Pan-Immune-Inflammation Value

泛免疫炎症值
  • 文章类型: Journal Article
    本研究旨在探讨泛免疫-炎症值(PIV)联合PILE评分对晚期非小细胞肺癌(NSCLC)患者免疫治疗的预测价值,并构建列线图预测模型,为临床工作提供参考。
    选择2019年1月至2021年12月在青岛市市立医院接受ICIs治疗的晚期非小细胞肺癌患者作为研究对象。卡方检验,Kaplan-Meier生存分析,采用Cox比例风险回归分析评估预后。结果通过列线图可视化,并通过受试者工作特性曲线下面积(AUC)和C指数等指标判断模型的性能。根据PILE评分将患者分为高危组和低危组,评估不同风险组患者的预后。
    多因素Cox回归分析显示,免疫相关不良事件(irAEs)是总生存期(OS)改善的预后因素,ECOGPS评分≥2分,治疗前骨转移,高PIV表达是OS的独立危险因素。通过列线图模型预测的OS的C指数为0.750(95%CI:0.677-0.823),标定曲线和ROC曲线表明该模型具有良好的预测性能。与低风险组相比,PILE高危人群的患者与较高的炎症状态和较差的身体状况相关,这通常导致预后较差。
    PIV可作为ICIs治疗晚期NSCLC患者的预后指标,并且可以构建一个列线图预测模型来评估患者的生存预测,从而有助于更好的临床决策和预后评估。
    UNASSIGNED: The purpose of this study was to investigate the predictive value of Pan-Immune-Inflammation Value (PIV) combined with the PILE score for immunotherapy in patients with advanced non-small cell lung cancer (NSCLC) and to construct a nomogram prediction model to provide reference for clinical work.
    UNASSIGNED: Patients with advanced NSCLC who received ICIs treatment in Qingdao Municipal Hospital from January 2019 to December 2021 were selected as the study subjects. The chi-square test, Kaplan-Meier survival analysis, and Cox proportional risk regression analysis were used to evaluate the prognosis. The results were visualized by a nomogram, and the performance of the model was judged by indicators such as the area under the subject operating characteristic curve (AUC) and C-index. The patients were divided into high- and low-risk groups by PILE score, and the prognosis of patients in different risk groups was evaluated.
    UNASSIGNED: Multivariate Cox regression analysis showed that immune-related adverse events (irAEs) were prognostic factors for overall survival (OS) improvement, and ECOG PS score ≥2, bone metastases before treatment, and high PIV expression were independent risk factors for OS. The C index of OS predicted by the nomogram model is 0.750 (95% CI: 0.677-0.823), and the Calibration and ROC curves show that the model has good prediction performance. Compared with the low-risk group, patients in the high-risk group of PILE were associated with a higher inflammatory state and poorer physical condition, which often resulted in a poorer prognosis.
    UNASSIGNED: PIV can be used as a prognostic indicator for patients with advanced NSCLC treated with ICIs, and a nomogram prediction model can be constructed to evaluate the survival prediction of patients, thus contributing to better clinical decision-making and prognosis assessment.
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  • 文章类型: Journal Article
    泛免疫炎症值(PIV)作为一种新型的炎症指标最近受到了更多的关注。我们旨在评估PIV与脓毒症患者预后之间的关系。数据是从重症监护医学信息集市IV数据库中提取的。主要和次要结局是28天和90天死亡率。通过Kaplan-Meier曲线评估PIV与结果之间的关联,Cox回归分析,限制三次样条曲线和子群分析。共纳入11,331例脓毒症患者。Kaplan-Meier曲线显示PIV较高的脓毒症患者28天生存率较低。在多变量Cox回归分析中,log2-PIV与28天死亡风险呈正相关[HR(95%CI)1.06(1.03,1.09),P<0.001]。log2-PIV与28天死亡率之间的关系是非线性的,预测拐点为8。在拐点的右边,高log2-PIV与28天死亡风险增加相关[HR(95%CI)1.13(1.09,1.18),P<0.001]。然而,在这一点的左边,此关联无显著意义[HR(95%CI)1.01(0.94,1.08),P=0.791]。对于90天死亡率也发现了类似的结果。我们的研究表明PIV与脓毒症患者28天和90天死亡风险之间存在非线性关系。
    Pan-Immune-Inflammation Value (PIV) has recently received more attention as a novel indicator of inflammation. We aimed to evaluate the association between PIV and prognosis in septic patients. Data were extracted from the Medical Information Mart for Intensive Care IV database. The primary and secondary outcomes were 28-day and 90-day mortality. The association between PIV and outcomes was assessed by Kaplan-Meier curves, Cox regression analysis, restricted cubic spline curves and subgroup analysis. A total of 11,331 septic patients were included. Kaplan-Meier curves showed that septic patients with higher PIV had lower 28-day survival rate. In multivariable Cox regression analysis, log2-PIV was positively associated with the risk of 28-day mortality [HR (95% CI) 1.06 (1.03, 1.09), P < 0.001]. The relationship between log2-PIV and 28-day mortality was non-linear with a predicted inflection point at 8. To the right of the inflection point, high log2-PIV was associated with an increased 28-day mortality risk [HR (95% CI) 1.13 (1.09, 1.18), P < 0.001]. However, to the left of this point, this association was non-significant [HR (95% CI) 1.01 (0.94, 1.08), P = 0.791]. Similar results were found for 90-day mortality. Our study showed a non-linear relationship between PIV and 28-day and 90-day mortality risk in septic patients.
