prognostic markers

预后标志物
  • 文章类型: Journal Article
    对苯二胺是许多商业染发剂中的主要成分,急性摄入或皮肤吸收后可产生严重的局部和全身毒性反应。这项研究的目的是评估导致急性对苯二胺中毒病例的发病率和死亡率的因素。重点评估由此产生的肝和心脏毒性。
    这项观察性研究是针对在Sohag大学医院就诊的急性对亚苯基二胺中毒患者进行的,并包括2021年2月至2022年1月的回顾性部分和2022年2月至2022年7月的预期部分。提取临床数据并创建接受者操作特征曲线以鉴定预后标志物。
    在50名符合条件的患者中,有39名(78%)康复,11人(22%)死亡或有永久性并发症。在复杂病例中,血管性水肿和无尿是最常见的特征。通过接收机工作特性分析,天冬氨酸转氨酶活性的增加大于644IU/L或丙氨酸转氨酶活性大于798IU/L,提交的时间延迟超过4.5小时,pH值小于7.32与发病率和死亡率的显著增加相关.虽然心脏酶活性,在大多数情况下,血尿素氮和肌酐的浓度增加,它们与死亡率无关.
    对亚苯基二胺中毒患者的处理主要是支持性的,因为没有特定的解毒剂。呼吸衰竭和肾衰竭是最危及生命的并发症。也发生肝毒性和心脏毒性。预测事件的能力可以帮助指导患者的处置和护理。
    肝酶活性升高,增加了入院的时间延迟,pH值降低,血管性水肿和无尿的存在可以作为急性对苯二胺中毒患者发病率和死亡率的预测因子。
    UNASSIGNED: Paraphenylenediamine is the main component in many commercial hair dyes, and can produce severe local and systemic toxicity reactions after acute ingestion or dermal absorption. The aim of this study was to assess the factors contributing to morbidity and mortality in cases of acute paraphenylenediamine poisoning, with a focus on evaluating the resultant hepatic and cardiac toxicity.
    UNASSIGNED: This observational study was conducted on patients with acute paraphenylenediamine poisoning presenting to Sohag University Hospitals, and included a retrospective part from February 2021 to January 2022 and a prospective part from February 2022 to July 2022. Clinical data were extracted and receiver operating characteristic curves created to identify prognostic markers.
    UNASSIGNED: Among 50 eligible patients 39 (78 percent) recovered, and 11 (22 percent) died or had permanent complications. Angioedema and anuria were the most frequent features in complicated cases. By receiver operating characteristic analysis, either an increase in aspartate aminotransferase activity greater than 644 IU/L or alanine aminotransferase activity greater than 798 IU/L, a time delay to presentation of greater than 4.5 hours, and a pH of less than 7.32 were associated with a significant increase in morbidity and mortality. While cardiac enzyme activities, and concentrations of blood urea nitrogen and creatinine increased in most cases, they were not associated with mortality.
    UNASSIGNED: Management of patients with paraphenylenediamine poisoning is mainly supportive, as there is no specific antidote. Respiratory failure and kidney failure are the most life threatening complications. Hepatoxicity and cardiotoxicity also occur. The ability to predict the events can help guide patient disposition and care.
    UNASSIGNED: Elevated liver enzyme activities, increased time delay to admission, decreased pH, and the presence of angioedema and anuria can be used as predictors of morbidity and mortality in patients with acute paraphenylenediamine poisoning.
