Combining systemic inflammatory response index and albumin fibrinogen ratio to predict early serious complications and prognosis after resectable gastric cancer

BACKGROUND Gastric cancer has a high incidence and fatality rate,and surgery is the preferred course of treatment.Nonetheless,patient survival rates are still low,and the incidence of major postoperative complications cannot be disregarded.The systemic inflammatory response,nutritional level,and coagulation status are key factors affecting the postoperative recovery and prognosis of gastric cancer patients.The systemic inflammatory response index(SIRI)and the albumin fibrinogen ratio(AFR)are two valuable comprehensive indicators of the severity and prognosis of systemic inflammation in various medical conditions.AIM To assess the clinical importance and prognostic significance of the SIRI scores and the AFR on early postoperative outcomes in patients undergoing radical gastric cancer surgery.METHODS We conducted a retrospective analysis of the clinicopathological characteristics and relevant laboratory indices of 568 gastric cancer patients from January 2018 to December 2019.We calculated and compared two indicators of inflammation and then examined the diagnostic ability of combined SIRI and AFR values for serious early postoperative complications.We scored the patients and categorized them into three groups based on their SIRI and AFR levels.COX analysis was used to compare the three groups of patients the prognostic value of various preoperative SIRI-AFR scores for 5-year overall survival(OS)and disease-free survival(DFS).RESULTS SIRI-AFR scores were an independent risk factor for prognosis[OS:P=0.004;hazards ratio(HR)=3.134;DFS:P<0.001;HR=3.543]and had the highest diagnostic power(area under the curve:0.779;95%confidence interval:0.737-0.820)for early serious complications in patients with gastric cancer.The tumor-node-metastasis stage(P=0.001),perioperative transfusion(P=0.044),positive carcinoembryonic antigen(P=0.014)findings,and major postoperative complications(P=0.011)were factors associated with prognosis.CONCLUSION Preoperative SIRI and AFR values were significantly associated with early postoperative survival and the occurrence of severe complications in gastric cancer patients.

C-reactive protein to albumin ratio predict responses to programmed cell death-1 inhibitors in hepatocellular carcinoma patients

BACKGROUND Over the years,programmed cell death-1(PD-1)inhibitors have been routinely used for hepatocellular carcinoma(HCC)treatment and yielded improved survival outcomes.Nonetheless,significant heterogeneity surrounds the outcomes of most studies.Therefore,it is critical to search for biomarkers that predict the efficacy of PD-1 inhibitors in patients with HCC.AIM To investigate the role of the C-reactive protein to albumin ratio(CAR)in evaluating the efficacy of PD-1 inhibitors for HCC.METHODS The clinical data of 160 patients with HCC treated with PD-1 inhibitors from January 2018 to November 2022 at the First Affiliated Hospital of Guangxi Medical University were retrospectively analyzed.RESULTS The optimal cut-off value for CAR based on progression-free survival(PFS)was determined to be 1.20 using x-tile software.Cox proportional risk model was used to determine the factors affecting prognosis.Eastern Cooperative Oncology Group performance status[hazard ratio(HR)=1.754,95%confidence interval(95%CI)=1.045-2.944,P=0.033],CAR(HR=2.118,95%CI=1.057-4.243,P=0.034)and tumor number(HR=2.932,95%CI=1.246-6.897,P=0.014)were independent prognostic factors for overall survival.CAR(HR=2.730,95%CI=1.502-4.961,P=0.001),tumor number(HR=1.584,95%CI=1.003-2.500,P=0.048)and neutrophil to lymphocyte ratio(HR=1.120,95%CI=1.022-1.228,P=0.015)were independent prognostic factors for PFS.Two nomograms were constructed based on independent prognostic factors.The C-index index and calibration plots confirmed that the nomogram is a reliable risk prediction tool.The ROC curve and decision curve analysis confirmed that the nomogram has a good predictive effect as well as a net clinical benefit.CONCLUSION Overall,we reveal that the CAR is a potential predictor of short-and long-term prognosis in patients with HCC treated with PD-1 inhibitors.If further verified,CAR-based nomogram may increase the number of markers that predict individualized prognosis.