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  • 文章类型: Journal Article
    背景:造影剂肾病(CIN)是侵入性心血管手术后最重要的并发症之一。考虑到炎症在CIN发育中的关键作用,使用基于外周血的指标可能是预测CIN风险的一个容易获得的生物标志物.因此,在本研究中,我们评估了泛免疫炎症值(PIV)与CI风险之间的关联。患者和方法:共纳入1343例接受冠状动脉造影(CAG)的患者。用以下等式计算PIV:(中性粒细胞计数×血小板计数×单核细胞计数)/淋巴细胞计数。多变量回归分析用于确定临床和实验室参数与CIN发展之间的关联。结果:该队列的中位年龄为58岁(IQR50-67),48.2%的患者为女性。在随访中,202例患者(15%)出现CIN。在多变量分析中,年龄较大(OR:1.015,95%CI:1.002-1.028,p=0.020)和较高的PIV水平(OR:1.016,95%CI:1.004-1.028,p=0.008)与较高的CIN风险相关,而使用抗血小板药物与低CIN风险相关(OR:0.670,95%CI:0.475-0.945,p=0.022).结论:我们证明,在接受稳定性缺血性心脏病CAG的大型队列患者中,PIV较高的患者和年龄较大的患者中,CIN的风险明显更高。如果有潜在证据支持,PIV水平可以用作CIN的微创反射器。
    Background: Contrast-induced nephropathy (CIN) is one of the most important complications after invasive cardiovascular procedures. Considering the pivotal role of inflammation in CIN development, the use of peripheral blood-based indexes may be an easily available biomarker to predict CIN risk. Therefore, in the present study, we evaluated the association between the pan-immune-inflammation value (PIV) and the risk of CIN. Patients and Methods: A total of 1343 patients undergoing coronary angiography (CAG) were included. The PIV was calculated with the following equation: (neutrophil count × platelet count × monocyte count)/lymphocyte count. Multivariable regression analyses were used to determine the association between clinical and laboratory parameters and CIN development. Results: The median age of the cohort was 58 (IQR 50-67), and 48.2% of the patients were female. CIN developed in 202 patients (15%) in follow-up. In multivariate analyses, older age (OR: 1.015, 95% CI: 1.002-1.028, p = 0.020) and higher PIV levels (OR: 1.016, 95% CI: 1.004-1.028, p = 0.008) were associated with a higher CIN risk, while the use of antiplatelet agents was associated with a lower risk of CIN (OR: 0.670, 95% CI: 0.475-0.945, p = 0.022). Conclusions: We demonstrated that the risk of CIN was significantly higher in patients with higher PIV and older patients in a large cohort of patients undergoing CAG for stable ischemic heart disease. If supported with prospective evidence, PIV levels could be used as a minimally invasive reflector of CIN.
