characteristics of adult patients in a multicenter cohort with lymphoma-associated HLH who had baseline serum B2M levels between August 2009 and June 2023 were retrospectively analyzed. The diagnosis of HLH was established according to the HLH-2004 criteria. Results: A total of 326 cases were included and the median serum B2M level was 5.19 mg/L. The most common subtype of lymphoma was T/NK cell lymphoma (51.8%, 169/326), followed by B-cell non-Hodgkin lymphoma (45.4%, 148/227) and Hodgkin lymphoma 8/326 (2.5). The optimal cut-off value of serum B2M for predicting overall survival was 8.73 mg/L (p &amp;lt; 0.0001). Patients were divided into two subgroups by the optimal cut-off value. The median survival was 21 days for the high level subgroup, and 236 days for the low level subgroup (Figure 1). The 6-month survival rates were 22% and 54%, respectively. The subgroup with B2M level &amp;gt; 8.73 mg/L was older and had a higher proportion of stage IV. Patients with higher levels of B2M showed lower levels of platelets, albumin, and fibrinogen, and high levels of creatinine. A moderate correlation between creatinine and serum B2M was found (Spearman's ρ = 0.417, p &amp;lt; 0.001). The multivariate analysis showed that the high levels of serum B2M (&amp;gt; 8.73 mg/L) and creatinine (≥ 133 μmol/L), decreased fibrinogen (≤ 1.5 g/L), agranulocytosis (&amp;lt; 0.5×10 9/L), severe thrombocytopenia (&amp;lt; 50×10 9/L), and increased Epstein-Barr virus DNA were found to have significant prognostic values in all patients. The high serum B2M level (&amp;gt; 8.73 mg/L), severe thrombocytopenia (&amp;lt; 50×10 9/L), agranulocytosis (&amp;lt; 0.5×10 9/L), and high Epstein-Barr virus DNA copy number were independent prognostic factors in patients with creatinine &amp;lt; 133 μmol/L. Finally, a prognostic scoring system was established based on serum B2M levels as well as five other independent prognostic factors and divided the patients into three groups with significant prognostic differences (median survival: low-risk [score ≤ 1] 428 days vs. intermediate-risk [score = 2] 102 days vs. high-risk [score ≥ 3] 18 days, P &amp;lt; 0.0001) (Figure 2). The 6-month survival rates were 67%, 46% and 14%, respectively. Conclusions: This study confirmed that the serum B2M level could be an independent prognostic factor in lymphoma-associated HLH and established a prognostic scoring system to predict patients' survival.

Survival Outcomes of US Patients Diagnosed with CMML over the Past Two Decades, Analysis from the SEER Database

