scholarly journals Brain Metastases in Lung Cancer Patients: Clinical Potential Risk Factors of CYFRA21-1 and CEA

2021 ◽  
Author(s):  
Jing Tang ◽  
Tie Sun ◽  
Qian-Min Ge ◽  
Rong-Bin Liang ◽  
Ting Su ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lung Cancer ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Brain Metastasis ◽  
Brain Metastases ◽  
Cancer Patients ◽  
Binary Logistic Regression ◽  
Binary Logistic Regression Analysis ◽  
Lung Cancer Patients

Abstract Background At present, little is known about the specific risk factors of brain metastasis in patients with lung cancer. This study aims to explore the risk factors of brain metastasis. Methods From April 1999 to July 2017, a total of 1,615 lung cancer patients were included in this retrospective study. The patients were divided into two groups, namely brain metastasis group and non-brain metastasis group. Student's t test, non-parametric rank sum test and chi-square test were used to describe whether there is a significant difference between the two groups. We compared the serum biomarkers of the two groups of patients, including alkaline phosphatase (ALP), Calcium, calcium hemoglobin (HB), alpha fetoprotein (AFP), cancer embryonic antigen (CEA), CA-125, CA-199, CA- 153, CA-724, cytokeratin fragment 19 (CYFRA 21 − 1), total prostate specific antigen (TPSA), squamous cell carcinoma antigen (SCC-Ag) ,and neuron specific enolase (NSE). Binary logistic regression analysis was used to determine its risk factors, and receiver operating curve (ROC) analysis was used to evaluate its diagnostic value for brain metastases in patients with lung cancer. Results In the analysis of brain metastases in patients with lung cancer, binary logistic regression analysis showed that CYFRA21-1 and CEA are independent risk factors for brain metastases in patients with lung cancer (both P < 0.001). The sensitivity and specificity of diagnosing brain metastasis were CYFRA21-1, 38.0% and 87.4%, respectively; CEA was 39.7% and 79.3%, respectively. Conclusion Serum CYFRA21-1 and CEA have predictive value in the diagnosis of brain metastases in patients with lung cancer.

Risk Factors, Prognosis and A New Nomogram for Predicting Cancer-Specific Survival Among Lung Cancer Patients with Brain Metastasis: A Retrospective Study Based on SEER

2021 ◽  
Author(s):  
Guihong Zhang ◽  
Yue Jiao Liu ◽  
Ming De Ji
Keyword(s):  
Risk Factors ◽  
Lung Cancer ◽  
Prognostic Factors ◽  
Brain Metastasis ◽  
Cancer Patients ◽  
Primary Site ◽  
Histological Type ◽  
Extracranial Metastasis ◽  
Cancer Specific Survival ◽  
Lung Cancer Patients

Abstract Purpose: A comprehensive population-based study on risk and prognostic factors of lung cancer with brain metastasis is lacking. Methods: 95191 patients diagnosed with lung cancer between 2010 and 2017 were collected from the Surveillance, Epidemiology and End Results (SEER) database. Patients were stratified by different variables. Multivariable logistic and Cox regression were applied to analyze the risk and prognostic factors of brain metastasis among lung cancer patients, respectively. The Fine and Gray’s competing risk regression model was performed to obtain prognostic factors associated with cancer-specific mortality.Results: Among the 95191 patients diagnosed with lung cancer, 10765 patients have brain metastasis, with a metastatic incidence of 11.31%. The primary site of tumor, residence type, age, histological type, race and extracranial metastasis were all independent risk factors of brain metastasis. Compared with other histological types, small cell lung cancer displayed a highest incidence of brain metastasis (16.62%). The median overall survival (OS) among lung cancer patients with brain metastasis was only 6.05 months. The primary site of tumor, median household income, age, histological type, race, gender and extracranial metastasis were all associated with the prognosis of brain metastasis. Patients with squamous cell carcinoma had the worst prognosis, the median OS was only 3.68 months. And our established new nomogram showed a good discriminative ability on predicting the probability of cancer-specific survival among patients with brain metastasis, the C-index was 0.61.Conclusion: Our study provided a deeper insight into the risk factors and prognosis of brain metastasis among lung cancer patients.