C-reactive Protein/Albumin Ratio as a Prognostic Indicator in Posttraumatic Shock and Outcome of Multiple Trauma Patients

Objective C-reactive protein(CRP)/albumin ratio(CAR)is a new inflammation-based index for predicting the prognosis of various diseases.The CAR determined on admission may help to predict the prognostic value of multiple trauma patients.Methods A total of 264 adult patients with severe multiple trauma were included for the present retrospective study,together with the collection of relevant clinical and laboratory data.CAR,CRP,albumin,shock index and ISS were incorporated into the prognostic model,and the receiver operating characteristic(ROC)curve was drawn.Then,the shock index for patients with different levels of CAR was analyzed.Finally,univariate and multivariate logistic regression analyses were performed to identify the independent risk factors for the 28-day mortality of multiple trauma patients.Results A total of 36 patients had poor survival outcomes,and the mortality rate reached 13.6%.Furthermore,after analyzing the shock index for patients with different levels of CAR,it was revealed that the shock index was significantly higher when CAR was≥4,when compared to CAR<2 and 2≤CAR<4,in multiple trauma patients.The multivariate logistic analysis helped to identify the independent association between the variables CAR(P=0.029)and shock index(P=0.019),and the 28-day mortality of multiple trauma patients.Conclusion CAR is higher in patients with severe multiple trauma.Furthermore,CAR serves as a risk factor for independently predicting the 28-day mortality of multiple trauma patients.The shock index was significantly higher when CAR was≥4 in multiple trauma patients.

Role of fibrinogen,albumin and fibrinogen to albumin ratio in determining angiographic severity and outcomes in acute coronary syndrome

BACKGROUND Coronavirus disease 2019(COVID-19)pandemic unmasked the huge deficit in healthcare resources worldwide.It highlighted the need for efficient risk stratification in management of cardiovascular emergencies.AIM To study the applicability of the old,available and affordable nonconventional biomarkers:albumin and fibrinogen in their ability to predict angiographic severity and clinical outcomes in patients with acute coronary syndrome(ACS).METHODS In this prospective,observational study,166 consecutive patients with ACS were enrolled.Fibrinogen,albumin and their ratio were determined from serum.Patients with underlying chronic liver disease,active malignancy,autoimmune disease,active COVID-19 infection and undergoing thrombolysis were excluded.RESULTS Mean age of the population was 60.5±1.5 years,74.1%being males.ST elevation myocardial infarction(STEMI)was most common presentation of ACS seen in 57%patients.Fibrinogen albumin ratio(FAR)≥19.2,had a sensitivity of 76.9%and specificity of 78.9%[area under the receiver operating characteristic curves(AUROC)=0.8,P=0.001]to predict≤thrombolysis in myocardial infarction(TIMI)1 flow in culprit artery in STEMI patients.Even in non-STEMI patients,FAR≥18.85 predicted the same with 80%sensitivity and 63%specificity(AUROC=0.715,P=0.006).CONCLUSION Novel biomarkers,with their high cost,lack of availability and long turn over time are impractical for real-world use.Identifying≤TIMI 1 flow in the culprit artery has significant impact of management and outcome.Our study has shown that readily available biomarkers like fibrinogen and albumin can help identify these high-risk patients with good accuracy.This allows risk-stratification and individualization of treatment in ACS.

Systemic immune inflammation index, ratio of lymphocytes to monocytes, lactate dehydrogenase and prognosis of diffuse large Bcell lymphoma patients

