scholarly journals Nomograms based on inflammatory biomarkers for predicting tumor grade and micro-vascular invasion in stage I/II hepatocellular carcinoma

2018 ◽  
Vol 38 (6) ◽  
Author(s):  
Peng Li ◽  
Wei Huang ◽  
Feng Wang ◽  
Ye-Fang Ke ◽  
Lin Gao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Roc Curve ◽  
Tumor Size ◽  
Vascular Invasion ◽  
Tumor Volume ◽  
Tumor Grade ◽  
Stage I ◽  
Inflammatory Biomarkers ◽  
Independent Risk Factors

Background: Increasing evidences reveal that inflammation plays a critical role in tumorigenesis and progression. We aimed to develop the nomograms based on inflammatory biomarkers to predict micro-vascular invasion (MVI) and tumor grade in stage I/II hepatocellular carcinoma (HCC). Methods: A retrospective cohort of 627 patients with stage I/II HCC between January 2007 and December 2014 was included in the study. Logistic regression was performed to identify the independent risk factors of tumor grade and MVI. The significant predictors including neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (dNLR), lymphocyte-to-monocyte ratio (LMR), tumor volume age, and tumor size were subsequently incorporated to build the nomograms. The prediction accuracies of the nomograms were evaluated using the area under the receiver operating characteristic (ROC) curve. Results: The independent risk factors for tumor grade were NLR, dNLR, and tumor volume (P<0.001, P=0.001, and P<0.001, respectively), which were assembled into tumor grade nomogram. MVI nomogram was developed by dNLR, LMR, age, and tumor size (P<0.001, P<0.001, P<0.001, and P=0.001, respectively) which were the independent predictors for MVI. The area under the ROC curve of nomograms for predicting tumor grade and MVI were 0.727 (95% confidence intervals [CI]: 0.690–0.761) and 0.839 (95% CI: 0.808–0.867), respectively. Patients who had a nomogram score of less than 100 and 79 were considered to have high possibility of moderate grade and have low risks of MVI presence, respectively. Conclusion: We successfully developed nomograms predicting tumor grade and MVI based on inflammatory biomarkers with high accuracy, leading to a rational therapeutic choice for stage I/II HCC.

scholarly journals Commentary on: Nomograms based on inflammatory biomarkers for predicting tumor grade and microvascular invasion in stage I/II hepatocellular carcinoma

2019 ◽  
Vol 39 (10) ◽  
Author(s):  
Liang Xiao ◽  
Furong Zeng ◽  
Guangtong Deng
Keyword(s):  
Hepatocellular Carcinoma ◽  
Multivariate Analysis ◽  
Tumor Size ◽  
Tumor Grade ◽  
Microvascular Invasion ◽  
Stage I ◽  
Inflammatory Biomarkers ◽  
Independent Dataset ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio

Abstract Some doubts were generated during the reading of nomograms based on inflammatory biomarkers for preoperatively predicting tumor grade and microvascular invasion in stage I/II hepatocellular carcinoma (HCC). We would like to highlight and discuss with authors. First, neutrophil-lymphocyte ratio (NLR) and derived NLR (dNLR) should not be entered into multivariate analysis simultaneously. Second, authors should clarify how the cutoffs of these variables including lymphocyte-monocyte ratio (LMR), dNLR, age and tumor size were set. We insist that the type of variables should be consistent when we carry out the analysis and establish the nomogram. Last, we have to point out that Li et al.’s (Biosci. Rep. (2018), 38) study failed to validate nomograms using an independent dataset.

scholarly journals Reply to: Comments on “Nomograms based on inflammatory biomarkers for predicting tumor grade and micro-vascular invasion in stage I/II hepatocellular carcinoma”

2019 ◽  
Vol 39 (12) ◽  
Author(s):  
Peng Li ◽  
Wei Huang ◽  
Feng Wang ◽  
Ye-Fang Ke ◽  
Lin Gao ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Vascular Invasion ◽  
Cox Regression ◽  
Tumor Grade ◽  
Stage I ◽  
Inflammatory Biomarkers ◽  
Categorical Variables ◽  
Risk Level ◽  
Continuous Variables ◽  
To Receive