Brain metastasis in lung cancer: Are there any predictive risk factors?

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e21740-e21740
Author(s):  
Salma Ait Batahar
Keyword(s):  
Lung Cancer ◽  
Brain Metastasis ◽  
Brain Metastases ◽  
Cancer Patients ◽  
Control Group ◽  
Lung Cancer Patients ◽  
Poorly Differentiated Carcinoma ◽  
Poorly Differentiated ◽  
The Mean ◽  
The Moment

e21740 Background: Lung cancer is the first cause of death by cancer worldwide. Brain metastases in lung cancer are associated to an even poorer prognosis of this cancer. Identifying patients with a higher risk of developing brain cancer may help their prognosis by including systematic brain radiotherapy to their treatment. But what are risk factors of brain metastasis occurrence in lung cancer patients? Methods: To answer this question, we conducted a case control study comparing two groups of lung cancer patients. The cases group included 35 lung cancer patients with brain metastasis at the moment of diagnosis while the control group was made of 49 lung cancer patient with no brain metastasis at the moment of diagnosis. Many parameters were compared between the two groups such as: professional exposure, type and duration of smoking, medical history, clinical and radiological presentation as well as the histological type of the carcinoma. Results: The mean age was 56 for the cases group and 61 for the control group. Nonsmokers represented 14% in the cases group and 4% in the control group. The average smoking was 34 pack-year for the cases group and 31 pack-year for the control group and in both groups 51% of patients smoked a mixture of tobacco and Cannabis. 36% of the control group patients had an exposure to a professional carcinogen while 48% of the cases group patients had one. Digital clubbing was found in 62% of cases group patients and in 51% of the control group patients. 17% of the cases group patients had two more metastases outside the lungs and other than the brain ones while this rate was only 6% for the control group patients. The mean level of LDH (Lactate Dehydrogenase) was 340 U/L for the cases group and 342 U/L for the control group while the CRP (C- reactive protein) one was 78 mg/L for the cases group and 59 mg/L for the control group. The main histological type found in both groups was Adenocarcinoma (25% in the cases group and 18% in the control group) followed by the poorly differentiated carcinoma in the cases group and the squamous cell carcinoma in the control group. Small cell carcinoma was found in 5% of the patients with brain metastases and in 8% of the patients without brain metastases. Conclusions: Patients with brain metastases have a higher professional carcinogens exposure, a higher percentage of nonsmokers, more digital clubbing, and higher CRP levels than patients with no brain metastases. They also have more than one metastasis at the moment of the diagnosis and the predominant histological types are Adenocarcinoma and poorly differentiated carcinoma.

scholarly journals Serum markers change for intraocular metastasis in renal cell carcinoma

2021 ◽  
Author(s):  
Tie Sun ◽  
Jing Tang ◽  
Yi-Cong Pan ◽  
Chen-Yu Yu ◽  
Biao Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Renal Cell Carcinoma ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Risk Factor ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Binary Logistic Regression ◽  
Binary Logistic Regression Analysis ◽  
Intraocular Metastasis

Objective: Intraocular metastasis(IOM) of renal cell carcinoma is rare. In this study, we studied the relationship between different biochemical indicators and the occurrence of IOM in renal cancer patients, and identified the potential risk factors. Methods: A retrospective analysis of the clinical data of 214 patients with renal cell carcinoma from October 2001 to August 2016. Analyze the difference and correlation of various indicators between the two groups with or without IOM, and use binary logistic regression analysis to explore the risk factors of IOM in renal cancer patients. Calculate the diagnostic value of each independent related factor according to the receiver operating curve (ROC). Results: The level of neuron specific enolase （NSE） in renal cell carcinoma patients with IOM was significantly higher than that in patients without IOM (P &lt; 0.05). There was no significant difference in ALP, Hb, serum calcium concentration, AFP, CEA, CA-125 etc. between IOM group and non-intraocular metastasis (NIOM) group (P &gt; 0.05). Binary logistic regression analysis showed that NSE was an independent risk factor for IOM in renal cell carcinoma patients (P &lt; 0.05). ROC curve shows that the factor has high accuracy in predicting IOM, and the area under the curve is 0.774. The cut-off value of NSE was 49.5U/L, the sensitivity was 72.2%, and the specificity was 80.1%. Conclusion：NSE concentration is a risk factor for IOM in patients with renal cell cancer. If the concentration of NSE in the patient's body is ≥49.5U/L, disease monitoring and eye scans should be strengthened.

