Delta-like ligand 4 level in colorectal cancer is associated with tumor aggressiveness, body mass index and clinical outcome

2021 ◽  
pp. 1-8
Author(s):  
Zixi Zhang ◽  
Xiao Li ◽  
Xueli Yan ◽  
He Qiu ◽  
Gai Li ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Body Mass Index ◽  
Body Mass ◽  
Proportional Hazards ◽  
Prognostic Indicator ◽  
Clinicopathological Characteristics ◽  
Cox Proportional Hazards ◽  
Normal Tissues ◽  
Kaplan Meier ◽  
Numerous Cell

BACKGROUND: The Notch signaling regulates numerous cell growth, differentiation, and death. However, the expression pattern of its ligand Delta-like 4 (DLL4) in tumors is still uncertain. OBJECTIVE: In the present study, we examined DLL4 expression in colorectal cancer as well as assessed its role as a prognostic indicator in the present study. Methods: DLL4 expression was examined by immunohistochemistry in 265 surgically resected specimens of colorectal cancer and adjacent normal tissues. The relationship between DLL4 expression and clinicopathological characteristics was analyzed. The association of DLL4 expression with the patients’ overall survival rate was assessed by Kaplan-Meier and Cox proportional-hazards regression. RESULTS: Increased DLL4 level was detected in colorectal cancer compared with that of normal tissues. Elevated DLL4 level in colorectal cancer was associated with increased body mass index of patients. Moreover, increased DLL4 level was also found to be correlated with tumor invasion, metastases and unfavorable clinical outcom of patients. CONCLUSIONS: DLL4 level is increased in colorectal cancer, especially in patients with increased body mass index, indicating potential involvement of obesity-related tumorigenesis and development. It might also serve as a novel molecular marker to predicate outcome of patients.

Body mass index impact on acute myeloid leukemia (AML) outcomes.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 7094-7094
Author(s):  
Ahmed Elkhanany ◽  
Niamh Keane ◽  
Sharukh Hashmi ◽  
Kebede Begna ◽  
Rajiv Pruthi ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Proportional Hazards ◽  
Univariate Analysis ◽  
Cox Proportional Hazards ◽  
White Blood Count ◽  
Glucose Levels ◽  
Kaplan Meier ◽  
Blast Count ◽  
Pediatric Aml

7094 Background: Obesity is associated with comorbidities that could cause negative outcome upon delivering intensive care. In pediatric AML patients (pts), obesity was associated with more toxicity and worse prognosis. Here, we study Body-Mass Index (BMI) impact on clinical outcome of adult AML pts. Methods: A total of 180 adult pts with AML between 2003-2011 were enrolled. Retrospective data included demographics, labs, cytogenetics and outcome. LeukemiaNET Standardization (LNS), complete remission (CR), overall survival (OS) and relapse free survival (RFS) were obtained (Dohner E, Blood 2010). BMI of 25-30 was defined as overweight, while >30 as obesity. Fischer’s and Wilcoxon tests were used for comparatives between groups, cox proportional hazards and logistic regression for associations for OS/RFS and CR, Kaplan-Meier test for OS and RFS estimates via JMP software V9.0. IRB approval was obtained according to Helsinki declaration. Results: The median age was 63 years, with 115 (64%) were men. Of 159 pts, karyotype was favorable, Intermediate I, II and adverse in 21 (13%), 76 (48%), 23 (%14) and 39 (25%) pts respectively. Median BMI was 28.2 (range 16.8-47.8). 48 (26%) had normal BMI, 62 (34%) were overweight, and 70 (38%) were obese. At diagnosis, BMI classes were not associated with age, sex, glucose, white blood count (WBC), platelets, blasts, ECOG status, LNS, FLT3/NPM1 status; nor treatment toxicities, CR rates, or relapse after CR. BMI classes were associated with presence of concomitant comorbidities (p=0.047) and glucose levels (p=0.044). In univariate analysis, overweight (OR=1.8, p=0.16) and obesity (OR=1.9, p=0.13) did not affect CR rates. On adjusting for age, sex, LNS, WBC and blast count at diagnosis, only overweight pts had a significant higher CR (76% vs 63%) rates (OR=2.99, p=0.043). OS and RFS were not associated with BMI in univariate (p=0.51) and multivariate (p=0.32) models. Median OS and RFS were not different across BMI subgroups (p=0.52 and 0.59). Conclusions: BMI subgroups showed no correlation with treatment toxicity, LNS, relapse rates, OS or RFS. This should encourage giving therapy to pts regardless of their BMI status. Overweight was associated with better CR rates despite increased concomitant morbidities.