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  • 文章类型: Journal Article
    有效生物标志物的预后价值,泛免疫炎症值(PIV),对于头颈部鳞状细胞癌(HNSCC)患者,在根治性手术或放化疗后尚未得到很好的探索。本研究旨在构建和验证基于PIV的列线图,以预测HNSCC患者的生存结果。
    共有161例接受根治性手术的HNSCC患者被纳入回顾性研究队列。使用最大选择的秩统计方法确定PIV的截止值。进行了多变量Cox回归和最小绝对收缩和选择算子(LASSO)回归分析,以开发两个预测无病生存(DFS)的列线图(模型A和模型B)。一致性指数,接收机工作特性曲线,校正曲线,和决策曲线分析用于评估列线图。由50例仅接受放疗或放化疗(RT/CRT)的患者组成的队列用于PIV和列线图的一般性测试。
    PIV较高(≥123.3)的患者DFS较差(HR,5.01;95%CI,3.25-7.72;p<0.0001)和总生存期(OS)(HR,与发展队列中PIV较低(<123.3)的患者相比,5.23;95%CI,3.34-8.18;p<0.0001)。模型A的预测因素包括年龄,TNM阶段,中性粒细胞与淋巴细胞比率(NLR),还有PIV,模型B包括TNM阶段,淋巴细胞与单核细胞比率(LMR),和PIV。与单独的TNM阶段相比,这两个列线图显示出良好的校准和鉴别,并在内部验证中显示出令人满意的临床效用.一般性测试结果表明,在RT/CRT队列中,较高的PIV也与较差的生存结果相关,并且两个列线图可能对接受不同治疗的患者具有普遍适用性。
    基于PIV的列线图,一个简单但有用的指标,可以为根治性手术后的单个HNSCC患者提供预后预测,可广泛应用于单纯RT/CRT术后的患者。
    UNASSIGNED: The prognostic value of an effective biomarker, pan-immune-inflammation value (PIV), for head and neck squamous cell carcinoma (HNSCC) patients after radical surgery or chemoradiotherapy has not been well explored. This study aimed to construct and validate nomograms based on PIV to predict survival outcomes of HNSCC patients.
    UNASSIGNED: A total of 161 HNSCC patients who underwent radical surgery were enrolled retrospectively for development cohort. The cutoff of PIV was determined using the maximally selected rank statistics method. Multivariable Cox regression and least absolute shrinkage and selection operator (LASSO) regression analyses were performed to develop two nomograms (Model A and Model B) that predict disease-free survival (DFS). The concordance index, receiver operating characteristic curves, calibration curves, and decision curve analysis were used to evaluate the nomograms. A cohort composed of 50 patients who received radiotherapy or chemoradiotherapy (RT/CRT) alone was applied for generality testing of PIV and nomograms.
    UNASSIGNED: Patients with higher PIV (≥123.3) experienced a worse DFS (HR, 5.01; 95% CI, 3.25-7.72; p<0.0001) and overall survival (OS) (HR, 5.23; 95% CI, 3.34-8.18; p<0.0001) compared to patients with lower PIV (<123.3) in the development cohort. Predictors of Model A included age, TNM stage, neutrophil-to-lymphocyte ratio (NLR), and PIV, and that of Model B included TNM stage, lymphocyte-to-monocyte ratio (LMR), and PIV. In comparison with TNM stage alone, the two nomograms demonstrated good calibration and discrimination and showed satisfactory clinical utility in internal validation. The generality testing results showed that higher PIV was also associated with worse survival outcomes in the RT/CRT cohort and the possibility that the two nomograms may have a universal applicability for patients with different treatments.
    UNASSIGNED: The nomograms based on PIV, a simple but useful indicator, can provide prognosis prediction of individual HNSCC patients after radical surgery and may be broadly applicated for patients after RT/CRT alone.
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  • 文章类型: Journal Article
    目的:使用术前泛免疫-炎症值(PIV)和单核细胞与高密度脂蛋白比值(MHR)来反映炎症,豁免权,和胆固醇代谢,我们旨在开发并可视化一种新的列线图模型,用于预测结直肠癌(CRC)患者的生存结局.
    方法:对172例接受根治性切除术的CRC患者进行回顾性分析。根据PIV和MHR的最佳临界值对患者进行分组后进行生存分析。使用Cox比例风险回归进行单变量和多变量分析以筛选独立的预后因素。基于这些因素,构建并验证了列线图.
    结果:PIV与肿瘤位置显著相关(P<0.001),肿瘤最大直径(P=0.008),和T阶段(P=0.019)。MHR与性别密切相关(P=0.016),肿瘤最大直径(P=0.002),和T阶段(P=0.038)。多因素分析结果显示,PIV(危险比(HR)=2.476,95%置信区间(CI)=1.410-4.348,P=0.002),MHR(HR=3.803,95CI=1.609-8.989,P=0.002),CEA(HR=1.977,95CI=1.121-3.485,P=0.019),和TNM分期(HR=1.759,95CI=1.010-3.063,P=0.046)是总生存期(OS)的独立预后指标。开发了包含这些变量的列线图,证明了操作系统的强大预测准确性。预测模型的曲线下面积(AUC)值1-,2-,和3年分别为0.791,0.768,0.811。在1-,2-,和3年提出了很高的可信度。此外,在1-,2-,和3年证明了预测生存结果的重要临床效用。
    结论:术前PIV和MHR是影响CRC预后的独立危险因素。新开发的列线图展示了强大的预测能力,在促进临床决策过程中提供了实质性的效用。
    OBJECTIVE: Using the preoperative pan-immune-inflammation value (PIV) and the monocyte to high-density lipoprotein ratio (MHR) to reflect inflammation, immunity, and cholesterol metabolism, we aim to develop and visualize a novel nomogram model for predicting the survival outcomes in patients with colorectal cancer (CRC).
