ABSTRACT
SARS-CoV-2 disturbs the normal immune responses causing an uncontrolled inflammatory response in patients with severe COVID-19. The pattern of the immune response to the SARS-CoV-2 in individuals may fluctuate. Some have a virus-dependent protective immune response resulting in asymptomatic or mild disease with elimination of the virus within 7-10 days after onset of infection. Others develop virus non-dependent uncontrolled hyper-inflammation in the later period, leading to severe disease with cytokine storm, acute respiratory distress syndrome, disseminated intravascular coagulation and multi-organ failure. MethodsThe serum of 72 patients was investigated for titers of 15 cytokines and chemokines using Enzyme-linked immunosorbent assay (ELISA) kits in the serum of peripheral blood samples. The means of groups were compared using ANOVA followed by Tukey multiple post hoc comparisons if the ANOVA p-value was <0.05. ResultsPatients with pulmonary infiltrates on CT demonstrated a lower percentage of eosinophils (1.38{+/-}1.46%) and elevated level of serum CRP (8.57{+/-}19.10 mg/dL) compared to patients without pulmonary infiltrates (2.52{+/-}1.47% and 1.96{+/-}3.02 mg/dL respectively; p<0.05). ROC analysis for patients aged [≥]35 years showed patients with mild disease (n=3) had a significantly higher titer of IL-1{beta} and MCP-1 (AUC, 0.958 and 0.917 respectively, p<0.05) compared to patients with moderate disease (n=7).
ABSTRACT
PURPOSE: Hepatocellular carcinoma (HCC) is the most common cancer in Mongolia. We aimed to investigate the clinical features, therapeutic modalities, overall survival and prognostic factors for Mongolian patients with HCC. METHOD: One hundred ninety-five patients with HCC were consecutively enroled in our study. RESULTS: The mean age was 61.7 years. The most common etiology for HCC was HCV infection (n = 89, 45.6%), followed by HBV infection (n = 67, 34.4%). The mean tumor diameter was 6.0 ± 2.6 cm. Only 29 (14.9%) patients had a single lesion, while 39 (20.2%) had >3 lesions. Extrahepatic metastasis to lung (n = 23), bone (n = 10) and lymph node (n = 3) were detected in 36 (18.5%) patients. Most patients had advanced HCC-88 (45.1%) in stage III and 57 (29.2%) in stage IV. Surgical resection was performed in 27 (13.8%) patients, RFA in 23 (11.8%) and TACE in 107 (54.9%). When all the patients were categorized as 'treated' (n = 156) and 'not treated' (n = 39), the 3-year survival was significantly lower in the 'not treated' group than in the 'treated' group (11 vs. 0%, P < 0.001). Tumor diameter (<3 cm vs. ≥3 cm), extrahepatic metastasis, TNM stage (I/II vs. III/IV) and treatment (or supportive care) were selected as independent predictors for survival. CONCLUSIONS: High proportion of patients with HCC in Mongolia is diagnosed at an advanced stage and survival of these patients is lower compared to other countries. A surveillance system and referral policy for high-risk groups should be urgently established and implemented in Mongolia.