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  • 文章类型: Journal Article
    透明细胞肾细胞癌(ccRCC)是肾癌的常见和侵袭性亚型。许多患者被诊断为晚期,使早期检测至关重要。不幸的是,目前没有ccRCC的非侵入性测试,强调需要新的生物标志物。此外,ccRCC通常对放疗和化疗等治疗产生耐药性。识别预测治疗结果的生物标志物对于个性化护理至关重要。人工智能(AI)的集成,多组学分析,和计算生物学在提高检测精度和弹性方面有希望,为未来的调查开辟了道路。放射性基因组学和生物材料基础免疫调节的融合标志着诊断医学的革命性突破。这篇综述总结了现有的文献,并强调了新兴的生物标志物,增强了诊断,预测性,和ccRCC的预后能力,为未来的临床研究奠定了基础。
    Clear cell renal cell carcinoma (ccRCC) is a common and aggressive subtype of kidney cancer. Many patients are diagnosed at advanced stages, making early detection crucial. Unfortunately, there are currently no noninvasive tests for ccRCC, emphasizing the need for new biomarkers. Additionally, ccRCC often develops resistance to treatments like radiotherapy and chemotherapy. Identifying biomarkers that predict treatment outcomes is vital for personalized care. The integration of artificial intelligence (AI), multi-omics analysis, and computational biology holds promise in bolstering detection precision and resilience, opening avenues for future investigations. The amalgamation of radiogenomics and biomaterial-basedimmunomodulation signifies a revolutionary breakthrough in diagnostic medicine. This review summarizes existing literature and highlights emerging biomarkers that enhance diagnostic, predictive, and prognostic capabilities for ccRCC, setting the stage for future clinical research.
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  • 文章类型: Journal Article
    背景:口腔鳞状细胞癌(OSCC)是南亚最常见的恶性肿瘤之一,也是印度的主要公共卫生问题。该研究的目的是确定印度北部北方邦人口的三级护理中心中OSCC的各种临床病理参数之间的相关性。由于该地区缺乏可用数据,因此这项研究势在必行。
    方法:在2021年1月至2021年12月期间,对病理科接收的病例进行了回顾性观察性研究。该研究分析了OSCC的病例,关注各种因素,如年龄,性别,习惯,肿瘤部位,肿瘤大小,分化,肿瘤基质比,肿瘤浸润淋巴细胞,肿瘤出芽,最糟糕的入侵模式,入侵深度,神经周浸润,淋巴管浸润,下面的骨和上面的皮肤受累,区域淋巴结转移,和2年总生存率。
    结果:患者的平均年龄为47.80±12.48岁,男女比例为15.6:1。颊粘膜是最常见的受影响的部位,其次是舌头。56%的病例报告有烟草滥用史。36%的患者有区域淋巴结转移,并表现出与年龄较小的强烈关联。药物滥用,肿瘤大小较大,舌头作为一个部位,中度至重度肿瘤分化,低肿瘤浸润淋巴细胞,和更高的神经周和淋巴血管侵犯。此外,在两年生存分析结束时,34%的患者死于该疾病。观察到肿瘤最大尺寸<2cm时,总生存期明显更好。分化良好的肿瘤形态学,较高的肿瘤浸润淋巴细胞,没有淋巴结转移.
    结论:该研究强调了OSCC中各种组织病理学因素的复杂相关性,阐明它们对预后的潜在影响。
    BACKGROUND: Oral squamous cell carcinoma (OSCC) is one of the most prevalent malignant neoplasms in South Asia and a major public health problem in India. The purpose of the study was to identify correlations among various clinicopathological parameters of OSCC in a tertiary care center in the Eastern Uttar Pradesh population of North India. The study is imperative due to the scarcity of available data from this region.
    METHODS: A retrospective observational study was conducted on the cases received in the Department of Pathology over the period of January 2021 to December 2021. The study analyzed cases of OSCC, focusing on various factors such as age, gender, habits, tumor site, tumor size, differentiation, tumor-stroma ratio, tumor-infiltrating lymphocytes, tumor budding, worst pattern of invasion, depth of invasion, perineural invasion, lymphovascular invasion, underlying bone and overlying skin involvement, regional lymph node metastasis, and overall two-year survival.
    RESULTS: The mean age of the patients was 47.80 ± 12.48 years, and the male-to-female ratio was 15.6:1. Buccal mucosa was the most frequently affected site followed by the tongue. Fifty-six percent of cases reported with a history of tobacco abuse. Thirty-six percent of the patients had regional lymph node metastasis and exhibited a strong association with younger age, substance abuse, higher tumor size, tongue as a site, moderate-to-poor tumor differentiation, low tumor-infiltrating lymphocytes, and higher perineural and lymphovascular invasion. Moreover, at the end of the two-year survival analysis, 34% of patients succumbed to the disease. Overall survival was observed to be significantly better with <2 cm maximum tumor size, well-differentiated tumor morphology, higher tumor-infiltrating lymphocytes, and no nodal metastasis.