    METHODS: A total of 172 patients with CRC who underwent radical resection were retrospectively analyzed. Survival analysis was conducted after patients were grouped according to the optimal cut-off values of PIV and MHR. Univariate and multivariate analyses were performed using Cox proportional hazards regression to screen the independent prognostic factors. Based on these factors, a nomogram was constructed and validated.
    RESULTS: The PIV was significantly associated with tumor location (P < 0.001), tumor maximum diameter (P = 0.008), and T stage (P = 0.019). The MHR was closely related to gender (P = 0.016), tumor maximum diameter (P = 0.002), and T stage (P = 0.038). Multivariate analysis results showed that PIV (Hazard Ratio (HR) = 2.476, 95% Confidence Interval (CI) = 1.410-4.348, P = 0.002), MHR (HR = 3.803, 95%CI = 1.609-8.989, P = 0.002), CEA (HR = 1.977, 95%CI = 1.121-3.485, P = 0.019), and TNM stage (HR = 1.759, 95%CI = 1.010-3.063, P = 0.046) were independent prognostic indicators for overall survival (OS). A nomogram incorporating these variables was developed, demonstrating robust predictive accuracy for OS. The area under the curve (AUC) values of the predictive model for 1-, 2-, and 3- year are 0.791,0.768,0.811, respectively. The calibration curves for the probability of survival at 1-, 2-, and 3- year presented a high degree of credibility. Furthermore, Decision curve analysis (DCA) for the probability of survival at 1-, 2-, and 3- year demonstrate the significant clinical utility in predicting survival outcomes.
    CONCLUSIONS: Preoperative PIV and MHR are independent risk factors for CRC prognosis. The novel developed nomogram demonstrates a robust predictive ability, offering substantial utility in facilitating the clinical decision-making process.
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  • 文章类型: Journal Article
    目的:本研究旨在进一步评估泛免疫-炎症值(PIV)作为喉部和咽部肿瘤患者预后标志物的潜在价值。
    方法:选择在山东大学齐鲁医院接受手术治疗的喉咽部肿瘤患者545例。我们确定了PIV的最佳截止值,并将患者分为两组。通过卡方检验和Mann-WhitneyU检验探讨PIV与临床病理特征之间的关系。采用生存分析和Cox回归分析评价PIV与总生存期(OS)和无病生存期(DFS)的关系。我们还比较了PIV与其他炎症相关标志物的预后预测价值。最后,我们基于几个独立的预后参数建立了一个简单的评分预测模型.
    结果:我们发现PIV与临床病理特征如肿瘤分期有统计学关联(p<0.001),节点阶段(p=0.001),术后化疗(p=0.026),血管血栓形成(p=0.027)。生存分析显示PIV升高与OS和DFS降低之间存在显著相关性(p<0.0001)。多因素Cox回归分析进一步证实PIV是预后指标(HR2.507;95%CI1.343-4.681;p=0.004),优于SII,NLR,MLR和PLR。通过多变量Cox回归分析筛选出的独立预后因素中的三个被选择用于创建一致指数为0.756的评分系统。
    结论:喉部和咽部肿瘤患者PIV升高与预后不良相关,提示PIV可能是评估患者预后的重要辅助指标。
    注册号:KYLL-202307-001,日期:2023年7月。
    OBJECTIVE: This study aimed to further evaluate the potential value of Pan-Immune-Inflammation Value (PIV) as a prognostic marker in patients with laryngeal and pharyngeal tumors.
    METHODS: A total of 545 patients with laryngeal and pharyngeal tumors who underwent surgery at Qilu Hospital of Shandong University were included. We determined the optimal cutoff of PIV and divided the patients into two groups. The relationship between PIV and clinicopathological features was explored by the chi-square test and the Mann-Whitney U test. Survival analysis and Cox regression analysis were used to evaluate the relationship between PIV and overall survival (OS) and disease-free survival (DFS). We also compared the prognostic predictive value of PIV with other inflammation-related markers. Finally, we developed a simple scoring prediction model based on several independent prognostic parameters.
