scholarly journals Association of neutrophil-to-lymphocyte ratio with severe radiation-induced mucositis in pharyngeal or laryngeal cancer patients: a retrospective study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yumiko Kawashita ◽  
Masayasu Kitamura ◽  
Sakiko Soutome ◽  
Takashi Ukai ◽  
Masahiro Umeda ◽  
...  

Abstract Background The neutrophil-to-lymphocyte ratio (NLR) is a marker of systemic inflammation that informs clinical decisions regarding recurrence and overall survival in most epithelial cancers. Radiotherapy for head and neck cancer leads to mucositis in almost all patients and severe radiation-mucositis affects their quality of life (QOL). However, little is known about the NLR for severe mucositis. Therefore, this study aimed to show the association between the NLR and severe radiation-induced mucositis in hypopharyngeal or laryngeal cancer patients. Methods In this retrospective study, we determined the incidence of grade 3 mucositis in 99 patients who were receiving definitive radiotherapy or chemoradiotherapy (CRT) for hypopharyngeal or laryngeal cancer. We performed univariate and multivariate logistic regression analyses to investigate the characteristics of grade 3 mucositis. Kaplan–Meier curves and log-rank tests were used to evaluate the occurrence of grade 3 mucositis between two groups with high (NLR > 5) or low (NLR < 5) systemic inflammation. Results The incidence of grade 3 mucositis was 39%. Univariate logistic regression analysis showed that the NLR (Odd ratio [OR] = 1.09; 95% confidence interval [CI] = 1.02–1.16; p = 0.016) and smoking (OR = 1.02; 95% CI = 1.00–1.03; p = 0.048) were significantly associated with grade 3 mucositis. Multivariate logistic regression analysis showed that the NLR was independently associated with grade 3 mucositis (OR = 1.09; 95% CI = 1.01–1.17; p = 0.021). Kaplan–Meier curves also showed that patients with higher NLR (NLR > 5) prior to radiotherapy developed grade 3 mucositis more frequently than those with lower NLR during radiotherapy (p = 0.045). Conclusion This study suggests that a higher NLR is a risk factor and predictor of severe radiation-induced mucositis in hypopharyngeal or laryngeal cancer patients.

2017 ◽  
Vol 41 (3) ◽  
pp. 865-874 ◽  
Author(s):  
Junjie Xiao ◽  
Rongrong Gao ◽  
Yihua Bei ◽  
Qiulian Zhou ◽  
Yanli Zhou ◽  
...  

Background/Aims: Identification of novel biomarkers to identify acute heart failure (AHF) patients at high risk of mortality is an area of unmet clinical need. Recently, we reported that the baseline level of circulating miR-30d was associated with left ventricular remodeling in response to cardiac resynchronization therapy in advanced chronic heart failure patients. However, the role of circulating miR-30d as a prognostic marker of survival in patients with AHF has not been explored. Methods: Patients clinically diagnosed with AHF were enrolled and followed up for 1 year. Quantitative reverse transcription polymerase chain reactions were used to determine serum miR-30d levels. The univariate logistic regression analysis and multivariate logistic regression analysis were used to determine the predictors for all-cause mortality in AHF patients. Kaplan–Meier survival analysis was used to analyze the role of miR-30d in prediction of survival. Results: A total of 96 AHF patients were enrolled and followed up for 1 year. Serum miR-30d was significantly lower in AHF patients who expired in the one year follow-up period compared to those who survived. Univariate logistic regression analysis yielded 18 variables that were associated with all-cause mortality in AHF patients, while the multivariate logistic regression analysis identified 4 variables including heart rate, hemoglobin, serum sodium, and serum miR-30d level associated with mortality. ROC curve analysis showed that hemoglobin, heart rate and serum sodium displayed poor prognostic value for AHF (AUCs not higher than 0.700) compared to miR-30d level (AUC = 0.806). Kaplan–Meier survival analysis confirmed that patients with higher serum miR-30d levels had significantly lower mortality (P=0.001). Conclusion: In conclusion, this study shows evidence for the predictive value of circulating miR-30d as 1-year all-cause mortality in AHF patients. Large multicentre studies are further needed to validate our findings and accelerate the transition to clinical utilization.


2020 ◽  
Vol 5 (1) ◽  
pp. e000354 ◽  
Author(s):  
Koichi Wakimasu ◽  
Koji Kitazawa ◽  
Kanae Kayukawa ◽  
Isao Yokota ◽  
Tsutomu Inatomi ◽  
...  

