Mi-So Jeong, Jeong-Yeon Mun, Gi-Eun Yang, Seung-Woo Baek, Sang-Yeop Lee, Sung Ho Yun, Seung Il Kim, Jae-Jun Kim, Seo-Yeong Yoon, Jong-Kil Nam, Yung-Hyun Choi, Hyeok Jun Goh, Tae-Nam Kim, Sun-Hee Leem
<p>Dear Editor,</p><p>Research on liquid biopsy markers is actively ongoing as an alternative diagnostic method for patients with bladder cancer (BC), which frequently recurs.<span><sup>1-3</sup></span> Our study shows that LCN2 expression is linked to BC progression and may serve as a valuable urinary biomarker for identifying early-stage patients and predicting outcomes.</p><p>To identify secreted proteins linked to BC progression, we analysed stepwise 5637 gemcitabine-resistant cell (GRC) lines established in our previous study.<span><sup>4</sup></span> The conditioned media (CM) from highly motile GRC sublines enhanced invasion and migration (Figure S1A,B). Liquid Chromatography-Tandem Mass Spectrometry (LC‒MS/MS) analysis of concentrated CM revealed 408 differentially expressed proteins, with 178 upregulated in the highly mobile P7 cell line. Ingenuity pathway analysis identified 56 proteins associated with three motility-related pathways, 17 of which overlapped between expression and pathway analyses (Figure 1A). Notably, LCN2 demonstrated the strongest differential expression in RNA sequencing data, prompting further investigation due to its established correlation with motility.<span><sup>4</sup></span> LCN2 has been associated with tumour progression and metastasis and has been proposed as a non-invasive prognostic indicator,<span><sup>5-8</sup></span> although its precise role in BC remains unclear.</p><p>The GSE13057 dataset confirmed elevated LCN2 expression in BC tissues compared to normal tissues (Figure S1C). In the 5637GRC model, both intracellular levels and secretion of LCN2 increased at P3 and P7 stages, which were characterised by higher motility (Figure S1D‒H). Analysis of three NMIBC datasets (UROMOL2021, GSE163209 and GSE32894) revealed that 197 genes consistently correlated with LCN2 expression (Figure 1B). Pathway enrichment analysis linked these genes to biological processes involved in cell motility (Figure 1C). High LCN2 expression was associated with activation of Nuclear Factor kappa-light-chain-enhancer of activated B cells (NF-κB), Janus Kinase-Signal Transducer and Activator of Transcription (JAK‒STAT) and Phosphoinositide 3-Kinase (PI3K) signalling pathways, supporting its correlation with aggressive phenotypes (Figure 1D).</p><p>Clinical analyses highlighted the prognostic significance of LCN2. In the GSE163209 cohort, the LCN2 signature predicted progression to metastatic disease (AUC = .714; Figure 1E). Kaplan‒Meier survival analyses across three NMIBC cohorts revealed significantly poorer progression-free survival for patients with high LCN2 expression. In GSE163209, elevated LCN2 levels were also linked to a higher rate of metastatic progression (Figure 1F-I). Likewise, in The Cancer Genome Atlas (TCGA) and GSE13507 cohorts, elevated LCN2 expression was associated with poor cancer-specific survival and increased metastasis (Figure 1J-M). These results underscore LCN2 as a secreted protein linked to BC progre
{"title":"Lipocalin 2 as a potential liquid biopsy marker for early detection of bladder cancer","authors":"Mi-So Jeong, Jeong-Yeon Mun, Gi-Eun Yang, Seung-Woo Baek, Sang-Yeop Lee, Sung Ho Yun, Seung Il Kim, Jae-Jun Kim, Seo-Yeong Yoon, Jong-Kil Nam, Yung-Hyun Choi, Hyeok Jun Goh, Tae-Nam Kim, Sun-Hee Leem","doi":"10.1002/ctm2.70540","DOIUrl":"10.1002/ctm2.70540","url":null,"abstract":"<p>Dear Editor,</p><p>Research on liquid biopsy markers is actively ongoing as an alternative diagnostic method for patients with bladder cancer (BC), which frequently recurs.<span><sup>1-3</sup></span> Our study shows that LCN2 expression is linked to BC progression and may serve as a valuable urinary biomarker for identifying early-stage patients and predicting outcomes.</p><p>To identify secreted proteins linked to BC progression, we analysed stepwise 5637 gemcitabine-resistant cell (GRC) lines established in our previous study.<span><sup>4</sup></span> The conditioned media (CM) from highly motile GRC sublines enhanced invasion and migration (Figure S1A,B). Liquid Chromatography-Tandem Mass Spectrometry (LC‒MS/MS) analysis of concentrated CM revealed 408 differentially expressed proteins, with 178 upregulated in the highly mobile P7 cell line. Ingenuity pathway analysis identified 56 proteins associated with three motility-related pathways, 17 of which overlapped between expression and pathway analyses (Figure 1A). Notably, LCN2 demonstrated the strongest differential expression in RNA sequencing data, prompting further investigation due to its established correlation with motility.