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【Objective】 To investigate the predictive value of nutritional risk index (NRI), systemic immune inflammatory index (SⅡ) and triglyceride glucose (TyG) index on the condition and prognosis of patients with acute pancreatitis (AP). 【Methods】 A total of 173 AP patients were divided into mild acute pancreatitis (MAP) group (n=79), moderate acute pancreatitis (MSAP) group (n=44), and severe acute pancreatitis (SAP) group (n=50) according to their severity. All the 50 SAP patients were divided into death group (19 cases) and survival group (31 cases) according to the death situation. The NRI, SⅡ and TyG indexes of each group were recorded and compared. The values of NRI, SⅡ and TyG index in predicting the occurrence and death of SAP were analyzed with ROC curve. Pearson correlation analysis of the correlation between NRI, SⅡ, and TyG index in SAP patients was made. 【Results】 NRI was significantly lower in SAP group (89.25±4.50) than in MSAP group (93.40±6.25) and MAP group (97.62±8.60), while SⅡand TyG index in SAP group (2 706.30±1 052.74, 7.84±1.21) were significantly higher than those in MSAP group (1 937.24±983.48, 6.52±1.05) and MAP group (1 280.58±717.36, 4.65±0.58) (P<0.001). NRI in death group (86.40±3.70) was significantly lower than that in survival group (91.46±5.28), while SⅡ and TyG index in death group (3 085.73±1 192.48, 9.05±1.37) were significantly higher than those in survival group (2 270.26±994.53, 6.70±1.10) (P<0.001). The ROC curve showed that the AUC of NRI, SⅡ and TyG index jointly predicting SAP occurrence and death was 0.850 (95% CI: 0.792-0.908) and 0.905 (95% CI: 0.843-0.966), respectively. Correlation analysis showed that NRI was negatively correlated with SⅡ and TyG index in SAP patients (r=-0.761, P<0.001, r=-0.813, P<0.001), while SⅡ was positively correlated with TyG index (r=0.842, P<0.001). 【Conclusion】 NRI, SⅡ and TyG index are related to the severity and death of AP patients, and the combination of the three indexes has good value in predicting the occurrence and prognosis of SAP.
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Objective:To investigate the prognostic value of serum levels of miR-320 in sepsis children complicated with acute kidney injury (AKI).Methods:A total of 158 sepsis children with complicated with AKI who were admitted to Hainan Women and Children′s Medical Center from January 2017 to June 2019 were divided into survival group (105 cases) and death group (53 cases) according to their 28-day survival.Serum levels of miR-320, neutrophil gelatinase associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1) and serum creatinine (Scr) were detected in the two groups.Multivariate Logistic regression was used to analyze the risk factors of death in children with sepsis complicated with AKI.The receiver operating characteristic curve (ROC) was drawn to analyze the value of serum levels of miR-320, NGAL, KIM-1 and Scr in predicting the death of children with sepsis complicated with AKI.The correlation between serum levels of miR-320 and NGAL, KIM-1 and Scr was analyzed using Pearson correlation analysis. Results:The serum levels of miR-320 (1.28±0.47 vs. 0.54±0.12), NGAL [(537.40±48.26) mg/L vs. (285.60±29.40) mg/L], KIM-1 [(26.80±5.72) μg/ L vs. (16.35±3.17) μg/L] and Scr[(573.70±105.46) μmol/L vs. (390.64±74.38) μmol/L] in the death group were significantly higher than those in the survival group (all P<0.001). Multivariate Logistic regression analysis showed that serum levels of miR-320 ( OR=2.280, 95% CI: 1.483-4.380), NGAL ( OR=2.753, 95% CI: 1.826-5.227), KIM-1 ( OR=1.985, 95% CI: 1.274-3.518) and Scr ( OR=1.714, 95% CI: 1.105-2.986) were independent risk factors for death in sepsis children with AKI (all P<0.001). ROC curve analysis showed that the area under the curve (0.952, 95% CI: 0.894-0.990) of serum miR-320, NGAL, KIM-1 and Scr levels combined to predict the death of children with sepsis and AKI was the largest, with a high sensitivity and specificity of 95.8% and 90.6%.Correlation analysis showed that the expression level of serum miR-320 in the death group was positively correlated with NGAL, KIM-1 and Scr ( r=0.874, 0.830, 0.702, all P<0.01). Conclusions:Serum levels of miR-320 are significantly increased in sepsis children with AKI, which is an independent risk factor for death in sepsis children with AKI.The combination of NGAL, KIM-1 and Scr levels has important value in predicting the prognosis of children with AKI.
