Biomarkers in medicine最新文献

Aim: This paper aims to perform a meta-analysis to provide the most updated and comprehensive evidence on the link between neutrophil-lymphocyte ratio (NLR) and the development and prognosis of hypertension.

Materials & methods: Cochrane Library, PubMed, Embase, and Web of Science were thoroughly searched for studies published from the inception of the databases up to 4 May 2024 using the keywords "Lymphocytes," "Neutrophils," "Ratio," and "Hypertension." The odds ratios (OR) and 95% confidence intervals (CI) were extracted for random-effects meta-analysis. We employed Egger's test to check publication bias, sensitivity analyses to identify studies that significantly impacted the meta-analysis results, and subgroup analyses to ascertain the source of heterogeneity.

Results: 10 articles involving 78,194 patients were enrolled. The pooled data indicated that NLR was a significant predictor of hypertension risk (OR = 1.11, 95% CI = 1.05-1.17, p = 0.004). Additionally, NLR was notably linked with all-cause (OR = 2.02, 95% CI = 1.29-3.15, p = 0.002) and cardiovascular deaths (OR = 2.10, 95% CI = 1.51-2.61, p < 0.0001) in hypertensive patients. Sensitivity analyses validated the robustness of the findings, and subgroup analyses ascertained a source of heterogeneity.

Conclusion: NLR is a reliable and valuable biomarker for predicting both the risk of hypertension and outcomes in hypertensive patients.

Aims: We aimed to explore the prognostic role of circulating DNA-related markers to improve clinical decision-making in patients with lung malignancies.

Methods: A systematic search was performed on PubMed, Scopus, and Web of Science.

Results: About 133 articles were included, comprising 5750 EGFR-positive, 1583 ALK-positive, and 9657 patients without specified genetic groups. Circulating tumor DNA (ctDNA) response was a significant prognostic marker associated with improved overall survival (OS) (HR = 0.36 [0.27, 0.47], I2 = 0%) and progression-free survival (PFS) (HR = 0.31 [0.18, 0.55], I2 = 67.33%) in advanced non-small cell lung cancer (NSCLC). Meta-analysis of tumor mutational burden (TMB) in the same group demonstrated trends toward poorer survival outcomes for higher TMB -pooled HR of 1.63 (95%-CI: 0.92, 2.88, I2 = 71.23%) for OS and 1.09 (95%-CI: 0.63, 1.89, I2 = 86.66%) for PFS. Finally, meta-analysis in advanced EGFR-positive NSCLC implicated significant prognostic effect of EGFR response positivity on OS and PFS -pooled HR of 0.39 and 0.27, respectively.

Conclusion: Circulating DNA markers entailed valuable information in patient prognostication and depicting treatment efficacies in lung cancer. Further studies are needed to decipher more robust criteria for the presently accepted markers - namely ctDNA and EGFR response measures. Additionally, there are several markers - i.e. TMB - that have more exploratory clinical benefits.

Background: Inflammatory markers are associated with the severity of disease and outcomes in rheumatic mitral stenosis (RMS). This study explored the connection between newer inflammatory indices - specifically, the systemic immune inflammation index (SII) and systemic inflammation response index (SIRI) - and clinical outcomes in RMS patients who underwent percutaneous balloon mitral valvuloplasty (PBMV).

Methods: A total of 131 patients with severe RMS who received PBMV at Tehran Heart Center between August 2015 and February 2021 were assessed. Inflammatory markers were measured prior to the procedure. Echocardiographic parameters, Wilkins scores, and complications were analyzed over a three-year follow-up period. ROC curves and multivariate logistic regression were employed to evaluate predictive associations.

Results: The average age of participants was 47.9 years, and 79.4% were female. Lower systolic pulmonary pressure and younger age were associated with a greater success rate of PBMV. Frequent complications included mitral regurgitation (47.5%) and readmission (27.5%). Higher levels of NLR, MLR, SII, and SIRI were correlated with increased Wilkins scores. SIRI was an independent predictor of PBMV success.

Conclusion: SIRI demonstrated the highest predictive capability for PBMV success, with 71% sensitivity and 80% specificity. It was also associated with complications and mid-term outcomes in severe RMS.

Background: Late gadolinium enhancement (LGE) on cardiac magnetic resonance imaging indicates myocardial scarring and has prognostic value in myocarditis. The Pan-Immune-Inflammation Value (PIV) is a novel biomarker reflecting systemic inflammation; however, its association with LGE in myocarditis remains uninvestigated. This study aims to evaluate whether PIV levels can predict the presence of LGE in patients with myocarditis.