Abstract We appreciate to receive commentary from Dr Guangtong Deng and Dr Liang Xiao to our article, “Nomograms based on inflammatory biomarkers for predicting tumor grade and micro-vascular invasion in stage I/II hepatocellular carcinoma”. First, neutrophil-to-lymphocyte ratio (NLR) and derived NLR (dNLR) are two different parameters. Some studies show that NLR is inconsistent with dNRL in prognostic value through multivariate Cox regression, therefore, it is reasonable that both NLR and dNLR entered into multivariate analysis simultaneously. Second, it is common that articles of predictive nomograms turned continuous variables into categorical variables. The reason is that the categorization of patient clinical variables is beneficial to doctors to make decisions based on the risk level of individual patients in clinical. At last, multicenter validation is quite difficult and we have listed the shortcomings in the limitations of our article. Further validation will need the joint efforts by other institutions.

scholarly journals A nomogram based on combining systemic and hepatic inflammation markers for predicting microscopic bile duct tumour thrombus in hepatocellular carcinoma

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jun-Yi Wu ◽  
Ju-Xian Sun ◽  
Jia-Yi Wu ◽  
Xiao-Xiao Huang ◽  
Yan-Nan Bai ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Bile Duct ◽  
Roc Curve ◽  
Critical Role ◽  
Hepatic Inflammation ◽  
Inflammation Markers ◽  
Tumour Thrombus ◽  
Independent Risk Factors ◽  
Glutamyl Transferase

Abstract Background Bile duct invasion is a relatively rare event and is not well characterised in hepatocellular carcinoma (HCC). It remains very difficult to diagnose HCC with bile duct tumour thrombus (BDTT) before surgery. Increasing evidence has revealed that inflammation plays a critical role in tumorigenesis. This study aimed to develop nomograms based on systemic and hepatic inflammation markers to predict microscopic BDTT (micro-BDTT) before surgery in HCC. Methods A total of 723 HCC patients who underwent hepatectomy as initial therapy between January 2012 and June 2020 were included in the study. Logistic regression analysis was used to identify independent risk factors for micro-BDTT. The nomograms were constructed using significant predictors, including α-fetoprotein (AFP), alkaline phosphatase (ALP), direct bilirubin (DB), prognostic nutritional index (PNI), and γ-glutamyl transferase (γ-GT)/alanine aminotransferase (ALT). The prediction accuracies of the nomograms were evaluated using the area under the receiver operating characteristic (ROC) curve. Results AFP, ALP, DB, PNI, and γ-GT/ALT were independent risk factors for predicting micro-BDTT (P = 0.036, P = 0.004, P = 0.013, P = 0.012, and P = 0.006, respectively), which were assembled into the nomograms. The area under the ROC curve of the nomograms combining PNI and γ-GT/ALT for predicting micro-BDTT was 0.804 (95% confidence interval [CI]: 0.730–0.878). The sensitivity and specificity values when used in predicting micro-BDTT before surgery were 0.739 (95% CI: 0.612–0.866) and 0.781 (95% CI: 0.750–0.813), respectively. Conclusions The nomogram based on combining systemic and hepatic inflammation markers is suitable for predicting micro-BDTT before surgery in HCC patients, leading to a rational therapeutic choice for HCC.

scholarly journals Prognostic Significance of Preoperative Serum Uric Acid-to-Lymphocyte Ratio in Hepatocellular Carcinoma Patients Undergoing Postoperative Transarterial Chemoembolization: A Propensity Score-Matching Study

2020 ◽  
Author(s):  
Shan-shan Hu ◽  
Li-heng Liu ◽  
Li-ping Tang
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Uric Acid ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Tumor Size ◽  
Lymphocyte Ratio ◽  
Low Level ◽  
Liver Cancers ◽  
Independent Risk Factors

Abstract BackgroundHepatocellular carcinoma (HCC) accounts for 85%–90% of primary liver cancers and is the seventh most common cancer worldwide. The purpose of this study is to determine an innovative and effective clinical index for prognosis prediction in HCC patients. MethodsA total of 132 patients with HCC were included in this research. A cohort of 72 cases was obtained through propensity score-matching. Patients were divided into high- and low-level groups based on the ratio of preoperative uric acid levels to lymphocytes. The differences in clinical characteristics and survival indicators were compared between the two groups.ResultsThere was a statistical difference between uric acid-to-lymphocyte ratio (ULR) level and tumor size (P < 0.01). Multivariate analysis showed that ULR (P = 0.03) and tumor size (P = 0.03) were independent risk factors for overall survival (OS). ULR (P < 0.04) and diabetes (P = 0.04) were independent risk factors for progression-free survival (PFS) in HCC patients. Further survival analysis of the entire cohort and propensity score-matching cohort showed that the OS and PFS in the high-level ULR group were significantly shorter than those in the low-level ULR group (log-rank P < 0.001). Conclusion This study demonstrated that ULR is a marker of poor prognosis in postoperative HCC patients, while high ULR levels predicted shorter OS and PFS.

