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2021 ◽  
Vol 21 (1) ◽  
Efsun Somay ◽  
Busra Yilmaz

Abstract Background The systemic immune-inflammation index (SII) has been demonstrated to be a valid biomarker of a patient's immunological and inflammatory state, with the ability to accurately predict outcomes in a variety of disease conditions. In the absence of comparable studies, we intended to examine the relevance of pretreatment SII in predicting the success rates of temporomandibular joint arthrocentesis (TMJA) at 1-week, 1-month, and 6-month periods, defined as maximum mouth opening (MMO) > 35 mm and VAS ≤ 3. Methods A sum of 136 patients with disc displacement without reduction (DDwo-red) who underwent TMJA was included. For each patient, pre-TMJA SII was calculated as; SII = Platelets × neutrophils/lymphocytes. Additionally, baseline MMO and VAS measurements were recorded for each patient. The success criteria of TMJA included MMO > 35 mm and VAS ≤ 3. The optimal pre-TMJA SII cutoff that predicts TMJA success was determined using receiver operating characteristic (ROC) curve analysis. The primary endpoint was the link between the pre-treatment SII and TMJA success (simultaneous achievement of MMO > 35 mm and VAS ≤ 3). Results The median pre-TMJA jaw locking duration, maximum mouth opening (MMO), and visual analog score (VAS) were 7 days, 24 mm, and 8, respectively. The overall TMJA success rates were determined as 80.1%, 91.9%, and 69.1% at 1-week, 1-month, and 6-months, respectively. The results of ROC curve analysis exhibited the optimal SII cutoff at 526 (AUC: 67.4%; sensitivity: 66.7%; specificity: 64.2%) that grouped the patients into two subgroups: Group 1: SII ≤ 526 (N = 81) and SII > 526 (N = 55), respectively. Spearman correlation analysis revealed a strong inverse relationship between the pretreatment SII values and the success of TMJA 1-week (rs: − 0.83; P = 0.008) and 1-month, (rs: − 0.89; P = 0.03). Comparative analyses displayed that TMJA success rates at 1-week (87.7% vs. 69.1%; P = 0.008) and 1-month (96.2% vs. 80%; P = 0.03) were significantly higher in the SII ≤ 526 than SII > 526 group, respectively, while the 6-month results favored the SII ≤ 526 group with a trend approaching significance (P = 0.084). Conclusion The current study's findings suggested the SII as a unique independent prognostic biomarker that accurately predicts treatment outcomes for up to 6 months. Trial registration The results of this research were retrospectively registered.

Caner Ediz ◽  
Serkan Akan ◽  
Neslihan Kaya Terzi ◽  
Aysenur Ihvan

IntroductionThis study aimed to discuss the necessity of a second prostate biopsy in patients with atypical small acinar proliferation (ASAP) and to develop a scoring system and risk table to be used as new criteria for a second biopsy.Material and methodsThe study reviewed the data of 2,845 patients; who underwent transrectal ultrasonography-guided prostate biopsy in the period between January 2008 and May 2019. A total of 128 patients with ASAP were included in the study. The tPSA, fPSA, f/tPSA, and PSA-Density levels before the first and second biopsies and changes in the measured levels between the values obtained before the first and the second biopsies were recorded. “ASAP Scoring System and risk table” (ASS-RT) was evaluated before the second biopsy.ResultsThe mean age of 128 patients with ASAP was 62.9±7.8 years. The ASS-RT scores of prostate cancer patients were significantly higher compared to patients without prostate cancer (p: 0.001). In the ROC curve analysis of ASS-RT, the area under the curve was 0.804 and the standard error was 0.04. The area under the ROC curve was significantly higher than 0.5 (p:0.001). The cut-off point of ASS-RT scores in diagnosing cancer was ≥ 7 with 60.8% sensitivity and 80.5% specificityConclusionsThe cut-off value of 7 determined for the ASS-RT score in this study suggests that patients with ASS-RT scores of ≥7 should undergo a second prostate biopsy. We think that there may be no need for a second biopsy if the ASS-RT score is <7, especially for low-risk patients.