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OBJECTIVE@#To investigate the prognostic value of plasma miR-1290 in patients with oral squamous cell carcinoma (OSCC).@*METHODS@#Seventy patients with OSCC admitted to Danzhou People's Hospital from January 2014 to December 2018 were included in this study. Real-time fluorescence quantitative polymerase chain reaction (PCR) was used to detect the expression of miR-1290 in these patients. The optimal cut-off value of plasma miR-1290 expression was determined by the ROC curve method, and patients with OSCC were divided into the high (n=31) and low (n=39) miR-1290-expressing groups. The clinicopathological features of the two groups were compared, and survival curves were drawn using the Kaplan-Meier method. Risk factors affecting the poor prognosis of patients were analyzed using univariate and multivariate COX regression models.@*RESULTS@#The expression level of plasma miR-1290 in the OSCC group was significantly lower than that in the control group (0.65±0.14 vs. 2.06±0.90; t=13.912, P<0.001). The low expression of plasma miR-1290 appeared to be related to the clinical stage, differentiation degree, tumor diameter, and lymph node metastasis of OSCC (P<0.05). Survival analysis showed that the overall survival rate and the progression-free survival rate of the low-miR-1290 group were significantly lower than that of the high-miR-1290 group (P<0.01). Multivariate COX regression analysis showed that clinical stage, lymph node metastasis, and plasma miR-1290<1.14 were independent risk factors for the poor prognosis of patients with OSCC (P<0.05).@*CONCLUSIONS@#The expression level of plasma miR-1290 in patients with OSCC significantly decreased, and the low expression of miR-1290 is related to the short survival time of OSCC patients. Thus, miR-1290 may be a potential marker predicting the poor prognosis of OSCC.
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Humans , Biomarkers, Tumor , Carcinoma, Squamous Cell , Lymphatic Metastasis , MicroRNAs , Mouth Neoplasms , PrognosisABSTRACT
Objective To explore the value of serum microRNA-494 (miR-494) expression in predicting the prognosis of acute renal injury (AKI) after cardiac surgery in children. Methods 116 children with AKI after cardiopulmonary bypass for congenital heart disease admitted to Sanya People's Hospital from January 2016 to March 2019 were enrolled. The expression of miR-494 in serum was detected by real-time fluorescence quantitative polymerase chain reaction (RT-qPCR), and the levels of serum neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) were detected by enzyme linked immunosorbent assay (ELISA) of all the children. The children were divided into survival group and death group according to 28-day survival. Serum levels of miR-494, NGAL and KIM-1 were measured in two groups. Multivariate Logistic regression was used to analyze the risk factors of death in children with AKI after cardiac surgery. The receiver operating characteristic (ROC) curve analysis of serum levels of miR-494, NGAL and KIM-1 in predicting prognosis of children with AKI after cardiac surgery was performed. Pearson correlation analysis was used to analyze the correlation between serum levels of miR-494 and NGAL, KIM-1. Results After cardiopulmonary bypass in 116 children with AKI, 27 cases died and 89 cases survived during the 28-day observation. Compared with the survival group, the proportion of cyanosis in the death group was significantly increased, the proportion of blood perfusion was significantly decreased, the time of cardiopulmonary bypass and postoperative mechanical ventilation were significantly prolonged, and the blood glucose level was significantly increasedafter operation. There was no significant difference in other general data. The serum levels of miR-494, NGAL and KIM-1 in the death group were significantly higher than those in the survival group [miR-494 (2-ΔΔCt): 3.75±1.28 vs. 1.48±0.71, NGAL (mg/L): 583.60±52.72 vs. 320.52±31.84, KIM-1 (μg/L): 30.53±6.38 vs. 17.40±3.72, all P < 0.01]. Multivariate Logistic regression analysis showed cyanosis [odds ratio (OR) = 1.716, 95％ confidence interval (95％CI) was 1.184-2.982, P = 0.039], postoperative blood glucose (OR = 1.925, 95％CI was 1.262-3.387, P = 0.005), serum miR-494 (OR = 2.527, 95％CI was 1.706-5.148, P < 0.001), NGAL (OR = 2.473, 95％CI was 1.620-4.935, P < 0.001) and KIM-1 (OR = 1.805, 95％CI was 1.213-3.106, P < 0.001) were independent risk factors for death in children with AKI after cardiac surgery. ROC curve analysis showed the area under the curve (AUC) to predict the death of children with postoperative AKI was 0.868, 0.857 and 0.819 respectively, AUC of serum miR-494, NGAL and KIM-1 levels combination to predict the death of children with postoperative AKI was the largest (0.964, 95％CI was 0.908-0.997), with a high sensitivity and specificity of 97.0％ and 91.8％. The correlation analysis showed the expression level of serum miR-494 was positively correlated with NGAL and KIM-1 in the death group (r1 = 0.902, r2 = 0.873, both P < 0.01). Conclusion Serum levels of miR-494 increased significantly in children with AKI after cardiac surgery, which is an independent risk factor for death in children with AKI after cardiac surgery, and the combination of NGAL and KIM-1 levels had a high value in predicting the prognosis of children with AKI after cardiac surgery.