Aims: We retrospectively analyzed 141 patients with myocarditis between 2021 and 2024. PIV, troponin levels, and other inflammatory markers were analyzed for their association with LGE.

Results: LGE was observed in 68.8% of the patients, with a higher proportion of males in the LGE+ group. The LGE+ group showed significantly elevated levels of PIV (1.661.2 ± 22.269) and troponin (786.2 ± 10.711 ng/L) compared to the LGE- group. Multivariate regression analysis confirmed PIV (OR: 1.002, p = 0.005) and troponin (OR: 1.003, p = 0.001) as predictors of LGE. ROC analysis identified a PIV threshold of >1153.2, achieving 95% specificity with a positive predictive value of 92.9% for LGE presence.

Conclusions: Our findings indicate that elevated PIV levels are significant predictors of LGE, suggesting that PIV may serve as a valuable tool in assessing risk and guiding follow-up strategies for patients with myocarditis.

Aim: Metastatic non-small cell lung cancer (NSCLC) patients face a poor prognosis, with a 5-year overall survival (OS) rate of under 10%. In this investigation, we examined the prognostic implications of sarcopenia and metabolic metrics obtained from 18F-FDG PET/CT imaging in individuals diagnosed with metastatic non-squamous NSCLC (nsNSCLC).

Methods: The investigation included 124 individuals with metastatic nsNSCLC who underwent 18F-FDG PET/CT imaging on diagnosis. Sarcopenia was determined by evaluating the skeletal muscle index at the L3 vertebral level. Metabolic metrics obtained from 18F-FDG PET/CT imaging, maximum standard uptake, metabolic tumor volume, and total lesion glycolysis were measured for whole body lesions (SUVmax_WB, MTV_WB, and TLG_WB) and primary tumors (SUVmax_T, MTV_T, and TLG_T). Primary endpoints examined were OS and the rate of sarcopenia diagnosis.

Results: Patients with sarcopenia, comprising 74.2% of the cohort, experienced a markedly reduced median OS of 4.7 months compared to 9.8 months in the non-sarcopenic cohort, which accounted for 25.8% of the population. Multivariate analysis revealed that sarcopenia, as well as metabolic metrics, including SUVmax_T, MTV_T, TLG_T, and SUVmax_WB, were independent predictors of OS in metastatic nsNSCLC patients.

Conclusion: The presence of sarcopenia and unfavorable metabolic metrics on 18F-FDG PET/CT are linked to worse survival outcomes in metastatic nsNSCLC patients.

Background: Early distinction of bacterial etiology from viral causes represents a cornerstone for rational antimicrobial therapy. Through evaluation of dual-biomarker strategies, this investigation examined the diagnostic utility of simultaneous PCT and CRP measurement while elucidating underlying inflammatory pathways.

Methods: A retrospective analysis encompassed 284 patients diagnosed with pneumonia (bacterial: n = 162, viral: n = 122) hospitalized during January 2023 through December 2024. Laboratory parameters including PCT, CRP, leukocyte counts, neutrophil proportions, IL-6, and TNF-α underwent comprehensive measurement. Diagnostic accuracy was evaluated through ROC analysis, with severity correlations systematically assessed.

Results: Marked increases in inflammatory markers characterized the bacterial cohort (all parameters p < 0.001). Among single biomarkers, PCT demonstrated superior diagnostic capability (AUC = 0.892). When combined measurement was employed, PCT+CRP yielded optimal performance (AUC = 0.943, sensitivity 92.6%, specificity 89.3%). Positive correlations emerged between biomarker concentrations and clinical severity scores (PCT: r = 0.782, CRP: r = 0.743, both p < 0.001). Following multivariate adjustment, concurrent elevation of both markers emerged as the strongest independent correlate of bacterial etiology (OR = 8.74, 95% CI: 5.26-14.53, p < 0.001).

Conclusion: The synergistic assessment of PCT with CRP surpasses individual marker performance for bacterial-viral pneumonia discrimination, capturing differential inflammatory cascades and severity stratification. This dual-biomarker strategy optimizes therapeutic decisions and antimicrobial governance.

Objective: The immunoproteasome is linked to endothelial function and may act as a proangiogenic factor. This study explored its predictive value for coronary collateral circulation (CCC) in ST-elevation myocardial infarction (STEMI) patients.