Trauma ◽  
2021 ◽  
pp. 146040862110501
Yunfei Qiu ◽  
Mark Fitzgerald ◽  
Biswadev Mitra

Introduction The neutrophil-to-lymphocyte ratio (NLR) has been proposed as a marker of systemic inflammation in major trauma patients that is associated with in-hospital mortality. We aimed to determine the discriminative ability of initial NLR as a predictor of outcomes following major trauma. Methods This was a registry-based cohort study involving all major trauma patients meeting criteria for inclusion into the Alfred Health Trauma Registry who presented directly from the scene of injury over a 24-month period (January 2018 to December 2019). The initial NLR was calculated for each patient and was compared against the Shock Index (SI), lactate and Revised Trauma Score (RTS). Outcomes observed were mortality at hospital discharge and intensive care unit (ICU) admission. We assessed the predictive capacity of each test using the receiver operating characteristic (ROC) curve and performed area under the ROC curve (AUROC) analysis to compare their performance. Results Data were extracted for 1687 major trauma patients, of which 72% were male, the median age was 49 years (IQR 31–68) and most (90%) of patients presented after a blunt mechanism of injury. In-hospital mortality occurred in 165 (9.77%) patients, and 725 (42.92%) patients required ICU admission. The median NLR was 6.84 (IQR 3.89–11.52). Initial NLR performed poorly with an AUROC of 0.46 (95% confidence interval (CI): 0.40–0.52) for prediction of mortality and AUROC of 0.53 (95% CI: 0.50–0.56) for prediction of ICU admission. The AUROCs of initial NLR for both mortality at hospital discharge and ICU admission were significantly lower than SI, lactate and RTS. Conclusion Initial NLR was not predictive of outcomes in major trauma. NLR at other time-points may provide better predictive capacity for outcomes.

2021 ◽  
Yongjie Li ◽  
Min Zeng ◽  
Ting Wang ◽  
Feng Jiang

Abstract Pancreatic cancer is a malignant tumor of digestive system with high fatality rate, and its prognosis is very poor. Type Ⅴ collagen α3 (COL5A3) is highly expressed in a variety of tumor tissues, but its prognostic value and immune infiltration in pancreatic cancer are still unclear. Therefore, we evaluated the prognostic role of COL5A3 in pancreatic cancer and its correlation with immune infiltration. The transcriptional expression profiles of COL5A3 in pancreatic cancer and normal tissues were downloaded from the Cancer Genome Atlas (TCGA). In the GEO (Gene expression omnibus) dataset (GSE16515), we compared the expression of COL5A3 in normal and tumor tissues. The expression of COL5A3 protein was evaluated by the human protein atlas (THPA). The effect of COL5A3 on survival was evaluated by Kaplan-Meier method. Receiver operating characteristic (ROC) curve was used to distinguish pancreatic cancer from paracancerous normal tissues. Protein-protein interaction (PPI) network was constructed by the STRING. Use the "ClusterProfiler" package for functional enrichment analysis. Tumor immune estimation resource (TIMER) and tumor-immune system interaction database (TISIDB) were used to determine the relationship between COL5A3 mRNA expression and immune infiltration. Compared with normal tissues, COL5A3 is highly expressed in pancreatic cancer tissues. The high expression of COL5A3 is related to the poor clinicopathological features and poor prognosis of pancreatic cancer. Kaplan-Meier survival analysis showed that the prognosis of pancreatic cancer patients with high expression of COL5A3 was worse than that of patients with low expression of COL5A3. ROC curve shows that COL5A3 has high sensitivity and specificity in the diagnosis of pancreatic cancer. Correlation analysis showed that the expression of COL5A3 mRNA was related to immune cell infiltration. This study reveals for the first time that COL5A3 may be a new prognostic biomarker related to immune infiltration and provide a new target for the diagnosis and treatment of pancreatic cancer.

2021 ◽  
Vol 11 (1) ◽  
Xiaolei Wang ◽  
Jin Huang ◽  
Yixiang Zheng ◽  
Sisi Long ◽  
Huijun Lin ◽  

