Combining serum inflammation indexes at baseline and post treatment could predict pathological efficacy to anti­PD­1 combined with neoadjuvant chemotherapy in esophageal squamous cell carcinoma.

BACKGROUND: The neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) have been used to predict therapeutic response in different tumors. However, no assessments of their usefulness have been performed in esophageal squamous cell carcinoma (ESCC) patients receiving anti­PD­1 combined with neoadjuvant chemotherapy. METHODS: The respective data of 64 ESCC patients receiving anti­PD­1 combined with neoadjuvant chemotherapy were analyzed. Whether NLR, LMR, PLR, and SII at baseline and post-treatment might predict pathological response to anti­PD­1 plus neoadjuvant chemotherapy, and cutoff values of these parameters were all determined by ROC curve analysis. RESULTS: NLR (cutoff = 3.173, AUC = 0.644, 95% CI 0.500-0.788, P = 0.124, sensitivity = 1.000, specificity = 0.373), LMR (cutoff = 1.622, AUC = 0.631, 95% CI 0.477-0.784, P = 0.161, sensitivity = 0.917, specificity = 0.137), PLR (cutoff = 71.108, AUC = 0.712, 95% CI 0.575-0.849, P = 0.023, sensitivity = 1.000, specificity = 0.059), and SII at baseline (cutoff = 559.266, AUC = 0.681, 95% CI 0.533-0.830, P = 0.052, sensitivity = 0.373, specificity = 1.000) seemed to be a useful predictor for distinguishing responders from non-responders. Combining NLR with SII at baseline (AUC = 0.729, 95% CI 0.600-0.858, P = 0.014, sensitivity = 0.917, specificity = 0.510), LMR and SII at baseline (AUC = 0.735, 95% CI 0.609-0.861, P = 0.012, sensitivity = 1.000 specificity = 0.471), PLR and SII at baseline (AUC = 0.716, 95% CI 0.584-0.847, P = 0.021, sensitivity = 1.000 specificity = 0.431), and LMR and PLR at post-treatment in the third period (AUC = 0.761, 95% CI 0.605-0.917, P = 0.010, sensitivity = 0.800, specificity = 0.696) might slightly increase the prediction ability to determine patients who have response or no response. Finally, combining LMR at baseline, SII at post-treatment in the second period with PLR at post-treatment in the third period could be considered a better predictor for discriminating responders and non-responders than single or dual biomarkers (AUC = 0.879, 95% CI 0.788-0.969, P = 0.0001, sensitivity = 0.909, specificity = 0.800). CONCLUSIONS: The models we constructed allowed for the accurate and efficient stratification of ESCC patients receiving anti-PD-1 plus chemotherapy and are easily applicable for clinical practice at no additional cost.

The influence of traditional values of education of Greek students' real and ideal self-concepts.

Students' real and ideal self-concepts were studied with respect to their acceptance or rejection of the traditional values of Greek education. The relationship between the real and the ideal components of self-concept was also examined. A sample of Athenian students who answered a questionnaire accepted most of the traditional values of education. The students' internalization of such values predicted their moderately satisfied real self-concepts and their extremely developed ideal self-concepts, which symbolized their hopes and ambitions for academic achievement. The factor-analyzed items of self-concept revealed a disparity between the real and the ideal components of the participants' self-concepts.

Primary malignant mesodermal ovarian sarcomas.

Primary malignant mesodermal ovarian sarcomas are rare tumors and have a poor prognosis. The disease is usually diagnosed at a late stage and 5-year survivals are uncommon. Most patients are treated with debulking surgery followed by adjuvant chemotherapy. We report ten patients treated at a single institution. All patients underwent surgery and 90% received adjuvant chemotherapy. The median survival was 20 months, and only one patient survived beyond 5 years. Newer treatment strategies are urgently needed in the management of this disease.