Biomarkers in medicine最新文献

Aims: The hemoglobin-to-red cell distribution width ratio (Hb/RDW) is a prognostic biomarker in various malignancies. However, its prognostic value in endometrial cancer (EC) remains unclear. This study investigated the association between preoperative Hb/RDW ratio and 5-year overall survival (OS) in patients with EC.

Materials & methods: This retrospective cohort study included 548 patients with histologically confirmed EC who underwent surgery at a single tertiary center in Taiwan between 2010 and 2021. Patients were stratified on the basis of an Hb/RDW threshold of 1.0, which was derived from receiver operating characteristic curve analysis. Propensity score matching (1:1) and multivariate Cox regression were performed to identify the aforementioned association.

Results: Patients with an Hb/RDW ratio of < 1 had significantly poorer 5-year OS than did those with an Hb/RDW ratio of ≥ 1 (adjusted HR: 2.15; 95% CI: 1.19-3.89; p = 0.012). The association between preoperative Hb/RDW ratio and 5-year OS persisted even after propensity score matching (adjusted HR: 2.33; 95% CI: 1.20-4.55; p = 0.013).

Conclusions: The present study highlights the preoperative Hb/RDW ratio as a readily available, cost-effective biomarker with independent prognostic value in EC. This ratio may be incorporated into preoperative risk models to optimize clinical decision-making.

Background: The ossification of the posterior longitudinal ligament (OPLL) represents a disabling spinal condition. The specific function of miR-153-3p in the context of OPLL has not been elucidated.

Aim: To explore the function of miR-153-3p in OPLL and its regulatory mechanism related to KLF5.

Methods: RT-qPCR was used to detect the transcriptional levels of miR-153-3p, osteogenic markers, and inflammatory cytokines in OPLL and normal populations. The interaction between miR-153-3p and KLF5 was validated through dual-luciferase reporter assays and RNA immunoprecipitation. Cell transfection experiments were performed to analyze the effects of miR-153-3p and KLF5 on osteogenic markers and inflammatory cytokines.

Results: There was a significant decrease in miR-153-3p expression in OPLL samples. Osteogenic markers and inflammatory cytokines were significantly upregulated. The negative correlation between miR-153-3p and KLF5 was validated. MiR-153-3p was found to inhibit KLF5 expression. In ligament fibroblasts (LFC), miR-153-3p mimics uppressed the expression of osteogenic markers and inflammatory cytokines. Conversely, KLF5 overexpression reversed these inhibitory effects.

Conclusion: MiR-153-3p is downregulated in OPLL and acts as a negative regulator of OPLL progression by directly targeting KLF5, thereby inhibiting LFC osteogenic differentiation.

Introduction: Although the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) scoring system has been used in metastatic renal cell carcinoma (mRCC) for years, debate continues over its ability to predict survival.

Materials and methods: Our study was a single-center retrospective review of medical records of 181 patients diagnosed with mRCC between June 2013 and March 2023.

Results: Low serum albumin level (p < 0.001) and high serum uric acid level (p < 0.001) were significantly associated with worse OS. Furthermore, the number of metastatic sites (p = 0.003) had a significantly adverse impact on OS. Although the HGB level of <12 g/dL adversely affected OS (p = 0.042), none of the remaining parameters used for the IMDC scoring had a significant impact on OS.

Discussion: Even though the IMDC system scores them equally, we concluded that each parameter might express dissimilarities on survival; some might even lack any significant effect. Furthermore, factors such as serum albumin and uric acid levels, the presence of specific organ metastases, or the number of metastatic sites might affect survival more than the IMDC parameters. Further studies are needed to predict prognosis and develop a treatment plan using an individualized risk score that includes molecular biomarkers, imaging findings, and patient clinical characteristics.

Aim: Persons who inject drugs (PWID) are prone to bloodstream infections, but diagnosis is often delayed. This study evaluated the utility of admission serum procalcitonin for early detection of bacteremia.

Methods: A total of 131 adult male PWID admitted with suspected sepsis were prospectively enrolled.

