Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 83.173
Filtrar
1.
Medicine (Baltimore) ; 98(45): e17475, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31702609

RESUMO

The prognostic role of neutrophil to lymphocyte ratio (NLR) in patients with ovarian cancer remains inconsistent. This meta-analysis was conducted to evaluate the predictive value of this biomarker for prognoses in ovarian cancer patients.We systematically searched PubMed, Web of Science, and Embase for eligible studies embracing multivariate results. The Newcastle-Ottawa Scale were used to assess the study quality. Pooled hazard ratios (HRs), and 95% confidence intervals (CIs) were calculated.Ten studies involving 2919 patients were included in this meta-analysis. In multivariate analysis, the group with higher NLR had worse overall survival (OS) (HR = 1.34, 95% CI = 1.16-1.54) and shorter PFS (HR = 1.36, 95% CI = 1.17-1.57) than the control group. Furthermore, PLR values higher than the cut-off were associated with not only poorer OS (HR = 1.97, 95% CI = 1.61-2.40) but also more unfavorable PFS (HR = 1.79, 95% CI = 1.46-2.20). Univariate analysis also indicated the same results. Additionally, subgroup analysis showed that when the cut-off values for NLR and PLR were higher, their predictive effects became stronger.This comprehensive meta-analysis suggested that the values of inflammatory marker of NLR was associated with ovarian cancer survival. Therefore, inflammatory markers can potentially serve as prognostic biomarkers.


Assuntos
Neutrófilos/citologia , Neoplasias Ovarianas/sangue , Feminino , Humanos , Contagem de Linfócitos , Estudos Observacionais como Assunto , Prognóstico , Análise de Sobrevida
2.
Zhongguo Zhen Jiu ; 39(11): 1169-72, 2019 Nov 12.
Artigo em Chinês | MEDLINE | ID: mdl-31724351

RESUMO

OBJECTIVE: To observe the effect of grain-moxibustion at Zusanli (ST 36) and Weishu (BL 21) on neutrophil to lymphocyte ratio (NLR) and quality of life (QOL) in patients with advanced gastric cancer. METHODS: Sixty patients with advanced gastric cancer were randomly divided into an observation group and a control group, 30 cases in each one. In the control group, conventional chemotherapy regimen combined with symptomatic treatment,such as antiemetic, acid-suppressive, liver-protecting drugs. On the basis of the treatment in the control group, grain-moxibustion was applied at Zusanli (ST 36) and Weishu (BL 21) in the observation group, 9 cones for each acupoint, once a day for a total of 90 days. The levels of NLR were observed before and after treatment, and the clinical efficacy and quality of life were evaluated in the two groups. RESULTS: After treatment, the value of NLR in the observation group was significantly lower than before treatment (P<0.05), there was no significant difference before and after treatment in the control group (P>0.05), and the descend range of observation group was larger than the control group (P<0.05). The effective rates (RR) were 33.3% (10/30) in the observation group and 36.7% (11/30) in the control group, there was no significant difference between the two groups (P>0.05). After treatment, the QOL in the observation group was improved in diarrhea, loss of appetite, fatigue, nausea and vomiting, general health states (P<0.05), there was no significant difference in the control group before and after treatment in varions scores (P>0.05), and the observation group was superior to the control group in fatigue, sleep disorder, loss of appetite, diarrhea and general health states after treatment (P<0.05). CONCLUSION: Grain-moxibustion at Zusanli (ST 36) and Weishu (BL 21) can decrease NLR and improve QOL of patients with advanced gastric cancer.


Assuntos
Linfócitos/imunologia , Moxibustão , Neutrófilos/imunologia , Qualidade de Vida , Neoplasias Gástricas , Pontos de Acupuntura , Humanos , Moxibustão/métodos , Neoplasias Gástricas/imunologia , Neoplasias Gástricas/psicologia , Neoplasias Gástricas/terapia
3.
Klin Lab Diagn ; 64(10): 594-598, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31742951

