Biomarkers in medicine最新文献

Aims: To examine urothelial cancer-associated 1 (UCA1) expression in severe pneumonia children and explore its regulatory role in this condition.

Patients & methods: Seventy-eight healthy children and 84 children with severe pneumonia were included. Serum UCA1 expressions were detected by quantitative real-time PCR. The sensitivity and specificity of UCA1 for the diagnosis of severe pneumonia were appraised by the receiver operating characteristic curve. The prognosis and factors affecting the prognosis were estimated by the Kaplan-Meier survival curve and multivariate Cox regression. A luciferase reporter assay assessed the targeting interaction between UCA1 and miR-185-5p.

Results: Serum UCA1 level in patients with severe pneumonia was higher than that in controls. The sensitivity and specificity of UCA1 for severe pneumonia were 82.1% and 85.9%, respectively. Children with high UCA1 expression had lower overall survival than children with low UCA1 expression, and UCA1 and procalcitonin were prognosis risk factors. Cell experiments suggested that inhibition of UCA1 reversed LPS-induced decline in cell viability and increased apoptosis and inflammatory factors. UCA1 directly targeted miR-185-5p in MRC-5 cells.

Conclusions: Abnormal elevated UCA1 demonstrated good clinical diagnostic and prognostic meaning for severe pneumonia. UCA1 May have effects on the regulation of cell function and inflammatory response by combining with miR-185-5p.

Background: Pyogenic liver abscess (PLA) is a severe infectious condition characterized by hepatic parenchymal pus accumulation, posing diagnostic and management challenges despite medical advances. Sepsis ensuing from PLA signifies a critical clinical scenario with notable morbidity and mortality implications.

Methods: A retrospective analysis encompassing 202 PLA patients over five years discerned 79 with sepsis (PLAS group) and 123 without sepsis (PLA group). Baseline characteristics, pathogen distribution, and serum heparin-binding protein (HBP) levels were assessed, alongside statistical analyses including multivariate logistic regression and receiver operating characteristic (ROC) curve analysis.

Results: Significant differences in biliary tract disease prevalence, plasma procalcitonin (PCT), and blood lactate levels were noted between PLAS and PLA groups, suggesting potential sepsis indicators in PLA patients. Klebsiella pneumoniae predominated among cultured pathogens, with no significant difference between septic and non-septic groups. Serum HBP levels were markedly elevated in PLAS patients, exhibiting positive correlations with sepsis severity and serving as an independent sepsis risk factor. ROC analysis demonstrated enhanced diagnostic performance for sepsis when combining serum HBP, PCT, and blood lactate levels.

Conclusion: Serum HBP provides diagnostic and prognostic value for sepsis in PLA patients, and its combination with established biomarkers improves early detection and management.

Objective: To evaluate the association between microRNA (miRNA) polymorphisms and rheumatoid arthritis (RA) susceptibility through meta-analysis.

Methods: We systematically searched MEDLINE, EMBASE, and Web of Science for case-control studies examining five miRNA polymorphisms: miR-146a rs2910164, miR-499 rs3746444, miR-196a2 rs11614913, miR-155 rs767649, and miR-149 rs2292832. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using random-effects models.

Results: Twenty-three studies comprising 4,303 RA patients and 5,337 controls were included. Significant associations were identified for three polymorphisms. MiR-499 rs3746444 demonstrated increased RA risk across multiple genetic models (allelic, recessive, and homozygote). MiR-146a rs2910164 showed population-specific effects, conferring protection in Arabs (OR = 0.666, 95% CI = 0.520-0.853, p = 0.001) but not in Asian or European populations. The miR-149 rs2292832 A allele exhibited strong protective effects (OR = 0.314, 95% CI = 0.215-0.458, p < 0.001). No significant associations were observed for miR-196a2 rs11614913 or miR-155 rs767649 polymorphisms.