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Objective@#To explore the value of serum microRNA-494 (miR-494) expression in predicting the prognosis of acute renal injury (AKI) after cardiac surgery in children.@*Methods@#116 children with AKI after cardiopulmonary bypass for congenital heart disease admitted to Sanya People's Hospital from January 2016 to March 2019 were enrolled. The expression of miR-494 in serum was detected by real-time fluorescence quantitative polymerase chain reaction (RT-qPCR), and the levels of serum neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) were detected by enzyme linked immunosorbent assay (ELISA) of all the children. The children were divided into survival group and death group according to 28-day survival. Serum levels of miR-494, NGAL and KIM-1 were measured in two groups. Multivariate Logistic regression was used to analyze the risk factors of death in children with AKI after cardiac surgery. The receiver operating characteristic (ROC) curve analysis of serum levels of miR-494, NGAL and KIM-1 in predicting prognosis of children with AKI after cardiac surgery was performed. Pearson correlation analysis was used to analyze the correlation between serum levels of miR-494 and NGAL, KIM-1.@*Results@#After cardiopulmonary bypass in 116 children with AKI, 27 cases died and 89 cases survived during the 28-day observation. Compared with the survival group, the proportion of cyanosis in the death group was significantly increased, the proportion of blood perfusion was significantly decreased, the time of cardiopulmonary bypass and postoperative mechanical ventilation were significantly prolonged, and the blood glucose level was significantly increased after operation. There was no significant difference in other general data. The serum levels of miR-494, NGAL and KIM-1 in the death group were significantly higher than those in the survival group [miR-494 (2-ΔΔCt): 3.75±1.28 vs. 1.48±0.71, NGAL (mg/L): 583.60±52.72 vs. 320.52±31.84, KIM-1 (μg/L): 30.53±6.38 vs. 17.40±3.72, all P < 0.01]. Multivariate Logistic regression analysis showed cyanosis [odds ratio (OR) = 1.716, 95% confidence interval (95%CI) was 1.184-2.982, P = 0.039], postoperative blood glucose (OR = 1.925, 95%CI was 1.262-3.387, P = 0.005), serum miR-494 (OR = 2.527, 95%CI was 1.706-5.148, P < 0.001), NGAL (OR = 2.473, 95%CI was 1.620-4.935, P < 0.001) and KIM-1 (OR = 1.805, 95%CI was 1.213-3.106, P < 0.001) were independent risk factors for death in children with AKI after cardiac surgery. ROC curve analysis showed the area under the curve (AUC) to predict the death of children with postoperative AKI was 0.868, 0.857 and 0.819 respectively, AUC of serum miR-494, NGAL and KIM-1 levels combination to predict the death of children with postoperative AKI was the largest (0.964, 95%CI was 0.908-0.997), with a high sensitivity and specificity of 97.0% and 91.8%. The correlation analysis showed the expression level of serum miR-494 was positively correlated with NGAL and KIM-1 in the death group (r1 = 0.902, r2 = 0.873, both P < 0.01).@*Conclusion@#Serum levels of miR-494 increased significantly in children with AKI after cardiac surgery, which is an independent risk factor for death in children with AKI after cardiac surgery, and the combination of NGAL and KIM-1 levels had a high value in predicting the prognosis of children with AKI after cardiac surgery.