RESUMO

Degenerative-dystrophic processes in the articular tissues are accompanied by the changes in the values of congenital immunity, being a result of immune responses to aseptic inflammation. The purpose of this study - to investigate the oxygen-dependent mechanisms of neutrophil phagocytic activity (NBT-test, myeloperoxidase activity), the biochemical values of lipid peroxidation, the oxidative modification of proteins and the activity of enzyme antioxidant protection in children (at the age of 12-16 years) with osteochondropathy of the femoral head.The increase in spontaneous NBT-test and myeloperoxidase content in neutrophils, the decrease in NBT stimulation index, as well as the statistically significant increase in the activity of superoxide dismutase, the main producer of hydroperoxide, was revealed in the group examined. At the same time, no increase in catalase activity and in the content of lipoperoxidation products was observed, however, redistribution of the products of oxidative modification of proteins with ketone predominance was found. In case of osteochondropathy development in children the activation of the oxygendependent mechanisms of neutrophil phagocytic activity is observed, as well as the increase in the number of the secondary products of protein peroxidation - ketones. An increase in SOD activity, with a simultaneous and significant decrease in catalase activity evidence of accumulation of hydroperoxide causing neutrophil activation and chemotaxis. The study data can be used for predicting osteonecrosis development as additional criteria when decision-making of the advisability of performing reconstructive surgeries of the joint.


Assuntos
Cabeça do Fêmur/patologia , Osteocondrodisplasias/fisiopatologia , Estresse Oxidativo , Oxigênio , Adolescente , Antioxidantes/metabolismo , Catalase/metabolismo , Criança , Humanos , Peroxidação de Lipídeos , Neutrófilos/enzimologia , Peroxidase/metabolismo , Superóxido Dismutase/metabolismo
4.
Adv Exp Med Biol ; 1197: 165-178, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31732941

RESUMO

Periodontitis is a multifactorial chronic inflammatory infectious disease that compromises the integrity of tooth-supporting tissues. The disease progression depends on the disruption of host-microbe homeostasis in the periodontal tissue. This disruption is marked by a shift in the composition of the polymicrobial oral community from a symbiotic to a dysbiotic, more complex community that is capable of evading killing while promoting inflammation. Neutrophils are the main phagocytic cell in the periodontal pocket, and the outcome of the interaction with the oral microbiota is an important determinant of oral health. Novel culture-independent techniques have facilitated the identification of new bacterial species at periodontal lesions and induced a reappraisal of the microbial etiology of periodontitis. In this chapter, we discuss how neutrophils interact with two emerging oral pathogens, Filifactor alocis and Peptoanaerobacter stomatis, and the different strategies deploy by these organisms to modulate neutrophil effector functions, with the goal to outline a new paradigm in our knowledge about neutrophil responses to putative periodontal pathogens and their contribution to disease progression.


Assuntos
Neutrófilos , Periodontite , Clostridiales/imunologia , Disbiose , Humanos , Microbiota/imunologia , Neutrófilos/imunologia , Neutrófilos/microbiologia , Periodontite/imunologia , Periodontite/microbiologia , Periodonto/microbiologia
5.
Anticancer Res ; 39(11): 6283-6290, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31704858

RESUMO

BACKGROUND/AIM: The usefulness of C-reactive protein-to-albumin ratio (CAR) as a predictive indicator for clinically-relevant postoperative pancreatic fistula (CR-POPF) after pancreaticoduodenectomy (PD) is unclear. We performed a retrospective analysis to identify reliable inflammatory indicators for prediction of CR-POPF after PD. PATIENTS AND METHODS: We enrolled 160 consecutive patients who underwent PD. Multivariate logistic regression analysis was performed. The areas under curves (AUCs) were compared with the discriminatory ability of inflammatory indicators, namely, C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), platelet count multiplied by C-reactive protein (P-CRP), and CAR. RESULTS: The AUC for CAR on POD 3 to predict CR-POPF was 0.782 (p<0.001) and higher than that for CRP (0.773), NLR (0.652), PLR (0.504), and P-CRP (0.703). Multivariate analysis revealed that CAR on POD 3 was an independent predictive indicator of CR-POPF. CONCLUSION: CAR on POD 3 is a reliable predictor of CR-POPF after PD.