scholarly journals Documentation of Body Mass Index is Associated with an Improvement of Mortality in Sepsis: Analysis of MIMIC-III Database

2021 ◽  
Author(s):  
Yuting Wang ◽  
Jiefei Ma ◽  
Xiaoming W Lin ◽  
Ting Huang ◽  
Rongcheng Xie ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Propensity Score ◽  
Body Mass ◽  
Proportional Hazards ◽  
Propensity Score Analysis ◽  
Cox Proportional Hazards ◽  
Matched Cohort ◽  
Kaplan Meier ◽  
Score Analysis ◽  
Mimic Iii

Abstract Purpose: While improving outcomes in septic patients is currently becoming one of the hot research topics, the contribution of a body mass index (BMI) medical record to altering outcomes among septic patients in intensive care units (ICU) has not been examined. This study was designed to examine the association of BMI record with mortality specifically in ICU septic patients.Methods: The MIMIC-III database was employed to identify septic patients who had or had not measured height and weight to calculate BMI. Propensity score analysis was used to minimize confounders. The comparative risks of outcomes were further adjusted in the matched cohort with the use of a Cox proportional-hazards regression model. Kaplan-Meier survivor curve was plotted for outcomes in the propensity-score-matched cohort.Results: Among 10418 eligible septic patients, 4157 patients who had measured height and weight (BMI group) and 4157 patients who had not measured height and weight (No-BMI group) had similar propensity score. Significant benefit in terms of hospital mortality was observed among BMI group, compared to No-BMI group (19.24% vs. 24.44%, p<0.001). 30-day mortality (20.30% vs. 26.36%, p<0.001) and 1 year mortality (38.66% vs. 44.17%, p<0.001) was significantly higher in No-BMI group.Conclusions: In a general population of critically ill patients with sepsis, documentation of BMI is associated with an improvement of mortality

Il-8 as an underutilized prognostic factor in metastatic colorectal cancer.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 409-409
Author(s):  
Manasi S Shah ◽  
David R. Fogelman ◽  
Carrie Daniel-MacDougall ◽  
Kanwal Pratap Singh Raghav ◽  
John Heymach ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Metastatic Colorectal Cancer ◽  
Proportional Hazards ◽  
Principal Component ◽  
Cox Proportional Hazards ◽  
Mortality Data ◽  
Subsequent Work ◽  
Term Survival ◽  
Inflammatory Biomarker ◽  
Kaplan Meier

409 Background: Cancer-associated inflammation has been identified as a key determinant of disease progression and survival in colorectal cancer. We investigated the association between circulating inflammatory cytokines and survival in metastatic colorectal cancer (mCRC) patients. Methods: Plasma levels of 47 cytokines were measured using multiplex-bead assays in a cohort of 168 previously untreated mCRC patients. Demographic, clinical-pathological features, body mass index, and mortality data were abstracted from patient medical records. Overall survival (OS) was evaluated by Kaplan-Meier analysis and Cox proportional hazards regression. Results: Using principal component analysis, we identified a subset of cytokines explaining the maximum variance in OS; and found interleukin (IL)-1b, IL-5, IL-8, IL-12 and VEGF to be significantly associated with OS. However, only IL-8 was significantly and independently associated with OS in multivariable-adjusted models. For each 100 pg/ml increase in the level of circulating IL-8, hazard rate for death increased by 1.6 (95% CI 1.24-1.97). IL-8 measurements ranged from <1 to 413 pg/ml with a median value of 22 pg/ml. Median uncensored survival was 26.5 and 15.5 months among patients with IL-8 levels below and above this value, respectively. ROC analysis of IL-8 demonstrated an AUC of 0.69 (95% CI 0.60-0.76), as compared to 0.52 for CEA (95% CI 0.46-0.59). Conclusions: We identified an association between IL-8 and OS in previously untreated mCRC patients, suggesting its potential role as a prognostic inflammatory biomarker. In this dataset, IL-8 outperformed CEA as a prognostic biomarker, a finding which requires validation in subsequent work. Appropriately identifying, monitoring and managing chronic inflammation and the host inflammatory response during colorectal cancer treatment may be important for improving long-term survival.

scholarly journals Clinicopathological Significance of MicroRNA-20b Expression in Hepatocellular Carcinoma and Regulation of HIF-1αand VEGF Effect on Cell Biological Behaviour