scholarly journals Changes in Cognitive Function and Risk Factors for Cognitive Impairment of the Elderly in China: 2005–2014

2019 ◽  
Vol 16 (16) ◽  
pp. 2847 ◽  
Author(s):  
Qilin Zhang ◽  
Yanli Wu ◽  
Tiankuo Han ◽  
Erpeng Liu
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Logistic Regression Analysis ◽  
Binary Logistic Regression ◽  
The Elderly ◽  
Binary Logistic Regression Analysis ◽  
Chinese Elderly

Background: The cognitive function of the elderly has become a focus of public health research. Little is known about the changes of cognitive function and the risk factors for cognitive impairment in the Chinese elderly; thus, the purposes of this study are as follows: (1) to describe changes in cognitive function in the Chinese elderly from 2005–2014 and (2) to explore risk factors for cognitive impairment of the Chinese elderly. Design and setting: A total of 2603 participants aged 64 years and above participated in the Chinese Longitudinal Healthy Longevity Survey (CLHLS) and were followed up from 2005 to 2014. Cognitive function and cognitive impairment were assessed using the Chinese version of the Mini-Mental State Examination (MMSE). Binary logistic regression analysis was used to estimate the odds ratio (OR) and 95% confidence intervals (CI) of cognitive impairment. Results: Results revealed that the cognitive function of the Chinese elderly shows diversified changes: deterioration (55.09%), unchanged (17.21%) and improvement (27.70%). In addition, there are significant demographic differences in gender, age, education, marriage and other aspects when it comes to the changes of cognitive function in Chinese elderly. In the binary logistic regression analysis, female, increased age, lower education level, no spouse, less income, worse PWB (psychological well-being), less fresh fruit and vegetable intake, more activities of daily living (ADL) limitations, lower social engagement were significantly associated with higher odds for cognitive impairment. Conclusions: Various interventions should be implemented to maintain cognitive function in Chinese elderly.

scholarly journals Neurofilament Light Chain as A Biomarker for Brain Metastases

Cancers ◽  
2020 ◽  
Vol 12 (10) ◽  
pp. 2852 ◽  
Author(s):  
Anne Winther-Larsen ◽  
Claus Vinter Bødker Hviid ◽  
Peter Meldgaard ◽  
Boe Sandahl Sorensen ◽  
Birgitte Sandfeld-Paulsen
Keyword(s):  
Lung Cancer ◽  
Brain Metastasis ◽  
Brain Metastases ◽  
Cancer Patients ◽  
Single Molecule ◽  
Light Chain ◽  
Neurofilament Light Chain ◽  
Neurofilament Light ◽  
Lung Cancer Patients ◽  
Potential Biomarker

Background: Brain metastases are feared complications in cancer. Treatment by neurosurgical resection and stereotactic radiosurgery are only available when metastatic lesions are limited and early detection is warranted. The neurofilament light chain (NfL) is a sensitive neuron-specific biomarker released following neuronal decay. We explored serum NfL as a biomarker of brain metastases. Methods: Serum was collected from 43 stage IV lung cancer patients with brain metastases and 25 stage I lung cancer patients. Serum was collected at time of cancer diagnosis and at time of brain metastasis diagnosis. In nine patients with brain metastases, additional samples were available between the two time points. NfL was quantified by Single Molecule Array (Simoa)™. Results: The median NfL level was significantly higher in patients with brain metastases than in patients without (35 versus 16 pg/mL, p = 0.001) and separated patients with an area under the curve of 0.77 (0.66–0.89). An increase in NfL could be measured median 3 months (range: 1–5) before the brain metastasis diagnosis. Further, a high level of NfL at time of brain metastasis diagnosis correlated with an inferior survival (hazard ratio: 2.10 (95% confidence interval: 1.11–3.98)). Conclusions: This study implies that NfL could be a potential biomarker of brain metastases.