    RESULTS: We found that PIV was statistically associated with clinicopathological features such as tumor stage (p < 0.001), node stage (p = 0.001), postoperative chemotherapy (p = 0.026), and vascular thrombosis (p = 0.027). Survival analysis demonstrated a significant correlation between elevated PIV and reduced OS and DFS (p < 0.0001). Multivariate Cox regression analysis further confirmed PIV as a prognostic indicator (HR 2.507; 95% CI 1.343-4.681; p = 0.004), which is superior to SII, NLR, MLR and PLR. Three of the independent prognostic factors screened by multivariate Cox regression analysis were selected to be used to create a scoring system with a concordance index of 0.756.
    CONCLUSIONS: Elevated PIV is associated with poor prognosis in patients with laryngeal and pharyngeal tumors, suggesting that PIV may be an important adjunctive indicator for assessing patient prognosis.
    UNASSIGNED: Registration number: KYLL-202307-001, date: July 2023.
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  • 文章类型: Journal Article
    在这项研究中,分析慢性冠脉综合征(CCS)患者泛免疫-炎症值(PIV)与冠脉侧支循环(CCC)的相关性.该研究包括663例CCS患者,这些患者接受了冠状动脉造影,并且至少有一条主要冠状动脉血管的冠状动脉狭窄≥95%。将参与者分为两组:良好的CCC(Rentrop评分2-3)和较差的CCC(Rentrop评分0-1)。PIV评分计算为单核细胞x血小板x中性粒细胞/淋巴细胞计数。当比较发展良好和不良CCC的患者组时,中性粒细胞/淋巴细胞比值(NLR)(P<.001),C反应蛋白(CRP)水平,CRP/白蛋白比值(CAR)(P<.001),全身免疫炎症指数(SII)(P<0.001),CCC较差患者的PIV和PIV(P<.001)较高。在多变量逻辑回归分析中,年龄,SII,NLR,CRP,汽车,和PIV被发现是不良CCC的独立预测因子(P<.001,全部)。接收器工作特性(ROC)分析表明,与其他标记物相比,PIV的截断值442.2预测不良CCC的效果略好,敏感性为76.8%,特异性为70.1%(ROC曲线下面积=0.808(95%CI:0.764-0.851),P<.001)。这些发现表明PIV可以用作CCC发展的独立预测因子。
    In this study, the correlation between pan-immune-inflammation value (PIV) and coronary collateral circulation (CCC) in patients with chronic coronary syndrome (CCS) was analyzed. The study included 663 patients with CCS who underwent coronary angiography and had coronary stenosis of ≥95% in at least one major coronary vessel. The participants were divided into two groups: good CCC (Rentrop score 2-3) and poor CCC (Rentrop score 0-1). PIV score was calculated as monocyte x platelet x neutrophil/lymphocyte count. When the patient groups who developed good and poor CCC were compared, neutrophil/lymphocyte ratio (NLR) (P < .001), C-reactive protein (CRP) levels, CRP/albumin ratio (CAR) (P < .001), systemic immune-inflammation index (SII) (P < .001), and PIV (P < .001) were higher in patients with poor CCC. In multivariate logistic regression analysis, age, SII, NLR, CRP, CAR, and PIV were found to be independent predictors of poor CCC (P < .001, for all). Receiver operating characteristic (ROC) analysis demonstrated that a cut-off value of 442.2 for PIV predicted poor CCC slightly better compared to other markers, with 76.8% sensitivity and 70.1% specificity (area under ROC curve = 0.808 (95% CI: 0.764-0.851), P < .001). These findings suggest that PIV can be used as an independent predictor of CCC development.
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  • 文章类型: Journal Article
    背景:最近使用的泛免疫炎症值(PIV)尚未被充分研究为免疫抑制患者死亡率的预测指标。这项研究的目的是评估基线PIV水平作为革兰氏阴性血流感染(GN-BSI)的实体器官移植(SOT)接受者30天死亡率的预测因子的有用性。
    方法:本回顾性研究,横断面研究于2019年1月1日至2022年12月31日期间在1104名SOT接受者中进行.在学习期间,113例患者共记录118GN-BSI。临床,流行病学,收集了实验室数据,并记录死亡率(30日及全因).