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Objective: We retrospectively studied the adaptation and limits of applying Biological Prognostic Score Version-2 composed only of blood test results to prognostic prediction in end-of-life non-cancer patients. Methods: The prognostic score was calculated from the cholinesterase, blood urea nitrogen, and white blood cell counts of hospitalized end-of-life non-cancer patients, divided into three groups with cutoff values, and prediction accuracy analysis, survival analysis, and simple regression analysis were performed. Results: Diagnostic accuracy of 204 non-cancer patients at the same cut-off value and predicted survival time as cancer was 79% accurate at 3 weeks survival and 63% at 9 weeks. Specificity and negative predictive value were highly accurate, sensitivity and positive predictive value were low. In the survival analysis, the discrimination between the 3 groups was significant (p<0.05), but the regression coefficient in the regression analysis was not significant (p=0.43). Conclusion: The prognostic prediction using this score for non-cancer patients has high prediction accuracy in the case of good prognosis. It is suggested that clinical use of this score is also possible if used cautiously.
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There were no reports about long survival predictors in palliative care settings. We divided categories into more than 31 days of hospitalization (short period hospitalization) and more than 61 days of hospitalization) (long hospitalization) and analyzed prognostic factors in multivariate methods. We measured the association between the long hospitalization and short period hospitalization groups with regard to terminal symptoms (cancer pain, delirium, nausea and vomiting, fatigue, and dyspnea) and treatment (hydration, continuous sedation, and opioids). In the more than 31 days of hospitalization group, sex (Odds Ratio 0.502), consciousness (Odds Ratio 0.258), and calcium levels (Odds Ratio 0.559) were statistically significant. In the more than 61 days of hospitalization group, the serum CRP level (Odds Ratio 0.254) was statistically significant and serum calcium level (Odds Ratio 0.376) exhibited a trend. The prevalence of fatigue and amount of hydration were significantly low in the more than 31 days of hospitalization group. There were no differences in terminal symptoms and treatment in the more than 61 days of hospitalization group.
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<p>Little is known about early death after admission during the terminal phase in advanced cancer patients. We retrospectively analyzed data from 510 advanced cancer patients who were at the end-of-life between August 2011 and August 2016, and found that 83 patients (16.3%) died within 3 days after admission to our institute. We divided the deceased patients into those who died within 3 days (early death group) and those who died after more than 4 days (non-early death group) after admission. Prevalence of delirium, cancer pain, dyspnea, nausea and vomiting, and fatigue patients showed no significant differences. Mean hydration at the end of life was significantly more per infusion for early death group than non-early death group. Continuous sedation and mean opioid use was significantly less for early death group than non-early death group. The risk factor of age, sex, clinical stage, histological state, overtreatment of chemotherapy, comorbidity had no significant associated with early death. The primary site of cancer, the number of metastatic sites, the consciousness level, and the performance status might be predictors for early death after admission in advanced cancer patients at the end-of-life.</p>
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<p>Objectives: We developed versions 2 and 3 of the Biological Prognostic Score (BPS) for advanced cancer patients and confirmed the prediction accuracy. Methods: We conducted a parametric survival analysis using blood test data, performance status (PS), clinical symptoms, age, sex, and cancer type as variables for advanced cancer patients who completed or suspended cancer treatment, in the development of BPS2 and BPS3. We then prospectively compared the accuracy between BPS2/BPS3 and the Palliative Prognostic Index (PPI). Results: We developed the BPS2 and BPS3 based on the data from 589 patients in a development cohort. While the former version was calculated based on the cholinesterase, blood urea nitrogen, and white blood cell counts, the latter was calculated based on the BPS2, ECOG PS and edema. For 206 patients in a validation cohort, the overall accuracy in prediction of survival for 3 and 6 weeks using the BPS2 and BPS3 were significantly higher than those for the PPI. Conclusion: The usefulness of BPS2 and BPS3 was suggested.</p>
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Objective: To develop and confirm the validity of a Biological Prognostic Score using only blood test results for prediction of prognosis in patients with advanced cancer. Methods: We conducted parametric survival time analysis using blood test results, age, sex, and primary diagnosis as independent variables, and event of death as a dependent variable, among patients in a palliative care unit (a development cohort). We then developed the Biological Prognostic Score (BPS). Thereafter, we confirmed the accuracy of the BPS and the Palliative Prognostic Index (PPI) prospectively among patients, who withdrew or withheld further curative or life-prolonging therapies, in other facilities (a validation cohort). Results: We developed the BPS, which consists of cholinesterase, blood urea nitrogen, and total iron-binding capacity, from 122 patients in a development cohort. We then examined 195 patients in a validation cohort and found that the area under the receiver operating characteristic curve for 1-9 week survival prediction was BPS=0.76-0.86 and PPI=0.69-0.73. Discussion: Our results suggest that the BPS was valid. It will be necessary to perform further examinations in multiple facilities and to explore more generalized parameters that could replace total iron-binding capacity in our BPS.