Evaluation of axial length/total corneal refractive power ratio as a potential marker for ocular diagnosis of Marfan’s syndrome in children

AIM: To investigate whether the axial length (AL)/total corneal refractive power (TCRP) ratio is a sensitive and simple factor that can be used for the early diagnosis of Marfan’s syndrome (MFS) in children. METHODS: The relationship between the AL/TCRP ratio and the diagnosis of MFS for 192 eyes in 97 children were evaluate. The biological characteristics, including age, sex, AL, and TCRP, were collected from medical records. Receiver operating characteristic (ROC) curve analysis was performed to investigate whether the AL/TCRP ratio effectively distinguishes MFS from other subjects. The Youden index was used to re-divide the whole population into two groups according to an AL/TCRP ratio of 0.59. RESULTS: Of 96 subjects (mean age 7.46±3.28y) evaluated, 56 (110 eyes) had a definite diagnosis of MFS in childhood based on the revised Ghent criteria, 41 (82 eyes) with diagnosis of congenital ectopia lentis (EL) were included as a control group. AL was negatively correlated with TCRP, with a linear regression coefficient of -0.36 (R2=0.08). A significant correlation was found between age and the AL/TCRP ratio (P=0.023). ROC curve analysis showed that the AL/TCRP ratio distinguished MFS from the other patients at a threshold of 0.59. MFS patients were present in 24/58 (41.38%) patients with an AL/TCRP ratio of ≤0.59 and in 34/39 (87.18%) patients with an AL/TCRP ratio of >0.59. CONCLUSION: An AL/TCRP ratio of >0.59 is significantly associated with the risk of MFS. The AL/TCRP ratio should be measured as a promising marker for the prognosis of children MFS. Changes in the AL/TCRP ratio should be monitored over time.

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The effect of BKV reactivation on cytokines behavior in kidney transplanted patients

BMC Nephrology ◽

10.1186/s12882-021-02645-y ◽

2022 ◽

Vol 23 (1) ◽

Author(s):

Zahra Rahimi ◽

Ramin Yaghobi ◽

Afsoon Afshari ◽

Jamshid Roozbeh ◽

Mohammad Javad Mokhtari ◽

...

Keyword(s):

Real Time ◽

Roc Curve ◽

Real Time Pcr ◽

Curve Analysis ◽

Expression Level ◽

Control Group ◽

Roc Curve Analysis ◽

Tnf Α ◽

Ifn Γ ◽

Inactive Group

Abstract Background BK virus associated nephropathy (BKVAN) is one of the common causes of graft loss among kidney transplanted recipients (KTRs). The current treatment for BKV nephropathy is decreasing the immunosuppressive regimen in KTRs. Interleukin-27 (IL-27) is a multifunctional cytokine that might be the front-runner of an important pathway in this regard. Therefore, in current study it is tried to evaluate the changes in the expression level of IL-27 and some related molecules, resulting from BKV reactivation in KTR patients. Methods EDTA-treated blood samples were collected from all participants. Patients were divided into two groups, 31 kidney transplant recipients with active and 32 inactive BKV infection, after being monitored by Real time PCR (Taq-Man) in plasma. Total of 30 normal individuals were considered as healthy control group. Real time PCR (SYBR Green) technique is used to determine the expression level of studied genes. Results The results of gene expression comparisons showed that the expression level of IL-27, IFN-γ, TNF-α, TNFR2 and IRF7 genes was significantly higher in inactive group in comparison to active group. The expression level of TLR4 was lower in both active and inactive groups in comparison to control group. ROC curve analysis showed that IL-27 and IRF7 are significantly different amongst other studied genes. Finally, the analyses revealed that the expression level of most of the studied genes (except for TNF-α and TLR4) have significant correlation with viral load. Conclusions Our findings revealed that IL-27, IFN-γ, TNF-α, TNFR2 and IRF7 expression level is higher in inactive group and TLR4 expression level is lower in patients’ groups in comparison to control group. Also, ROC curve analysis showed IL-27 and IRF7 can significantly differentiate studied groups (BKV active vs. inactive). Therefore, these results might help elucidating the pattern in charge of BKV reactivation in kidney transplanted patients.