AbstractGenome-wide DNA methylation profiling have been used to find maternal CpG sites related to the occurrence of gestational diabetes mellitus (GDM). However, none of these differential sites found has been verified in a larger sample. Here, our aim was to evaluate whether first trimester changes in target CpG sites in the peripheral blood of pregnancy women predict subsequent development of GDM. This nested case–control study was based upon an early pregnancy follow-up cohort (ChiCTR1900020652). Target CpG sites were extracted from related published literature and bioinformatics analysis. The DNA methylation levels at 337 CpG sites of 80 GDM cases and 80 matched healthy controls during the early pregnancy (10–15 weeks) were assessed using MethylTarget sequencing. The best cut-off level for methylation of CpG site was determined using the generated ROC curve. The independent effect of CpG site methylation status on GDM was analyzed using conditional logistic regression. Methylation levels at 6 CpG sites were significantly higher in the GDM group than in controls, whereas those at another 6 CpG sites were significantly lower (FDR < 0.05). The area under the ROC curve at each methylation level of the significant CpG sites ranged between 0.593 and 0.650 for the occurrence of GDM. After adjusting for possible confounders, the hypermethylation status of CpG site 68167324 (OR = 3.168, 1.038–9.666) and 24837915 (OR = 5.232, 1.659–16.506) was identified as more strongly associated with GDM; meanwhile, the hypermethylation of CpG site 157130156 (OR = 0.361, 0.135–0.966) and 89438648 (OR = 0.206, 0.065–0.655) might indicate lower risk of GDM. The methylation status of target CpG sites in the peripheral blood of pregnant women during the first trimester may be associated with GDM pathogenesis, and has potential as a predictor of GDM.

HNO ◽  
2021 ◽  
Michaela Plath ◽  
Matthias Sand ◽  
Philipp S. van de Weyer ◽  
Kilian Baierl ◽  
Mark Praetorius ◽  

Zusammenfassung Hintergrund Der Nijmegen Cochlear Implant Questionnaire (NCIQ) ist ein krankheitsspezifischer Fragebogen zur Erhebung der gesundheitsbezogenen Lebensqualität von Patienten vor und nach Cochleaimplantation. Ziel der Arbeit Validierung und Reliabilitätsprüfung der deutschen Übersetzung des NCIQ. Material und Methoden Es wurde eine prospektive Studie an 100 postlingual ertaubten oder hochgradig schwerhörigen Patienten durchgeführt, welche präoperativ sowie 3 und 6 Monate nach einer Cochleaimplantation mittels NCIQ, Abbreviated Profile of Hearing Aid Benefit (APHAB) und Hearing Participation Scale (HPS) untersucht wurden. Als Kontrolle fungierte ein postlingual ertaubtes oder hochgradig schwerhöriges, unbehandeltes Patientenkollektiv (n = 54). Cronbach‑α und Test-Retest-Reliabilität dienten der Reliabilitätsüberprüfung. Es wurde auf Inhalts‑, Übereinstimmungs- und auf diskriminative Validität getestet. Die Konstruktvaliditätsprüfung basiert auf kürzlich veröffentlichen Daten. Als Gütekriterien wurden die Sensitivität und eine ROC(„Receiver Operating Characteristic“)-Analyse, inklusive AUC(„Area Under the ROC Curve“)-Betrachtung, eingesetzt. Ergebnisse Das Test-Retesting ergab nach 3 und 6 Monaten postoperativ stabile NCIQ-Werte. Die Cronbach-α-Werte wiesen auf eine gute interne Konsistenz hin. Der NCIQ diskriminierte valide zwischen behandelten und unbehandelten Patientengruppen. Es ergaben sich statistisch signifikante, wenn auch schwache, Korrelationen zwischen dem NCIQ und dem APHAB (r = −0,22; p = 0,04) und dem HPS (r = 0,30; p = 0,01). Sensitivitäts- und ROC-Analysen zeigten eine gute Messqualität des deutschsprachigen NCIQ. Schlussfolgerung Die deutsche Übersetzung des NCIQ misst zuverlässig und valide die Lebensqualität vor und nach Cochleaimplantation und kann zur klinischen Erfolgskontrolle nach Cochleaimplantationen verwendet werden.