ObjectiveTo assess graft survival and endothelial cell density (ECD) over a 5-year follow-up period after Descemet’s stripping automated endothelial keratoplasty (DSAEK).Methods and analysisThis retrospective study involved 130 eyes of 130 consecutive patients with Fuchs endothelial corneal dystrophy (FECD), non-FECD bullous keratopathy (BK) (non-FECD) or BK post-trabeculectomy or tube-shunt surgery (glaucoma with bleb) who underwent DSAEK between August 2007 and January 2012 and were followed for more than 5 years postoperatively. Patients with previous keratoplasty, graft suture failure, primary graft failure, postoperative endophthalmitis and ocular infection were excluded. Graft survival and ECD was then examined in all patients who underwent DSAEK and completed the postoperative follow-up period. The association between clinical factors and 5-year graft survival after DSAEK was analysed with multivariate logistic regression analysis.ResultsThe overall graft survival rate at 5 years postoperatively was 85%, yet significantly poorer in the glaucoma with bleb eyes (47%) than in the FECD (100%) or non-FECD (90%) eyes (p<0.01, log-rank test). In the FECD, non-FECD and glaucoma with bleb eyes, the mean ECD at 5 years postoperatively was 1054 cells/mm2, 1137 cells/mm2 and 756 cells/mm2, respectively. Multivariate logistic regression analysis showed history of trabeculectomy or tube-shunt surgery and postoperative allograft rejection to be negative factors for graft survival at 5 years after DSAEK (OR 0.01, 95% CI 0.00 to 0.10 and OR 0.02, 95% CI 0.00 to 0.33, respectively).ConclusionOur findings show that at 5 years postoperatively, the surgical outcome after DSAEK was poorer in eyes after trabeculectomy or tube-shunt surgery.Trial registration numberUMIN000024891.


2017 ◽  
Vol 42 (2) ◽  
pp. 615-622 ◽  
Author(s):  
Shutong Shen ◽  
Rongrong Gao ◽  
Yihua Bei ◽  
Jin Li ◽  
Haifeng Zhang ◽  
...  

Background/Aims: Irisin is a peptide hormone cleaved from a plasma membrane protein fibronectin type III domain containing protein 5 (FNDC5). Emerging studies have indicated association between serum irisin and many major chronic diseases including cardiovascular diseases. However, the role of serum irisin as a predictor for mortality risk in acute heart failure (AHF) patients is not clear. Methods: AHF patients were enrolled and serum was collected at the admission and all patients were followed up for 1 year. Enzyme-linked immunosorbent assay was used to measure serum irisin levels. To explore predictors for AHF mortality, the univariate and multivariate logistic regression analysis, and receiver-operator characteristic (ROC) curve analysis were used. To determine the role of serum irisin levels in predicting survival, Kaplan-Meier survival analysis was used. Results: In this study, 161 AHF patients were enrolled and serum irisin level was found to be significantly higher in patients deceased in 1-year follow-up. The univariate logistic regression analysis identified 18 variables associated with all-cause mortality in AHF patients, while the multivariate logistic regression analysis identified 2 variables namely blood urea nitrogen and serum irisin. ROC curve analysis indicated that blood urea nitrogen and the most commonly used biomarker, NT-pro-BNP, displayed poor prognostic value for AHF (AUCs ≤ 0.700) compared to serum irisin (AUC = 0.753). Kaplan-Meier survival analysis demonstrated that AHF patients with higher serum irisin had significantly higher mortality (P<0.001). Conclusion: Collectively, our study identified serum irisin as a predictive biomarker for 1-year all-cause mortality in AHF patients though large multicenter studies are highly needed.


2021 ◽  
Vol 49 (7) ◽  
pp. 030006052110280
Author(s):  
Wen Zhang ◽  
Hong-Yan Xu ◽  
Yan-Chun Zhang ◽  
Kai-Bo Liu

Objective To assess the prevalence and survival rate of newborns with a delayed diagnosis of critical congenital heart defects (CCHD) in Beijing. Methods This retrospective study analysed data from births between 2010 and 2017 from the Birth Defects Monitoring Network in Beijing. Newborns with CCHD were analysed according to seven categories. Statistical analyses were used to calculate the mortality rate within the first week (days 0–6) after live birth. Multivariate logistic regression analysis of survival was performed to analyse the potential risk factors for newborn mortality. Results A total of 1 773 935 perinatal newborns were screened in Beijing and 1851 newborns were diagnosed with CCHD, showing a prevalence of 10.43 per 10 000. Among the total 1851 CCHD patients, the majority (1692 of 1851; 91.41%) were identified through prenatal diagnosis, 104 of 1851 (5.62%) were diagnosed before obstetric discharge/transfer and 55 of 1851 (2.97%) were identified through delayed diagnosis. The prevalence of CCHD in newborns was 1.96 per 10 000 births. Multivariate logistic regression analysis of survival demonstrated that gestational age at delivery was the only risk factor for death within the first week after birth. Conclusions Within the first week after birth, gestational age was the only risk factor for death in newborns with CCHD.