    结果:113名接受者的中位年龄为50岁[四分位距(IQR)37.5-61.5岁],男性占优势(n=72,63.7%)。最常见的三种微生物如下:46株(38.9%)大肠杆菌,41例(34.7%)肺炎克雷伯菌,鲍曼不动杆菌12例(10.2%)。在44.9%和35.6%的分离物中,检测到产超广谱β-内酰胺酶和碳青霉烯耐药性,分别。碳青霉烯类耐药GN-BSI在肝脏受者中的发生率高于肾脏受者(n=27,69.2%vsn=13,17.6%,p<0.001)。GN-BSI后的全因死亡率和30天死亡率为26.5%(n=30),和16.8%(n=19),分别。在GN-BSI相关的30天死亡率组中,PIV中位数水平显着降低(327.3,IQR64.8-795.4与1049.6,IQR338.6-2177.1;p=0.002)。二元逻辑回归分析确定了低PIV水平[风险比(HR)=0.93,95%置信区间(CI)0.86-0.99;p=0.04],年龄增加(HR=1.05,95%CI1.01-1.09;p=0.002)是与30天死亡率相关的因素。受试者工作特征分析显示,PIV可以确定GN-BSI相关的30天死亡率,曲线下面积(AUC):0.723,95%CI0.597-0.848,p=0.0005。
    结论:PIV是一种简单而廉价的生物标志物,可用于估计免疫抑制患者的死亡率。但结果需要仔细解释。
    BACKGROUND: The recently used pan-immune-inflammation value (PIV) has not been adequately studied as a predictive marker for mortality in immunosuppressed patients. The aim of this study was to evaluate the usefulness of baseline PIV level as a predictor of 30-day mortality in solid organ transplant (SOT) recipients with gram negative bloodstream infections (GN-BSI).
    METHODS: This retrospective, cross-sectional study was conducted between January 1, 2019, and December 31, 2022, in 1104 SOT recipients. During the study period, 118 GN-BSI were recorded in 113 patients. Clinical, epidemiological, and laboratory data were collected, and mortality rates (30-day and all-cause) were recorded.
    RESULTS: The 113 recipients had a median age of 50 years [interquartile range (IQR) 37.5-61.5 years] with a male predominance (n = 72, 63.7%). The three most common microorganisms were as follows: 46 isolates (38.9%) of Escherichia coli, 41 (34.7%) of Klebsiella pneumoniae, and 12 (10.2%) of Acinetobacter baumannii. In 44.9% and 35.6% of the isolates, production of extended-spectrum beta-lactamases and carbapenem resistance were detected, respectively. The incidence of carbapenem-resistant GN-BSI was higher in liver recipients than in renal recipients (n = 27, 69.2% vs n = 13, 17.6%, p < 0.001). All-cause and 30-day mortality rates after GN-BSI were 26.5% (n = 30), and 16.8% (n = 19), respectively. In the group with GN-BSI-related 30-day mortality, the median PIV level was significantly lower (327.3, IQR 64.8-795.4 vs. 1049.6, IQR 338.6-2177.1; p = 0.002). The binary logistic regression analysis identified low PIV level [hazard ratio (HR) = 0.93, 95% confidence interval (CI) 0.86-0.99; p = 0.04], and increased age (HR = 1.05, 95% CI 1.01-1.09; p = 0.002) as factors associated with 30-day mortality. The receiver operating characteristic analysis revealed that PIV could determine the GN-BSI-related 30-day mortality with area under curve (AUC): 0.723, 95% CI 0.597-0.848, p = 0.0005.
    CONCLUSIONS: PIV is a simple and inexpensive biomarker that can be used to estimate mortality in immunosuppressed patients, but the results need to be interpreted carefully.
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  • 文章类型: Journal Article
    本研究旨在探讨泛免疫炎症值(PIV)的预后作用,并开发一种新的风险模型,以指导射频消融(RFA)治疗早期肝细胞癌(HCC)。
    接受RFA治疗的早期HCC患者随机分为训练队列A(n=65)和测试队列B(n=68)。在队列A中筛选各种免疫炎症生物标志物(IIB)。在队列B和C中评估和验证了PIV的预后作用。分别。在队列C中建立列线图风险模型,并在合并队列D中进行验证。在低和高风险组中评估RFA后辅助抗血管生成疗法加免疫检查点抑制剂(AA-ICI)的临床益处。
    PIV的截止点是120。高PIV是不利的无复发生存率(RFS)和总生存率(OS)的独立预测因子。在队列B(PRFS=0.016,POS=0.011)和C(PRFS<0.001,POS<0.001)中,高PIV患者的RFS和OS率均明显低于低PIV患者。基于PIV的列线图模型,在外部验证队列C中,肿瘤数量和BCLC分期在风险分层中表现良好。AA-ICI辅助治疗对高危患者的OS有额外益处(p=0.011).