Assuntos
Proteína C-Reativa/análise , Fístula Pancreática/sangue , Pancreaticoduodenectomia/efeitos adversos , Complicações Pós-Operatórias/sangue , Albumina Sérica/análise , Idoso , Amilases/análise , Biomarcadores/sangue , Feminino , Humanos , Modelos Logísticos , Contagem de Linfócitos , Masculino , Neutrófilos/citologia , Pâncreas/patologia , Ductos Pancreáticos/patologia , Fístula Pancreática/diagnóstico , Fístula Pancreática/etiologia , Contagem de Plaquetas , Complicações Pós-Operatórias/diagnóstico , Curva ROC , Estudos Retrospectivos
6.
Anticancer Res ; 39(11): 6347-6353, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31704866

RESUMO

BACKGROUND/AIM: The aim of this study was to determine the significance of immunonutritional and physical index in the assessment of risk associated with pancreaticoduodenectomy (PD) in the elderly. PATIENTS AND METHODS: This study enrolled 92 patients who underwent PD. They were divided into 2 groups: Group A included patients 79 years and younger (n=79) and Group B patients 80 years and older (n=13). Among 37 patients, physical function and body composition were also evaluated. RESULTS: Significantly higher neutrophil-lymphocyte ratio, lower prognostic nutritional index (PNI), and controlling nutritional score were observed in Group B. Muscle strength and walking ability were significantly impaired in Group B, although there was no significant difference in body composition. Age was not correlated with the incidence of postoperative complications, overall survival or recurrence-free survival by univariate and multivariate analysis. CONCLUSION: PD is justified for the elderly, with acceptable morbidity and prognosis. However, immunonutritional status and physical function are significantly impaired; thus, appropriate case selection and active nutritional support are required for the elderly.


Assuntos
Limitação da Mobilidade , Força Muscular , Estado Nutricional , Pancreaticoduodenectomia/efeitos adversos , Complicações Pós-Operatórias , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , Neoplasias dos Ductos Biliares/cirurgia , Composição Corporal , Comorbidade , Neoplasias Duodenais/cirurgia , Feminino , Humanos , Contagem de Leucócitos , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Neutrófilos/citologia , Avaliação Nutricional , Neoplasias Pancreáticas/cirurgia , Pancreaticoduodenectomia/mortalidade , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos , Medição de Risco , Albumina Sérica/análise
7.
Zhonghua Jie He He Hu Xi Za Zhi ; 42(11): 845-851, 2019 Nov 12.
Artigo em Chinês | MEDLINE | ID: mdl-31694095

RESUMO

Objective: To explore the role of S100A8, the receptor for advanced glycation endproducts (RAGE) and Caveolin-1 in neutrophilic asthmatic rats, and to further study the intervention of roxithromycin and the possible mechanisms. Methods: Male Brown Norway rats were randomly assigned to a control group, an asthma group and a Roxithromycin group. The asthmatic rat model was established by intraperitoneal injection of ovalbumin (OVA) and Freund's complete adjuvant (FCA) mixture, and aerosol inhalation of OVA. Rats in the Roxithromycin group were given roxithromycin injection 30 mg/kg 30 minutes before each challenge. Rats in the control and the asthma groups were replaced with equal volumes of saline, respectively. Bronchoalveolar lavage fluid (BALF) neutrophil percentage (Neu%) and pathological changes of pulmonary tissue (hematoxylin-eosin, HE staining) were measured to confirm the establishment of asthmatic models. The concentration of inflammatory cytokines and S100A8 were quantified by enzyme-linked immunosorbent assay (ELISA), and the expression of Caveolin-1 and RAGE at protein levels were detected by immunohistochemistry and Western blot. Results: Neu% in BALF of the asthma group was significantly higher than those of the control group, and Neu% in the Roxithromycin group was lower than the asthma group (all P<0.01). Pulmonary histology revealed that there were a large number of inflammatory cells infiltrated in the bronchial and perivascular, pulmonary interstitial and alveolar spaces, and the bronchial wall and smooth muscles were thickened obviously in the asthma group. Rats in the Roxithromycin group showed milder inflammation and airway remodeling change than the asthma group. There was no obvious pathological damage in the control group. The concentration of IL-6 and IL-17 in BALF and serum of rats in the asthma group were significantly higher than those in the control group (P<0.01), and Roxithromycin inhibited the high expression of these cytokines (P<0.05). The expression of S100A8 and RAGE in the asthma group were significantly higher than those in the control group [(20.6±4.4) vs (7.1±2.0) ng/L; (885±118) vs (462±102) ng/L; (14.2±1.7) vs (7.6±1.8) ng/L; (774±166) vs (406±69) ng/L, all P<0.05], and Roxithromycin inhibited the high expression of these proteins [(14.3±3.7) vs (20.6±4.4) ng/L; (650±53) vs (885±118) ng/L; (10.4±1.2) vs (14.2±1.7) ng/L; (560±64) vs (728±72) ng/L] (all P<0.05). Meanwhile, the expression of Caveolin-1 in the asthma group was significantly lower than that in the control group (P<0.01), and Roxithromycin up-regulated its expression (P<0.01). Correlation analysis showed that there was a significantly positive correlation between the expression of S100A8 and RAGE (r=0.706, P<0.01), while there was a significantly negative correlation between the expression of S100A8 and Caveolin-1 (r=-0.775, P<0.01), and between the expression of Caveolin-1 and RAGE (r=-0.919, P<0.01). Conclusion: S100A8 and Caveolin-1 may play an important role in neutrophilic asthma via RAGE, and Roxithromycin may exerts anti-inflammatory effects and inhibition of airway remodeling partly through this signaling pathway.