BACKGROUND In malignant tumors,inflammation plays a vital role in the development,invasion,and metastasis of cancer cells.Diffuse large B-cell lymphoma(DLBCL),the most common malignant proliferative disease of the lymphatic system,is commonly associated with inflammation.The international prognostic index(IPI),which includes age,lactate dehydrogenase(LDH),number of extranodal lesions,Ann Arbor score,and Eastern Cooperative Oncology Group(ECOG)score,can evaluate the prognosis of DLBCL.However,its use in accurately identifying highrisk patients and guiding treatment is poor.Therefore,it is important to find novel immune markers in predicting the prognosis of DLBCL patients.AIM To determine the association between the systemic immune inflammation index(SII),ratio of lymphocytes to monocytes(LMR),ratio of LMR to LDH(LMR/LDH),and prognosis of patients with DLBCL.METHODS A total of 68 patients diagnosed with DLBCL,treated in our hospital between January 2016 and January 2020,were included.χ2 test,Pearson’s R correlation,Kaplan Meier curves,and Cox proportional risk regression analysis were used.The differences in the SII,LMR,and LMR/LDH among patients with different clinicopathological features were analyzed.The differences in progression-free survival time among patients with different SII,LMR,and LMR/LDH expressions and influencing factors affecting the prognosis of DLBCL patients,were also analyzed.RESULTS The LMR and LMR/LDH in patients with Ann Arbor stage III–IV,ECOG score≥2,and SII,IPI score 2–5 were significantly higher than those of patients with Ann Arbor stage I-II and ECOG score<2(P<0.05).Patients with high SII,LMR,and LMR/LDH had progression-free survival times of 34 mo(95%CI:32.52–38.50),35 mo(95%CI:33.42–36.58)and 35 mo(95%CI:33.49–36.51),respectively,which were significantly lower than those with low SII,LMR,and LMR/LDH(P<0.05);the SII,LMR,and LMR/LDH were positively correlated(P<0.05).Cox proportional risk regression analysis showed that the SII,LMR,and LMR/LDH were influencing factors for the prognosis of DLBCL patients(hazard ratio=1.143,1.665,and 1.704,respectively;P<0.05).CONCLUSION The SII,LMR,and LMR/LDH are related to the clinicopathological features of DLCBL,and they also influence the prognosis of patients with the disease.

Prognostic significance of the fibrinogen-to-albumin ratio in gallbladder cancer patients

AIM To investigate the prognostic role of fibrinogen-toalbumin ratio(FAR) on patients with gallbladder cancer(Gbc) in this study.METHODS One hundred and fifty-four Gbc patients were retro-spectively analyzed, who received potentially curative cholecystectomy in our institute from March 2005 to December 2017. Receiver operating characteristic curve(ROc curve) was used to determine the optimal cut-offs for these biomarkers. In addition, Kaplan-Meier survival analysis as well as multivariate analysis were applied for prognostic analyses.RESULTS ROc curve revealed that the optimal cut-off value for FAR was 0.08. FAR was significantly correlated with age(P = 0.045), jaundice(P < 0.001), differentiation(P = 0.002), resection margin status(P < 0.001), T stage(P < 0.001), TNM stage(P < 0.001), and c A199(P < 0.001) as well as albumin levels(P < 0.001). Multivariate analysis indicated that the resection margin status [hazard ratio(HR): 2.343, 95% confidence interval(c I): 1.532-3.581, P < 0.001], TNM stage(P = 0.035), albumin level(HR = 0.595, 95%c I: 0.385-0.921, P = 0.020) and FAR(HR: 2.813, 95%c I: 1.765-4.484, P < 0.001) were independent prognostic factors in Gbc patients.CONCLUSION An elevated preoperative FAR was significantly correlated with unfavorable overall survival in Gbc patients, while an elevated preoperative albumin level was a protective prognostic factor for patients with Gbc. The preoperative FAR could be used to predict the prognosis of Gbc patients, which was easily accessible, costeffective and noninvasive.

Neutrophil to lymphocyte ratio and albumin bilirubin grade in hepatocellular carcinoma: A systematic review