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Early detection of pancreatic ductal adenocarcinoma using abnormal urinary fragmentation ratio of a liver-originated protein.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.4_suppl.214 ◽

2019 ◽

Vol 37 (4_suppl) ◽

pp. 214-214

Author(s):

Motoyasu Kan ◽

Shuichi Mitsunaga ◽

Masafumi Ikeda ◽

Izumi Ohno ◽

Hironobu Tsubouchi ◽

...

Keyword(s):

Roc Curve ◽

Curve Analysis ◽

Control Group ◽

Healthy Controls ◽

Roc Curve Analysis ◽

Protein Fragments ◽

Abnormal Protein ◽

Pdac Tissue ◽

Healthy Control ◽

Fragmentation Ratio

214 Background: Non PDAC tissue-originated proteins are cleaved by proteases derived from PDAC, which can result in abnormal cleavage patterns in the urine of PDAC patients. Urinary proteomic analysis for quantifying the ratios of the abnormal protein fragments to the non-fragmented protein levels in the urine may be useful to distinguish early PDAC from healthy controls. This proof-of-concept study was planned to determine the usefulness of measuring the protein fragments from non PDAC tissue-originated proteins in the urine using the multiple-reaction-monitoring technique (MRM) for discriminating resectable PDAC from healthy controls. Methods: Urinary proteins were digested with trypsin, and resultant peptides were measured by MRM analysis and the ratio of the level of each fragment to the non-fragmented protein level (fragmentation ratio) was calculated. Fragments for which the fragmentation ratios were higher in the PDAC group than those in the healthy group were defined as abnormal protein fragments. The diagnostic capability of each abnormal protein fragment for discriminating cases of PDAC from healthy controls was evaluated by receiver operating characteristic (ROC) curve analysis. Results: A total of 21 patients with resectable PDAC and 30 healthy control subjects were enrolled in this study. All the PDAC patients were treated by pancreatic resection. Urine samples for this study were collected prior to the surgery from the PDAC patients. The non PDAC tissue-originated protein was determined as a liver-originated protein. The fragmentation ratios for six fragments were found to be higher in the PDAC group as compared to those in the healthy control group, and these fragments were determined as abnormal protein fragments. ROC curve analysis was performed for each of the abnormal fragments to determine the areas under the curve (AUCs) for discriminating cases of PDAC from healthy controls. The best AUC was 0.81 (95% CI, 0.68-0.91). Conclusions: The urinary fragmentation ratios showed the ability to discriminate cases of resectable PDAC from a healthy control group; abnormal fragmentation ratios may be promising, noninvasively measurable biomarkers of early PDAC.

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P1376 The utility of platelets indices in predicting the presence of left atrial appendage thrombus in patients with atrial fibrillation

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jez319.810 ◽

2020 ◽

Vol 21 (Supplement_1) ◽

Author(s):

A Vijan ◽

C Delcea ◽

A Andrus ◽

I Daha ◽

G A Dan

Keyword(s):