scholarly journals Asphyxia and Neonatal Respiratory Distress Syndrome Are Independent Predictors of the Non-response to Inhaled Nitric Oxide in the Newborns With PPHN

2021 ◽  
Vol 9 ◽  
Author(s):  
Yuwei Zhao ◽  
Lei Liang ◽  
Guanghui Liu ◽  
Hong Zheng ◽  
Liying Dai ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Risk Factors ◽  
Pulmonary Hypertension ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Distress Syndrome ◽  
Binary Logistic Regression ◽  
Binary Logistic Regression Analysis ◽  
Neonatal Respiratory Distress ◽  
Independent Risk Factors

Aim: Not all the neonates respond with improvement in oxygenation following inhaled nitric oxide treatment (iNO) treatment. The aim of this study was to assess the independent risk factors associated with non-response to iNO during the 2 weeks of postnatal treatment in neonates diagnosed with persistent pulmonary hypertension (PPHN).Materials and Methods: This retrospective cohort study included all newborns with PPHN who received iNO treatment for more than 24 h. Demographic, obstetric, perinatal data and clinical complications were extracted from the hospitalization records. Subjects were divided into two groups according to their response to iNO inspiration during the first 24 h of iNO treatment. No response was defined as an increase in SpO2 &lt; 5% or the inability to sustain saturation levels in the first 24 h of iNO treatment. For descriptive statistics, χ2 and t-test analysis were used to compare categorical and continuous variables between the two groups. To evaluate independent risk factors of non-responsiveness to iNO treatment, binary logistic regression analysis were performed.Results: A total of 75 newborns were included in the study. Sixty-two cases were in the responders group, and 13 cases were in the non-responders group. Univariate analysis showed that asphyxia, neonatal respiratory distress syndrome (NRDS), pulmonary surfactant administration, meconium aspiration syndrome (MAS), the severity of pulmonary hypertension (PH), and high-frequency oscillatory ventilation (HFOV) therapy were the high-risk factors affecting the response to iNO treatment in the newborns with PPHN. The binary logistic regression analysis indicated that asphyxia and NRDS incidence were independent predictors of non-responsiveness to iNO treatment [asphyxia: OR 4.193, 95% CI 1.104–15.927, P = 0.035; NRDS: OR 0.154, 95% CI 0.036–0.647, P = 0.011]. The patients in the non-responders group had shorter iNO inspiration followed by MV duration, supplemental oxygen and hospital stay, and higher mortality. There were no significant differences in IVH, PVL, and BPD between two groups.Conclusion: In the newborns with PPHN, asphyxia and NRDS resulted as the independent risk factors of non-responsiveness to iNO therapy. Asphyxia in the newborns with PPHN is detrimental to the response to iNO treatment, while NRDS is beneficial.

Risk factors of psychological distress and quality of life in lung cancer patients.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e23187-e23187
Author(s):  
Fan Zhang ◽  
Junyan Wang ◽  
Lei Hong ◽  
Yu Xu ◽  
Da Jiang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Lung Cancer ◽  
Logistic Regression ◽  
Psychological Distress ◽  
Cancer Patients ◽  
Life Questionnaire ◽  
Lung Cancer Patients ◽  
Quality Of Life Questionnaire