Results: Bacteremia was confirmed in 52 (39.7%) cases, primarily due to Staphylococcus aureus and S. haemolyticus. Infective endocarditis was the leading diagnosis among bacteremic patients. Procalcitonin levels ≥0.51 ng/mL demonstrated high sensitivity (88.5%) and negative predictive value (82.9%), but low specificity (36.7%), resulting in limited diagnostic utility (area under the curve [AUC] 0.613). C-reactive protein (AUC 0.680) and serum albumin (AUC 0.723) outperformed procalcitonin. In-hospital mortality was 35.1%.

Conclusion: Admission procalcitonin has limited diagnostic value for detecting bacteremia in PWID.

Objective: This study aimed to extract radiomics (Rad) and deep learning (DL) features from preoperative CT of patients with Non-Muscle Invasive Bladder Cancer (NMIBC) and develop models incorporating clinical characteristics to assess Human-Epidermal-Growth-Factor-Receptor-2 (HER2) expression status and prognosis in these patients.

Methods: From January 2019 to December 2024, 181 patients with NMIBC were retrospectively enrolled in this study. A deep learning radio-clinical signature model (DLCS) was created by integrating DL score, Rad score, and clinicopathologic features to predict HER2 expression in NMIBC and compared with a deep learning model, a radiomic model, and a Clinical model. An additional model was built to predict Recurrence-Free Survival (RFS) in NMIBC patients.

Results: 181 patients with NMIBC were divided into a training cohort (n = 126) and a test cohort (n = 55). The DLCS model achieved the highest area under the curve (AUC) for HER2 prediction in the test cohort (AUC = 0.894 (95% CI: 0.814-0.974)). The univariate and multivariate Cox regression analyses identified both the DL score and Rad score as independent risk factors for RFS (p < 0.05).

Conclusion: The DLCS model demonstrates good diagnostic performance in predicting HER2 expression, and the prognosis model can stratify the risk of tumor recurrence in patients with NMIBC.

Aims: This study tends to identify serum biomarkers for early diagnosis of treatment-resistant schizophrenia (TRS) and prediction of clozapine treatment response, given the heterogeneity of schizophrenia and limitations of antipsychotic treatment.

Patients & methods: Participants of this prospective cohort study (recruited at Shanghai Mental Health Center; 2020-2023) included 42 TRS patients (TRRIP criteria), 42 first-line antipsychotic responders (age/sex-matched 1:1 to TRS), and 70 age/sex-matched healthy controls. TRS patients were stratified post-clozapine into responders (TRS-R, n = 26) and ultra-treatment-resistant (UTRS, n = 16) subgroups. Symptom severity was assessed using PANSS. Serum neuregulin-1 (NRG-1) levels were quantified via ELISA.

Results: Healthy controls showed significantly higher NRG-1 levels than schizophrenia patients (F = 39.76, p < 0.001). TRS patients had lower NRG-1 than treatment responders (p < 0.001). Clozapine responders (TRS-R) exhibited increased NRG-1 post-treatment (t = -3.32, p < 0.001), unlike UTRS patients (t = -0.332, p = 0.745). NRG-1 negatively correlated with symptom severity in both TRS (r = -0.647, p < 0.001) and responders (r = -0.596, p < 0.001). NRG-1 demonstrated diagnostic utility for TRS (AUC = 0.827, 95% CI:0.741-0.914; specificity = 0.786, sensitivity = 0.786).

Conclusion: Serum NRG-1 shows significant promise as a potential biomarker for diagnosing TRS and monitoring clozapine treatment response, suggesting involvement in TRS pathophysiology.

Background: Postoperative recurrence remains a significant challenge in renal cell carcinoma (RCC). While circulating tumor cells (CTCs) have emerged as promising prognostic biomarkers, the predictive value of their subtypes (epithelial, hybrid, mesenchymal) and their dynamic changes over time for postoperative recurrence is not yet fully understood. This study aimed to analyze CTCs characteristics and develop a prognostic model for recurrence prediction.

Methods: We included 124 patients after RCC resection, collecting serial peripheral blood samples at regular intervals post-surgery to quantify CTCs subtypes using standardized enrichment and identification protocols. We extracted 54 variables, comprising 45 CTC characteristics and 9 clinical/pathological factors. Seven machine learning algorithms were trained to predict recurrence based on these features, with the SHAP (SHapley Additive exPlanations) framework applied to interpret the model.