    CONCLUSIONS: The study highlights the intricate correlations of various histopathological factors in OSCC, shedding light on their potential implications for prognosis.
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  • 文章类型: Journal Article
    背景:口腔鳞状细胞癌(OSCC)在全球范围内构成了重大的医疗保健挑战,需要精确的生物标志物以进行有效管理。唾液中的白细胞介素-6(IL-6)已成为潜在的生物标志物,然而,其动态化疗和放疗后仍未充分开发。
    目的:我们的研究目的是研究术后OSCC患者在化疗和放疗后一年随访期间唾液白细胞介素-6(IL-6)表达的纵向动态。
    方法:这项纵向研究招募了60名参与者,包括术后OSCC患者和对照组,收集一年以上的唾液样本。RT-PCR和ELISA技术检测IL-6的表达。统计分析,包括重复测量方差分析和单变量检验,评估IL-6动力学。
    结果:预处理,与对照相比,OSCC患者表现出升高的IL-6水平。治疗后,IL-6水平显著降低,p<0.0001,表明治疗反应和在6个月随访时基线正常化的进一步结果。在各治疗阶段观察到显著差异,支持IL-6作为OSCC的诊断和预后标志物。RT-PCR和ELISA结果显示IL-6作为预测标志物的作用具有统计学意义。
    结论:唾液IL-6在OSCC管理中成为有希望的生物标志物,需要进一步研究以利用其诊断和治疗潜力。通过了解IL-6动力学,可以开发个性化的治疗方法来改善患者的预后。具有较大队列和多组学方法的纵向研究有必要验证发现并确定新的治疗靶标。
    BACKGROUND: Oral squamous cell carcinoma (OSCC) poses a significant healthcare challenge globally, necessitating precise biomarkers for effective management. Interleukin-6 (IL-6) in saliva has emerged as a potential biomarker, yet its dynamics post-chemotherapy and radiotherapy remain underexplored.
    OBJECTIVE: The aim of our study is to investigate the longitudinal dynamics of salivary interleukin-6 (IL-6) expression in postoperative OSCC patients over a one-year follow-up period after chemotherapy and radiotherapy.
    METHODS: This longitudinal study enrolled 60 participants, including postoperative OSCC patients and controls, collecting saliva samples over one year. RT-PCR and ELISA techniques measured IL-6 expression. Statistical analyses, including repeated measures ANOVA and univariate tests, evaluated IL-6 dynamics.
    RESULTS: Pre-treatment, OSCC patients exhibited elevated IL-6 levels compared to controls. Post-therapy, IL-6 levels decreased significantly with p < .0001, indicating treatment response and further result to baseline normalizing at 6-month follow-up. Significant differences were observed across treatment stages, supporting IL-6 as a diagnostic and prognostic marker for OSCC. RT-PCR and ELISA results showed the statistical significance of IL-6\'s role as a predictive marker.
    CONCLUSIONS: Salivary IL-6 emerges as a promising biomarker in OSCC management, necessitating further research to harness its diagnostic and therapeutic potential. By understanding IL-6 dynamics, personalized treatment approaches can be developed to improve patient outcomes. Longitudinal studies with larger cohorts and multi-omics approaches are warranted to validate findings and identify novel therapeutic targets.
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  • 文章类型: Journal Article
    雷德西韦目前被批准用于治疗COVID-19住院患者。然而,监测其在各种临床环境中的安全性和有效性是当务之急。本研究旨在评估雷米地韦对COVID-19炎症和预后标志物的影响。
    进行了为期两个月的以医院为基础的前瞻性纵向研究,其中包括按照标准指南对COVID-19患者进行事件监测。人口统计细节,收集风险因素和所有基线参数.从每天的第1天到出院或死亡,对患者进行了任何药物不良反应(ADR)的随访。在第2天、第4天、第6天和第10天进行了重复的实验室测试,以评估雷米西韦对COVID-19炎症和预后标志物的影响。还评估了队列中生存的重要预测因子。
    共60例COVID-19患者接受了雷米西韦治疗。患者的平均年龄为59.2(+13.7)岁。血清肌酐有显著改善(从0.9下降到0.7mg/dL),淋巴细胞计数{从9.2降低到7.3(109个细胞/L)}和血清钠(从134.6增加到137.4)在给药后6天。显著的生存预测因子是多器官衰竭(P0.046)和第10天的白细胞计数(P0.001)。
    雷德西韦治疗改善了COVID-19患者的预后生物标志物谱。
    UNASSIGNED: Remdesivir is currently approved for treating hospitalised patients with COVID-19. However, it is a priority to monitor its safety and effectiveness in various clinical settings. This study was undertaken to assess the impact of remdesivir on inflammatory and prognostic markers of COVID-19.
