Prognostic Relationship Between the ABO Blood Groups and Metastatic Gastric Cancer.

AIM:  Gastric cancer is one of the most common malignant tumors of the digestive system and has a poor prognosis. Since recurrence and distant metastasis are common in gastric cancer, it is important to use practical and reliable prognostic parameters. In this study, the prognostic relationship between the ABO blood groups and metastatic gastric cancer was investigated. METHOD AND MATERIAL:  Data were collected by retrospectively scanning the files of 225 patients who were followed up with the diagnosis of metastatic gastric cancer in 2010-2022. The patients' demographic data (age, gender), tumor histopathology, tumor location, and ABO and Rh blood groups were evaluated. RESULTS:  Of the patients, 138 (61.3%) were male and 87 (38.7%) were female. According to the distribution of the ABO system, blood group A was present in 109 (48.4%) patients, B in 33 (14.7%), AB in 20 (8.9%), and O in 63 (28%). Signet ring cell carcinoma, antrum tumor localization, and distant metastasis were more common in blood groups A and O. According to both the univariate and multivariate analyses, overall survival (OS) was statistically worse in patients with signet ring cell carcinoma and peritoneal metastasis (p < 0.05). The OS rate was the worst in blood group A and best in blood groups AB and B. CONCLUSION:  In this study, blood group A presented as both a risk factor and a poor prognostic factor in the development of metastatic gastric cancer. In addition, signet ring cell histopathology and presence of metastasis were found to be more common in patients with blood group A and associated with a poor prognosis. Blood groups are inexpensive, easily available, and reliable parameters that can provide an idea about both prognosis and survival in gastric cancer. Therefore, they can serve as a guide for clinicians in the follow-up and evaluation of the prognosis of these patients.

Prognostic Significance of Hemoglobin/Prognostic Nutritional Index and Hemoglobin/Red Blood Cell Distribution in Rectal Cancer.

BACKGROUND: We aimed to investigate the effect of hemoglobin/prognostic nutritional index and hemoglobin/red blood cell distribution, which are indicators of inflammation and nutrition, on prognosis and survival in patients with rectal cancer. METHODS: The retrospective study reviewed medical records of 138 patients with rectal cancer who were followed up between 2010 and 2021. The effects of hemoglobin/red blood cell distribution, hemoglobin/prognostic nutritional index, tumor stage, and lymph node status on survival and prognosis were evaluated using univariate and multivariate analyses. Overall survival and disease-free survival were calculated for both groups. RESULTS: Survival and prognosis were found to be significantly better in nonanemic patients with the hemoglobin/prognostic nutritional index higher than the cut-off value than in anemic patients with a normal or lower hemoglobin/prognostic nutritional index. Similarly, survival and prognosis were found to be significantly better in nonanemic patients with a hemoglobin/red blood cell distribution higher than the cut-off value than in anemic patients with a normal or lower hemoglobin/red blood cell distribution. CONCLUSION: The results indicated that nutrition and inflammatory markers have independent prognostic significance in rectal cancer. These markers are simple, inexpensive, and useful biomarkers commonly used in clinical practice, and they were found to predict overall survival and disease-free survival independently.

What does the Procalcitonin Level Tell us in Patients with Acute Pancreatitis?

OBJECTIVE: To determine the factors affecting the procalcitonin level, and its association with the severity of pancreatitis in patients with acute pancreatitis (AP). STUDY DESIGN: Cross-sectional analytical study. PLACE AND DURATION OF STUDY: Division of Gastroenterology, University of Health Sciences, Diyarbakir Gazi Yasargil Education and Research Hospital and Department of Gastroenterology, Dicle University School of Medicine, Diyarbakir, Turkey, between April 2017 and June 2021. METHODOLOGY: The study included 214 patients diagnosed with AP according to Atlanta criteria. By checking the PCT and CRP values of the patients in the first 12 hours, the relationship with these scales that predict the severity of pancreatitis was statistically examined. RESULTS: Hundred and fifty-two patients (71.0%) had mild, while 62 patients (29.0%) had severe pancreatitis. According to the Atlanta criteria, the mean PCT level of patients with mild pancreatitis was 1.4±0.7 ng/mL, while the mean PCT level of patients with severe pancreatitis was 9.0±12.3 ng/mL (p<0.001). The diagnostic performance of PCT was better for predicting severe AP. For the 0.94 ng/mL cut-off, PCT had 86.9% sensitivity and 50.7% specificity. (AUC=0.731[95% CI: 0.669-0.811]; p<0.001; LR: 1.7). In patients with severe pancreatitis, the PCT level was 4.7±18.5 ng/mL in patients without concomitant infection and 15.8±8.1 ng/mL in patients with concomitant infection (p<0.001). CONCLUSION: High PCT value measured at the time of the first admission to the hospital may predict severe pancreatitis. In addition, a high PCT value at the time of admission to the hospital in patients with pancreatitis may indicate another concomitant infection. KEY WORDS: Acute pancreatitis, Coinfection, Procalcitonin, Severity of pancreatitis.