Background: CMML is a rare and one of the most aggressive forms of leukemias with hybrid features of myeloproliferative neoplasms (MPN) and myelodysplastic neoplasms/syndromes (MDS). Given its rarity and the fact that CMML was categorized previously as MPN or MDS, the true incidence of CMML is unknown. To the best of our knowledge, the largest and most up to date study addressing the incidence and survival outcomes of patients with CMML in the United States covered a period from 2000 to 2013, with a sample size of 2,238 patients. The aim of this study is to investigate the clinical characteristics, survival outcomes, and independent prognostic factors of patients with CMML over the past two decades with a larger sample size. Methods: A total of 4,124 patients diagnosed with CMML, between 2000 and 2017, were ultimately enrolled in our study by retrieving data from the Surveillance, Epidemiology, and End Results (SEER) database. We analyzed demographics, clinical characteristics, and overall mortality (OM) as well as cancer-specific mortality (CSM) of HSTCL. Variables with a p value &amp;lt;0.01 in the univariate Cox regression were incorporated into the multivariate Cox model to determine the independent prognostic factors, with a hazard ratio (HR) of greater than 1 representing adverse prognostic factors. Results: Our cohort had a male predominance (61.57%). Most patients were diagnosed between the age of 60- and 79-year-old (55.16%) and CMML was least common among patients younger than 40 (1.41%). Non-Hispanic whites (79.03%) were most represented. Univariate cox proportional hazard regression analyses of factors affecting all-cause mortality revealedhigher overall mortality among patients 80 and older (HR= 2.68, 95% CI 1.89-3.79, p&amp;lt;0.01) followed by patients aged 60-79 (HR=1.85, 95% CI 1.31-2.62, p&amp;lt;0.01), patients living in nonmetropolitan counties not adjacent to a metropolitan area (HR=1.28, 95% CI 1.11-1.48, p&amp;lt;0.01), widowed patients (HR=1.42, 95% CI 1.30-1.54, p&amp;lt;0.01) and those that underwent chemotherapy (HR=1.20, 95% CI 1.13-1.29, p&amp;lt;0.01). Lower OM was observed in patients with yearly income of $75,000+ (HR=0.85, 95% CI 0.77-0.94, p&amp;lt;0.01) and those that undergo radiation (HR=0.64, 95% CI 0.47-0.87, p&amp;lt;0.01). CSM was higher among male patients (HR=1.12, 95% CI 1.03-1.22, &amp;lt;0.01), those aged 80 or older (HR=1.90, 95% CI 1.28-2.81, p&amp;lt;0.01), patients living in nonmetropolitan counties not adjacent to a metropolitan area (HR=1.30, 95% CI 1.10-1.54, p&amp;lt;0.01), widowed patients (HR=1.27, 95% CI 1.15-1.41, p&amp;lt;0.01), and those that underwent chemotherapy (HR=1.59, 95% CI 1.47-1.73, p&amp;lt;0.01). Multivariate cox proportional hazard regression analyses of factors affecting OM revealedhigher mortality in male patients, those 80+, patients living in counties in metropolitan areas of 250,000 to 1 million persons, single patients, widowed and those that underwent chemotherapy. Lower OM was found in patients with an annual income of $75,000+. CSM revealed a higher mortality in male patients, those aged 80+, patients living in counties in metropolitan areas of 250,000 to 1 million persons, single patients, widowed and those that underwent chemotherapy. Conclusion: CMML remains a rare and very dismal hematologic condition. In this United States population-based retrospective cohort study using the SEER database, we found that male sex, advanced aged, single, widowed and those that underwent chemotherapy are independent factors of poor prognosis. While one would expect older patients and those that require chemotherapy to have a poor prognosis as they have a baseline poor performance status and present at advanced disease respectively, it remains unclear why widowed/single and male patients are at higher mortality risk. Perhaps, for widowed and single patients, earlier involvement of family members and community support may lower their mortality. This data paves the way for larger prospective studies addressing factors associated with worse prognosis widowed/single and male patients.

Meta-Analysis Global Group in Chronic Heart Failure score for the prediction of mortality in valvular heart disease.

Valvular heart disease (VHD) is one of the leading causes of heart failure. Clinically significant VHD can induce different patterns of cardiac remodelling, and risk stratification is challenging in patients with various degrees of cardiac dysfunction. The study aimed to investigate the prognostic implications of Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) score in patients with VHD. This study used data from the China Valvular Heart Disease (China-VHD) registry, which was a multicentre, prospective, observational cohort study for patients with significant (at least moderate) VHD. In total, 10446 patients with moderate or greater VHD from the China-VHD study were included in the present analysis. The primary outcome of interest was all-cause mortality within 2years. Among 10446 patients with VHD, the mean age was 61.98±13.47years, and 5819 (55.7%) were male. During 2years of follow-up, 895 (8.6%) patients died. The MAGGIC score was monotonically and independently associated with mortality in both total cohort [adjusted hazard ratio: 1.095, 95% confidence interval (CI): 1.084-1.107, P<0.001] and most types of VHD (aortic regurgitation, mitral stenosis, mitral regurgitation, tricuspid regurgitation, mixed aortic stenosis and aortic regurgitation, and multiple VHD). The score was also an independent prognostic factor in patients with or without symptoms or preserved left ventricular ejection fraction (LVEF) and exhibited both satisfactory discrimination and calibration properties in predicting mortality. The prognostic value of MAGGIC score was robust in most quartiles of N-terminal pro-brain natriuretic peptide level, with no significant interaction observed (Pinteraction =0.498). Compared with the EuroSCORE II, the MAGGIC score achieved significantly better predictive performance in overall population [C index: 0.769 vs. 0.727; net reclassification improvement index (95% CI): 0.354 (0.313-0.396), P<0.001; integrated discrimination improvement index (95% CI): 0.069 (0.052-0.085), P<0.001] and in subgroups of patients divided by therapeutic strategy, LVEF, symptomatic status, stage of VHD, and aetiology of VHD. The MAGGIC score is a reliable prognostic factor across the range of cardiac dysfunction in VHD and may assist in risk stratification and guide clinical decision-making.

Construction and validation of a prognostic model for tongue cancer based on three genes signature.