scholarly journals A nomogram based on combining systemic and hepatic inflammation markers for predicting microscopic bile duct tumour thrombus in hepatocellular carcinoma

2021 ◽  
Author(s):  
Jun-Yi Wu ◽  
Ju-Xian Sun ◽  
Jia-Yi Wu ◽  
Xiao-Xiao Huang ◽  
Yan-Nan Bai ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Bile Duct ◽  
Roc Curve ◽  
Critical Role ◽  
Hepatic Inflammation ◽  
Inflammation Markers ◽  
Tumour Thrombus ◽  
Independent Risk Factors ◽  
Glutamyl Transferase

Abstract Background: Bile duct invasion is a relatively rare event and is not well characterised in hepatocellular carcinoma (HCC). It remains very difficult to diagnose HCC with bile duct tumour thrombus (BDTT) before surgery. Increasing evidence has revealed that inflammation plays a critical role in tumorigenesis. This study aimed to develop nomograms based on systemic and hepatic inflammation markers to predict microscopic BDTT (micro-BDTT) before surgery in HCC. Methods: A total of 723 HCC patients who underwent hepatectomy as initial therapy between January 2012 and June 2020 were included in the study. Logistic regression analysis was used to identify independent risk factors for micro-BDTT. The nomograms were constructed using significant predictors, including α-fetoprotein (AFP), alkaline phosphatase (ALP), direct bilirubin (DB), prognostic nutritional index (PNI), and γ-glutamyl transferase (γ-GT)/alanine aminotransferase (ALT). The prediction accuracies of the nomograms were evaluated using the area under the receiver operating characteristic (ROC) curve. Results: AFP, ALP, DB, PNI, and γ-GT/ALT were independent risk factors for predicting micro-BDTT (P=0.036, P=0.004, P=0.013, P=0.012, and P=0.006, respectively), which were assembled into the nomograms. The area under the ROC curve of the nomograms combining PNI and γ-GT/ALT for predicting micro-BDTT was 0.804 (95% confidence interval [CI]: 0.730–0.878). The sensitivity and specificity values when used in predicting micro-BDTT before surgery were 0.739 (95% CI: 0.612–0.866) and 0.781 (95% CI: 0.750–0.813), respectively. Conclusions: The nomogram based on combining systemic and hepatic inflammation markers is suitable for predicting micro-BDTT before surgery in HCC patients, leading to a rational therapeutic choice for HCC.

scholarly journals Early and Late Postoperative Seizures in Meningioma Patients and Prediction by a Recent Scoring System

Cancers ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 450
Author(s):  
Peter Baumgarten ◽  
Mana Sarlak ◽  
Daniel Monden ◽  
Andrea Spyrantis ◽  
Simon Bernatz ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Tumor Volume ◽  
Total Risk ◽  
Increased Risk ◽  
Independent Risk Factors ◽  
Temporal Location ◽  
Meningioma Surgery ◽  
Impaired Quality

Seizures are among the most common symptoms of meningioma. This retrospective study sought to identify risk factors for early and late seizures in meningioma patients and to evaluate a modified STAMPE2 score. In 556 patients who underwent meningioma surgery, we correlated different risk factors with the occurrence of postoperative seizures. A modified STAMPE2 score was applied. Risk factors for preoperative seizures were edema (p = 0.039) and temporal location (p = 0.038). For postoperative seizures preoperative tumor size (p < 0.001), sensomotory deficit (p = 0.004) and sphenoid wing location (p = 0.032) were independent risk factors. In terms of postoperative status epilepticus; sphenoid wing location (p = 0.022), tumor volume (p = 0.045) and preoperative seizures (p < 0.001) were independent risk factors. Postoperative seizures lead to a KPS deterioration and thus an impaired quality of life (p < 0.001). Late seizures occurred in 43% of patients with postoperative seizures. The small sub-cohort of patients (2.7%) with a STAMPE2 score of more than six points had a significantly increased risk for seizures (p < 0.001, total risk 70%). We concluded that besides distinct risk factors, high scores of the modified STAMPE2 score could estimate the risk of postoperative seizures. However, it seems not transferable to our cohort

scholarly journals Clinicopathological Characteristics and Prognosis in Endometrial Cancer With Bone Metastasis: A SEER-Based Study of 584 Women