BACKGROUND Hepatocellular carcinoma(HCC)is a frequent cause of cancer related death globally.Neutrophil to lymphocyte ratio(NLR)and albumin bilirubin(ALBI)grade are emerging prognostic indicators in HCC.AIM To study published literature of NLR and ALBI over the last five years,and to validate NLR and ALBI locally in our centre as indicators of HCC survival.METHODS A systematic review of the published literature on PubMed of NLR and ALBI in HCC over the last five years.The search followed the guidelines of the preferred reporting items for systematic reviews and meta-analyses.Additionally,we also investigated HCC cases between December 2013 and December 2018 in our centre.RESULTS There were 54 studies describing the relation between HCC and NLR and 95 studies describing the relation between HCC and ALBI grade over the last five years.Our local cohort of patients showed NLR to have a significant negative relationship to survival(P=0.011).There was also significant inverse relationship between the size of the largest HCC nodule and survival(P=0.009).Median survival with alpha fetoprotein(AFP)<10 KU/L was 20 mo and with AFP>10 KU/L was 5 mo.We found that AFP was inversely related to survival,this relationship was not statically significant(P=0.132).Mean survival for ALBI grade 1 was 37.7 mo,ALBI grade 2 was 13.4 months and ALBI grade 3 was 4.5mo.ALBI grades performed better than Child Turcotte Pugh score in detecting death from HCC.CONCLUSION NLR and ALBI grade in HCC predict survival better than the conventional alpha fetoprotein.ALBI grade performs better than Child Turcotte Pugh score.These markers are done as part of routine clinical care and in cases of normal alpha fetoprotein,these markers could give a better understanding of the patient disease progression.NLR and ALBI grade could have a role in modified easier to learn staging and prognostic systems for HCC.

The prognostic potential of pretreatment C-reactive protein to albumin ratio in stage IE/IIE extranodal natural killer/T-cell lymphoma

Objective The aim of this study was to determine the prognostic significance of the C-reactive protein-toalbumin ratio (CRP/Alb) for stage IE/IIE upper aerodigestive tract extranodal NK/T cell lymphoma patients. Methods One hundred and fourteen patients diagnosed with extranodal NK/T cell lymphoma at Sichuan Cancer Hospital from September 2011 to November 2016 were retrospectively reviewed. An optimal cutoff value of CRP/Alb for overall survival rate as an endpoint was obtained using the receiver operating curve (ROC). Results The optimal cutoff value of CRP/Alb was 0.15. For the low CRP/Alb group, the 3-year progression-free survival (PFS) was 78.6% and the 3-year overall survival (OS) was 80.7%. The 3-year PFS and OS values for the high CRP/Alb group were 41.6% and 45.2%, respectively. Differences for PFS (P < 0.001) and OS (P < 0.001) between the two groups were statistically significant. Univariate analysis showed that ECOG, IPI, CRP, GPS, and CRP/Alb were significantly associated with PFS. Similarly, all five were also significantly associated with OS. Multivariate analysis further confirmed that ECOG and CRP/ Alb were independent prognostic factors for both PFS and OS. Moreover, the cutoff value of CRP/Alb showed superior prognostic ability in discriminating between patients with different outcomes in low-risk group based on GPS, IPI, and KPI scores. Conclusion CRP/Alb is a promising prognostic marker for early-stage extranodal NK/T cell lymphoma.

Albumin-to-alkaline phosphatase ratio: A novel prognostic index of overall survival in cholangiocarcinoma patients after surgery

AIM To clarify the prognostic significance of preoperative albumin-to-alkaline phosphatase ratio(AAPR) in cholangiocarcinoma(CCA) subjects receiving surgery.METHODS In this retrospective study, we included 303 CCA patients receiving surgery without preoperative therapy between 2002 and 2014. Clinicopathological characteristics(including AAPR) were analyzed to determine predictors of postoperative overall survival and recurrence-free survival(RFS). In addition,univariate and multivariate Cox proportional hazards models were conducted,followed by application of time-dependent receiver operating curves to identify the optimal cut-off.RESULTS Univariate and multivariate analyses revealed both decreased overall survival[hazard ratio(HR): 2.88, 95%CI: 1.19-5.78] and recurrence-free survival(HR: 2.31,95%CI: 1.40–3.29) in patients with AAPR < 0.41 compared to those with AAPR ≥0.41. The optimal cut-off of AAPR was 0.41. Of the 303 subjects, 253(83.5%) had an AAPR over 0.41. The overall 1-, 3- and 5-year survival rates were 70.2%, 38.0% and 16.5%, respectively in the low(< 0.41) AAPR group, which were significantly lower than those in the high(≥ 0.41) AAPR group(81.7%, 53.9%, and 33.4%,respectively)(P < 0.0001). Large tumor size, multiple tumors, and advanced clinical stage were also identified as significant predictors of poor prognosis.CONCLUSION Our outcomes showed that AAPR was a potential valuable prognostic indicator in CCA patients undergoing surgery, which should be further confirmed by prospective studies. Moreover, it is necessary to investigate the mechanisms concerning the correlation of low AAPR with poor post-operative survival in CCA patients.