Atrial Fibrillation ◽

Risk Ratio ◽

Roc Curve ◽

Left Atrial ◽

Left Atrial Appendage ◽

Curve Analysis ◽

Atrial Appendage ◽

Youden Index ◽

Risk Indicator ◽

Roc Curve Analysis

Abstract Background Atrial fibrillation (AF) is the most frequent arrhythmia with a high risk for thromboembolic events. The presence of left atrial appendage (LAA) thrombus is associated with a greater risk for stroke, yet few papers investgated predictor factors for LAA thrombus. Platelets indices-Mean platelet volume (MPV) and plateletcrit (PTC)-have been correlated with platelet reactivity, thrombogenicity and a high cardiovascular risk. Purpose The aim of this study is to determine if MPV-to-PCT and MPV-to-platelet (PLT) ratios could predict the presence of LAA thrombus in nonvalvular AF patients. Methods This retrospective study includes 112 patients screened with trans-esophageal echography (TEE) for LAA thrombus from January 2018 to Aprilie 2019. We excluded patients with manifest, deep vein thrombosis, pulmonary trombembolism and malignancies. The platelets indices were measured on admission. ROC curve analysis and the Youden index associated criterion was used to determine the cut-off values and Chi –square test to estimate associated risks. Results The focus group consisted of 112 AF patients, with a mean age of 67 ± 10.02 and 52.3% males. 71% patients had persistent AF, 19.64% (22) patients had LAA thrombi. Higher MPV-to-PCT, respectively MPV-to-PLT ratios were associated with LAA thrombus. In ROC curve analysis MPV-to-PLT ratio (AUC 0.618 95% CI 0.521 to 0.708, p = 0.0729) and MPV-to-PCT ratio (AUC 0.627, 95% CI 0.530 to 0.716, p = 0.05) predicted LAA thrombi, with a cut-off value of >38 for MPV-to-PCT and >0.049 for MPV-to-PLT ratio. Patients with an MPV-to-PCT ratio > 38 had a risk ratio of 1.21 (95% CI 1.03 - 1.44, p = 0.039) and those with an MPV-to-PLT ratio> 0.049 a risk ratio of 1.27 (95%CI 1.03 - 1.58, p = 0.01 ) of having a LAA thrombus. Conclusion Platelets indices are cost efficient, readily available thrombogenesis biomarkers that could be auxilliary parameters useful for the associtation of LAA thrombi in non-valvular AF patients undergoing TEE before cardioversion. We suggest the cut-off values of MPV-to-PCT> 38 and MPV-to-PLT > 0.049 to be considered as risk indicator.

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Diagnostic and Prognostic Value of IL-6 and sTREM-1 in SIRS and Sepsis in Children

Mediators of Inflammation ◽

10.1155/2020/8201585 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Beata Smok ◽

Krzysztof Domagalski ◽

Małgorzata Pawłowska

Keyword(s):

Roc Curve ◽

Prognostic Value ◽

Curve Analysis ◽

Assay Method ◽

Enzyme Linked Immunosorbent Assay ◽

Control Group ◽

Serum Concentrations ◽

Roc Curve Analysis ◽

Baseline Serum ◽

Diagnostic And Prognostic Value

Purpose. The aim of this study was to evaluate the diagnostic and prognostic value of IL-6 and sTREM-1 in the course of SIRS and sepsis in children with reference to routinely used CRP and PCT. Methods. A prospective study included 180 patients at the ages from 2 months to 18 years hospitalized due to fever from November 2015 to January 2017. Forty-nine children without fever hospitalized due to noninfectious causes formed the control group. IL-6 and sTREM-1 serum concentrations were assessed with the enzyme-linked immunosorbent assay method. Results. The mean serum concentrations of all the analyzed biomarkers were statistically significantly higher in the study group compared to the control group. Mean IL-6, sTREM-1, and PCT serum concentrations were statistically significantly higher in the group of patients with SIRS/sepsis compared to the group of feverish patients without diagnosed SIRS (N-SIRS). Based on the ROC curve analysis, it was shown that of all the biomarkers tested, only two—IL-6 and procalcitonin—had potential usefulness in the diagnosis of SIRS/sepsis in children with fever. Conclusion. Elevated levels of IL-6 and PCT are important risk factors for the development of SIRS/sepsis in children with fever. It seems that elevated IL-6 baseline serum level may predict a more severe course of febrile illness in children, because based on the ROC curve analysis, it was found that IL-6 is a statistically significant prognostic marker of prolonged fever≥3 days and prolonged hospitalization>10 days. The assessment of the usefulness of sTREM-1 in the diagnosis of SIRS/sepsis in feverish children requires further research.