2021 ◽  
Vol 11 ◽  
Author(s):  
Hejia Hu ◽  
Zhan Wang ◽  
Miaofeng Zhang ◽  
Feng Niu ◽  
Qunfei Yu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Endometrial Cancer ◽  
Bone Metastasis ◽  
Brain Metastases ◽  
Systemic Chemotherapy ◽  
Tumor Grade ◽  
Seer Database ◽  
Tumor Subtype ◽  
Local Surgery ◽  
Independent Risk Factors

PurposeBone metastasis from endometrial cancer (EC) is rare and poorly described. The purpose of the present study was to investigate the correlation between the clinically accessible factors and survival time among EC patients with bone metastasis.Patients and MethodsWe retrospectively identified and reviewed EC patients with bone metastasis from 2010 to 2016, based on the Surveillance, Epidemiology and End Results (SEER) database. Univariable and multivariable Cox regressions were applied to evaluate the effects of clinical variables on survival. Kaplan–Meier plots were used to visually demonstrate the correlation between independent risk factors and survival.ResultsClinical data of 584 EC patients with bone metastasis from the SEER database were analyzed. EC patients with bone metastasis experienced extremely poor survival, with 1-year overall survival (OS) and cancer-specific survival (CSS) rates 33.8 and 35.8%, respectively. Variables associated with OS and CSS in the univariable analysis included race, tumor grade, tumor subtype, tumor size, lung, liver and brain metastases, surgery, radiotherapy, and chemotherapy. In the multivariable analysis, tumor grade, tumor subtype, liver and brain metastases, local surgery, and systemic chemotherapy remained independent risk factors for OS and CSS. However, local radiotherapy was an independent predictor of OS, not CSS.ConclusionsWe identified several factors affect the survival of EC patients with bone metastasis, which is useful for clinicians to assess patients’ outcomes. Our study supports surgery and radiotherapy of primary EC, and systemic chemotherapy for prolonging survival among EC patients with bone metastasis, which lays a solid foundation for defining optimal treatment strategy in this specific cohort.

scholarly journals Serum gamma-glutamyl transferase to alanine aminotransferase ratio predict the vascular invasion and outcome in hepatitis B virus related hepatocellular carcinoma

2021 ◽  
Author(s):  
Zhifeng Zhao ◽  
Jiayun Lin ◽  
Xiaochun Ni ◽  
Hongjie Li ◽  
Lei Zheng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Subgroup Analysis ◽  
Alanine Aminotransferase ◽  
Vascular Invasion ◽  
Gamma Glutamyl Transferase ◽  
B Virus ◽  
Glutamyl Transferase

Abstract Backgrounds: The ratio of gamma-glutamyl transferase (GGT) to alanine aminotransferase (ALT) is a predictive biomarker for hepatitis and hepatocellular carcinoma (HCC). In this study, the relationship between GGT/ALT ratio and vascular invasion was explored in hepatitis B virus (HBV)-related HCC and tumor prognosis. Methods: Totally 558 patients were involved in this study. Univariate and multivariate logistic analysis were used to evaluate GGT/ALT as the risk factor of vascular invasion. Prognostic value of GGT/ALT was investigated by univariate and multivariate Cox analysis combined with Kaplan Meier curves. In order to reduce confounding bias, subgroup analysis and propensity score matching (PSM) were performed. Results: Patients were divided into high and low GGT/ALT groups with an optimal cut-off value of 2.95 in predicting vascular invasion. In univariate and multivariate logistic regression, high GGT/ALT group was listed as the independent risk factors for vascular invasion(P=0.03), the other risk factors included age (P=0.001), α-fetoprotein (AFP) (P=0.026), tumor size (P<0.001), tumor capsule (P=0.018), pathological differentiation (P<0.001) and Barcelona Clinic Liver Cancer (BCLC) classification (P<0.001). In survival analysis, high GGT/ALT ratio was associated with decreased overall survival (OS) (HR: 1.38; 95% CI: 1.03, 1.87; P<0.0001) and disease-free survival (DFS) rates (HR: 1.32; 95% CI: 1.03, 1.87; P<0.0001). In sensitivity analysis, comparable results were furtherly confirmed by subgroup analysis. In PSM analysis, GGT/ALT was still associated with vascular invasion independently (OR, 186; 95% CI, 1.23, 3.33). Conclusion: Preoperative GGT/ALT has good predictive value for vascular invasion, tumor severity and outcome in HBV-related HCC patients.