Assuntos
Antibacterianos/farmacologia , Asma/tratamento farmacológico , Calgranulina A/efeitos dos fármacos , Caveolina 1/efeitos dos fármacos , Roxitromicina/farmacologia , Remodelação das Vias Aéreas , Animais , Antibacterianos/administração & dosagem , Western Blotting , Líquido da Lavagem Broncoalveolar , Calgranulina A/metabolismo , Caveolina 1/metabolismo , Modelos Animais de Doenças , Ensaio de Imunoadsorção Enzimática , Imuno-Histoquímica , Pulmão/fisiopatologia , Masculino , Neutrófilos/efeitos dos fármacos , Neutrófilos/metabolismo , Ovalbumina , Ratos , Receptor para Produtos Finais de Glicação Avançada , Roxitromicina/administração & dosagem
8.
Anticancer Res ; 39(10): 5581-5588, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31570453

RESUMO

BACKGROUND/AIM: The utility of peripheral blood neutrophil-to-lymphocyte ratios (NLRs) and platelet-to-lymphocyte ratios (PLRs) as prognostic predictors of surgery and chemotherapy in breast cancer has been reported. In this study, NLRs and PLRs were calculated before treatment and during cancer progression in primary hormone receptor-positive breast cancer (HRBC) patients who chose endocrine therapy (ET) as the primary treatment, and prognostic prediction and factor analysis were performed. PATIENTS AND METHODS: A total of 55 patients diagnosed with stage IIIB, IIIC, or IV HRBC who received ET as the primary treatment were included. RESULTS: Increased NLRs were found to significantly contribute to a shorter overall survival from cancer progression (OS-CP) (p=0.040, log-rank). Increased PLRs were similarly associated with a shorter OS-CP (p=0.036, log-rank). In multivariate analysis, an increased NLR was an independent prognostic factor (p=0.035, hazard ratio(HR)=5.221). CONCLUSION: Changes in NLRs and PLRs become prognostic indicators when the therapeutic effect of ET is limited.


Assuntos
Plaquetas/patologia , Neoplasias da Mama/patologia , Células Endócrinas/patologia , Linfócitos/patologia , Neutrófilos/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Intervalo Livre de Doença , Feminino , Humanos , Contagem de Leucócitos/métodos , Contagem de Linfócitos/métodos , Pessoa de Meia-Idade , Terapia Neoadjuvante/métodos , Prognóstico , Estudos Retrospectivos
9.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 31(9): 1091-1096, 2019 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-31657331

