Evaluation of Human Leukocyte Antigen Class I and Class II in End-Stage Renal Disease Occurrence in Indonesian Transplantation Patients.

BACKGROUND: Genetic studies of end-stage renal disease (ESRD), including those of human leukocyte antigen (HLA) genes, have been reported in several populations but have not yet been evaluated in Indonesia. Some studies have reported that these genes had a substantial role in ESRD. This study aims to analyze the association between HLA genes and ESRD within the Indonesian community. METHOD: A retrospective study to investigate HLA class I and II alleles to find out the distribution of HLA-A, -B, -C, -DPB1, -DQB1, and -DRB1 in renal transplant recipients and to ascertain their role in susceptibility to ESRD was performed on totally 149 subjects, consisting of 69 ESRD patients and 80 healthy controls. HLA typing was determined using Luminex techniques. The allele and haplotype frequencies were compared between ESRD patients and controls. RESULT: High-frequency alleles were HLA-A∗24 (43.6%), B∗15 (38.2%), C∗08 (30.8%), DRB1∗12 (47.3%), DQB1∗03 (50.6%), and DPB1∗13 (22.5%). HLA-A∗24 (p=0.01) and HLA-B∗35 (p=0.02) were associated with a protective effect, with OR 0.537 (95%CI 0.34-0.86) and 0.316 (95%CI 0.11-0.88), respectively. There were some two-locus haplotypes associated with susceptibility to ESRD, such as B∗15-DRB1∗12, B∗13-DRB1∗15, A∗02-B∗15, A∗02-C∗08, and B∗13-DQB1∗05. HLA-A∗02-B∗15-DRB1∗12 and A∗24-B∗13-DRB1∗15 appear to be associated with susceptibility to ESRD. CONCLUSION: The allele groups of HLA-A∗24 and HLA-B∗35 are associated with protection from ESRD. Meanwhile, HLA-B∗13-DRB1∗15 and A∗24-B∗13-DRB1∗15 are the most frequent HLAs associated with ESRD in two-locus and three-locus haplotype, respectively.

Pretreatment Neutrophil-to-Lymphocyte ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR) as a Predictive Value of Hematological Markers in Cervical Cancer

Background: Inflammation represents a pivotal role in the progression of cervical cancer. The hematological markers of inflammation in complete blood count (CBC) panel are potentially useful in determining the prognosis of the disease. Objective: The aim of the study was to investigate whether the pretreatment neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) could be used as in predicting the stage of cervical cancer. Methods: A retrospective cross-sectional study involving 282 patients with cervical cancer was enrolled at Sanglah General Hospital for five years (2013-2017). The histopathological records and complete blood counts (CBC) of the patients were collected and analyzed using SPSS ver. 16 software. FIGO stage I­II and III-IV were classified as early and advance stage respectively. Results: The median NLR and PLR were significantly higher in the advance stage compared with early stage (7.58 (1.36-33.20) and 247.89 (97.10-707.11); p-value = 0.001). A strong positive correlation was found between the staging of cervical cancer and NLR (r=0.638) and PLR (r=0.668). The AUC, sensitivity, and specificity value of NLR and PLR were 0.803 (82%; 71%) and 0.716 (72%; 70%). Advanced stage of cervical cancer was found in high NLR (adjusted OR: 9.02; 95%CI=2.42-33.64; p=0.001) and PLR (adjusted OR = 2.47; 95% CI = 1.45-4.85; p = 0.032). Conclusion: Increased pretreatment NLR and PLR values may provide a useful information in predicting the staging of cervical cancer.