scholarly journals Risk Factors for Progression in Vestibular Schwannomas After Incomplete Resection: A Single Center Retrospective Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Jiuhong Li ◽  
Xueyun Deng ◽  
Daibo Ke ◽  
Jian Cheng ◽  
Si Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Tumor Size ◽  
Tumor Volume ◽  
Univariate Analysis ◽  
Residual Tumor ◽  
Vestibular Schwannomas ◽  
Incomplete Resection ◽  
Cystic Component

Background and Purpose: The risk factors for progression in vestibular schwannomas (VSs) after incomplete resection (IR) remain to be elucidated. The purpose of this study was to investigate the risk factors for progression in remnant VSs after surgery.Methods: From January 2009 to January 2018, 140 consecutive patients who underwent IR of VSs via suboccipital retrosigmoid approach in our institution were retrospectively analyzed. During follow-up, if progression was detected, the patient was classified into Progressive Group (PG); if the residual tumor was stable or shrank, the patient was classified into Stable Group (SG). Univariate analysis and multivariate analysis were used to evaluate the risk factors for progression after IR of VSs.Results: After a mean follow-up of 80.4 months (range, 24–134 months), 35 (25.0%) patients (PG) had a progression, and no progression was detected in 105 (75.0%) patients (SG). The average tumor size was 36.5 ± 8.9 mm in PG and 31.0 ± 9.8 mm in SG, respectively. The residual tumor volume was 304.6 ± 443.3 mm3 in PG and 75.9 ± 60.0 mm3 in SG, respectively. Univariate analysis showed that preoperative tumor size, residual tumor volume, and irregular internal auditory canal (IAC) expansion were significantly different between the two groups, whereas gender, age, cystic component, or Ki-67 labeling index (LI) did not differ significantly between the two groups. Multivariate analysis showed residual tumor volume was the independent risk factor for progression.Conclusions: VSs that underwent IR with larger preoperative size, greater residual tumor volume, or irregular IAC expansion may have a higher progression rate. Strict follow-up with shorter interval in these patients to detect early progression is necessary.

Factors predictive of cystoid macular oedema following endothelial keratoplasty: a single-centre review of 2233 cases

2021 ◽  
pp. bjophthalmol-2020-318076
Author(s):  
James Myerscough ◽  
Harry William Roberts ◽  
Angeli Christy Yu ◽  
Michael Mimouni ◽  
Luca Furiosi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Roc Curve ◽  
Macular Oedema ◽  
Curve Analysis ◽  
Cystoid Macular Oedema ◽  
Continuous Variables ◽  
Endothelial Keratoplasty ◽  
Roc Curve Analysis ◽  
Close Observation ◽  
Independent Risk Factors

AimsTo describe the incidence of postoperative cystoid macular oedema (CMO) after endothelial keratoplasty (EK) and to identify its contributory risk factors.Methods2233 patients undergoing EK at Ospedali Privati Forlì ‘Villa Igea’, between January 2005 to October 2018 for Descemet stripping automated endothelial keratoplasty (DSAEK) and June 2014 to August 2018 for Descemet membrane endothelial keratoplasty (DMEK) with a minimum follow-up of 18 months were evaluated. Univariate and multivariate analyses were conducted to identify and quantify contributory risk factors. Receiver operating characteristic (ROC) curve analysis were performed to determine ideal cut-off points of continuous variables.ResultsCMO was identified in 2.82% (n=63) of the cases. CMO occurred in 2.36% of DSAEK eyes and in 5.56% of DMEK eyes (p=0.001). Average onset of CMO was 4.27±6.63 months (range: 1–34 months) postoperatively. Compared with those who did not develop CMO, a higher proportion of patients in the CMO group had diabetes (24.2% vs 9.8%, p<0.001) (OR=3.16, 95% CI: 1.72 to 5.81, p<0.001), a higher proportion of patients who underwent DMEK rather than DSAEK (28.6% vs 14.1%, p=0.001) (OR=2.42, 95% CI: 1.35 to 4.33, p=0.003) and were older (70.5±10.0 vs 67.1±14.3 years, p=0.01). Using the cut-off of 67 years as identified by ROC curve analysis, subjects aged >67 years (OR=2.35, 95% CI: 1.30 to 4.26, p=0.005) were more likely to develop CMO. There were no other significant differences between the groups.ConclusionsOlder age (>67 years), diabetes mellitus and DMEK have been identified as independent risk factors for postoperative CMO following EK. Close observation is necessary during the first postoperative year after EK, particularly in patients with risk factors.

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