Prognostic significance of the preoperative hemoglobin to albumin ratio for the short-term survival of gastric cancer patients

BACKGROUND Hemoglobin and albumin are associated with the prognosis of gastric cancer(GC)patients. However, the prognostic value of the hemoglobin to albumin ratio(HAR) for the short-term survival of GC patients with D2 radical resection has not been studied.AIM To investigate the significance of the HAR in evaluating the short-term survival of GC patients after D2 radical resection and to construct a nomogram to predict the prognosis in GC patients after surgery, thus providing a reference for the development of postoperative individualized treatment and follow-up plans.METHODS Cox regression and Kaplan-Meier analysis was used for prognostic analysis.Logistic regression was used to analyze the relationships between HAR and the clinicopathological characteristics of the GC patients. A prognostic nomogram model for the short-term survival of GC patients was constructed by R software.RESULTS HAR was an independent risk factor for the short-term survival of GC patients.GC patients with a low HAR had a poor prognosis(P < 0.001). Low HAR was markedly related to high stage [odds ratio(OR) = 0.45 for Ⅱ vs Ⅰ;OR = 0.48 for Ⅲ vs Ⅰ], T classification(OR = 0.52 for T4 vs T1) and large tumor size(OR = 0.51 for ≥4 cm vs < 4 cm)(all P < 0.05). The nomogram model was based on HAR, age,CA19-9, CA125 and stage, and the C-index was 0.820.CONCLUSION Preoperative low HAR was associated with short-term survival in GC patients.The prognostic nomogram model can accurately predict the short-term survival of GC patients with D2 radical resection.

Different dietary methionine to lysine ratios in the lactation diet:effects on the performance of sows and their offspring and methionine metabolism in lactating sows

Background:Over the last decade,the nutritional requirements of lactating modern genotype sows have increased.The current nutritional recommendations might be unable to meet the needs of increased litter size and milk production,and thus the nutritional requirements need to be re-evaluated.The current study was conducted to investigate the effects of dietary methionine to lysine(Met:Lys)ratios on the performance of and methionine metabolism in lactating sows.Results:During the 1st week of lactation,piglets reared on sows in the 0.37 to 0.57 Met:Lys ratio groups grew faster than those reared on sows in the control group(0.27)(P<0.01).The 0.37-ratio group showed increased levels of GSHPx in plasma during lactation(P<0.01)and decreased concentrations of urea nitrogen in the plasma of sows(P<0.05).Compared with the 0.27-ratio group,the levels of T-AOC and GSH-Px in the plasma and homocysteine in the milk of lactating sows were significantly increased in sows in the 0.47-ratio group(P<0.01).In sows fed a 0.57-ratio diet,the levels of glutathione and taurine in the plasma and milk were improved significantly during lactation.However,the content of TBARS in the blood(P<0.05 at day 7 and P=0.06 at weaning day)was increased(P<0.01).Moreover,there were linear increases in the levels of homocysteine in the blood and milk of sows during the lactation period(P<0.01)with increased dietary Met:Lys ratios in the lactation diet.Conclusions:The current study indicated that increasing the dietary Met:Lys ratio(0.37~0.57)in the lactation diet had no significant effect on the overall performance of sows or the colostrum and milk composition,but it increased piglet mean BW and piglet ADG during the first week of lactation.Increasing dietary methionine levels had no significant effect on antioxidant function in lactation sows,even though it increased levels of GSH and GSH-Px in the plasma of sows during lactation.However,the content of homocysteine in the plasma and milk increased during lactation due to a high level of dietary methionine.