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Tong-min Xue ◽  
Li-de Tao ◽  
Miao Zhang ◽  
Jie Zhang ◽  
Xia Liu ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Proportional Hazards ◽  
Clinicopathological Characteristics ◽  
Cox Proportional Hazards ◽  
Biological Behaviour ◽  
Proportional Hazards Regression ◽  
Kaplan Meier ◽  
Clinicopathological Significance ◽  
Tumor Types

miRNA-20b has been shown to be aberrantly expressed in several tumor types. However, the clinical significance of miRNA-20b in the prognosis of patients with hepatocellular carcinoma (HCC) is poorly understood, and the exact role of miRNA-20b in HCC remains unclear. The aim of the present study was to investigate the association of the expression of miR-20b with clinicopathological characteristics and overall survival of HCC patients analyzed by Kaplan-Meier analysis and Cox proportional hazards regression models. Meanwhile, the HIF-1αand VEGF targets of miR-20b have been confirmed. We found not only miR-20b regulation of HIF-1αand VEGF in normal but also regulation of miR-20b in hypoxia. This mechanism would help the tumor cells adapt to the different environments thus promoting the tumor invasion and development. The whole study suggests that miR-20b, HIF-1α, and VEGF serve as a potential therapeutic agent for hepatocellular carcinoma.

scholarly journals Childhood body mass index and multiple sclerosis risk: a long-term cohort study

2013 ◽  
Vol 19 (10) ◽  
pp. 1323-1329 ◽  
Author(s):  
Kassandra L Munger ◽  
Joan Bentzen ◽  
Bjarne Laursen ◽  
Egon Stenager ◽  
Nils Koch-Henriksen ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Body Mass Index ◽  
Body Mass ◽  
School Health ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Z Score ◽  
Cox Proportional Hazards Models ◽  
Increased Risk ◽  
Unit Increase

Background: Obesity in late adolescence has been associated with an increased risk of multiple sclerosis (MS); however, it is not known if body size in childhood is associated with MS risk. Methods: Using a prospective design we examined whether body mass index (BMI) at ages 7–13 years was associated with MS risk among 302,043 individuals in the Copenhagen School Health Records Register (CSHRR). Linking the CSHRR with the Danish MS registry yielded 774 MS cases (501 girls, 273 boys). We used Cox proportional hazards models to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs). Results: Among girls, at each age 7–13 years, a one-unit increase in BMI z-score was associated with an increased risk of MS (HRage 7=1.20, 95% CI: 1.10–1.30; HRage 13=1.18, 95% CI: 1.08–1.28). Girls who were ≥95th percentile for BMI had a 1.61–1.95-fold increased risk of MS as compared to girls <85th percentile. The associations were attenuated in boys. The pooled HR for a one-unit increase in BMI z-score at age 7 years was 1.17 (95% CI: 1.09–1.26) and at age 13 years was 1.15 (95% CI: 1.07–1.24). Conclusion: Having a high BMI in early life is a risk factor for MS, but the mechanisms underlying the association remain to be elucidated.

scholarly journals P109 Impact of ethnicity on colorectal cancer incidence in a cohort of colitis-associated dysplasia patients

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S201-S202
Author(s):  
M Kabir ◽  
K Curtius ◽  
P Kalia ◽  
I Al Bakir ◽  
C H R Choi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Racial Differences ◽  
Proportional Hazards ◽  
Hazard Analysis ◽  
Cox Proportional Hazards ◽  
Time Interval ◽  
Low Grade ◽  
Kaplan Meier ◽  
The Impact

Abstract Background Racial disparities in inflammatory bowel disease (IBD) phenotypic presentations and outcomes are recognised. However, there are conflicting data from Western population-based cohort studies as to whether racial differences in colitis-associated colorectal cancer (CRC) incidence exists. To our knowledge this is the first study to investigate the impact of ethnicity on the natural history of dysplasia in ulcerative colitis (UC). Methods We performed a retrospective multi-centre cohort study of adult patients with UC whose first low-grade dysplasia (LGD) diagnosis within the extent of colitis was made between 1 January 2001 and 30 December 2018. Only patients with at least one follow-up colonoscopy or colectomy by 30 August 2019 were included. The study end point was time to CRC or end of follow-up. Statistical differences between groups were evaluated using Mann-Whitney U tests and Chi-squared tests. Survival analyses were performed using Kaplan-Meier estimation and multivariate Cox proportional hazards models. Results 408 patients met the inclusion criteria (see Figure 1 for patient and clinical demographics). More patients from a Black or Asian (BAME) background progressed to CRC [13.4% vs. 6.4%; p=0.036] compared to their White Caucasian counterparts, despite having surveillance follow-up. Figure 2 displays Kaplan-Meier curves demonstrating the probability of remaining CRC-free after LGD diagnosis and categorised by ethnicity. BAME patients were more likely to have moderate-severe inflammatory activity on colonic biopsy within the 5 preceding years [42.0% vs. 28.9%; p=0.023], but no significant differences in medication use and a longer median time interval from LGD diagnosis to colectomy date [32 months vs. 11 months; p=0.021]. After adjusting for sex, age and UC duration at time of LGD diagnosis and presence of moderate-severe histological inflammation, being Black or Asian was a predictive factor for CRC progression on multivariate Cox proportional hazard analysis [HR 2.97 (95% CI 1.22 – 7.20); p = 0.016]. However, ethnicity was no longer predictive of CRC progression on sub-analysis of the 317 patients who did not have a colectomy during the follow-up period. Conclusion In this UK multi-centre cohort of UC surveillance patients diagnosed with LGD, delays in receiving cancer preventative colectomy may contribute to an increased CRC incidence in certain ethnic groups. Further work is required to elucidate whether these delays are related to institutional factors (e.g. inequity in the content of decision-making support given or access to healthcare) or cultural factors.