    UNASSIGNED: A hospital-based prospective longitudinal study was conducted over two months comprising event monitoring of COVID-19 patients administered remdesivir as per standard guidelines. The demographic details, risk factors and all baseline parameters were collected. The patients were followed up for the appearance of any adverse drug reactions (ADRs) after the start of remdesivir therapy from Day 1 to discharge or death every day. Repeat Lab tests were done on days 2, 4, 6 and 10 days to assess the impact of remdesivir on inflammatory and prognostic markers of COVID-19 over time. Significant predictors of survival in the cohort were also assessed.
    UNASSIGNED: A total of 60 COVID-19 patients were administered remdesivir. The mean age of the patients was 59.2 (+13.7) years. There was a significant improvement in the serum creatinine (decreased from 0.9 to 0.7 mg/dL), lymphocyte count {decreased from 9.2 to 7.3 (109 cells/L)} and serum sodium (increased from 134.6 to 137.4) of the patients over six days after the administration of remdesivir. The significant survival predictors were multiple organ failure (P 0.046) and WBC count on Day 10 (P 0.001).
    UNASSIGNED: Remdesivir administration improved the prognostic biomarker profile in COVID-19 patients.
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  • 文章类型: Journal Article
    几项评估犬皮肤肥大细胞肿瘤(cMCT)中Ki67的研究报告了当包括所有组织学等级的肿瘤时,其预后价值。这项研究旨在评估Ki67指数在G2/LGcMCT与HN2淋巴结(LN)的同质队列中是否具有预测价值,并描述临床结果。第二个目标是探索Ki67指数与MC之间的相关性。回顾性搜索了三个机构的医学数据库,以寻找接受cMCT和LN摘除手术治疗的狗,组织学诊断为G2/LG与HN2LN。有关组织学边缘的信息,MC,Ki67指数,局部复发,淋巴结复发,远处转移,包括从头cMCT的发生,日期和死亡原因。共发现39例。这些都没有发生局部和淋巴结复发或转移性远处疾病。MC中位数为1(0-2)。Ki67指数中位数为3.5(0.7-14.3)。Ki67与MC无显著相关性。在研究结束时,32只(82%)狗活着,7只(18%)狗死于无关原因,4只(10.2%)狗失去了随访。未达到ST中位数,平均值为893天(104-2241天)。考虑到严格的纳入标准,仅接受手术治疗的G2/LG和HN2LN的犬可能具有良好的肿瘤学结局;Ki67指数对预后没有影响.
    Several studies evaluating Ki67 in canine cutaneous mast cell tumors (cMCTs) have reported its prognostic value when tumors of all histological grades are included. This study aims to evaluate whether the Ki67 index has a predictive value in a homogeneous cohort of G2/LG cMCTs with HN2 lymph nodes (LNs) and to describe the clinical outcome. The second goal was to explore the correlation between the Ki67 index and MC. The medical databases of three institutions were retrospectively searched for dogs undergoing surgical treatment for cMCT and LN extirpation, with a histological diagnosis of G2/LG with HN2 LNs. Information about histological margins, MC, Ki67 index, local recurrence, nodal relapse, distant metastasis, de novo cMCT occurrence and date and cause of death were included. A total of 39 cases were identified. None of these developed local and nodal relapse or metastatic distant disease. Median MC was 1 (0-2). Median Ki67 index was 3.5 (0.7-14.3). Ki67 and MC were not significantly correlated. At the end of the study, 32 (82%) dogs were alive, 7 (18%) dogs were dead from unrelated causes and 4 (10.2%) dogs were lost to follow-up. The median ST was not reached, and the mean was 893 days (104-2241 days). Considering the strict inclusion criteria, dogs affected by G2/LG with HN2 LNs treated with surgery alone may have a good oncologic outcome; the Ki67 index does not have prognostic impact.