Plasma glutathione and oxidized glutathione level, glutathione/oxidized glutathione ratio, and albumin concentration in complicated and uncomplicated falciparum malaria

Objective: To compare the level of glutathione(GSH) and oxidized glutathione(GSSG),the ratio of GSH/GSSG and the concentration of albumin in plasma of patients with complicated and un-complicated falciparum malaria.Methods: This research was a cross sectional study using comparison analysis with the plasma GSH and GSSG, the ratio of plasma GSH/GSSG and the concentration of plasma albumin as variables. The complicated malaria patients were obtained from Dr. Saiful Anwar Hospital Malang, whereas uncomplicated malaria patients were obtained from the Regency of Pleihari South Kalimantan. Plasma GSH and GSSG levels were determined by the spectrophotometer at the wave length of 412 nm, whereas the concentration of albumin was determined by bromocresol green method in the p H of 4.1.Results: There were no significant differences between the level of plasma GSH and GSSG in complicated and uncomplicated malaria patients, as well as the ratio of plasma GSH/GSSG in the two groups(P = 0.373; P = 0.538; and P = 0.615, respectively, independent ttest). In contrast, the plasma albumin concentration in complicated malaria patients were significantly higher than uncomplicated malaria patients(P = 0.000, Mann Whitney U test).Conclusions: It can be concluded that the average of plasma GSH and GSSG level, also plasma GSH/GSSG ratio in complicated malaria are not different from uncomplicated malaria. Although plasma concentration of albumin in both groups is below the normal range,there is an increase in complicated malaria that might be as compensation of oxidative stress.

Establish Albumin-creatinine Ratio Reference Value of Adults in the Rural Area of Hebei Province

Objective To establish albumin-creatinine ratio(ACR) reference value of the rural population in Hebei province.Methods This study enrolled 5154 participants.By excluding subjects with hypertension,diabetes,dyslipidemia,cardiovascular and cerebrovascular diseases,kidney diseases,and overweight condition,as well as those with an estimated glomerular filtration rate(eGFR)<60 ml/(min·1.73 m^2),apparently healthy subjects(1168) were selected.Urine albumin was measured by using the immunoturbidimetic method,serum creatinine was measured by using Jaffe's kinetic method on a morning spot-urine sample,and ACR was calculated.The 95 th percentile of ACR in the healthy subjects was used as the normal upper limit.Results The normal upper limit of ACR was 28.71 mg/g(3.25 mg/mmol) for males and 31.85mg/g(3.60 mg/mmol) for females.Based on this ACR reference value,the age-gender standardized prevalence of albuminuria in the rural areas of Hebei province was 12.9%.Conclusion The ACR reference value in the rural of Hebei province is higher than that of the Western population.

Comparison between different methods of urine collection for estimation of albumin-creatinine ratio in patients with type-2 diabetes mellitus

In patients with diabetes mellitus, urinary albumin-creatinine-ratio (ACR) predicts progressive kidney disease. In order to determine the better urine sample for detecting ACR, we estimated ACR in three modes of urine sample. Two hundred patients of uncontrolled diabetes mellitus with proteinuria irrespective of age and sex were studied for urinary ACR in all the three types of samples over a period of 2 years. The statistical analysis showed that first morning ACR (r = 0.999, p > 0.001) of the subjects was more significantly correlated with their 24 hour urine sample ACR than spot urine (r = 0.995,

Concentration Changes of Medroxyprogesterone Acetate in Serum and Milk in Lactating Woman Who Used Depo Geston~

Objective To determine the concentration changes of medroxyprogesterone acetate (MPA) in serum and milk in the Chinese lactating women who used Depo Geston? Methods Ten postpartum and breastfeeding women received an injectable contraceptive of Depo Geston? (depo medroxyprogesterone acetate,DMPA, 150 mg/ampoule). Serum and milk samples were collected in the 1st, 2nd, 4th, 6th, 8th 10th and 12th week after contraceptive injection. The concentrations of medroxyprogesterone acetate (MPA) in serum and milk were determined by radioimmunoassay. Results The highest MPA concentration in serum was observed at the 1st week and then the level of serum MPA decreased obviously at the 2nd and 4th week. After the 4th week, the decline of serum MPA level slowed down. The concentration of milk MPA reached the highest level at 1st week. But at the 2nd week the average level of MPA in milk dropped by half. The MPA concentration in the milk was changed in the range of 5.2-8.3 ng/mL in the following 10 weeks. During observation, the average ratios of concentration and area under curve (AUC) in milk/serum were both 0.55. There was a wide variation in MPA concentrations and ratios of milk/serum between subjects. Conclusion MPA concentrations maintained a certaim level at the 12th week after DMPA injection. However, whether mather’s intake of DMPA during feeding period has effect on children’s growth, espcially pubertal growth, deserves further studies.