scholarly journals Effect of Health Care Provider Delays on Short-Term Outcomes in Patients With Colorectal Cancer: Multicenter Population-Based Observational Study

10.2196/15911 ◽  
2020 ◽  
Vol 9 (3) ◽  
pp. e15911
Author(s):  
Ahmed Abdulaal ◽  
Chanpreet Arhi ◽  
Paul Ziprin
Keyword(s):  
Colorectal Cancer ◽  
Observational Study ◽  
Proportional Hazards ◽  
Cox Regression ◽  
Diagnostic Delay ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Treatment Delays ◽  
Cox Regression Analysis ◽  
Kaplan Meier

Background The United Kingdom has lower survival figures for all types of cancers compared to many European countries despite similar national expenditures on health. This discrepancy may be linked to long diagnostic and treatment delays. Objective The aim of this study was to determine whether delays experienced by patients with colorectal cancer (CRC) affect their survival. Methods This observational study utilized the Somerset Cancer Register to identify patients with CRC who were diagnosed on the basis of positive histology findings. The effects of diagnostic and treatment delays and their subdivisions on outcomes were investigated using Cox proportional hazards regression. Kaplan-Meier plots were used to illustrate group differences. Results A total of 648 patients (375 males, 57.9% males) were included in this study. We found that neither diagnostic delay nor treatment delay had an effect on the overall survival in patients with CRC (χ23=1.5, P=.68; χ23=0.6, P=.90, respectively). Similarly, treatment delays did not affect the outcomes in patients with CRC (χ23=5.5, P=.14). The initial Cox regression analysis showed that patients with CRC who had short diagnostic delays were less likely to die than those experiencing long delays (hazard ratio 0.165, 95% CI 0.044-0.616; P=.007). However, this result was nonsignificant following sensitivity analysis. Conclusions Diagnostic and treatment delays had no effect on the survival of this cohort of patients with CRC. The utility of the 2-week wait referral system is therefore questioned. Timely screening with subsequent early referral and access to diagnostics may have a more beneficial effect.

scholarly journals Numbers and Mortality Risk of Hypertensive Patients with or without Elevated Body Mass Index in China

2021 ◽  
Vol 19 (1) ◽  
pp. 116
Author(s):  
Xiaoqin Luo ◽  
Hexiang Yang ◽  
Zhangya He ◽  
Shanshan Wang ◽  
Tao Chen ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Mortality Risk ◽  
Proportional Hazards ◽  
Premature Death ◽  
Cox Proportional Hazards ◽  
Nutrition Survey ◽  
Hypertensive Patients ◽  
Elevated Body Mass Index ◽  
Number Of Patients

Objective: Our study aimed to estimate the number of hypertension patients with or without elevated body mass index (BMI), and assess their mortality risk. Methods: We used data from the China Health and Retirement Longitudinal Study (CHARLS) to estimate the population of hypertensive patients with or without elevated BMI. The mortality risk of hypertension with elevated BMI was estimated by using the China Health and Nutrition Survey (CHNS) data. Cox proportional hazards models were used to estimate hazard ratios and 95% confidence intervals (CI). Results: In total, 23.02% of adults, representing 117.74 (95% CI: 108.79, 126.69) million, had both high BMI and hypertension. Among them, 38.53 (95% CI: 35.50, 41.56) million were recommended to initiate antihypertensive medication but did not take it. Moreover, there were 38.40 (95% CI: 35.50, 41.56) million hypertensive patients with elevated BMI who did not achieve the goal of blood pressure control. All-cause mortality and premature death mortality, especially for the elderly, were significantly and positively associated with the severity of the hypertensive condition (p for trend = 0.001). Conclusion: In China, there were a huge number of patients with hypertension and elevated BMI, and the treatment and control rates for them were low. The more severe the degree of hypertension, the higher risk of all-cause death and premature death in these patients.