RESUMO

OBJECTIVE: To investigate the effect and mechanism of autophagy on the expression of neutrophil programmed death ligand-1 (PD-L1) in mice with sepsis. METHODS: (1) In vivo experiment: male C57BL/6 mice aged 6-8 weeks were divided into sham operation group (Sham group), cecum ligation and perforation (CLP) group, and rapamycin (RAP)+CLP group by random number table with 10 mice in each group. The sepsis model was reproduced by CLP, and the cecum and perforation were not ligated in Sham group, and other operations were the same as CLP group. The mice in RAP+CLP group were intraperitoneally injected with autophagy agonist RAP 4 mg×kg-1×d-1 7 days before modeling, while the mice in Sham group and CLP group were not treated. Lung, liver, spleen and pancreas tissues were harvested for immunohistochemical staining 4 days after the operation, and the infiltration of neutrophils in various organs was observed under light microscope. Meanwhile, the expressions of immunosuppressive molecule PD-L1 and autophagy marker microtubule-associated protein 1 light chain 3 (LC3) in lung neutrophils were determined by immunofluorescence staining. (2) In vitro experiment: mouse bone marrow neutrophils were extracted and re-suspended to 1×1010/L, and they were divided into blank control group (without any treatment), RAP control group (RAP 100 µmol/L), autophagy inhibitor Bafilomycin A1 (Baf) control group (Baf 10 µmol/L), lipopolysaccharide (LPS) stimulation group (LPS 1 mg /L), RAP+LPS group, and Baf+LPS group. The latter two groups were pretreated with 100 µmol/L RAP or 10 µmol/L Baf 30 minutes before LPS stimulation, respectively. The expression of PD-L1 mRNA of neutrophils was determined by reverse transcription-polymerase chain reaction (RT-PCR) at 0, 4, 12 hours after LPS stimulation. At the same time, the expressions of PD-L1, LC3 and p62 at the protein level were determined by Western Blot. RESULTS: (1) In vivo experiment: according to immunohistochemical experiments, a large amount of infiltration of neutrophils in lung, liver, spleen and pancreas was found at 4 hours after CLP. In the immunofluorescence, with the time extension after CLP, the positive expression of LC3 in the lung tissue showed a decreased tendency, and PD-L1 expression was significantly increased. RAP pretreatment could promote the expression of LC3 and reduce the expression of PD-L1 in CLP mice. (2) In vitro experiment: in terms of mRNA levels, with the extension of LPS stimulation time, the expression of PD-L1 mRNA in mouse neutrophils was increased continuously, and peaked at 12 hours, it was significantly higher than that in the blank control group (2-ΔΔCT: 72.2±10.0 vs. 13.0±0.8, P < 0.01). Compared with LPS stimulation group, the expression of PD-L1 mRNA in RAP+LPS group was significantly down-regulated [12-hour PD-L1 mRNA (2-ΔΔCT): 47.4±7.3 vs. 72.2±10.0, P < 0.01]. In Baf+LPS group, PD-L1 mRNA expression was significantly up-regulated as compared with that in LPS stimulation group [12-hour PD-L1 mRNA (2-ΔΔCT): 109.1±7.4 vs. 72.2±10.0, P < 0.01]. At the protein levels, at 4 hours after LPS stimulation, the positive expressions of PD-L1, LC3 and p62 were increased significantly as compared with those in the blank control group, and PD-L1 and p62 were increased continuously with time. Compared with the LPS stimulation group, the expressions of PD-L1 and p62 in the RAP+LPS group were significantly down-regulated, while the expression of LC3 was continually increased, indicating that the level of autophagy was increased, and autophagy was circulated smoothly. On the contrary, the expressions of PD-L1, LC3 and p62 in the Baf+LPS group were significantly up-regulated, indicating that the binding of autophagy and lysosome was blocked, and autophagy was not smooth. CONCLUSIONS: In sepsis, the infiltration of neutrophils in all organs increased, and the expression of PD-L1 of neutrophils in lungs was increased significantly, while the expression level of autophagy was decreased. The expression of PD-L1 stimulated by LPS can be inhibited by autophagy agonists, and promoted by autophagy inhibitors. PD-L1 has a negative regulatory effect on sepsis. It can reduce the expression of PD-L1 molecule in sepsis by targeting autophagy, so as to improve sepsis.


Assuntos
Autofagia , Sepse , Animais , Antígeno B7-H1/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Modelos Animais , Neutrófilos
10.
Rev Assoc Med Bras (1992) ; 65(9): 1182-1187, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31618335

RESUMO

OBJECTIVE: To compare the complete blood counts, namely the plateletcrit (PCT) and Platelet-To-Lymphocyte Ratio (PLR) of healthy subjects and those with morbid obesity in the young population. METHODS: We included 45 patients with morbid obesity (body mass index -BMI - greater than or equal to 45 kg/m2) and 45 healthy subjects (BMI less than or equal to 25 kg/m2) in our study. Blood samples were obtained from the participants following a 12-hour fasting period. Then we evaluated the levels of hemoglobin (Hb), hematocrit (HCT), red cell distribution width (RDW), mean platelet volume (MPV), white blood cell (WBC), PLR, platelet counts, and PCT in the complete blood count. RESULTS: The morbid obesity group had significantly higher platelet counts and PCT values (p<0.001), and PLR values (p=0.033). The value of WBC was also higher in the obese group (p=0.001). MPV was lower in the obesity group but not statistically significant (p=0.815). No significant difference was found between hemoglobin and hematocrit values in these groups; but RDW valuewere higher and statistically significant in the obese group (p=0.001). CONCLUSION: PLR or PCT may be more useful as a marker in determining an increased thrombotic state and inflammatory response in morbid obesity.