    PIV是接受治愈性RFA的早期HCC患者RFS和OS的可行独立预后因素。提出的基于PIV的列线图风险模型可以帮助临床医生识别高危患者,并制定辅助系统治疗和疾病随访方案。
    关键发现高泛免疫炎症值(PIV)是接受根治性射频消融(RFA)的早期肝细胞癌(HCC)患者的不良无复发生存期(RFS)和总生存期(OS)的独立指标。佐剂抗血管生成靶向治疗加免疫检查点抑制剂(AA-ICI)治疗显示,对于基于PIV的列线图风险模型定义的高危患者,OS有额外的益处。肿瘤数量和BCLC分期。什么是已知的,什么是新的?炎症和宿主免疫力受损与肝癌的发生和进展有关。越来越多的证据表明,免疫炎症生物标志物(IIB)在接受RFA的早期HCC患者中具有预后作用。然而,在这种情况下,尚未确定PIV的预后潜力。在这里,首次报道,在接受根治性RFA治疗的早期HCC患者中,高PIV是导致RFS和OS不良的独立危险因素,并有助于区分低危和高危患者.RFA后辅助AA-ICI治疗有利于高危患者的OS。这意味着什么,现在应该改变什么?对于具有高风险因素的早期肝癌(高PIV,多个肿瘤病灶和更晚期的BCLC分期),有必要在治愈性RFA后进行强化随访和系统辅助治疗.
    UNASSIGNED: This study aimed to explore the prognostic role of pan-immune-inflammation value (PIV) and develop a new risk model to guide individualized adjuvant systemic treatment following radiofrequency ablation (RFA) for early-stage hepatocellular carcinoma (HCC).
    UNASSIGNED: Patients with early-stage HCC treated by RFA were randomly divided into training cohort A (n = 65) and testing cohort B (n = 68). Another 265 counterparts were enrolled into external validating cohort C. Various immune-inflammatory biomarkers (IIBs) were screened in cohort A. Prognostic role of PIV was evaluated and validated in cohort B and C, respectively. A nomogram risk model was built in cohort C and validated in pooled cohort D. Clinical benefits of adjuvant anti-angiogenesis therapy plus immune checkpoint inhibitor (AA-ICI) following RFA was assessed in low- and high-risk groups.
    UNASSIGNED: The cutoff point of PIV was 120. High PIV was an independent predictor of unfavorable recurrence-free survival (RFS) and overall survival (OS). RFS and OS rates of patients with high PIV were significantly lower than those with low PIV both in cohort B (PRFS=0.016, POS=0.011) and C (PRFS<0.001, POS<0.001). The nomogram model based on PIV, tumor number and BCLC staging performed well in risk stratification in external validating cohort C. Adjuvant AA-ICI treatment showed an added benefit in OS (p = 0.011) for high-risk patients.
    UNASSIGNED: PIV is a feasible independent prognostic factor for RFS and OS in early-stage HCC patients who received curative RFA. The proposed PIV-based nomogram risk model could help clinicians identify high-risk patients and tailor adjuvant systemic treatment and disease follow-up scheme.
    Key findingsHigh pan-immune-inflammation value (PIV) is an independent indicator of unfavorable recurrence-free survival (RFS) and overall survival (OS) for early-stage hepatocellular carcinoma (HCC) patients who received curative radiofrequency ablation (RFA).Adjuvant anti-angiogenesis target therapy plus immune checkpoint inhibitor (AA-ICI) treatment showed added benefit in OS for the high-risk patients defined by a nomogram risk model based on PIV, tumor number and BCLC staging.What is known and what is new?Inflammation and impaired host immunity are associated with carcinogenesis and progression of HCC. Increasing evidences showed that immune-inflammatory biomarkers (IIBs) had prognostic roles in early-stage HCC patients who received RFA. However, prognostic potential of PIV has not been determined in this setting.Herein, high PIV was first reported to be an independent risk factor of poor RFS and OS in early-stage HCC patients treated by curative RFA and helped to discriminate patients between low- and high-risk groups. Adjuvant AA-ICI treatment following RFA was beneficial to OS of patients in the high-risk group.What is the implication, and what should change now?For early-stage HCC with high-risk factors (high PIV, multiple tumor foci and more advanced BCLC stage), intensive follow-up and adjuvant systemic therapy following curative RFA were warranted.