白蛋白-球蛋白比值与维持性血液透析患者预后的相关性

目的:分析白蛋白-球蛋白比值(AGR)与维持性血液透析(MHD)患者预后的相关性。方法:回顾2010年01月—2020年12月在韶关市第一人民医院收治的320例MHD患者的临床资料,AGR水平波动于0.41~3.26之间,根据AGR中位数(1.21)将患者分为高AGR组(n=162)和低AGR组(n=158),通过倾向性匹配评分匹配分为高AGR组和低AGR组各94例,分析患者死亡原因,采用Kaplan-Meier法分析两组生存情况,并用COX比例风险模型分析AGR对MHD患者心血管死亡和全因死亡的影响。结果:(1)低AGR组患者白细胞计数、血小板计数、纤维蛋白原、球蛋白水平均高于高AGR组,血清磷、血尿酸、血肌酐、血尿素氮、白蛋白水平均低于高AGR组(P<0.05)。(2)中位随访时间41.35个月,随访期间转腹膜透析治疗4例(2.13%),肾移植1例(0.53%),失访2例(1.06%),死亡62例(32.98%),死亡原因分别为:心血管疾病44例(70.97%)、感染9例(14.52%)、肿瘤3例(4.84%)、其它6例(9.68%)。(3)Kaplan-Meier分析显示,高AGR组患者累积全因生存率(P<0.001)和累积心血管疾病存活率(P<0.001)均优于低AGR组患者。(4)COX回归分析显示,未校正的模型中低AGR组患者全因死亡风险(HR:3.842)及心血管死亡风险(HR:3.752)均显著增加,校正后,低AGR组患者全因死亡风险(HR:2.657)和心血管死亡风险(HR:2.764)仍显著增加,在此基础上进一步校正变量后,低AGR仍然是增加全因死亡风险(HR:2.740)和心血管死亡风险(HR:2.651)的独立风险因素。此外,AGR预测全因死亡风险和心血管死亡风险的AUC分别为:0.751和0.744。结论:低AGR是MHD患者心血管和全因死亡的独立危险因素,AGR可作为评估MHD患者预后可靠指标。

系统免疫炎症指数联合白蛋白-纤维蛋白原比值对初诊前列腺癌患者骨转移的预测价值

目的探讨系统免疫炎症指数(SII)联合白蛋白-纤维蛋白原比值(AFR)对初诊前列腺癌患者骨转移的预测价值。方法回顾性分析305例前列腺癌患者的临床资料,其中骨转移组108例、无骨转移组197例,采用二元Logistic回归分析SII、AFR对前列腺癌骨转移率的影响,采用受试者工作特征曲线分析SII、AFR对前列腺癌骨转移的预测效能。结果骨转移组SII为500.22(350.19~697.46)×109/L,AFR为11.53(9.91~12.87),无骨转移组分别为350.03(258.49~529.15)×109/L、13.84(11.69~15.95)(Z=10.335,P<0.001;Z=12.101,P<0.001)。在校正混杂因素后,SII每增加1个标准差,骨转移优势比(OR)为1.001(1.000,1.002),AFR每增加1个标准差,骨转移OR为0.812(0.717,0.919)。SII、AFR单独和联合检测的曲线下面积分别为0.671、0.717、0.747。单独检测SII的最佳截断值为411.49×109/L,敏感性为68.52%,特异性为60.91%;单独检测AFR的最佳截断值为13.35,敏感性为84.26%,特异性为55.84%。SII+AFR联合检测的敏感性为72.22%,特异性为70.05%。SII+AFR联合检测的曲线下面积高于单独检测SII(Z=2.396,95%CI:0.014~0.139,P<0.001)和AFR(Z=2.062,95%CI:0.001~0.059,P<0.001)。结论SII、AFR与初诊前列腺癌患者骨转移相关,SII+AFR联合检测效能高于单独检测,对初诊前列腺癌患者骨转移具有更好的预测价值。

