Elevated Preoperative NMPR Predicts an Unfavorable Chance of Survival in Resectable Esophageal Squamous Cell Carcinoma.

Background and objectives: Combined peripheral neutrophil−platelet indexes reflecting the systemic inflammatory status have been reported to predict the clinical outcome in patients with various types of cancer. However, the prognostic value of combined neutrophil−platelet indexes in operable esophageal squamous cell carcinoma (ESCC) remains unclear. The study introduced a novel combined neutrophil−meanplateletvolume−platelet ratio (NMPR) index and investigated its clinical and prognostic value in patients with operable ESCC receiving curative surgery. Materials and Methods: A retrospective analysis of the clinicopathologic data of 277 consecutive ESCC patients who received curative resection at Zhejiang Cancer Hospital in China between January 2007 and December 2010 was conducted (the training cohort). In addition, the clinicopathologic data of 101 resectable ESCC patients at Renmin Hospital of Hubei University of Medicine between December 2018 and June 2021 were collected (the external validation cohort). The optimal cutoff value of NMPR concerning overall survival (OS) in the training cohort was determined by X-tile software. Univariate and multivariate Cox regression analyses were used to evaluate the prognostic value of NMPR along with other variables in the training cohort, which was further validated with the same cutoff value in the external validation cohort. Significant predictors of OS were used to construct the nomogram, of which the discrimination and calibration was evaluated by concordance index (C-index) and calibration plots. Results: With a cutoff value of 16.62, the results from both the training and external validation cohorts supported the association of high NMPR (>16.62) with increased tumor length and advanced T stage but not with other variables. In the training cohort, a significant association between shorter OS and high NMPR (p = 0.04) as well as high CRP (p < 0.001), poor tumor differentiation (p = 0.008), advanced T stage (p = 0.006), advanced N stage (p < 0.001) and high CEA (p = 0.007) was revealed. Additionally, the high NMPR was verified to independently predict unfavorable OS (p = 0.049) in the external validation cohort. The C-index of the OS nomogram cooperating significant predictors in the training cohort was 0.71 and the calibration plots of the OS nomogram fitted well. Conclusions: The present study demonstrates that high NMPR is an independent predictor of unfavorable OS in resectable ESCC patients without neoadjuvant therapy.

Fractional amplitude of low-frequency fluctuation in patients with neovascular glaucoma: a resting-state functional magnetic resonance imaging study.

BACKGROUND: Neovascular glaucoma (NVG) is a secondary refractory disease with a poor prognosis, and there are few advanced studies on its pathogenesis and treatment. In this research, the fractional amplitude of low-frequency fluctuation (fALFF) technology was used in resting-state functional magnetic resonance imaging (rsfMRI) to investigate intrinsic neuron activity in the patient's brain with NVG. METHODS: Sixteen patients with NVG (eight males and eight females) and 16 healthy controls (HCs) of similar age and sex were included. All patients and controls received rsfMRI scans, and the differences between the two groups in fALFF values were compared by independent sample t-test. Receiver operating characteristic (ROC) curves were used to compare fALFF values in the brain regions of NVG patients and HCs and assess accuracy. Finally, Pearson linear correlation analysis assessed the correlation between fALFF signals in brain regions and the clinical evaluation indicators of patients with NVG. RESULTS: In patients with NVG, fALFF signal values in the right Rolandic operculum, left anterior cingulate and paracingulate gyri, and right caudate were significantly decreased. In contrast, fALFF signal values in the left precuneus were significantly higher than those recorded in the HCs. Analysis of the ROC curve for each brain region showed that the area under the ROC curve of NVG patients was large (close to 1), and the accuracy was good. In the NVG group, the hospital anxiety and depression scale (r=-0.952, P<0.001) and left best-corrected visual acuity (r=-0.802, P<0.001) had a negative linear correlation with the fALFF signal value of the right Rolandic operculum. The hospital anxiety and depression scale had a negative linear correlation with the fALFF signal value of the right caudate (r=-0.948, P<0.001). CONCLUSIONS: NVG patients showed dysfunction in several brain regions. These findings may assist in revealing the underlying neural mechanism of brain activity associated with NVG.