2021 ◽  
Yuanshan Cui ◽  
Zhongbao Zhou ◽  
Yumeng Chai ◽  
Yong Zhang

Abstract Background: Gasdermin B (GSDMB) is part of the gasdermin (GSDM) family and they use varying means of domain interactions in molecules to adjust their pore-forming and lipid-binding actions. The GSDM family has roles in the regulation of cell differentiation and proliferation, particularly in the process of pyroptosis. Nonetheless, the correlation of GSDMB with immune infiltrates and its prognostic values in Clear Cell Renal Cell Carcinoma (ccRCC) are still undefined. Therefore, we assessed the correlation of GSDMB with immune infiltrates and its prognostic role in ccRCC. Methods: The transcriptional expression profiles of GSDMB in ccRCC tissues in addition to normal tissues were retrieved from the Cancer Genome Atlas (TCGA), and additionally verified in a different independent cohort, which was obtained from the gene expression omnibus (GEO) database. The Human Protein Atlas and the Clinical Proteomic Tumor Analysis Consortium (CPTAC) were accessed to assess the protein expression of GSDMB. To differentiate between ccRCC and surrounding normal tissues, the receiver operating characteristic (ROC) curve was applied. Relationships between GSDMB expression, clinicopathologicical variables, and overall survival (OS) were evaluated with multivariate methods as well as Kaplan-Meier survival curves. Protein-protein interaction (PPI) networks were created with String. Functional enrichment analyses were conducted by utilizing the “ClusterProfiler” package. The tumor immune estimation resource (TIMER) and tumor-immune system interaction database (TISIDB) were utilized to determine the association between the mRNA expression of GSDMB and immune infiltrates. Results: GSDMB expression was significantly more up regulated in ccRCC tissues compared to surrounding normal tissues. An increase in the mRNA expression of GSDMB was related to high pathologic stage and advanced TNM stage. The analysis of the ROC curve indicated that GSDMB had an AUC value of 0.820 to distinguish between ccRCC tissues and adjacent normal controls. Kaplan-Meier survival analysis indicated that ccRCC patients with high-GSDMB had a poorer prognosis compared to those with low-GSDMB (P < 0.001). Correlation analysis showed that the mRNA expression of GSDMB was associated with immune infiltrates and the purity of the tumor. Upregulation of GSDMB is significantly related to immune infiltrates and poor survival in ccRCC. Conclusions: The results of this study indicates that GSDMB could be regarded as a biomarker for the detection of poor prognosis and potential target of immune treatment in ccRCC.

2021 ◽  
Vol 12 ◽  
Chao Sun ◽  
Xin Zheng ◽  
Yingxin Sun ◽  
Ju Yu ◽  
Minfeng Sheng ◽  

N6-methyladenosine (m6A) RNA modification can alter gene expression and function by regulating RNA splicing, stability, translocation, and translation. It is involved in various types of cancer. However, its role in gliomas is not well known. This study aimed to determine the prognostic value of the m6A RNA methylation regulator in gliomas and investigate the underlying mechanisms of the aberrant expression of m6A-related genes.mRNA expression profiles and clinical information of 448 glioma samples were obtained from The Cancer Genome Atlas and cBioportal. The expression of m6A-related genes in normal controls and low-grade glioma and glioblastoma was obtained from Gene Expression Profiling Interactive Analysis. Further, m6A-related gene expression and its relationship with prognosis were obtained through The Chinese Glioma Genome Atlas (CGGA). Multivariate Cox regression analyses were performed, and a nomogram was built with potential risk factors based on a multivariate Cox analysis to predict survival probability. Online tools such as Gene Set Enrichment Analysis, STRING, Cytoscape, and Molecular Complex Detection were applied for bioinformatics analysis and to investigate the underlying mechanisms of the aberrant expression of m6A-related genes. The multivariate Cox regression analysis found that higher expression levels of YTHDC2 and insulin-like growth factor 2 mRNA-binding protein 3 (IGF2BP3, also called IMP3) were independent negative and positive prognostic factors for overall survival (OS), respectively. Data from the CGGA database showed that IGF2BP3 expression increased when the tumor grade increased. Receiver operating characteristic (ROC) curve was used to evaluate the predictive specificity and sensitivity. The area under the ROC curve indicated that the OS prediction was 0.92 (1-year) and 0.917 (3-years), indicating that m6A-related genes could predict patient survival. In addition, IGF2BP3 was closely related to the shorter survival period of patients. Copy number variation and DNA methylation, but not somatic mutations, might contribute to the abnormal upregulation of IGF2BP3 in gliomas. Significantly altered genes were identified, and the protein–protein interaction network was constructed. Based on the data presented, our study identified several m6A-related genes, especially IGF2BP3, that could be potential prognostic biomarkers of gliomas. The study unveiled the potential regulatory mechanism of IGF2BP3 in gliomas.