白蛋白和凝血酶原时间比率对肝癌手术预后的预测价值

目的探讨肝癌患者行肝切除术前白蛋白和凝血酶原时间比率(APT)对预后的预测价值。方法选择2014年1月至2020年12月在广西医科大学第一附属医院治疗的272例经临床病理证实的肝细胞癌患者。建立ROC曲线,确定最佳截断值,将患者分为高低APT水平组,通过COX分析筛选肝癌患者的预测术后预后因素,K-M曲线分析APT对肝癌术后预后的影响。结果根据最佳截断值2.981,将APT分成高低水平组,曲线下面积为0.751(P<0.05)。总胆红素、凝血酶原时间(PT)、甲胎蛋白(AFP)等与APT水平分组均无明显相关(P>0.05),APT水平与肝癌患者预后呈正相关(P<0.05)。COX回归分析显示,总胆红素、AFP、肝硬化等与肝癌患者预后无关,而高低APT水平与肝癌预后相关[Exp(B)=4.32,95%CI:1.824~10.27,P=0.001]。结论APT是肝癌手术预后有效的预测指标。

白蛋白/碱性磷酸酶与宫颈癌化疗患者预后的相关性

目的 探讨白蛋白(ALB)/碱性磷酸酶(ALP)与宫颈癌化疗患者预后的相关性。方法 回顾性收集120例宫颈癌患者临床资料,所有患者接受4个周期的顺铂联合紫杉醇化疗。根据化疗周期完成后第30天时疗效评定结果将患者分为预后良好组(n=101)与预后不良组(n=19)。对比2组患者年龄、病程、疾病类型、疾病分期等基线资料;对比化疗前1周内所测的ALB、ALP及其他实验室指标,并计算ALB/ALP值。通过点二列相关性分析和受试者工作曲线(ROC)分析ALB/ALP与宫颈癌化疗患者预后的关系。结果 预后不良组肿瘤直径、ALP水平高于预后良好组,Ⅲ期与ⅣA期患者占比显著高于预后良好组,ALB、ALB/ALP显著低于预后良好组,差异有统计学意义(P<0.05)。经点二列相关性分析,ALB、ALP、ALB/ALP与宫颈癌化疗患者不良预后发生有关(P<0.05)。绘制受试者工作曲线(ROC),结果显示,ALB、ALP、ALB/ALP预测宫颈癌化疗患者不良预后的曲线下面积(AUC)值分别为0.804、0.215、0.862,ALB/ALP预测价值最高。结论 ALB/ALP与宫颈癌化疗患者不良预后间呈负相关,其值越低,不良预后发生可能性越高。

hs-CRP、NT-proBNP及NAR对急性冠状动脉综合征患者诊断价值分析

目的 探讨超敏C反应蛋白(hs-CRP)、氨基末端脑钠肽前体(NT-proBNP)及中性粒细胞与白蛋白比值(NAR)对急性冠状动脉综合征(ACS)患者的诊断价值。方法 选取2020年6月—2022年9月收治的ACS 71例作为研究组,同期健康体检者56例作为对照组,并依照不同疾病类型和血管病变支数将研究组分为ST段抬高型心肌梗死(STEMI)组、非ST段抬高型心肌梗死(NSTEMI)组、不稳定型心绞痛(UAP)组及单支、双支、多支病变组各3个亚组。比较研究组与对照组、不同疾病类型和血管病变支数各3个亚组hs-CRP、NT-proBNP及NAR,探讨hs-CRP、NT-proBNP及NAR单独或联合对ACS的诊断价值。结果 研究组hs-CRP、NT-proBNP及NAR均高于对照组;STEMI组、NSTEMI组和UAP组hs-CRP、NT-proBNP及NAR逐渐降低,单支、双支和多支病变组hs-CRP、NT-proBNP及NAR逐渐升高(P<0.05)。受试者工作特征曲线分析显示,hs-CRP、NT-proBNP和NAR单独或联合诊断ACS的曲线下面积分别为0.820、0.815、0.883及0.914,三者联合诊断ACS的曲线下面积高于单独诊断(P<0.05,P<0.01)。结论 hs-CRP、NT-proBNP及NAR三者联合对ACS的诊断价值较高。