<span><sup>4</sup></span> LCN2 has been associated with tumour progression and metastasis and has been proposed as a non-invasive prognostic indicator,<span><sup>5-8</sup></span> although its precise role in BC remains unclear.</p><p>The GSE13057 dataset confirmed elevated LCN2 expression in BC tissues compared to normal tissues (Figure S1C). In the 5637GRC model, both intracellular levels and secretion of LCN2 increased at P3 and P7 stages, which were characterised by higher motility (Figure S1D‒H). Analysis of three NMIBC datasets (UROMOL2021, GSE163209 and GSE32894) revealed that 197 genes consistently correlated with LCN2 expression (Figure 1B). Pathway enrichment analysis linked these genes to biological processes involved in cell motility (Figure 1C). High LCN2 expression was associated with activation of Nuclear Factor kappa-light-chain-enhancer of activated B cells (NF-κB), Janus Kinase-Signal Transducer and Activator of Transcription (JAK‒STAT) and Phosphoinositide 3-Kinase (PI3K) signalling pathways, supporting its correlation with aggressive phenotypes (Figure 1D).</p><p>Clinical analyses highlighted the prognostic significance of LCN2. In the GSE163209 cohort, the LCN2 signature predicted progression to metastatic disease (AUC = .714; Figure 1E). Kaplan‒Meier survival analyses across three NMIBC cohorts revealed significantly poorer progression-free survival for patients with high LCN2 expression. In GSE163209, elevated LCN2 levels were also linked to a higher rate of metastatic progression (Figure 1F-I). Likewise, in The Cancer Genome Atlas (TCGA) and GSE13507 cohorts, elevated LCN2 expression was associated with poor cancer-specific survival and increased metastasis (Figure 1J-M). These results underscore LCN2 as a secreted protein linked to BC progre","PeriodicalId":10189,"journal":{"name":"Clinical and Translational Medicine","volume":"15 12","pages":""},"PeriodicalIF":6.8,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12687296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145707486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p>Dear Editor,</p><p>Post-stroke cognitive impairment (PSCI) remains a prevalent and debilitating complication that profoundly impacts stroke survivors’ quality of life and long-term outcomes.<span><sup>1</sup></span> Building upon our previous report that 78.7% of Chinese patients with first-ever ischemic stroke developed PSCI,<span><sup>2</sup></span> we conducted a prospective cohort study to establish an interpretable, multidimensional prediction framework using multiple machine learning (ML) algorithms.</p><p>A total of 518 acute ischemic stroke (AIS) patients were recruited at Xuanwu Hospital between January and December 2022. Following rigorous screening, 437 patients completed a 3-month cognitive follow-up using the Telephone Interview for Cognitive Status-40 (TICS-40), and 190 (43.5%) were identified as having PSCI (see Figure S1 for details). We collected 89 clinical, neuroimaging, and serological variables (see Table S1 for details). The dataset was split 8:2 into training and test sets. All preprocessing steps, namely outlier removal, imputation, and normalisation, were applied exclusively to the training set. Using 10-fold cross-validation combined with Recursive Feature Elimination (RFE), six ML algorithms, including Logistic Regression (LR), Decision Tree (DT), Random Forest (RF), Light Gradient Boosting Machine (LightGBM), eXtreme Gradient Boosting (XGBoost) and Categorical Boosting (CatBoost), were trained and optimised. Model performance was subsequently evaluated on the test set (see Supplementary Information for details).</p><p>Through the feature selection process, a set of twenty features was identified across the six models (see Figure 1 and Figure S2 for details). Baseline characteristics were compared between the PSCI and non-PSCI groups in Table S2. Comparative analysis revealed that the gradient boosting models (LightGBM, XGBoost and CatBoost) consistently demonstrated superior comprehensive predictive performance compared to LR, DT and RF across key metrics, including area under the curve (AUC) (0.73–0.77), precision-recall balance, and clinical net benefit in decision curve analysis (DCA) (see Table 1 and Figure 2 for details). LightGBM and XGBoost excelled in computational efficiency and scalability, whereas CatBoost offered superior stability on limited and imbalanced data. This functional diversity highlights ensemble methods as a robust and adaptable framework for developing clinically viable PSCI predictors.