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The Role of Serum IL-1β in Combination with Fractional Exhaled Nitric Oxide in the Diagnosis of Adult Bronchial Asthma

NeuroQuantology ◽

10.14704/nq.2021.19.8.nq21107 ◽

2021 ◽

Vol 19 (8) ◽

pp. 13-19

Author(s):

Amjed H. Abbas ◽

Muna Abdulridha Rasheed ◽

Hayder Abdul-Amir Al-Hindy ◽

Mazin J. Mousa ◽

Hadeel Abd Ameir Al-Shalah

Keyword(s):

Nitric Oxide ◽

Roc Curve ◽

Exhaled Nitric Oxide ◽

Curve Analysis ◽

Control Group ◽

Fractional Exhaled Nitric Oxide ◽

Roc Curve Analysis ◽

Inferior Margin ◽

Waist Hip Ratio ◽

Lower Accuracy

Background: Asthma is a chronic airway disorder, in which cytokines are probably contributing in the inflammation and in the pathophysiology of the disease. This study aimed to determine the benefit of measurement of FENO and IL-1β in the diagnosis of asthma. Method: The study was conducted in Merjan Medical City and Spiro private clinic in Babylon province in the period from March to June 2019, 127 asthmatic patients were compared with 60 healthy subjects as control group. The age ranged from 10 to 60 years old, fractional exhaled nitric oxide (FENO) test was performed to assess asthma by using (Medisoft® company, Belgium). Body mass index (BMI) was subtracted as weight (kg)/height (m2). Waist circumference/cm (WC) was calculated between the inferior margin of thoracic ribs and midline of the iliac-crest. Hip circumference/cm (HC) was calculated from the broadest hip eminent before the waist/hip ratio (W/H) computed. The FENO measures had classified into low (<25 ppb) or intermediate-high (⩾25 ppb) according to the ‘’American Thoracic Society recommendations’’. Iterleukine-1 beta (IL-1β) was measured in the sera by ELISA technique using Human IL-1β (Interleukin 1-Beta) ELISA Kit from Elabscience®. Results: there was no significant correlation between the levels of FENO and IL-1β with body weight as measured by the way of BMI and waist/hip ratio. There was no correlation between duration of asthma with the levels of FENO and IL-1β. ROC curve analysis of FENO test in BA patients showed significant (p-0.001) high sensitivity (92%) and specificity (90%). However, ROC curve analysis of IL-1β in BA patients revealed non-significant (p-0.53), lower accuracy (56.4%), sensitivity 962%) and specificity (57%) to distinguish BA patients). Conclusion: No relation between obesity and eosinophilic airways inflammation. The measurement of FENO level is more important in assessment of asthma inflammation than IL-1β.

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Side Scatter Level of Main Populations in Peripheral Blood using Flow Cytometry as a Tool for the Screening/Detection of Dysplasia and Its Utility in the Diagnosis of Myelodysplastic Syndromes

Blood ◽

10.1182/blood.v112.11.5091.5091 ◽

2008 ◽

Vol 112 (11) ◽

pp. 5091-5091

Author(s):

Ekaterina Rusanova ◽

Ramon Simon-Lopez

Keyword(s):