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  • 文章类型: Journal Article
    背景:多形性胶质母细胞瘤(GBM)是成人中发生的最具侵袭性的脑肿瘤。尽管及时诊断和迅速给予治疗,预期存活率非常差。为了建立预测GBM患者预后的因素,已经进行了广泛的研究;然而,全球公认的预后标志物仍然缺乏。
    方法:我们回顾性评估了所有被诊断为原发性GBM并在三年期间(2017年1月至2019年12月)在急诊临床县医院神经外科接受手术治疗的成年患者。罗马尼亚。我们的目的是找到临床,想象,组织病理学特征和患者生存。
    结果:共有75例患者最终纳入我们的统计分析:男性40例,女性35例,平均年龄为61岁。平均肿瘤尺寸为45.28±15.52mm,平均生存率为4±6.75个月。单变量分析表明,肿瘤大小具有统计学意义。pre,术后KPSI对生存率的影响。此外,Cox多变量评估加强了先前关于术后KPSI(回归系数-0.03,HR0.97,95%CI(HR)0.96-0.99,p=0.002)作为患者生存的有利预后因子和GBM大小(回归系数0.03,HR1.03,95%CI(HR)1.01-1.05,p=0.005)作为患者生存的不良预后指标的研究结果.
    结论:我们的回顾性研究结果与先前的科学结果一致,这些结果提供了证据支持临床(通过KPSI量化)和影像学(特别是肿瘤尺寸)特征作为GBM患者生存的可靠预后因素的重要性。
    BACKGROUND: Glioblastoma multiforme (GBM) is the most aggressive brain tumor that occurs in adults. In spite of prompt diagnosis and rapidly administered treatment, the survival expectancy is tremendously poor. Extensive research has been performed in order to establish factors to predict the outcome of GBM patients; however, worldwide accepted prognostic markers are still lacking.
    METHODS: We retrospectively assessed all adult patients who were diagnosed with primary GBM and underwent surgical treatment during a three-year period (January 2017-December 2019) in the Neurosurgery Department of the Emergency Clinical County Hospital of Târgu Mureș, Romania. Our aim was to find any statistically relevant connections between clinical, imagistic, and histopathological characteristics and patients\' survival.
    RESULTS: A total of 75 patients were eventually included in our statistical analysis: 40 males and 35 females, with a median age of 61 years. The mean tumor dimension was 45.28 ± 15.52 mm, while the mean survival rate was 4 ± 6.75 months. A univariate analysis demonstrated a statistically significant impact of tumor size, pre-, and postoperative KPSI on survival rate. In addition, a Cox multivariate assessment strengthened previous findings regarding postoperative KPSI (regression coefficient -0.03, HR 0.97, 95% CI (HR) 0.96-0.99, p = 0.002) as a favorable prognostic factor and GBM size (regression coefficient 0.03, HR 1.03, 95% CI (HR) 1.01-1.05, p = 0.005) as a poor prognostic marker for patients\' survival.
    CONCLUSIONS: The results of our retrospective study are consistent with prior scientific results that provide evidence supporting the importance of clinical (quantified by KPSI) and imagistic (particularly tumor dimensions) features as reliable prognostic factors in GBM patients\' survival.
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  • 文章类型: Journal Article
    背景:晚期非小细胞肺癌(NSCLC)患者是一个具有较短寿命的异质性人群。我们旨在开发更好地区分生存期>90天的患者的方法。
    方法:我们评估了106例治疗初期的83个特征,东部肿瘤协作组表现状态(ECOG-PS)>1的IV期NSCLC患者。自动机器学习用于选择模型并优化超参数。对第二个(“lite”)模型进行100倍自举降维。在样本外验证队列中,通过C统计量和准确性指标来衡量绩效。“精简”模型在第二个独立模型上进行了验证,前瞻性队列(N=42)。进行网络分析(NA)以评估特征的中心性和连通性的差异。
    结果:选择的方法是ExtraTrees分类器,C统计量为0.82(p<0.01),准确度为0.81(p=0.01)。在第一队列中,“精简”模型有16个变量,C统计量为0.84(p<0.01),准确度为0.75(p=0.039),第二队列中的C统计量为0.706(p<0.01),准确性为0.714(p<0.01)。生存率较低的患者网络之间的联系更加紧密。与恶病质相关的特征,炎症,NA和生活质量的威望得分有统计学差异。
    结论:机器学习有助于晚期NSCLC的预后评估。生成的特征数量减少的模型显示出高可访问性和合理的度量。与生活质量相关的特征,恶病质,和绩效状态的相关性和重要性得分增加,表明它们在疾病后期发挥作用,符合已经描述的生物学原理。
    Patients with advanced non-small cell lung cancer (NSCLC) are a heterogeneous population with short lifespan. We aimed to develop methods to better differentiate patients whose survival was >90 days.