Conclusions: This meta-analysis demonstrates that miRNA polymorphisms exhibit variable associations with RA susceptibility. MiR-499 rs3746444 increases risk, while miR-146a rs2910164 and miR-149 rs2292832 provide protection, with ethnic-specific effects for miR-146a rs2910164.

Aim: In the present study, we aimed to investigate the prognostic importance of the De Ritis ratio [Aspartate Aminotransferase (AST)/Alanine Aminotransferase (ALT)] in predicting higher international normalized ratio in patients on warfarin treatment.

Patients and methods: Patients who were followed up for warfarin use at the Training and Research Hospital, between September 2023 and September 2024, were included in this study, consecutively and retrospectively.

Results: The study included a total of 357 consecutive patients, who were divided into three groups according to INR values: Group 1: Those with INR below 2, Group 2: Those with INR between 2 and 3.5, Group 3: INR values above 3.5. The median ages of the patients were 62 years (range, 22 to 88), 61 years (range, 24 to 87), and 61 years (range, 40 to 87), respectively (p = 0.833). There were significant differences between the groups regarding lymphocyte values (median: 2.1 × 10³/µL vs 2.1 × 10³/µL vs 1.6 × 10³/µL, respectively) and De Ritis ratio (median 1.03 vs 1.15 vs 1.92) (p = 0.005, and p < 0.001, respectively).

Conclusion: We demonstrated a significant correlation between a high De Ritis ratio and high INR values. In light of this finding, a high De Ritis ratio may be indicative of elevated INR values for us.

Background: Breast cancer is the most common cancer among women, with rising incidence and mortality rates, posing clinical treatment challenges.

Objective: To analyze the prognostic significance of serum immune HER2 and ERα36 biomarkers in estrogen receptor-positive breast cancer subtypes.

Methods: Sixty-one estrogen receptor-positive breast cancer cases from Fourth Hospital of Hebei Medical University (2016-2023) were analyzed. The qPCR was used to detect the expression level of ERα36 mRNA in the sample, and ELISA was used to detect the expression of HER2 in the sample. Associations between biomarker expression, clinicopathological features, and prognosis were evaluated.

Results: ERα36 mRNA expression was higher in breast cancer tissues than in adjacent tissues (p < 0.05). High ERα36 expression was associated with menopause (77.78%) and lymph node metastasis (75.00%) (p < 0.05). HER2 positivity correlated with menopause (55.56%) and lymph node metastasis (56.00%) (p < 0.05). No significant differences were found in age, reproductive history, family history, clinical stage, histologic grade, or T stage (p > 0.05). OS rates showed no significant difference, but PFS rates varied significantly (p < 0.05). Patients with high ERα36 expression in HER2-positive cases had the poorest prognosis (p < 0.05).

Conclusion: ERα36 and HER2 are valuable prognostic biomarkers, with their co-expression linked to increased lymph node metastasis and poorer survival outcomes.

Background: Nonalcoholic fatty liver disease (NAFLD) is a common hepatic disorder linked to metabolic syndrome. Endothelial dysfunction is crucial in NAFLD progression. Endocan, a marker of endothelial injury, has been studied in NAFLD, and we aim to systematically evaluate these findings.

Methods: PubMed, Scopus, Embase, and Web of Science were searched for studies measuring endocan levels in NAFLD patients compared to healthy controls. A random-effects meta-analysis was performed to estimate the standardized mean difference (SMD) with a 95% confidence interval (CI).

Results: Ten studies with 1045 participants (mean age 44.1 ± 9.8 years, 48.8% male) met inclusion criteria. Meta-analysis showed no significant difference in endocan levels between NAFLD patients and controls (SMD 0.03, 95% CI -0.59 to 0.65, p = 0.931). The diagnostic accuracy of endocan for NAFLD varied (AUC 0.647-0.867). Endocan was linked to endothelial dysfunction, atherosclerosis, and coronary artery disease in NAFLD patients.

Conclusion: Although serum endocan levels did not differ between NAFLD and controls, its role in endothelial dysfunction and disease prognosis suggests potential clinical relevance. Larger studies are needed to confirm these findings.