Flow Cytometry ◽

Myelodysplastic Syndromes ◽

Roc Curve ◽

Statistical Significance ◽

Area Under The Curve ◽

Curve Analysis ◽

Control Group ◽

Roc Curve Analysis ◽

Significance Level ◽

The Mean

Abstract The myelodysplastic syndromes (MDS) are a group of clonal bone marrow disorders characterized by peripheral cytopenias, ineffective hematopoiesis, and unilineage or multilineage dysplasia. The feature used commonly for the diagnostic of MDS includes several morphological cell characteristics such as the presence of hypogranulation in the neutrophils. We have observed in our daily experience at the Mean Scatter of neutrophils was lower in MDS than in normal cases. We have observed that Lymphocyte scatter is quite constant in normal cases and in the majority of MDS. 11 patients diagnosed with MDS and 16 normal blood donors as a control group were enrolled into this study. The protocol of study included evaluation of blood cell populations by hematological analyzer GenS (BC), smears microscopy and flow cytometry for identification a level of granularity of neutrophils (FC500, BC). We created a single tube protocol for immunophenotyping of blood cells by multiparametric flow cytometry using a panel of monoclonal antibodies: CD14-FITC, CD16-PE, CD33-PC5 and CD45-PC7 (BC). We isolated the neutrophil and the lymphocyte populations by subsequent gating steps according to FS/SS, CD45/SS, CD45/CD16 and CD33/CD14. After gating, we measured the Mean Side Scatter in lymphocytes and neutrophils. In order to standardize the NE Mean Scatter we used also a ratio that was calculated by dividing the Neutrophil Mean Scatter by Lymphocyte Mean Scatter. Descriptive Statistics Mean Scatter n Mean SD Median Normals 16 633.6 99.7 612 MDS 11 564.4 83.1 543 Comparative Statistics Normals vs MDS T-test Mean differences ROC AUC ROC cut-off sensitivity specificity sign. ROC Mean NE Scatter 0.071 69.11 0.685 <=543 54.5 87.5 0.0732 Ratio NES/LYS 0.016 2.175 0.824 <=8.34 81.82 81.25 0.0001 The results show the consistent differences between the Neutrophil Mean Scatter in the MDS group compared with the normals with a p =0.07 near the level of statistical significance. The Ratio between Mean Scatter of Neutrophils and the Mean Scatter of Lymphocytes (Ratio NE S/LY S) was significantly lower in MDS than in the group of normals (p=0.016). The ROC Curve analysis using the Neutrophil Mean Scatter to detect/flag MDS showed an acceptable area under the curve AUC=0.685 (significance level 0.073) with a cut-off of <=533 we obtain a sensitivity of 54.5% with a specificity of 87.5%. The ROC Curve analysis using the Ratio NE S/LY S to detect/flag MDS have shown a good area under the curve AUC=0.824 (significance level 0.0001) with a cut-off of <=8.34 we obtain a sensitivity of 81.8% with a specificity of 81.2%. The fact about hypogranularity of the neutrophils is a well known feature of MDS. Using the Neutrophil Mean Scatter and the Ratio between Mean Scatter of Neutrophils and the Mean Scatter of Lymphocytes may be useful tool to detect or flag the neutrophil hypogranularity and will permit to help in the differential diagnosis of MDS. These data are numerical, quantitative and objective. It will be necessary to increase the number of cases (MDS) and to include other hematologic malignancies in order to see the specificity of this findings compared with other diseases.

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An overview of procalcitonin in Crimean-Congo hemorrhagic fever: clinical diagnosis, follow-up, prognosis and survival rates

Turkish Journal of Biochemistry ◽

10.1515/tjb-2020-0001 ◽

2020 ◽

Vol 45 (5) ◽

pp. 593-600

Author(s):

Nahide Ekici-Günay ◽

Serhat Koyuncu

Keyword(s):

Roc Curve ◽

Survival Rates ◽

Hemorrhagic Fever ◽

Curve Analysis ◽

Control Group ◽

Operating Characteristics ◽

Roc Curve Analysis ◽

Crimean Congo Hemorrhagic Fever ◽

Diagnostic Threshold

AbstractObjectivesThis study investigates whether a diagnostic threshold value of procalcitonin exists in Crimean-Congo hemorrhagic fever (CCHF), while also determining the correlation between serum procalcitonin and routine diagnostic laboratory markers, monitoring changes in procalcitonin levels over time during hospitalization, and exploring the effect of procalcitonin levels on survival rates.MethodsA total of 161 patients, including 100 with laboratory-confirmed diagnosis of CCHF and 61 as a control group, were retrospectively investigated. Receiver operating characteristics (ROC) curve analysis was performed to evaluate the contribution of procalcitonin when diagnosing the onset in CCHF patients. Procalcitonin levels were measured with Diazyme latex-enhanced immunoturbidimetric method in Roche Cobas C501 analyzer. A Mann–Whitney U-test was applied to compare the groups, a Mantel–Haenszel (log-rank) test was used to calculate for graphic of original individual patient time-to-event data, and a Kaplan–Meier survival curve was plotted.ResultsA ROC curve analysis identified a best predictive procalcitonin level cut-off point of 0.560 μg/L, with a specificity of 97% and sensitivity of 27% for CCHF. The highest levels of procalcitonin were measured on day 2 during the follow-up throughout and on the 5th day peaked for a second time, lower than the first.ConclusionsProcalcitonin may serve as prognostic indicator and an auxiliary biomarker to rule out of CCHF.