    We evaluated 83 characteristics of 106 treatment-naïve, stage IV NSCLC patients with Eastern Cooperative Oncology Group Performance Status (ECOG-PS) >1. Automated machine learning was used to select a model and optimize hyperparameters. 100-fold bootstrapping was performed for dimensionality reduction for a second (\"lite\") model. Performance was measured by C-statistic and accuracy metrics in an out-of-sample validation cohort. The \"lite\" model was validated on a second independent, prospective cohort (N = 42). Network analysis (NA) was performed to evaluate the differences in centrality and connectivity of features.
    The selected method was ExtraTrees Classifier, with C-statistic of 0.82 (p < 0.01) and accuracy of 0.81 (p = 0.01). The \"lite\" model had 16 variables and obtained C-statistic of 0.84 (p < 0.01) and accuracy of 0.75 (p = 0.039) in the first cohort, and C-statistic of 0.706 (p < 0.01) and accuracy of 0.714 (p < 0.01) in the second cohort. The networks of patients with lower survival were more interconnected. Features related to cachexia, inflammation, and quality of life had statistically different prestige scores in NA.
    Machine learning can assist in the prognostic evaluation of advanced NSCLC. The model generated with a reduced number of features showed high accessibility and reasonable metrics. Features related to quality of life, cachexia, and performance status had increased correlation and importance scores, suggesting that they play a role at later disease stages, in line with the biological rationale already described.
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  • 文章类型: Journal Article
    背景:在这项研究中,我们评估了Immunoscore在亚洲人群I-III期结肠癌(CC)患者中的预后价值.这些患者最初被纳入由癌症免疫治疗协会(SITC)领导的一项针对2681例AJCC/UICC-TNMI-III期CC患者的国际研究。方法:通过数字病理定量肿瘤和浸润边缘的CD3和细胞毒性CD8T淋巴细胞密度。评估Immunoscore与预后的关系,评估复发时间(TTR),无病生存率(DFS),总生存率(OS)。结果:免疫评分将亚洲患者(n=423)分为不同的风险类别,不受年龄的影响。3年无复发率为78.5%,85.2%,和98.3%的低点,中间,和高免疫分数,分别(HR[低与高]=7.26(95%CI1.75−30.19);p=0.0064)。高免疫分数显示与延长的TTR显著相关,操作系统,和DFS(p<0.05)。在按中心分层的Cox多变量分析中,免疫评分与TTR的相关性独立于患者性别(HR[低vs-Int+高]=2.22(95%CI1.10−4.55)p=0.0269),T-stage,N级,片面性,和MSI状态。在MSS中也发现了高免疫分数与延长TTR的显着关联(HR[Low-vs-Int+High]=4.58(95%CI2.27−9.23);p≤0.0001),II期(HR[低-vs-Int+高]=2.72(95%CI1.35−5.51);p=0.0052),低风险II期(HR[Low-vs-Int+High]=2.62(95%CI1.21−5.68);p=0.0146),和高危II期患者(HR[低vs-Int+高]=3.11(95%CI1.39−6.91);p=0.0055)。结论:在亚洲人群中,高免疫分数与CC患者的生存期延长显著相关。
    BACKGROUND: In this study, we evaluated the prognostic value of Immunoscore in patients with stage I−III colon cancer (CC) in the Asian population. These patients were originally included in an international study led by the Society for Immunotherapy of Cancer (SITC) on 2681 patients with AJCC/UICC-TNM stages I−III CC. METHODS: CD3+ and cytotoxic CD8+ T-lymphocyte densities were quantified in the tumor and invasive margin by digital pathology. The association of Immunoscore with prognosis was evaluated for time to recurrence (TTR), disease-free survival (DFS), and overall survival (OS). RESULTS: Immunoscore stratified Asian patients (n = 423) into different risk categories and was not impacted by age. Recurrence-free