A preoperative prediction model based on Lymphocyte-C-reactive protein ratio predicts postoperative anastomotic leakage in patients with colorectal carcinoma: a retrospective study.

BACKGROUND & AIMS: Lymphocyte-C-reactive Protein Ratio (LCR) has been demonstrated as a promising new marker for predicting surgical and oncological outcomes in colorectal carcinoma (CRC). However, anastomotic leakage (AL) is also likely related to this inflammatory marker. Herein, we aimed to identify preoperative predictors of AL and build and develop a novel model able to identify patients at risk of developing AL. METHODS: We collected 858 patients with CRC undergoing elective radical operation between 2007 and 2018 at a single center were retrospectively reviewed. We performed univariable and multivariable analyses and built a multivariable model that predicts AL based on preoperative factors. Propensity adjustment was used to correct the bias introduced by non-random matching of the LCR. The model's performance was evaluated by using the area under the receiver operator characteristic curves (AUROCs), decision curve analysis (DCA), Brier scores, D statistics, and R2 values. RESULTS: Age, nutrition risk screening 2002 (NRS2002) score, tumor location and LCR, together with hemoglobin < 90 g/l, were independent predictors of AL. The models built on these variables showed good performance (internal validation: c-statistic = 0.851 (95%CI 0.803-0.965), Brier score = 0.049; temporal validation: c-statistic = 0.777 (95%CI 0.823-0.979), Brier score = 0.096). A regression equation to predict the AL was also established by multiple linear regression analysis: [Age(≥ 60 year) × 1.281] + [NRS2002(≥ 3) × 1.341] + [Tumor location(pt.) × 1.348]-[LCR(≤ 6000) × 1.593]-[Hemoglobin(< 90 g/L) × 1.589]-6.12. CONCLUSION: Preoperative LCR is an independent predictive factor for AL. A novel model combining LCR values, age, tumor location, and NRS2002 provided an excellent preoperative prediction of AL in patients with CRC. The nomogram can help clinical decision-making and support future research.

Breathing exercises improve post-operative pulmonary function and quality of life in patients with lung cancer: A meta-analysis.

Previous research has shown that breathing exercises may improve the prognosis and health status in patients with lung cancer by enhancing pulmonary function and quality of life (QOL). However, individually published results are inconclusive. The aim of the present meta-analysis was to evaluate the clinical value of breathing exercises on post-operative pulmonary function and QOL in patients with lung cancer. A literature search of Pubmed, Embase, the Web of Science and CBM databases was conducted from their inception through to October 2012. Crude standardized mean differences (SMDs) with 95% confidence intervals (CIs) were used to assess the effect of breathing exercises. A total of eight clinical studies were ultimately included with 398 lung cancer patients. When all the eligible studies were pooled into the meta-analysis, there was a significant difference between the pre-intervention and post-intervention results of breathing exercises on post-operative pulmonary function; forced expiratory volume in 1 sec (FEV1): SMD, 3.37; 95% CI, 1.97-4.77; P<0.001; FEV1/FVC: SMD, 1.77; 95% CI, 0.15-3.39; P=0.032). Furthermore, the QOL in patients with lung cancer was significantly improved following the intervention with breathing exercises; there were significant differences between the pre-intervention and post-intervention results on the ability of self-care in daily life (SMD, -1.00; 95% CI, -1.467 to -0.52; P<0.001), social activities (SMD, -0.94; 95% CI, -1.73 to -0.15; P=0.02), symptoms of depression (SMD, -0.91; 95% CI, -1.25 to -0.57; P<0.001) and symptoms of anxiety (SMD, -0.91; 95% CI, -1.20 to -0.63; P<0.001). Results from the present meta-analysis suggest that breathing exercises may significantly improve post-operative pulmonary function and QOL in patients with lung cancer.

CASP-1, -2 and -5 gene polymorphisms and cancer risk: A review and meta-analysis.

Accumulating evidence suggests the CASP gene family is important in the development of carcinogenesis. These genetic polymorphisms have been extensively investigated as a potential risk factor for cancer, but results have been inconclusive. This Human Genome Epidemiology (HuGE) review and meta-analysis was performed to investigate the associations between CASP-1, -2 and -5 and cancer risk. A literature search of Pubmed, Embase, Web of Science and CBM databases was conducted from inception through September 1st, 2012. Four case-control studies with a total of 1,592 cancer cases and 1,833 healthy controls were included in the present meta-analysis. Crude odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the strength of association. Five polymorphisms were examined, including rs501192 (G>A), rs4647297 (C>G), rs507879 (T>C), rs3181320 (G>C) and rs523104 (G>C). Meta-analysis results showed that the rs3181320*C allele/carrier were associated with increased risk of various types of cancers (OR=1.26; 95% CI, 1.04-1.54; P=0.020 and OR=1.33; 95% CI, 1.00-1.75; P=0.047, respectively). However, similar associations were not found in the rs501192, rs4647297, rs507879 and rs523104 polymorphisms (all P>0.05). Results from the current meta-analysis suggest that the rs3181320*C allele/carrier in CASP-5 gene are potential risk factors for cancer.