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Acute heart failure: predicting early in-hospital outcomes

European Journal of Preventive Cardiology ◽

10.1093/eurjpc/zwab061.019 ◽

2021 ◽

Vol 28 (Supplement_1) ◽

Author(s):

M Santos ◽

S Paula ◽

I Almeida ◽

H Santos ◽

H Miranda ◽

...

Keyword(s):

Heart Failure ◽

Logistic Regression ◽

Acute Heart Failure ◽

Roc Curve ◽

Real Life ◽

Study Data ◽

Curve Analysis ◽

Older Age ◽

Invasive Ventilation ◽

Roc Curve Analysis

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Patients (P) with acute heart failure (AHF) are a heterogeneous population. Risk stratification at admission may help predict in-hospital complications and needs. The Get With The Guidelines Heart Failure score (GWTG-HF) predicts in-hospital mortality (M) of P admitted with AHF. ACTION ICU score is validated to estimate the risk of complications requiring ICU care in non-ST elevation acute coronary syndromes. Objective To validate ACTION-ICU score in AHF and to compare ACTION-ICU to GWTG-HF as predictors of in-hospital M (IHM), early M [1-month mortality (1mM)] and 1-month readmission (1mRA), using real-life data. Methods Based on a single-center retrospective study, data collected from P admitted in the Cardiology department with AHF between 2010 and 2017. P without data on previous cardiovascular history or uncompleted clinical data were excluded. Statistical analysis used chi-square, non-parametric tests, logistic regression analysis and ROC curve analysis. Results Among the 300 P admitted with AHF included, mean age was 67.4 ± 12.6 years old and 72.7% were male. Systolic blood pressure (SBP) was 131.2 ± 37.0mmHg, glomerular filtration rate (GFR) was 57.1 ± 23.5ml/min. 35.3% were admitted in Killip-Kimball class (KKC) 4. ACTION-ICU score was 10.4 ± 2.3 and GWTG-HF was 41.7 ± 9.6. Inotropes’ usage was necessary in 32.7% of the P, 11.3% of the P needed non-invasive ventilation (NIV), 8% needed invasive ventilation (IV). IHM rate was 5% and 1mM was 8%. 6.3% of the P were readmitted 1 month after discharge. Older age (p < 0.001), lower SBP (p = 0,035) and need of inotropes (p < 0.001) were predictors of IHM in our population. As expected, patients presenting in KKC 4 had higher IHM (OR 8.13, p < 0.001). Older age (OR 1.06, p = 0.002, CI 1.02-1.10), lower SBP (OR 1.01, p = 0.05, CI 1.00-1.02) and lower left ventricle ejection fraction (LVEF) (OR 1.06, p < 0.001, CI 1.03-1.09) were predictors of need of NIV. None of the variables were predictive of IV. LVEF (OR 0.924, p < 0.001, CI 0.899-0.949), lower SBP (OR 0.80, p < 0.001, CI 0.971-0.988), higher urea (OR 1.01, p < 0.001, CI 1.005-1.018) and lower sodium (OR 0.92, p = 0.002, CI 0.873-0.971) were predictors of inotropes’ usage. Logistic regression showed that GWTG-HF predicted IHM (OR 1.12, p < 0.001, CI 1.05-1.19), 1mM (OR 1.10, p = 1.10, CI 1.04-1.16) and inotropes’s usage (OR 1.06, p < 0.001, CI 1.03-1.10), however it was not predictive of 1mRA, need of IV or NIV. Similarly, ACTION-ICU predicted IHM (OR 1.51, p = 0.02, CI 1.158-1.977), 1mM (OR 1.45, p = 0.002, CI 1.15-1.81) and inotropes’ usage (OR 1.22, p = 0.002, CI 1.08-1.39), but not 1mRA, the need of IV or NIV. ROC curve analysis revealed that GWTG-HF score performed better than ACTION-ICU regarding IHM (AUC 0.774, CI 0.46-0-90 vs AUC 0.731, CI 0.59-0.88) and 1mM (AUC 0.727, CI 0.60-0.85 vs AUC 0.707, CI 0.58-0.84). Conclusion In our population, both scores were able to predict IHM, 1mM and inotropes’s usage.

