Inflammation-related markers and prognosis of alpha-fetoprotein producing gastric cancer

BACKGROUND Inflammation-related markers including neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),monocyte-to-lymphocyte ratio(MLR),systemic immune-inflammation index(SII),systemic inflammation response index(SIRI)and prognostic nutritional index(PNI)could reflect tumor immune microenvironment and predict prognosis of cancers.However,it had not been explored in alpha-fetoprotein(AFP)producing gastric cancer(GC).AIM To determine the predictive value of inflammation-related peripheral blood markers including as NLR,PLR,MLR,SII,SIRI and PNI in the prognosis of AFPproducing GC(AFPGC).Besides,this study would also compare the differences in tumor immune microenvironment,clinical characteristics and prognosis between AFPGC and AFP-GC patients to improve the understanding of this disease.METHODS 573 patients enrolled were retrospectively studied.They were divided into AFP+group(AFP≥20 ng/mL)and AFP-group(AFP<20 ng/mL),comparing the levels of NLR/PLR/MLR/SII/SIRI/PNI and prognosis.In AFP+group,the impact of NLR/PLR/MLR/SII/SIRI/PNI and their dynamic changes on prognosis were further explored.RESULTS Compared with AFP-patients,AFP+patients had higher NLR/PLR/MLR/SII/-SIRI and lower PNI levels and poorer overall survival(OS).In the AFP+group,mortality was significantly lower in the lower NLR/PLR/MLR/SII/SIRI group and higher PNI group.Moreover,the dynamic increase(NLR/PLR/MLR/SII/-SIRI)or decrease(PNI)was associated with the rise of mortality within 1 year of follow-up.CONCLUSION Compared with AFP-patients,the level of inflammation-related peripheral blood markers significantly increased in AFP+patients,which was correlated with OS of AFP+patients.Also,the gradual increase of SII and SIRI was associated with the risk of death within one year in AFP+patients.AFPGC should be considered as a separate type and distinguished from AFP-GC because of the difference in tumor immune microenvironment.It requires basic experiments and large clinical samples in the future.

Pretreatment inflammatory indices predict Bevacizumab response in recurrent Glioma

Aim:It remains unclear what the best therapeutic option for recurrent glioma patients after Stupp treatment is.Bevacizumab(BVZ)is commonly administered in progression,but it appears that only some patients benefit.It would be useful to find biomarkers that determine beforehand who these patients are.Methods:The protocol included 31 high-risk progressing glioma patients after Stupp treatment who received BVZ 5-10 mg/kg every 14 days and temozolomide(3-19 cycles,150-200 mg five days each 28-day cycle)during a mean of eight cycles of BVZ or until tumor progression or unacceptable toxicity.We analyzed the clinical outcome values of inflammatory indices measured before BVZ administration.Results:Lymphocyte level before BVZ administration was the best independent predictor of overall survival(HR=0.34;95%CI:0.145-0.81;P=0.015).The area under the receiver operating characteristic(ROC)curve was 0.823,with 1.645 being the optimal cut-off value,and 0.80 and 0.85 the sensitivity and specificity values,respectively.Responder and non-responder survival curves were also significantly different,considering the first and second tertiles as cut-off points.The number of BVZ cycles was not related to lymphopenia.Pretreatment neutrophil platelet levels,platelet-to-lymphocyte ratio(PLR),and neutrophil-to-lymphocyte ratio(NLR)did not have independent predictive value.Inflammatory variables were not correlated with each other.However,patients with high NLR and PLR simultaneously(double positive PLR-NLR)showed a worse clinical outcome than the rest(P=0.043).Conclusion:Pretreatment lymphocyte levels and double positive PLR-NLR could be used as non-invasive hematological prognostic markers for recurrent gliomas treated with bevacizumab.A close relationship emerged between inflammation and angiogenesis.

Early therapeutic interventions of traditional Chinese medicine in COVID-19 patients:A retrospective cohort study

Objective:To observe the early interventions of traditional Chinese Medicine(TCM)on the conversion time of nucleic acid in patients with coronavirus disease 2019(COVID-19),and find possible underlying mechanisms of action.Methods:A retrospective cohort study was conducted on 300 confirmed COVID-19 patients who were treated with TCM,at a designated hospital in China.The patients were categorized into three groups:TCM1,TCM2 and TCM3,who respectively received TCM interventions within 7,8–14,and greater than15 days of hospitalization.Different indicators such as the conversion time of pharyngeal swab nucleic acid,the conversion time of fecal nucleic acid,length of hospital stay,and inflammatory markers(leukocyte count,and lymphocyte count and percentage)were analyzed to observe the impact of early TCM interventions on these groups.Results:The median conversion times of pharyngeal swab nucleic acid in the three groups were 5.5,7 and16 d(P<0.001),with TCM1 and TCM2 being statistically different from TCM3(P<0.01).TCM1(P<0.05)and TCM3(P<0.01)were statistically different from TCM2.The median conversion times of fecal nucleic acid in the three groups were 7,9 and 17 d(P<0.001).Conversion times of fecal nucleic acid in TCM1 were statistically different from TCM3 and TCM2(P<0.01).The median lengths of hospital stay in the three groups were 13,16 and 21 d(P<0.001).TCM1 and TCM2 were statistically different from TCM3(P<0.01);TCM1 and TCM3 were statistically different from TCM2(P<0.01).Both leucocyte and lymphocyte counts increased gradually with an increase in the length of hospital stay in TCM1 group patients,with a statistically significant difference observed at each time point in the group(P<0.001).Statistically significant differences in lymphocyte count and percentage in TCM2(P<0.001),and in leucocyte count(P=0.043)and lymphocyte count(P=0.038)in TCM3 were observed.The comparison among the three groups showed a statistically significant difference in lymphocyte percentage on the third day of admission(P=0.044).Conclusion:In this study,it was observed that in COVID-19 patients treated with a combination of Chinese and Western medicines,TCM intervention earlier in the hospital stay correlated with faster conversion time of pharyngeal swab and fecal nucleic acid,as well as shorter length of hospital stay,thus helping promote faster recovery of the patient.The underlying mechanism of action may be related to improving inflammation in patients with COVID-19.