e23187 Background: Most patients with lung cancer have psychological problems, which has a significant impact on patients' rehabilitation, treatment and quality of life. Through the distress and quality of life assessment, to understand the risk factors of distress, in order to improve the quality of life of lung cancer patients. Methods: The investigation was consisted of 209 lung cancer patients who were treated in Fourth Hospital of Hebei Medical University from February 2014 to December 2015.Patients were assessed through the use of distress thermometer, problem list, quality of life questionnaire. Lung cancer patients were divided into a significant distress group and a non-significant distress group. Chi-square test was used to analyze the relationship between demographic characteristics, disease information and significant distress. Logistic regression analysis was used to analyze risk factors for distress. The Spearman rank correlation was used to analyze the correlation between the significant distress group and each area of the quality of life questionnaire. The test level was significantly different at P< 0.05. Results: The distress of majority lung cancer patients was 0-4 points, 68 cases were significant distress, significant distress rate was 32.5%. Logistic regression showed PS scores, family residence, informed condition were risk factors of significant distress( P< 0.001 < P= 0.035, P= 0.031). Economic problems were the most common cause of psychological distress in lung cancer patients. Other risk factors included the lack of time and energy to take care for the elderly/children, fear, sadness, dizziness and pain. The significant distress of lung cancer patients was negatively correlated with health status, physical function, emotional function, cognitive function, social function, and was positively correlated with symptoms as fatigue, nausea and vomiting, pain, shortness of breath, insomnia, loss of appetite and constipation. Conclusions: The incidence of significant distress in patients with lung cancer is 32.5%. PS score, fully informed, and family residence are the risks of significant distress in patients. The distress of lung cancer patients is significantly related to the quality of life.

scholarly journals High Prevalence of Post-stroke Anxiety in Elderly Patients Following COVID-19 Outbreak

2021 ◽  
Vol 12 ◽  
Author(s):  
Meiling Yao ◽  
Hongjie Li ◽  
Ying Luo ◽  
Ling Li ◽  
Jian Yu
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Ischemic Stroke ◽  
Elderly Patients ◽  
Binary Logistic Regression ◽  
Female Gender ◽  
Binary Logistic Regression Analysis ◽  
Independent Risk Factors ◽  
Cutoff Threshold

Objective: Post-stroke anxiety (PSA) is a common affective disorder in patients with ischemic stroke. The elderly are more susceptible to mental health issues, however, few studies have so far focused on PSA in elderly patients, especially in the context of the COVID-19, causing psychological issues in the general population. The aim of the present study was to assess the prevalence and risk factors of PSA in elderly patients following COVID-19 outbreak.Methods: We retrospectively analyzed 206 elderly inpatients with newly diagnosed acute ischemic stroke in the First Affiliated Hospital, Sun Yat-sen University, from January 2020 to December 2020. Patients were categorized into the PSA group and the non-PSA group based on Hamilton Anxiety Scale scores at admission (within 1 week after stroke onset). Demographic and clinical data, mental state by Mini-Mental State Examination, depression by Hamilton Depression Scales (HAMD), and stroke severity and outcome by National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale were compared between the two groups. Univariate analysis and binary logistic regression analysis were used to analyze risk factors associated with PSA. We determined the cutoff scores for significant predictors of PSA using the area under the curve (AUC) and receiver operating characteristic.Results: Of the 206 stroke patients, 62 (30.1%) developed anxiety. Binary logistic regression analysis showed that female gender [adjusted odds ratio (aOR): 2.288, 95% confidence interval (CI):1.021–5.128, P = 0.044], high NIHSS scores [aOR: 1.264, 95% CI: 1.074–1.486, P = 0.005] and HAMD scores [aOR: 1.345, 95% CI: 1.215–1.490, P &lt; 0.001] were independent risk factors for PSA. The cutoff threshold for the NIHSS scores was 3.5 points with an AUC of 0.64 and the cutoff threshold for HAMD scores was 5.5 points with an AUC of 0.89.Conclusion: Our results showed a high incidence of PSA in elderly patients after the COVID-19 outbreak. Female gender, high NIHSS and HAMD scores were the independent risk factors for PSA.

scholarly journals Effects of Non-intubated Video-Assisted Thoracic Surgery on Patients With Pulmonary Dysfunction

2022 ◽  
Vol 8 ◽  
Author(s):  
Shiyu Deng ◽  
Yanyi Cen ◽  
Long Jiang ◽  
Lan Lan
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Thoracic Surgery ◽  
Binary Logistic Regression ◽  
Binary Logistic Regression Analysis ◽  
Pulmonary Dysfunction ◽  
Video Assisted Thoracic Surgery ◽  
Video Assisted ◽  
Different Types