</p><p>All models consistently identified age and education level as core determinants of PSCI (see Figure 1 for details). Ageing is a primary non-modifiable risk factor that promotes the accumulation of neuropathological proteins, neuroinflammation, lipid dysregulation, and neurodegeneration, culminating in cognitive decline.<span><sup>3</sup></span> In contrast, higher education confers protection, plausibly via mechanisms of cognitive reserve and socioeconomic advantage, sustaining compensatory neural effi
{"title":"Development of a multidimensional machine learning framework for predicting post-stroke cognitive impairment: A prospective cohort study","authors":"Aini He, Houlin Lai, Xuefan Yao, Benke Zhao, Wenjing Yan, Wei Sun, Xiao Wu, Kehui Ma, Yuan Wang, Haiqing Song","doi":"10.1002/ctm2.70546","DOIUrl":"10.1002/ctm2.70546","url":null,"abstract":"<p>Dear Editor,</p><p>Post-stroke cognitive impairment (PSCI) remains a prevalent and debilitating complication that profoundly impacts stroke survivors’ quality of life and long-term outcomes.<span><sup>1</sup></span> Building upon our previous report that 78.7% of Chinese patients with first-ever ischemic stroke developed PSCI,<span><sup>2</sup></span> we conducted a prospective cohort study to establish an interpretable, multidimensional prediction framework using multiple machine learning (ML) algorithms.</p><p>A total of 518 acute ischemic stroke (AIS) patients were recruited at Xuanwu Hospital between January and December 2022. Following rigorous screening, 437 patients completed a 3-month cognitive follow-up using the Telephone Interview for Cognitive Status-40 (TICS-40), and 190 (43.5%) were identified as having PSCI (see Figure S1 for details). We collected 89 clinical, neuroimaging, and serological variables (see Table S1 for details). The dataset was split 8:2 into training and test sets. All preprocessing steps, namely outlier removal, imputation, and normalisation, were applied exclusively to the training set. Using 10-fold cross-validation combined with Recursive Feature Elimination (RFE), six ML algorithms, including Logistic Regression (LR), Decision Tree (DT), Random Forest (RF), Light Gradient Boosting Machine (LightGBM), eXtreme Gradient Boosting (XGBoost) and Categorical Boosting (CatBoost), were trained and optimised. Model performance was subsequently evaluated on the test set (see Supplementary Information for details).</p><p>Through the feature selection process, a set of twenty features was identified across the six models (see Figure 1 and Figure S2 for details). Baseline characteristics were compared between the PSCI and non-PSCI groups in Table S2. Comparative analysis revealed that the gradient boosting models (LightGBM, XGBoost and CatBoost) consistently demonstrated superior comprehensive predictive performance compared to LR, DT and RF across key metrics, including area under the curve (AUC) (0.73–0.77), precision-recall balance, and clinical net benefit in decision curve analysis (DCA) (see Table 1 and Figure 2 for details). LightGBM and XGBoost excelled in computational efficiency and scalability, whereas CatBoost offered superior stability on limited and imbalanced data. This functional diversity highlights ensemble methods as a robust and adaptable framework for developing clinically viable PSCI predictors.</p><p>All models consistently identified age and education level as core determinants of PSCI (see Figure 1 for details). Ageing is a primary non-modifiable risk factor that promotes the accumulation of neuropathological proteins, neuroinflammation, lipid dysregulation, and neurodegeneration, culminating in cognitive decline.<span><sup>3</sup></span> In contrast, higher education confers protection, plausibly via mechanisms of cognitive reserve and socioeconomic advantage, sustaining compensatory neural effi","PeriodicalId":10189,"journal":{"name":"Clinical and Translational Medicine","volume":"15 12","pages":""},"PeriodicalIF":6.8,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12685603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145707520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pallabi Pal, Michele Carrer, Lan Weiss, Olga G. Jaime, Cheng Cheng, Alyaa Shmara, Victoria Boock, Danae Bosch, Marwan Youssef, Yasamin Fazeli, Megan Afetian, Tamar R. Grossman, Michael R. Hicks, Paymaan Jafar-nejad, Virginia Kimonis