2021 ◽  
Vol 8 ◽  
Author(s):  
Qian Hu ◽  
Yuan Shi ◽  
Zi-Yu Hua ◽  
Lei Bao ◽  
Fang Li ◽  
...  

Background and objective: Acute kidney injury (AKI) is recognized as an independent predictor for mortality in very-low-birth-weight (VLBW) infants and is reported to have a high incidence. In this study, we sought to identify the predictors for AKI in VLBW infants and thereby develop a prediction nomogram for the early detection and management of VLBW infants at high risk of developing AKI.Methods: We designed a retrospective study wherein we investigated the baseline hospitalization data of VLBW infants treated at our hospital between January 2012 and October 2018. Independent predictors of AKI in VLBW infants, as identified by multivariate logistic regression, were incorporated into a model. Hosmer–Lemeshow test was used to test the goodness of fit of the model, and a receiver operating characteristic (ROC) curve was plotted to assess the discriminative ability of the model. The model was internally validated using the 10-fold cross-validation method. A nomogram was plotted to predict the risk of AKI in VLBW infants on the basis of the results of multivariate logistic regression analysis.Results: We investigated the data of 604 VLBW infants, of which 144 (23.8%) developed AKI; in 111 (77.1%) of these infants, AKI occurred within 7 days of birth. Multivariate logistic regression analysis identified the following as predictive factors for AKI in VLBW infants: gestational age, red blood cell count within 3 days of birth, serum calcium concentration within 3 days of birth, maternal age of ≥35 years, and pulmonary arterial hypertension or myocardial injury. Furthermore, the nomogram was found to be effective in estimating the risk of AKI in VLBW infants, with an area under the curve (AUC) of 0.794 [95% confidence interval (CI): 0.754–0.834; P &lt; 0.001]. Internal validation done by cross-validation showed that the average AUC was 0.788.Conclusion: The nomogram developed in this study was found to be sensitive and specific for the preoperative prediction of AKI in VLBW infants, as per the Kidney Disease: Improving Global Outcomes (KDIGO) criteria modified for neonates.


2017 ◽  
Vol 229 (04) ◽  
pp. 223-228 ◽  
Author(s):  
Alicia Montaner ◽  
Raquel Pinillos ◽  
Zenaida Galve ◽  
Hector Boix ◽  
Carmen de la cuesta ◽  
...  

Abstract Aim To investigate whether increased brain natriuretic propeptide (NT-proBNP) levels at 48 to 72 h of life are associated with the development of bronchopulmonary dysplasia (BPD) or death in premature neonates. Methods A retrospective study was performed in neonates born before 32 weeks’ gestation or with birth weight below 1500 grams, in whom NT-proBNP determination and echocardiography were performed at 48 to 72 h of life. Associations between NT-proBNP levels and the combined outcome BPD or death were analyzed using multivariate logistic regression analysis. Results 117 neonates with mean gestational age 27.8±2.1 weeks and birth weight 949.7±267.5 grams were included. Forty (34.2%) had an outcome of BPD or death. The risk of this combined outcome was found to be 3.95-fold higher (OR 3.95; 95% CI 1.1–14.6) in neonates with NT-proBNP levels above 17800 pg/mL. Conclusion Increased NT-proBNP levels may be associated with a significant decrease in BPD-free survival in very immature newborns.