Background: Over the past decade, multiple research studies have focused on using miRNA expression in colorectal cancer (CRC) pathogenesis.

Materials & methods: 150 cases of two phases, where 14 miRNAs were first estimated in 75 cases for screening, followed by measuring miR-203a-3p, miR-7-5p, and miR-15b-5p relative expression in 75 subjects for further validation. Insilico analyses were done for confirmation.

Results: miR-203a-3p and miR-15b-5p were significantly downregulated, whereas miR-7-5p was highly expressed in CRC patients. Significantly elevated diagnostic efficacy for CRC was observed for miR-203a-3p, miR-7-5p, and miR-15b-5p (p < 0.001). Serum expression levels of these miRNAs are positively correlated with their matched tissue expression levels (p < 0.001).

Conclusion: Diagnostic biomarker potential was identified for miR-203a-3p, miR-7-5p, and miR-15b-5p in CRC.

Objective: Serum uric acid (SUA) level has been associated with the progression of chronic kidney disease (CKD), but the role of the SUA/creatinine (SUA/Cre) ratio remains unclear. This study aimed to evaluate whether the SUA/Cre ratio is superior to isolated SUA as a marker for CKD.

Methods: A retrospective observational study including 524 participants was conducted to compare SUA and SUA/Cre ratio in groups with and without CKD. Participants were categorized into 3 groups according to CKD stage: no CKD (n = 84), CKD stage 1-2 (n = 124), and CKD stage 3-4 (n = 316). Multivariate and receiver operating characteristic (ROC) analyses were performed to assess the association of SUA and SUA/Cre ratio with the presence of CKD.

Results: According to the ROC curve, SUA level showed a stronger correlation than the SUA/Cre ratio (area under the curve [AUC] = 0.768 vs AUC = 0.261; p < .001).

Conclusions: Although both the SUA/Cre ratio and SUA level were associated with renal dysfunction, SUA was found to be a better marker of CKD.

Background: The integration of serum biomarkers and gene polymorphisms may enhance early prognostic assessment in sepsis. Early and accurate prediction of outcomes is crucial for optimizing treatment strategies and improving survival. However, the clinical utility of combining genetic markers with conventional inflammatory indicators remains insufficiently validated.

Methods: In this retrospective cohort (n = 81; July 2022-July 2024), patients were grouped by 28-day outcome. Candidate genes (TLR4, PPARγ, IL-12B, IL-27) were shortlisted from GSE54514. After data standardization and complete-case handling of < 5% missingness, ten-fold cross-validated LASSO selected predictors for multivariable logistic regression. Model performance was assessed by ROC AUC, Hosmer - Lemeshow (H - L) test, calibration plots, bootstrap optimism-correction (1,000 resamples), and decision-curve analysis (DCA).

Results: 6 predictors were retained - PCT, CRP, lactate (LAC), lactate clearance rate (LCR), TLR4 rs4986790, and PPARγ rs1801282. The nomogram achieved AUC 0.885 (95% CI 0.812-0.943) with sensitivity 88.6% and specificity 73.9%; calibration was good (H - L χ² = 9.191, p = 0.156). Bootstrap-corrected AUC was 0.872, with calibration slope 0.97 and Brier score 0.165. DCA indicated higher net benefit than SOFA or APACHE II across 0.05-0.40 threshold probabilities. In benchmarking, the integrative model outperformed SOFA and APACHE II (ΔAUC 0.129 and 0.104; DeLong p = 0.004 and 0.009) and showed higher net benefit on decision-curve analysis across 0.05-0.40 threshold probabilities.

Conclusion: This integrative biomarker-genotype model demonstrated strong internal performance and potential clinical utility for individualized risk stratification in sepsis. The results support combining genetic susceptibility and inflammatory biomarkers for enhanced prognostic precision, although external and multi-ethnic validation remains warranted before widespread adoption.