Assuntos
Plaquetas/citologia , Contagem de Linfócitos , Obesidade Mórbida/sangue , Contagem de Plaquetas , Adulto , Contagem de Células Sanguíneas , Estudos Transversais , Índices de Eritrócitos , Hemoglobinas , Humanos , Contagem de Leucócitos , Masculino , Volume Plaquetário Médio , Neutrófilos/citologia , Sensibilidade e Especificidade
11.
Pharm Res ; 36(12): 163, 2019 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-31617004

RESUMO

PURPOSE: There is ongoing concern regarding increased toxicity from paclitaxel in elderly patients, particularly of severe neutropenia. Yet, data so far is controversial and this concern is not supported by a clinically relevant age-dependent difference in pharmacokinetics (PK) of paclitaxel. This study assessed whether age is associated with increased risk for paclitaxel-induced neutropenia. METHODS: Paclitaxel plasma concentration-time data, pooled from multiple different studies, was combined with available respective neutrophil count data during the first treatment cycle. Paclitaxel pharmacokinetic-pharmacodynamic (PK-PD) data was modeled using a non-linear mixed effects approach and a semiphysiological neutropenia model, where systemic paclitaxel exposure was linked to reduced proliferation of neutrophils. The impact of age was evaluated on relevant variables in the model, using a significance threshold of p < 0.005. RESULTS: Paclitaxel PK-PD data was evaluated from 300 patients, with a median age of 65 years (range 23-84 years), containing 116 patients ≥70 years (39%). First cycle neutrophil counts were adequately described by a threshold effect model of paclitaxel on the proliferation rate of neutrophils. Age as a continuous or dichotomous variable (≥70 versus <70 years) did not significantly impact sensitivity of the bone marrow to paclitaxel nor the average maturation time of neutrophils (both p > 0.005), causing a decline in the respective interindividual variability of <1%. CONCLUSION: Results from this large retrospective patient cohort do not suggest elderly patients to be at an increased risk of developing paclitaxel-associated neutropenia during the first treatment cycle. Reflexive dose reductions of paclitaxel in elderly patients are unlikely to improve the risk of severe neutropenia and may be deleterious.


Assuntos
Antineoplásicos Fitogênicos/efeitos adversos , Neutropenia/induzido quimicamente , Paclitaxel/efeitos adversos , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Medula Óssea/efeitos dos fármacos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neutrófilos/efeitos dos fármacos , Estudos Retrospectivos
12.
Gan To Kagaku Ryoho ; 46(10): 1611-1613, 2019 Oct.
Artigo em Japonês | MEDLINE | ID: mdl-31631151

RESUMO

BACKGROUND: This study examined the significance of preoperative neutrophil-lymphocyte ratio(NLR)as a predictor of postoperative outcomes of gastric cancer(GC). METHODS: NLR was calculated in 447 patients with GC undergoing curative gastrectomy, and its associations with postoperative short- and long-term outcomes were retrospectively examined. RESULTS: Patients were divided into high-(n=313)or low-(n=134)NLR groups using an optimal cut-off NLR value of 1.6 according to the ROC curve analysis. A high-NLR was significantly associated with other clinical factors such as undifferentiated histology, advanced cT, and cN+. There was no difference in the incidence of postoperative complications between the 2 groups. Meanwhile, a high NLR was associated with a poor 5-year overall survival. Multivariate analysis identified preoperative NLR to be an independent prognostic factor(hazard ratio: 2.77, 95% confidence interval: 1.39-6.33, p=0.003)along with performance status, tumor location, and cT. CONCLUSION: Preoperative NLR could be one of the useful predictors of postoperative long-term outcomes of GC.