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Presepsin values and prognostic nutritional index predict mortality in intensive care unit patients with sepsis: a pilot study

BMC Research Notes ◽

10.1186/s13104-021-05659-9 ◽

2021 ◽

Vol 14 (1) ◽

Author(s):

Yuichiro Shimoyama ◽

Osamu Umegaki ◽

Noriko Kadono ◽

Toshiaki Minami

Keyword(s):

Multivariate Analysis ◽

Roc Curve ◽

Operating Characteristic ◽

Prognostic Nutritional Index ◽

Early Mortality ◽

Curve Analysis ◽

Rank Test ◽

Roc Curve Analysis ◽

Log Rank Test ◽

Nutritional Index

Abstract Objective Sepsis is a major cause of mortality for critically ill patients. This study aimed to determine whether presepsin values can predict mortality in patients with sepsis. Results Receiver operating characteristic (ROC) curve analysis, Log-rank test, and multivariate analysis identified presepsin values and Prognostic Nutritional Index as predictors of mortality in sepsis patients. Presepsin value on Day 1 was a predictor of early mortality, i.e., death within 7 days of ICU admission; ROC curve analysis revealed an AUC of 0.84, sensitivity of 89%, and specificity of 77%; and multivariate analysis showed an OR of 1.0007, with a 95%CI of 1.0001–1.0013 (p = 0.0320).

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Soluble cytotoxic T-lymphocyte–associated antigen 4 (sCTLA-4) as a potential biomarker for diagnosis and evaluation of the prognosis in Glioma

BMC Immunology ◽

10.1186/s12865-021-00422-y ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Jiajia Liu ◽

Xiaoyi Tian ◽

Yan Wang ◽

Xixiong Kang ◽

Wenqi Song

Keyword(s):

T Lymphocyte ◽

Roc Curve ◽

Cytotoxic T Lymphocyte ◽

Tumor Grade ◽

Curve Analysis ◽

Enzyme Linked Immunosorbent Assay ◽

Low Grade ◽

High Grade ◽

Healthy Individuals ◽

Roc Curve Analysis

Abstract Background The cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) is widely considered as a pivotal immune checkpoint molecule to suppress antitumor immunity. However, the significance of soluble CTLA-4 (sCTLA-4) remains unclear in the patients with brain glioma. Here we aimed to investigate the significance of serum sCTLA-4 levels as a noninvasive biomarker for diagnosis and evaluation of the prognosis in glioma patients. Methods In this study, the levels of sCTLA-4 in serum from 50 patients diagnosed with different grade gliomas including preoperative and postoperative, and 50 healthy individuals were measured by an enzyme-linked immunosorbent assay (ELISA). And then ROC curve analysis and survival analyses were performed to explore the clinical significance of sCTLA-4. Results Serum sCTLA-4 levels were significantly increased in patients with glioma compared to that of healthy individuals, and which was also positively correlated with the tumor grade. ROC curve analysis showed that the best cutoff value for sCTLA-4 for glioma is 112.1 pg/ml, as well as the sensitivity and specificity with 82.0 and 78.0%, respectively, and a cut-off value of 220.43 pg/ml was best distinguished in patients between low-grade glioma group and high-grade glioma group with sensitivity 73.1% and specificity 79.2%. Survival analysis revealed that the patients with high sCTLA-4 levels (> 189.64 pg/ml) had shorter progression-free survival (PFS) compared to those with low sCTLA-4 levels (≤189.64 pg/ml). In the univariate analysis, elder, high-grade tumor, high sCTLA-4 levels and high Ki-67 index were significantly associated with shorter PFS. In the multivariate analysis, sCTLA-4 levels and tumor grade remained an independent prognostic factor. Conclusion These findings indicated that serum sCTLA-4 levels play a critical role in the pathogenesis and development of glioma, which might become a valuable predictive biomarker for supplementary diagnosis and evaluation of the progress and prognosis in glioma.

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