Development of hepatocellular carcinoma in patients with chronic hepatitis C who had sustained viral response following direct-acting antiviral therapy.

Background and Aim: Several studies have suggested that treatment with direct-acting antivirals (DAAs) in patients with chronic hepatitis C virus (HCV) may be associated with an increased risk of developing hepatocellular carcinoma (HCC). We investigated the incidence and risk factors of HCC in HCV patients who achieved a sustained virologic response (SVR) following DAA therapies. Materials and Methods: The medical data of patients who were diagnosed with HCV and received DAA therapy in two tertiary centers in Turkey were retrospectively collected. Results: Among them, 75 patients (52.4%) were noncirrhotic and 68 patients (47.6%) were cirrhotic. The overall SVR rate was 97.2% (139/143). It was 100% in noncirrhotic and 94.1% in cirrhotic patients. HCC was developed in 5 (7.4%) patients, all of whom had baseline cirrhosis. The annual rate of HCC occurrence was 2.94%, and the 5-year cumulative incidence of HCC was 7.3%. The mean Child-Pugh score (CPS) and Model for End-Stage Liver Disease (MELD) score significantly decreased after DAA treatment (CPS 7.0 vs 5.9, p=0.001; MELD 10.8 vs 9.5, p=0.003). Conclusion: There was no significant increase in the rate of HCC in cirrhotic HCV patients treated with DAAs. This treatment led to a remarkably high SVR rate and lowered CPS and MELD scores in cirrhotic HCV patients.

Relationship Between Lesions in Adenomatous Polyp-Dysplasia-Colorectal Cancer Sequence and Neutrophil-to-Lymphocyte Ratio.

BACKGROUND The aim of our study was to evaluate all lesions in the adenoma-dysplasia-cancer sequence of the colon and to examine whether the neutrophil-to-lymphocyte ratio (NLR) can distinguish polyps indicating dysplasia and cancer. MATERIAL AND METHODS A total of 397 patients who had colonoscopic polypectomy between January 2010 and December 2014 were included in our retrospective study. The patients were divided into four groups: patients with hyperplastic polyps, patients with adenomatous polyps, patients with dysplasia, and patients with cancer. The NLR was calculated as a simple ratio indicating the relationship between counts of absolute neutrophil and absolute lymphocyte. RESULTS The NLR increased in line with the adenomatous polyp-dysplasia-cancer sequence, with the highest ratio established among cancer patients (2.05 (0.27-10), 2.34 (0.83-14.70) and 3.25 (0.81-10.0), respectively). The NLR was significantly higher among cancer patients than among patients with adenomatous polyps and hyperplastic polyps (p values were 0.001 and 0.004, respectively). The lymphocyte count of cancer patients was prominently lower when compared to those in groups with adenomatous polyps and hyperplastic polyps (p values were 0.001 and 0.003, respectively). The NLR was found to be significantly higher in patients with polyps larger than 10 mm [2.71 (0.90-14.70)] when compared to those with polyps smaller than 10 mm [2.28 (0.27-11.67)] (p<0.001). With the NLR threshold set at 2.20, it was possible to predict cancerous polyps with a sensitivity of 71.4% and a specificity of 52.5% (AUC: 0.665, 95% CI: 0.559-0.772, p=0.001). CONCLUSIONS NLR is a cheap, universally available, simple and reliable test that can help predict cancerous polyps. It can be used as a non-invasive test for monitoring polyps.