2021 ◽  
Baishun Ma ◽  
Pu Wang

Abstract Background: PANK1 is expressed in some cancer types, but its role in clear cell renal carcinoma (ccRCC) is unclear. We aimed to demonstrate the relationship between PANK1 and ccRCC based on a cancer genomic atlas (TCGA) database.Methods: The Kruskal-Wallis test, Wilcoxon signed rank test and logistic regression were used to analyze the relationship between the clinical pathological characteristics of ccRCC and the expression of PANK1. The ROC curve was used to describe the prognostic value of PANK1 using area under curve (AUC) scores. Kaplan-Meier method and Cox regression analysis were used to evaluate the factors affecting the prognosis of ccRCC. Gene set enrichment analysis (GSEA) and immuno-infiltration analysis were performed to identify a significantly related function of PANK1.Results: PANK1 expression in renal clear cell carcinoma was different from that in stage N (P=1.3E-03),sex (P=5.1E-07),stage M(P=8.3E-04),residual tumor(P<0.001),T stage(T1 vsT4(P=6.5E-03),T1vsT3(P=6.9E-06)), histological grade (G1vsG4(P=3.6E-0.5),G2vsG4(P=2.1E-10),G3vsG4(P=1.7E-05)),pathologic stage(STAGE 1vs.STAGE4(P=1.4E-05),STAGE1vs.STAGE3(P=7.1E-05)). The ROC curve suggest that PANK1 has significant diagnostic and prognostic capabilities (AUC =0.898). Low expression of PANK1 predicted poor overall survival (OS) (P<0.001), while that of PANK1 (HR:0.398; 95% CI:0.248-0.639; P<0.001) is OS-independent predictor in patients with ccRCC. GSEA and immune infiltration analysis showed that the expression of PANK1 is related to extracellular matrix receptor pathway, signaling pathway related to hypertrophic cardiomyopathy, cytokine-cytokine receptor interaction pathway, as well as complement and coagulation cascade pathway.Conclusion: PANK1 expression is significantly associated with poor survival and immune infiltration of ccRCC, which may be a promising prognostic biomarker for ccRCC.

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Yoshitaka Sekine ◽  
Kazuhiko Kotani ◽  
Daisuke Oka ◽  
Hiroshi Nakayama ◽  
Yoshiyuki Miyazawa ◽  

Abstract Background Recently, presepsin has been reported to be a useful biomarker for early diagnosis of sepsis and evaluation of prognosis in septic patients. However, few reports have evaluated its usefulness in patients with urinary tract infections (UTI). This study aimed to evaluate whether presepsin could be a valuable marker for detecting severe sepsis, and whether it could predict the therapeutic course in patients with UTI compared with markers already used: procalcitonin (PCT) and C-reactive protein (CRP). Methods From April 2014 to December 2016, a total of 50 patients with urinary tract infections admitted to Gunma university hospital were enrolled in this study. Vital signs, presepsin, PCT, CRP, white blood cell (WBC) count, causative agents of urinary-tract infections, and other data were evaluated on the enrollment, third, and fifth days. The patients were divided into two groups: with (n = 11) or without (n = 39) septic shock on the enrollment day, and with (n = 7) or without (n = 43) sepsis on the fifth day, respectively. Presepsin was evaluated as a biomarker for systemic inflammatory response syndrome (SIRS) or septic shock. Results Regarding the enrollment day, there was no significant difference of presepsin between the SIRS and non-SIRS groups (p = 0.276). The median value of presepsin (pg/mL) was significantly higher in the septic shock group (p < 0.001). Multivariate logistic regression analysis showed that presepsin (≥ 500 pg/ml) was an independent risk factor for septic shock (p = 0.007). ROC curve for diagnosing septic shock indicated an area under the curve (AUC) of 0.881 for presepsin (vs. 0.690, 0.583, and 0.527 for PCT, CRP and WBC, respectively). Regarding the 5th day after admission, the median presepsin value on the enrollment day was significantly higher in the SIRS groups than in the non-SIRS groups (p = 0.006). On the other hand, PCT (≥ 2 ng/ml) on the enrollment day was an independent risk factor for SIRS. ROC curve for diagnosing sepsis on the fifth day indicated an AUC of 0.837 for PCT (vs. 0.817, 0.811, and 0.802 for presepsin, CRP, and WBC, respectively). Conclusions This study showed that presepsin may be a good marker for diagnosing septic shock based on admission data in patients with UTI.

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