Tongue squamous cell carcinoma (TSCC) has a poor prognosis and destructive characteristics. Reliable biomarkers are urgently required to predict disease outcomes and to guide TSCC treatment. This study aimed to develop a multigene signature and prognostic nomogram that can accurately predict the prognosis of patients with TSCC. We screened differentially expressed genes associated with TSCC using The Cancer Genome Atlas dataset. Based on this, we developed a new multi-mRNA gene signature using univariate Cox regression, Least Absolute Shrinkage and Selection Operator regression, and multivariate Cox regression. We used the concordance index to evaluate the accuracy of this new multigene model. Moreover, we performed receiver operating characteristic and Kaplan-Meier survival analyses to assess the predictive ability of the new multigene model. In addition, we created a prognostic nomogram incorporating clinical and pathological characteristics, with the aim of enhancing the adaptability of this model in practical clinical settings. We successfully developed a new prognostic model based on the expression levels of these 3 mRNAs that can be used to predict the prognosis of patients with TSCC. This prediction model includes 3 genes: KRT33B, CDKN2A, and CA9. In the validation set, the concordance index of this model was 0.851, and the area under the curve was 0.778 and 0.821 in the training and validation sets, respectively. Kaplan-Meier survival analysis showed that regardless of whether it was in the training or validation set, the prognosis of high-risk patients was significantly worse than that of low-risk patients (P < .001). Multivariate Cox regression analysis revealed that this model was an independent prognostic factor for patients with TSCC (P < .001). Our study suggests that this 3-gene signature model has a high level of accuracy and predictive ability, is closely related to the overall survival rate of patients with TSCC, and can independently predict the prognosis of TSCC patients with high accuracy and predictive ability.

Selection of M7G-related lncRNAs in kidney renal clear cell carcinoma and their putative diagnostic and prognostic role

BackgroundKidney renal clear cell carcinoma (KIRC) is a common malignant tumor of the urinary system. This study aims to develop new biomarkers for KIRC and explore the impact of biomarkers on the immunotherapeutic efficacy for KIRC, providing a theoretical basis for the treatment of KIRC patients.MethodsTranscriptome data for KIRC was obtained from the The Cancer Genome Atlas (TCGA) and International Cancer Genome Consortium (ICGC) databases. Weighted gene co-expression network analysis identified KIRC-related modules of long noncoding RNAs (lncRNAs). Intersection analysis was performed differentially expressed lncRNAs between KIRC and normal control samples, and lncRNAs associated with N(7)-methylguanosine (m7G), resulting in differentially expressed m7G-associated lncRNAs in KIRC patients (DE-m7G-lncRNAs). Machine Learning was employed to select biomarkers for KIRC. The prognostic value of biomarkers and clinical features was evaluated using Kaplan-Meier (K-M) survival analysis, univariate and multivariate Cox regression analysis. A nomogram was constructed based on biomarkers and clinical features, and its efficacy was evaluated using calibration curves and decision curves. Functional enrichment analysis was performed to investigate the functional enrichment of biomarkers. Correlation analysis was conducted to explore the relationship between biomarkers and immune cell infiltration levels and common immune checkpoint in KIRC samples.ResultsBy intersecting 575 KIRC-related module lncRNAs, 1773 differentially expressed lncRNAs, and 62 m7G-related lncRNAs, we identified 42 DE-m7G-lncRNAs. Using XGBoost and Boruta algorithms, 8 biomarkers for KIRC were selected. Kaplan-Meier survival analysis showed significant survival differences in KIRC patients with high and low expression of the PTCSC3 and RP11-321G12.1. Univariate and multivariate Cox regression analyses showed that AP000696.2, PTCSC3 and clinical characteristics were independent prognostic factors for patients with KIRC. A nomogram based on these prognostic factors accurately predicted the prognosis of KIRC patients. The biomarkers showed associations with clinical features of KIRC patients, mainly localized in the cytoplasm and related to cytokine-mediated immune response. Furthermore, immune feature analysis demonstrated a significant decrease in immune cell infiltration levels in KIRC samples compared to normal samples, with a negative correlation observed between the biomarkers and most differentially infiltrating immune cells and common immune checkpoints.ConclusionIn summary, this study discovered eight prognostic biomarkers associated with KIRC patients. These biomarkers showed significant correlations with clinical features, immune cell infiltration, and immune checkpoint expression in KIRC patients, laying a theoretical foundation for the diagnosis and treatment of KIRC.