Methods: We enrolled 252 STEMI patients from April 2021 to April 2024. Plasma levels of LMP2, LMP7, and PSMB10 were measured using ELISA. ROC curves assessed predictive ability for good CCC. Univariate and multivariate logistic regression analyses identified predictors, and restricted cubic spline (RCS) analysis evaluated the dose-response relationship. Subgroup analysis was also conducted.

Results: Patients with good CCC had significantly higher plasma levels of immunoproteasome components. Among them, LMP7 showed the best predictive value (AUC = 0.732), with an optimal cut-off of 3.824 ng/mL. Multivariate logistic regression confirmed LMP7 ≥3.824 ng/mL as an independent predictor for good CCC [OR = 7.914 (4.127-15.174)]. RCS analysis showed a J-shaped association: the odds of good CCC increased notably when LMP7 exceeded 3.824 ng/mL. Subgroup analyses supported these findings.

Conclusion: Higher plasma immunoproteasome levels, especially LMP7 ≥3.824 ng/mL, were independently associated with good CCC in STEMI patients, suggesting its potential role as a biomarker of collateral development.

Aims: In obstructive sleep apnea (OSA), the balance between inflammatory and anti-inflammatory responses is disrupted. This study examined the association between serum angiotensin 1 (Ang 1), angiotensin 1-7 (Ang 1-7), and Mas receptor levels and OSA severity.

Material and methods: A total of 190 subjects underwent polysomnography and serum analysis for Ang 1, Ang 1-7, and Mas using ELISA. Patients were classified into control, mild, moderate, and severe OSA groups based on AHI.

Results: Ang 1-7, Ang 1, and serum Mas levels were significantly lower in moderate and severe OSA groups compared to control and mild OSA (p < 0.001). Negative correlations were found between these biomarkers and AHI (e.g. Ang 1-7: R = -0.597, p < 0.001). ROC analysis showed strong diagnostic performance: AUC was 0.864 for Ang 1-7, 0.873 for Ang 1, and 0.837 for Mas, with sensitivity of 98%, 98%, and 97%, respectively.

Conclusion: Reduced levels of Ang 1-7, Ang 1, and Mas are associated with increased OSA severity. These biomarkers demonstrated high diagnostic value and may be useful in stratifying patients with moderate-to-severe OSA.

Background: Gastric cancer is the fifth most common malignancy worldwide. Early diagnosis of GC can increase survival rate and treatment outcome. In the present study, the expression of lncRNA ANRASSF1 was evaluated in gastric tumor tissues.

Methods: One hundred and two pairs of gastric tumors and non-tumor tissues were collected from Tabriz International Valiasr Hospital, Iran. RNA was extracted, followed by cDNA synthesis. Expression of ANRASSF1 was assessed using real-time PCR method.

Results: ANRASSF1 was significantly overexpressed in GC (p < 0.001). We found a significant association between ANRASSF1 expression and lymph node metastasis (p = 0.014), Helicobacter pylori infection (p = 0.029), and Lauren subtypes (p = 0.0001).

Conclusion: LncRNA ANRASSF1 appears to have an oncogenic role in GC, and it may be regarded as a diagnosis and prognostic biomarker in patients with GC.

Aim: Coronary artery ectasia (CAE) is localized or generalized dilatation of the coronary artery lumen. CAE is difficult to diagnose, treat, and manage and is associated with the risk of adverse cardiovascular events. In our study, we aimed to evaluate and compare these predictive parameters of CAE.

Materials & methods: We conducted a study that involved analyzing patients who had underwent angiography for acute coronary syndrome. The patients were categorized into two groups based on the presence or absence of CAE. The Cox regression analysis considered significant predictors for CAE while assessing independent variables. ROC Curve analysis was used to evaluate the predictive capability of these variables for CAE, and area under the curve (AUC) values were compared.

Results: 2279 patients included in the study were followed for an average of 498 days. Coronary ectasia was present in 5.35% of the patients. LDL/HDL ratio and lymphocyte count independently predicted CAE.

Conclusion: In our study, low density lipoprotein/high density lipoprotein (LDL/HDL) ratio and lymphopenia were observed to independently predict CAE. LDL/HDL ratio obtained from standard blood tests can be used as a cost-effective and simple method to predict CAE, making a significant contribution to treatment planning, prognosis and patient follow-up.