Results: Over a median follow-up of 41 months, 24 patients experienced recurrence, while 100 remained recurrence-free. The Random Forest model demonstrated superior performance, achieving a training AUC of 0.84 and a validation AUC of 0.77. SHAP analysis identified key predictors, including pT stage, tumor size, and changes in mesenchymal and hybrid CTC counts.

Background: Neurotensin (NTS) is a critical neuropeptide involved in multiple pathways in the central nervous and peripheral systems. We assessed the possible functional relevance of NTS in SCZ pathogenesis by focusing on the rs139226362 (delGATT) located in the 3' untranslated region (UTR) of the NTS.

Methods: A total of 88 Turkish individuals with known genotypes for the delGATT allele were included in the study. Differences in NTS mRNA expression and circulating NTS protein levels were evaluated by RT-qPCR and ELISA, respectively. The stability of RNA secondary structures and the binding patterns of RNA-binding protein (RBPs) interactions were evaluated by in silico analysis.

Results: Plasma NTS protein levels were significantly higher (p = 0.0003) in SCZ patients carrying the delGATT variant compared to those with wild-type genotype. This genotype-protein association was not observed in healthy controls, indicating a disease-specific effect. Moreover, plasma NTS levels were correlated with PANSS scores (r = -0.290, p = 0.041) and BMI (r = 0.306, p = 0.031) in SCZ patients.

Conclusions: These findings suggest that rs139226362 may influence post-transcriptional regulation, with the indel potentially associated with milder SCZ symptoms through altered molecular pathways. Further validation in experimental models may support the development of NTS-based personalized treatment strategies for SCZ management.

Inflammatory biomarkers are increasingly recognized as key tools in diagnosing, stratifying risk, and monitoring treatment in pericarditis, though their value is limited by non-specificity, variability, and treatment interactions. This narrative review integrates current evidence and recommendations from recent studies, as well as the 2025 ESC and ACC guidelines, focusing on conventional and emerging biomarkers across acute, recurrent, and chronic pericarditis. C-reactive protein remains the most practical biomarker for diagnosis and therapeutic monitoring, with persistent elevation linked to recurrence. Troponin identifies myocardial involvement, guiding follow-up but not adversely affecting outcomes in idiopathic cases. Erythrocyte sedimentation rate and white blood cell count add supportive yet nonspecific information. Exploratory markers - such as interleukins, soluble urokinase plasminogen activator receptor, microRNAs, and hematologic indices - show potential for refined risk prediction but remain investigational due to limited access and a lack of standardization. Imaging, particularly cardiac magnetic resonance, complements biomarker data and is particularly crucial in cases where biomarkers are negative. Biomarkers are central yet imperfect components of pericarditis management. Their future utility will rely on integration with imaging, composite marker panels, and artificial intelligence-based analytics, promoting precision medicine while current practice remains grounded in combined clinical, laboratory, and imaging assessment.

Aims: The no-reflow (NR) phenomenon is a serious complication of primary percutaneous coronary intervention (PCI) in ST-elevation myocardial infarction (STEMI), often reflecting distal embolization and microvascular obstruction, and representing a substrate for periprocedural (type 4a) myocardial infarction. NR has been linked to worse prognosis, including higher short- and long-term mortality. Inflammation is a key contributor to NR development. This study aimed to evaluate the relationship between the derived neutrophil-to-lymphocyte ratio (dNLR) and NR in STEMI patients undergoing PCI, and to assess its predictive value.

Methods: This retrospective, single-center observational study included consecutive STEMI patients undergoing primary PCI between May 2024 and May 2025. Patients were grouped based on post-procedural TIMI flow grade. Demographic, clinical, and laboratory parameters were compared. Regression and ROC analyses were performed.

Results: A total of 208 patients were analyzed, among whom no-reflow occurred in 26.4% (n = 55). The NR group had significantly higher dNLR, C-reactive protein (CRP), glucose, creatinine, and troponin levels, along with lower left ventricular ejection fraction (LVEF). dNLR, diabetes mellitus, CRP and LVEF were independent predictors of NR.

Conclusion: dNLR is a simple, cost-effective marker that may help identify patients at high risk of no-reflow in STEMI. Further prospective studies are warranted.