The prognostic significance of prognostic nutritional index in gastrointestinal stromal tumors: A systematic review and meta-analysis.

BACKGROUND: Risk assessment before treatment is important for gastrointestinal stromal tumors (GISTs), which will determine the priority of surgery or preoperative treatment. The prognostic nutritional index (PNI) is an integrated parameter consisting of serum albumin and lymphocyte count. Immunonutritional status defined in this manner is well-known to be closely linked to the prognosis of several other cancers. Nevertheless, the prognostic value of PNI specifically in GISTs has not been well-established. This study aimed to verify the prognostic role of PNI in patients with GISTs. METHODS: A comprehensive literature search was conducted on medical databases up to June, 2022, and the raw data (hazard ratios and 95% confidence intervals [CIs]) focusing on the prognostic value of PNI in patients with GISTs regarding recurrence-free survival were extracted and synthesized adopting the random-effects model. This review was registered in the PROSPERO database (CRD42022345440). RESULTS: A total of 8 eligible studies including 2627 patients with GISTs was analyzed and the pooled results confirmed that an elevated PNI was associated with a better recurrence-free survival (hazard ratio: 0.52, 95% CI: 0.40-0.68), with a moderate heterogeneity (I-square, 38%). The findings from subgroup analysis were consistent with the overall pooled results, and a sensitivity analysis, not the subgroup analysis, identified the source of heterogeneity. CONCLUSION: Elevated pretreatment PNI may be a useful indicator for assessing risk of recurrence in patients from China with GISTs. Studies in other countries and regions are needed to further verify the prognostic value of PNI in GISTs.

Implementations of two-photon four-qubit Toffoli and Fredkin gates assisted by nitrogen-vacancy centers.

It is desirable to implement an efficient quantum information process demanding fewer quantum resources. We designed two compact quantum circuits for determinately implementing four-qubit Toffoli and Fredkin gates on single-photon systems in both the polarization and spatial degrees of freedom (DoFs) via diamond nitrogen-vacancy (NV) centers in resonators. The gates are heralded by the electron spins associated with the diamond NV centers. In contrast to the ones with one DoF, our implementations reduce the quantum resource and are robust against the decoherence. Evaluations of fidelities and efficiencies of our gates show that our schemes may be implemented with current technology.