Assuntos
Linfócitos , Neutrófilos , Humanos , Contagem de Linfócitos , Prognóstico , Estudos Retrospectivos , Neoplasias Gástricas
13.
Medicine (Baltimore) ; 98(39): e17372, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574885

RESUMO

INTRODUCTION: Cyclic neutropenia (CyN) is a rare hematological disease, and patients with CyN often experience an early onset of severe periodontitis and are forced to undergo tooth extraction. Here, we report a case of a patient with CyN who showed different periodicity and oscillations of neutrophil count compared with her mother, despite sharing the same novel genetic mutation. PATIENT CONCERNS: A 17-year-old Japanese girl who had been diagnosed with CyN shortly after birth presented to our hospital with a complaint of mobility of her teeth and gingivitis. Upon presentation, an intraoral examination was performed and revealed redness and swelling of the marginal and attached gingiva. Radiographs revealed extreme resorption of the alveolar bone and apical lesions in her mandibular lateral incisors. The patient's hematologic data demonstrated a lack of blood neutrophils (0/µL). The patient had no history of dental extraction, and her mother also had a history of CyN. DIAGNOSES: The patient was diagnosed with severe periodontitis that was associated with CyN. Gene testing showed a novel heterozygous mutation in exon 4 of the ELANE gene (c.538delC, p.Leu180Ser fsX11). INTERVENTIONS: Based on the clinical findings, we planned to extract the patient's mandibular lateral incisors. Although the tooth extraction was scheduled considering the cyclic variation in neutrophil count, the patient's neutrophil count was 0/µL on the day before the planned extraction. Therefore, granulocyte-colony stimulating factor (G-CSF) was administered to increase the patient's neutrophil count. On the day of the patient's admission for the tooth extraction, she presented with fever (body temperature, 38.5°C), tonsillitis, and stomatitis. The extraction was subsequently delayed, and the patient was administered antibiotics and G-CSF for 4 days. At this time, the neutrophil count increased to 750/µL, and the tooth extraction was carried out safely. OUTCOMES: The postoperative course was uneventful, and the healing process at the extraction site was excellent. CONCLUSION: There is a possibility that the periodicity and oscillations of neutrophil count may change with growth in patients with CyN. Therefore, it is important to frequently examine and treat patients with fluctuating neutrophil levels for the management of invasive dental treatment in patients with CyN.


Assuntos
Elastase de Leucócito/genética , Neutropenia/genética , Periodontite/genética , Periodontite/cirurgia , Extração Dentária/efeitos adversos , Adolescente , Éxons , Feminino , Humanos , Contagem de Leucócitos , Mutação , Neutropenia/sangue , Neutropenia/complicações , Neutrófilos , Periodontite/sangue
14.
Anticancer Res ; 39(10): 5675-5682, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31570466

RESUMO

BACKGROUND/AIM: This study explored the prognostic significance of the neutrophil-to-lymphocyte ratio (NLR) and use of antibiotics in advanced esophageal squamous cell carcinoma (ESCC) patients receiving immune checkpoint inhibitors (ICIs). PATIENTS AND METHODS: Patients were enrolled from two referral centers in Taiwan. Clinical benefit was defined as complete response, partial response, or a stable disease for ≥6 months via Response Evaluation Criteria In Solid Tumors 1.1. Clinicopathological factors' impact on overall survival (OS) and progression-free survival (PFS) was analyzed via Cox proportional hazards model. RESULTS: Forty-nine patients were enrolled. The median PFS and OS were 1.8 and 6.1 months, respectively. The median NLR at baseline was 6.40, and 21 patients received antibiotics. Both high NLR and use of antibiotics were associated with inferior PFS (p=0.028 and p<0.001, respectively) and OS (p<0.001 and p<0.001, respectively) in multivariate analysis. CONCLUSION: High NLR and use of antibiotics were associated with inferior survival in advanced ESCC patients receiving ICIs.


Assuntos
Antibacterianos/uso terapêutico , Neoplasias Esofágicas/tratamento farmacológico , Carcinoma de Células Escamosas do Esôfago/tratamento farmacológico , Fatores Imunológicos/uso terapêutico , Linfócitos/patologia , Neutrófilos/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias Esofágicas/mortalidade , Neoplasias Esofágicas/patologia , Carcinoma de Células Escamosas do Esôfago/mortalidade , Carcinoma de Células Escamosas do Esôfago/patologia , Feminino , Humanos , Linfócitos/efeitos dos fármacos , Masculino , Pessoa de Meia-Idade , Neutrófilos/efeitos dos fármacos , Prognóstico , Intervalo Livre de Progressão , Estudos Retrospectivos , Taiwan
15.
Rinsho Ketsueki ; 60(9): 1166-1175, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31597840

