Neutrophil-lymphocyte ratio at 14th week predicts loss of response to 52-week infliximab therapy in patients with Crohn's disease / 南方医科大学学报

OBJECTIVE@#Loss of response (LOR) has become an important clinical problem in patients with Crohn's disease receiving infliximab (IFX) treatment. Neutrophil-lymphocyte ratio (NLR) has been shown to correlate with the activity of inflammatory bowel disease (IBD), and NLR at the 14th week of IFX therapy potentially allows the prediction of sustained response to IFX in Crohn's patients. The aim of this study was to explore whether NLR at the 14th week of IFX therapy could predict the occurrence of LOR to IFX in Crohn's patients.@*METHODS@#Between January, 2012 and December, 2016, 54 patients with Crohn's disease underwent a 52-week treatment with IFX and successfully achieved response to the induction treatment in Zhongnan Hospital. We retrospectively examined their medical records and assessed the association between NLR at 14 weeks and LOR during IFX therapy.@*RESULTS@#Of the 54 patients, 15 (27.8%) showed LOR to IFX during the follow-up. We noted a significant increase in NLR at 14 weeks in the patients with LOR as compared with the patients with sustained response to IFX[3.51 (2.9-6.25) 1.77 (1.23-2.56), =0.00]. Receiver-operating characteristic analysis showed that at the cut-off value of 2.75, NLR at 14 weeks was predictive of LOR within 52 weeks of IFX therapy with a sensitivity of 93.33% and a specificity of 84.62%, and the area under curve (AUC) of NLR was 0.903 (0.731-0.959). Univariate analysis revealed a significant correlation between relapse-free survival and the NLR at 14 weeks (=0.00). Multivariate analysis identified NLR at 14 weeks as an independent prognostic factor for LOR with a hazard ratio of 1.851 (95% :1.096-3.026, =0.021).@*CONCLUSIONS@#NLR at the 14th week during IFX therapy is a useful predictor for LOR in patients with Crohn's disease.

Correlation between colorectal cancer and helicobacter pylori infection in different countries: A meta-analysis / 解放军医学杂志

ObjectiveTo explore the relationship between Helicobacter pylori (Hp) infection and colorectal cancer in different continents or economic conditions. Methods Published case-control studies dealing with the correlation of colorectal cancer with Hp infection were retrieved from PubMed, EMBASE, High Wire Press, Ovid, Medline and EBSCO. Meta-analysis was performed by using RevMan 5.3 software. We selected the OR and 95% CI as indicators of the analysis according to different continents (Asia, Europe, and America) and economic conditions (developed countries and developing countries). Results A total of 23 studies dealing with the correlation of colorectal cancer with Hp infection were included in the present meta-analysis, and there was a total sample of 182,561 patients, including 88,378 cases in Hp positive group and 94,183 cases in Hp negative group. The results of meta-analysis showed the OR was 1.42 (95%CI 1.38-1.46). Geographically, the correlation was low in Asian countries (OR=1.29, 95%CI 1.13-1.48), and was highest in American countries (OR=1.44, 95%CI 1.39-1.48). According to the economic conditions, the correlation was low in developing countries (OR=1.17, 95%CI 1.01-1.37), and was higher in developed countries (OR=1.43, 95%CI 1.39-1.47). Conclusions Hp infection is a risk factor for colorectal cancer. It seems that there is a close relation ship between its incidence and geography, and also economic condition.