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  • 文章类型: Journal Article
    2型糖尿病(DM)是公认的慢性冠状动脉综合征(CCS)及其并发症的独立危险因素,急性冠脉综合征(ACS)。DM和糖尿病前期(preDM)患者面临ACS风险增加。炎症在CCS和ACS的发病机制中起重要作用。这项研究深入研究了新的炎症标志物,如全身免疫炎症指数(SII),全身炎症反应指数(SIRI),和全身炎症的综合指数(AISI,也称为SIIRI或PIV),在已诊断或未诊断为DM或DM前期的患者中,探讨其与ACS和CCS的关系。
    本研究包括493例胸痛患者行冠状动脉造影的数据。他们分为四组:1)无DM/preDM和CCS;2)同时具有DM/preDM和CCS;3)无DM/preDM和ACS,4)同时具有DM/preDM和ACS。使用标准的统计分析方法来揭示组间可能的差异,并在有DM/preDM和没有DM/preDM的组中找到最有影响力的ACS危险因素。
    分析表明SII没有显着差异,SIRI,或相应患者组之间的AISI。逻辑回归分析生成了一个包含SII的模型,高密度脂蛋白,和低密度脂蛋白水平是影响DM/preDM患者ACS的危险因素。该模型的准确率为71.0%,灵敏度为37.0%,和89.4%的特异性。
    研究结果表明,上述炎症标志物可能具有在低经济成本下区分ACS风险较高的DM/前DM患者的潜力。然而,需要进一步全面和精心设计的研究来验证其临床实用性。
    患有2型糖尿病(DM)和糖尿病前期(preDM)的人患心脏病的风险更高。这些包括慢性冠脉综合征(CCS)和急性冠脉综合征(ACS)。炎症是这些问题的关键因素。我们观察了493例胸痛患者。我们根据糖尿病状态(DM/preDMvs无糖尿病)和心脏病(ACS和CCS)将他们分为几组。我们探索了与炎症相关的新标志物。这些包括全身免疫炎症指数(SII),全身炎症反应指数(SIRI),和全身炎症的综合指数(AISI),所有这些都可以通过简单的血液检查来计算。我们发现这些标记在组间没有差异。为了更好地了解ACS的危险因素,我们使用统计分析。该模型发现了DM/前DM患者的关键因素:SII,LDL,和低密度脂蛋白水平。准确(71.0%),但是灵敏度是37.0%,特异性为89.4%。这些标记可能有助于通过低成本测试识别处于ACS风险的DM/preDM患者。我们需要更多的研究来确认它们在现实生活中的应用。
    UNASSIGNED: Type 2 diabetes mellitus (DM) is a recognized independent risk factor for both chronic coronary syndrome (CCS) and its complication, acute coronary syndrome (ACS). Patients with DM and prediabetes (preDM) face an increased ACS risk. Inflammation plays a significant role in the pathogenesis of both CCS and ACS. This study delves into novel inflammatory markers, such as the systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI, also known as SIIRI or PIV), to explore their relationship with ACS and CCS in patients that have been or have not been diagnosed with DM or preDM.
    UNASSIGNED: This study included data of 493 patients with chest pain undergoing coronary angiography. They were categorized into four groups: 1) without DM/preDM and with CCS; 2) with both DM/preDM and CCS; 3) without DM/preDM and with ACS, 4) with both DM/preDM and ACS. Standard methods of statistical analysis were used to reveal possible differences between groups and to find the most influential ACS risk factors in groups with DM/preDM and without DM/preDM.
    UNASSIGNED: The analysis showed no significant differences in SII, SIRI, or AISI between the respective patient groups. A logistic regression analysis generated a model incorporating SII, high-density lipoprotein, and low-density lipoprotein levels as the influential ACS risk factors for patients with DM/preDM. The model demonstrated 71.0% accuracy, 37.0% sensitivity, and 89.4% specificity.
    UNASSIGNED: The findings suggest that the aforementioned inflammatory markers may have potential for distinguishing DM/preDM patients at higher risk of ACS at a low financial cost. However, further comprehensive and well-designed research is required to validate their clinical utility.
    People with type 2 diabetes (DM) and prediabetes (preDM) have a higher risk of heart problems. These include chronic coronary syndrome (CCS) and acute coronary syndrome (ACS). Inflammation is a key element in these issues. We looked at 493 patients with chest pain. We divided them into groups based on diabetes status (DM/preDM vs no diabetes) and heart conditions (ACS and CCS). We explored new markers related to inflammation. These include the systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI) that all can be calculated from simple blood tests. We found no differences in these markers between groups. To understand ACS risk factors better, we used statistical analysis. The model found key factors for patients with DM/preDM: SII, LDL, and low-density lipoprotein levels. It was accurate (71.0%), but sensitivity was 37.0%, and specificity was 89.4%. These markers could be helpful in identifying DM/preDM patients at risk of ACS with low cost tests. We need more research to confirm their use in real-life medical settings.
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