scholarly journals Effect of body mass index on vertebral and hip fractures in older people and differences according to sex: a retrospective Japanese cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e049157
Author(s):  
Kyohei Shiomoto ◽  
Akira Babazono ◽  
Yumi Harano ◽  
Takako Fujita ◽  
Peng Jiang ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Cohort Study ◽  
Older People ◽  
Hip Fractures ◽  
Proportional Hazards ◽  
Normal Weight ◽  
Cox Proportional Hazards ◽  
Kaplan Meier ◽  
Males And Females ◽  
The Mean

ObjectivesThe purpose of this study was to investigate the incidence of vertebral and hip fractures in the older people and to clarify the relationship between these fractures and body mass index (BMI) along with the impact of sex differences.DesignThis was a retrospective cohort study.SettingWe used administrative claims data between April 2010 and March 2018.ParticipantsOlder people aged ≥75 years who underwent health examinations in 2010 and were living in the Fukuoka Prefecture, Japan were included in the study. A total of 24 691 participants were included; the mean age was 79.4±4.3 years, 10 853 males and 13 838 females, and an the mean duration of observation was 6.9±1.6 years.Primary and secondary outcome measuresWe estimated the incidence of vertebral and hip fractures by BMI category (underweight: <18.5 kg/m2, normal weight: 18.5–24.9 kg/m2, overweight and obese: ≥25.0 kg/m2) using a Kaplan-Meier curve in males and females and determined fracture risk by sex using Cox proportional hazards regression analyses.ResultsThe incidence of vertebral and hip fractures was 16.8% and 6.5%, respectively. The cumulative incidence of vertebral and hip fracture at the last observation (8 years) in each BMI groups (underweight/normal weight/overweight and obese) estimated using the Kaplan-Meier curve was 14.7%/10.4%/9.0% in males and 24.9%/23.0%/21.9% in females, and 6.3%/2.9%/2.4% in males and 14.1%/9.0%/8.1% in females, respectively, and both fractures were significantly higher in underweight groups regardless of sex. Multivariable Cox proportional hazards models showed that underweight was a significant risk factor only in males for vertebral fractures and in both males and females for hip fractures.ConclusionUnderweight was associated with fractures in the ageing population, but there was a sex difference in the effect for vertebral fractures.

scholarly journals Body-Mass Index and Progression of Hepatitis B: A Population-Based Cohort Study in Men

2008 ◽  
Vol 26 (34) ◽  
pp. 5576-5582 ◽  
Author(s):  
Ming-Whei Yu ◽  
Wei-Liang Shih ◽  
Chih-Lin Lin ◽  
Chun-Jen Liu ◽  
Jhih-Wei Jian ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Cohort Study ◽  
Hepatitis B ◽  
Body Mass ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Excess Body Weight ◽  
Biochemical Tests ◽  
Hazard Ratios

Purpose To determine prospectively whether body-mass index (BMI) is associated with liver-related morbidity and mortality among male hepatitis B virus (HBV) carriers. Patients and Methods We performed a prospective study of 2,903 male HBV surface antigen–positive government employees who were free of cancer at enrollment between 1989 and 1992. Main outcome measures included ultrasonography, biochemical tests, incident hepatocellular carcinoma (HCC), and liver-related death. Results During mean follow-up of 14.7 years, 134 developed HCC and 92 died as a result of liver-related causes. In Cox proportional hazards models adjusting for age, number of visits, diabetes, and use of alcohol and tobacco, the hazard ratios for incident HCC were 1.48 (95% CI, 1.04 to 2.12) in overweight men (BMI between 25.0 and 29.9 kg/m2) and 1.96 (95% CI, 0.72 to 5.38) in obese men (BMI ≥ 30.0 kg/m2), compared with normal-weight men (BMI between 18.5 and 24.9 kg/m2). Liver-related mortality had adjusted hazard ratios of 1.74 (95% CI, 1.15 to 2.65) in overweight men and 1.50 (95% CI, 0.36 to 6.19) in obese men. Excess BMI was also associated with the occurrence of fatty liver and cirrhosis detected by ultrasonography, as well as elevated ALT and γ-glutamyltransferase (GGT) activity during follow-up. The association of BMI with GGT was stronger than with ALT, and elevated GGT activity and cirrhosis were the strongest predictors for incident HCC and liver-related death. Conclusion This longitudinal cohort study indicates that excess body weight is involved in the transition from healthy HBV carrier state to HCC and liver-related death among men.

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