rates at 3 years were 78.5%, 85.2%, and 98.3% for a Low, Intermediate, and High Immunoscore, respectively (HR[Low-vs-High] = 7.26 (95% CI 1.75−30.19); p = 0.0064). A High Immunoscore showed a significant association with prolonged TTR, OS, and DFS (p < 0.05). In Cox multivariable analysis stratified by center, Immunoscore association with TTR was independent (HR[Low-vs-Int+High] = 2.22 (95% CI 1.10−4.55) p = 0.0269) of the patient’s gender, T-stage, N-stage, sidedness, and MSI status. A significant association of a High Immunoscore with prolonged TTR was also found among MSS (HR[Low-vs-Int+High] = 4.58 (95% CI 2.27−9.23); p ≤ 0.0001), stage II (HR[Low-vs-Int+High] = 2.72 (95% CI 1.35−5.51); p = 0.0052), low-risk stage-II (HR[Low-vs-Int+High] = 2.62 (95% CI 1.21−5.68); p = 0.0146), and high-risk stage II patients (HR[Low-vs-Int+High] = 3.11 (95% CI 1.39−6.91); p = 0.0055). CONCLUSION: A High Immunoscore is significantly associated with the prolonged survival of CC patients within the Asian population.
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  • 文章类型: Journal Article
    背景:对乙酰氨基酚中毒已成为欧洲和美国急性肝衰竭(ALF)的主要原因。
    目的:鉴定早期生物标志物,以预测猪对乙酰氨基酚中毒模型中ALF的发展。
    方法:六头德国长白猪通过空肠导管接受1g/kg体重的单次对乙酰氨基酚推注。以8小时间隔分析细胞因子和实验室参数,共40小时。
    结果:6只动物中有3只在中毒中存活。未存活的动物在中毒后8小时血清乳酸和白介素(IL)-6增加,凝血酶原时间(PT)和白蛋白浓度同时降低。在所有幸存的动物中,观察到中毒前和ALF过程中基线时肿瘤坏死因子α(TNF-α)水平升高.对乙酰氨基酚的血清浓度和毒物动力学在未存活的动物和存活的动物之间没有差异。高铁血红蛋白血症与给药剂量和对乙酰氨基酚血液水平成正比,但是高铁血红蛋白血症并不影响生存率.
    结论:肿瘤坏死因子α,IL-6,乳酸,凝血酶原时间,和白蛋白血药浓度被确定为对乙酰氨基酚中毒后结局的早期预测因子。对乙酰氨基酚暴露前TNF-α水平升高是致死结果的最早预后标志。因此,它可以作为一个非常早期的预后指标。
    BACKGROUND: Acetaminophen intoxication has become the leading cause of acute liver failure (ALF) in Europe and the USA.
    OBJECTIVE: To identify early biomarkers in order to predict the development of ALF in a porcine model of acetaminophen intoxication.
    METHODS: Six German Landrace pigs received a single acetaminophen bolus of 1 g/kg body weight via a jejunal catheter. Cytokines and laboratory parameters were analyzed at 8-hour intervals for a total of 40 h.
    RESULTS: Three of the 6 animals survived the intoxication. The nonsurviving animals had an increase in serum lactate and interleukin (IL)-6, with a simultaneous decrease in prothrombin time (PT) and albumin concentration 8 h after intoxication. In all nonsurviving animals, elevated levels of tumor necrosis factor alpha (TNF-α) at baseline before intoxication and during the course of ALF were observed. The acetaminophen serum concentrations and toxicokinetics did not differ between the nonsurviving and surviving animals. Methemoglobinemia was proportional to the administered doses and acetaminophen blood levels, but methemoglobinemia did not affect survival.
    CONCLUSIONS: Tumor necrosis factor alpha, IL-6, lactate, prothrombin time, and albumin blood concentration were identified as early predictors of outcome after acetaminophen intoxication. An elevated TNF-α level before acetaminophen exposure was the earliest prognostic marker for a lethal outcome. Therefore, it could serve as a very early indicator of prognosis.
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