2017 ◽  
Vol 35 (31_suppl) ◽  
pp. 74-74
Author(s):  
Pawel Bryniarski

74 Background: Dyselectrolytemia is a common problem in patients with terminal cancer. It worsens the quality of life and increases the amount of complications. The aim of our study was to determine factors connected with dyselectrolytemia in patients with terminal cancer. Methods: 310 terminal cancer patients admitted to Palliative Care Unit were retrospectively analyzed. Detailed physical examination, medical history and laboratory parameters were taken upon admission. Univariate and multivariate logistic regression analysis were used to determine possible predictors, symptoms and consequences of dyselectrolytemia. Results: On admission 67,74% of patients had dyselectrolytemia. They were more frequently admitted to hospital from Emergency Department (OR=Odds Ratio=2,879, p=probability value=0,00004), had higher PS scale note (OR=1,627, p=0,0001), were more often cachectic (OR=1,915, p=0,0083), had more often constipation (OR=1,728,p=0,0275), were more often dehydrated (OR=2,609 ,p=0,0007), had lower albumin level (OR=0,909, p=0,00001). They had 275% higher risk of death (OR=2,758, p=0,0001). Multivariate logistic regression analysis after adjustment for possible confounders reviled that admission to hospital from Emergency Department (OR=2,652, p=0,01), higher PS scale note (OR=1,445, p=0,001), opioids administration (OR=2,747, p=0,003), dehydration (OR=1,966 , p=0,038) and higher risk of death (OR=2,432, p=0,002) remained independently associated with dyselectrolytemia. Conclusions: Higher PS scale note, occurrence of dehydration, admission to hospital from Emergency Department and opioids administration are factors associated with dyselectrolytemia. Patients with electrolytes imbalances had 275% higher risk of death. Project "Extension of life and improvement of its quality and reduction of cancer patients' mortality due to proper control of water and electrolyte management and elimination of risk factors for dehydration and dyselectrolytemia." Co-financed by the European Social Fund under the project of the Ministry of Science and Higher Education of Poland entitled "Best of the best! 2.0 ".


2021 ◽  
Author(s):  
Xiaoyong Xiang ◽  
Zhen Ding ◽  
Qi Zeng ◽  
Lingling Feng ◽  
Chunyan Qiu ◽  
...  

Abstract Purpose: To identify clinical/dosimetric predictors of acute hematologic toxicity (HT) in cervical cancer patients undergoing concurrent chemotherapy and volumetric-modulated arc therapy (VMAT).Methods and Materials: We retrospectively analyzed 184 cervical cancer patients receiving concurrent chemotherapy and VMAT. Hematological parameters were collected during the treatment period. The total pelvic bone(TPB) was retrospectively delineated for each patient, and the volume of TPB receiving 10, 20, 30, 40, and 50 Gy (V10, V20, V30, V40, and V50, respectively) was calculated. We assessed the correlations between variables by the Spearman rank correlation test and compared the differences between groups by the Wilcoxon signed-rank test. Binary logistic regression analysis was used to analyze associations between HT and clinical/dosimetric parameters. The receiver operating characteristic curve(ROC) was used to determine the best cut-off values for dosimetric planning constraints.Results: The nadir of absolute monocyte count (AMC) was positively correlated with the nadir of absolute white blood cells (WBC) count (r=0.5378, 95%CI = 0.4227 to 0.6357, P<0.0001) and the nadir of absolute neutrophil count(ANC) (r=0.5000,95%CI = 0.3794 to 0.6039, P<0.0001). The decrease and increase of AMC usually occurred before the ANC and WBC. In multivariate logistic regression analysis, the chemotherapy regimen and the TPB_V20 were independent risk factors for developing Grade ≥3 hematologic toxicity. The optimal TPB_V20 cut-off value identified by ROC curves followed by Youden test was 71% (AUC = 0.788; 95%CI, 0.722–0.845; p-value<0.001).Conclusions: The changing trend of AMC can be used as an effective predictor for the timing and severity of the ANC/WBC nadirs. Maintain TPB_V20 < 71 % and selecting single-agent cisplatin or carboplatin could significantly reduce Grade ≥3 HT in cervical cancer patients undergoing concurrent chemoradiotherapy.


2021 ◽  
Author(s):  
Baran Akagunduz ◽  
Muhammet Ozer ◽  
Cengiz Karacin ◽  
Muhammed Mustafa Atcı ◽  
Hasan Cagrı Yıldırım ◽  
...  

The aim of this study was to assess the impact of coronaphobia on treatment and follow-up compliance in cancer patients. The records of 230 cancer patients were reviewed. Coronaphobia was assessed via the validated COVID-19 Phobia Scale (C19P-S). A total of 64% of the patients had a high coronaphobia score. Among them, 59% were noncompliant. In multivariate logistic regression analysis, low educational status, treatment type, following COVID-19 news, having knowledge about COVID-19 transmission and higher C19P-S score were associated with noncompliance (p = 0.006, p < 0.001, p = 0.002, p = 0.002 and p = 0.001, respectively). Multivariate analysis revealed that having knowledge about COVID-19 transmission was related to a higher C19P-S score (p = 0.001). The cancer patients studied had significant coronaphobia. Moreover, greater coronaphobia was significantly associated with noncompliance with follow-up and treatment.


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