Background: Non-intubated video-assisted thoracic surgery (NIVATS) can be safely performed in lung volume reduction surgery for patients with severe pulmonary dysfunction. However, there is still no cohort observation on the effects of NIVATS on patients with pulmonary dysfunction undergoing different types of thoracic procedures. This retrospective study aimed to observe the effects of NIVATS for this kind of patients.Methods: Three hundred and twenty-eight patients with moderate to severe obstructive pulmonary dysfunction, who underwent video-assisted thoracic surgery (VATS), were retrospectively collected from June 1st, 2017 to September 30th, 2019. Patients in NIVATS were case-matched with those in intubated video-assisted thoracic surgery (IVATS) by a propensity score-matched analysis. The primary outcome was the comparison of perioperative values, the secondary outcome was the risk factors for postoperative clinical complications (PCP) which were identified by binary logistic regression analysis.Results: After being matched, there were no differences in demographics and preoperative values of pulmonary function between NIVATS and IVATS groups. The duration of surgery and anesthesia had no difference (P = 0.091 and P = 0.467). As for the postoperative recovery, except for the mean intensive care unit (ICU) stay was longer in the IVATS group than in the NIVATS group (P = 0.015), the chest tube removal time and the postoperative hospital stay had no difference (P = 0.394 and P = 0.453), and the incidence of PCP also had no difference (P = 0.121). The binary logistic regression analysis revealed that the history of pulmonary disease, anesthesia method, and surgical location were risk factors of PCP.Conclusion: For patients with pulmonary dysfunction when undergoing different types of thoracic procedures, the NIVATS can be performed as effectively and safely as the IVATS, and can reduce the ICU stay.

Brain metastasis in a series of NSCLC: Egyptian experience.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e18001-e18001
Author(s):  
Salah Eldeen Elmesidy ◽  
Mahmoud Abdelsalam ◽  
Husam Zawam
Keyword(s):  
Lung Cancer ◽  
Brain Metastasis ◽  
Brain Metastases ◽  
Cancer Patients ◽  
Univariate Analysis ◽  
Developing Brain ◽  
Smoking History ◽  
Lung Cancer Patients ◽  
Significant Difference

e18001 Background: Incidence of cerebral metastasis is increasing among lung cancer patients. Many factors have been reported associated with increase risk of brain metastasis. The aim of this retrospective analysis is to investigate the predictive factors for the development of brain metastasis in lung cancer patients. Methods: We retrospectively analyzed histologically proven lung cancer patients radiologically diagnosed of having brain metastases who presented to Kasr Al-Eini Center for Oncology (NEMROCK) in the period from 2004 till 2010, with follow up period of 6 months at least. The following factors were analyzed: age, gender, PS, smoking history, tumor size & grade preceding development of brain metastasis. Results: Our study included 403 patients. 67 patients (16.6%) experienced brain metastasis during the course of their disease. 40 (10%) patients had brain metastasis among other sites of distant spread at first presentation which represent 88.9% of patients presented with metastatic disease. In a median follow-up of 17.1 months (6-77) the time to develop brain metastasis (TTBM) for the whole group was 5 months (range 2-22 months) (95% CI : 4.3-7.7). The most important factor affecting the TTBM was the use of chemotherapy before developing brain metastasis with a median TTBM of 5.9 months (95%CI : 3.2-6.8) among those who received chemotherapy compared to 2 months among the patients who didn't receive chemotherapy (P= <0.0001). The second factor was PS at time of initial diagnosis (P= 0.027). The median OS after brain metastasis was 6 months (95% CI : 4.26-7.74). On univariate analysis, PS and use of chemotherapy after developing brain metastases showed statistically significant difference affecting OS. Conclusions: We concluded that PS as well as use of chemotherapy are the 2 main factors associated with shorter time to develop brain metastasis. PS and use of chemotherapy after developing brain metastases showed longer OS after developing brain metastases. Keywords: NSCLC, Brain metastasis, Egypt

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