Biomarkers in medicine最新文献

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.

Purpose: After Cardiac Arrest (CA), serum biomarkers (SB) are released to the blood in response to brain damage and, therefore, may be helpful tools to predict neurological outcome. This systematic review aims at assessing the role of SB as neurological outcome indicators after pediatric CA.

Methods: A systematic literature search was performed in PubMed, Scopus, WebOfScience and Cochrane Library. All information retrieved from the selected articles was summarized in a data table.

Results: Eight studies, including a total of 539 patients, were analyzed. Neurological outcomes were assessed by using the Pediatric Cerebral Performance Category (PCPC) scale in all studies except one. Eleven serum biomarkers were evaluated, with higher concentrations observed in the unfavorable outcome group at various time points. However, only one study defined a specific cutoff value. The biomarkers with the highest predictive accuracy for neurological outcomes appear to be initial levels of IL-17 and CNFT, as well as NSE and S100B.

Conclusion: Following pediatric CA, SB may be helpful indicators of unfavorable neurological outcome, as they seem to appear in higher concentrations in this group. Further research is required to establish specific timepoints and cutoff values and to determine the implication of these findings in clinical practice.

Objective: To investigate the correlation between postoperative serum glial fibrillary acidic protein (GFAP) and 3-nitrotyrosine (3-NT) levels and neuronal injury severity in glioma patients.

Methods: 150 glioma patients were enrolled, with clinical baseline and pathological data recorded (age, sex, etc.). Neuronal injury was assessed using the National Institutes of Health Stroke Scale (NIHSS) postoperatively, categorizing patients into mild (NIHSS 1 ~ 4, n = 54) and moderate-to-severe (NIHSS ≥5, n = 96) groups. Serum GFAP and 3-NT levels were measured three days post-surgery via ELISA. Correlations with NIHSS were analyzed with Spearman's test. Patients were also stratified by median biomarker levels. Multivariate logistic regression identified severity risk factors. Receiver operating characteristic (ROC) curves evaluated diagnostic value.

Results: GFAP and 3-NT levels were higher in the moderate-to-severe group (p < 0.001) and positively correlated with NIHSS scores (GFAP: r = 0.552; 3-NT: r = 0.545). Higher biomarker levels were significantly associated with worse injury (p < 0.001). Both were independent risk factors for severity. Combining GFAP and 3-NT predicted severity significantly better than either alone (p < 0.001).

Conclusion: Postoperative serum GFAP and 3-NT levels correlate positively with neuronal injury severity in glioma patients. Their combination provides high diagnostic value for assessing postoperative injury severity.

Background: There are numerous controversies surrounding the diagnosis of matrix metalloproteinases (MMPs) in pancreatic cancer (PC). Consequently, this study conducts the first comprehensive meta-analysis evaluating the diagnostic performance of MMP family members in PC, highlight potential biomarkers, and investigate sources of heterogeneity.

Method: Articles on the MMP family and PC diagnosis were retrieved from PubMed and Web of Science. Diagnostic accuracy was assessed using sensitivity (SEN) and specificity (SPE). Threshold effects, heterogeneity (via meta-regression and subgroup analyses), and result robustness (via sensitivity analysis) were evaluated. Publication bias was examined using Deeks' funnel plot.

Result: This meta-analysis included 48 studies from 23 articles, covering 12 types of MMP. The aggregated SEN, SPE, and area under the curve (AUC) for MMPs in diagnosing PC ranged from 0.61 to 0.76, 0.66 to 0.78, and 0.7273 to 0.8840, respectively. Meta-regression identified sample type as a major contributor to heterogeneity, with tissue-based MMPs showing markedly superior diagnostic performance compared to serum or plasma-based assays. Overall, MMPs showed potential diagnostic value, but their accuracy remains moderate and requires further validation in larger, well-designed studies.

Conclusion: MMPs represent potential candidates for PC diagnosis, but current evidence is insufficient for clinical application, requiring further prospective studies.

Assessment of biomarkers through liquid biopsy, accompanied by low invasiveness, provides a more comprehensive analysis of the genetic profile of tumors, a deeper understanding of cancer mechanisms, the capacity for repeated testing over time, a short processing time, ease of obtaining, and economic benefits, making it easier to monitor diseases compared to tissue biopsy. Circulating tumor cells (CTCs), circulating tumor DNA (ctDNA), exosomes, non-coding RNAs, and metabolites provide precise and timely strategies for managing cancer patients. The main challenges are the low concentration of analytes isolated from liquid biopsies, the development of assays with both high sensitivity and specificity, and the lack of clear and comprehensive guidelines for assays, which further complicate the standardization process. Combined detection, including both CTCs and ctDNA assessment in circular bodies, provides valuable information at different stages of the tumor, despite the heterogeneity of tumor cells, for prognosis, dynamic monitoring, and mutation detection. In addition, the combination of biofluid biomarkers and artificial intelligence can enhance the accuracy and efficiency of liquid biopsy, improve real-time monitoring of tumor procedures and treatment responses, and provide precision medicine. This review examines the challenges in standardizing biofluid assays and explores potential solutions to achieve more consistent clinical outcomes.

Aim: In metastatic Non-small cell lung cancer (NSCLC) with driver mutations, resistance mechanisms may limit treatment benefit, and their detection is expensive. The aim of this retrospective study was to investigate the usability of inflammatory-nutritional indices and hemoglobin, albumin, lymphocyte and platelet (HALP) scores for predicting survival in patients with metastatic NSCLCs with driver mutations undergoing first-line treatment with tyrosine kinase inhibitors (TKIs).

Patients & methods: Ninety-two patients using TKIs for metastatic disease with driver mutations were followed up in our center from December 2018 to May 2024. We retrospectively investigated the effects on progression-free survival (PFS) and overall survival (OS) by calculating inflammatory-nutritional indices and HALP scores using pre-treatment laboratory values.

Results: Higher plate-let-to-lymphocyte ratios (PLRs) were associated with shorter PFS, whereas a higher prognostic nutritional index (PNI) predicted longer PFS. Similarly, high HALP and PNI scores were significantly associated with longer OS, while lower platelet-to-lymphocyte ratio (PLR), systemic immune inflammatory index (SII) and systemic inflammation response index (SIRI) were linked to improved OS. Multivariate analysis identified only SII as an independent OS prognostic factor (OR = 7.182, p = 0.003).

Conclusions: HALP score, PLR, SII, PNI and SIRI may serve as potential prognostic biomarkers in NSCLC patients with driver mutations treated with first-line TKIs.