RESUMO

The classical myeloproliferative neoplasms (MPN), polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF), are characterized by clonal myeloproliferation without features of myelodysplasia. The diagnostic approach proposed by the World Health Organization (WHO) uses clinical features, peripheral blood counts and smear analysis, bone marrow (BM) morphology, karyotype and molecular genetic tests to classify MPN subtypes. The detection of characteristic driver mutations like JAK2V617F, JAK2 exon 12, MPL, and calrecticulin (CALR) is a major diagnostic feature. JAK2 mutations are detected in more than 90% of patients with PV and are therefore used as highly sensitive clonal marker in this subtype. However, JAK2 mutations may also occur in ET and PMF, while CALR is virtually not seen in PV. Therefore, BM remains the central diagnostic platform and is essential for distinguishing ET from pre-fibrotic PMF and diagnosing cases which do not express JAK2, MPL or CALR ('wild-type' or 'triple-negative' MPN). The standardization of relevant BM features is mandatory to recognize characteristic and easy to assess patterns that enable an accurate discrimination between the MPN subtypes. Key parameters include cellularity, erythropoiesis and neutrophil granulopoiesis in context with specific features of megakaryocytes as well as the BM fiber content, especially in early stage MPN that present with thrombocytosis and clinically mimic essential thrombocythemia.


Assuntos
Transtornos Mieloproliferativos/diagnóstico , Medula Óssea/patologia , Calreticulina/genética , Diagnóstico Diferencial , Eritropoese , Humanos , Janus Quinase 2/genética , Megacariócitos/citologia , Mutação , Neutrófilos/citologia , Policitemia Vera , Trombocitemia Essencial , Organização Mundial da Saúde
17.
FP Essent ; 485: 11-16, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31613563

RESUMO

Leukopenia is a common finding in the outpatient setting. It typically occurs because of a significant reduction in neutrophils, which comprise 50% to 70% of circulating leukocytes. Neutropenia is defined as an absolute neutrophil count (ANC) of less than 1,500/mcL. Neutropenia is classified by whether it is transient or chronic. Chronic neutropenia can be further described as extrinsic or intrinsic. Extrinsic causes are varied. Intrinsic causes can include impaired proliferation and maturation of myeloid progenitor cells in the bone marrow. Assessment of patients with neutropenia should be guided by the severity on presentation. The duration of leukopenia and the clinical status of the patient also should be considered. Some patients with neutropenia can develop life-threatening bacterial infections. In neutropenic patients, the risk of febrile neutropenia should be assessed systematically. Patients with febrile neutropenia should undergo treatment with antibiotics. Other treatments are aimed at management of the underlying cause of neutropenia.


Assuntos
Neutropenia , Humanos , Neutropenia/diagnóstico , Neutropenia/etiologia , Neutropenia/terapia , Neutrófilos
18.
J Surg Oncol ; 120(7): 1102-1111, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31598983

RESUMO

BACKGROUND AND OBJECTIVES: To assess the prognostic significance of postoperative changes in immune status represented by total lymphocyte count (TLC) and neutrophil-to-lymphocyte ratio (NLR) in resectable pancreatic cancer. METHODS: Patients who underwent curative pancreatectomy for pancreatic adenocarcinoma were divided into high and low groups according to cut-off values of TLC, and NLR measured preoperatively, immediately after surgery, and 1 or 6 months after surgery. Oncologic outcomes were compared between the two groups at different times, and prognostic roles of TLC and NLR were evaluated. RESULTS: Of 193 patients, the median follow-up time was 22 months, and median survival was 18 months. Their immunologic status deteriorated within 3 to 4 days after the operation and recovered after that. At 1 and 6 months postoperatively, overall survival rates were significantly lower in the group with high NLR (>2.535 and >3.21, respectively) and low TLC (<1.66 × 109 and <1.62 × 109 /L, respectively). In multiple regression analyses, elevated NLR at postoperative 1 and 6 months and decreased TLC at postoperative 1 month were significant prognosis predictors. CONCLUSIONS: Changes in immune status such as decreased TLC and elevated NLR at postoperative 1 and 6 months are effective prognostic predictors after curative pancreatectomy in patients with pancreatic adenocarcinoma.


Assuntos
Adenocarcinoma/patologia , Linfócitos/patologia , Neutrófilos/patologia , Pancreatectomia/mortalidade , Neoplasias Pancreáticas/patologia , Adenocarcinoma/cirurgia , Idoso , Feminino , Seguimentos , Humanos , Contagem de Linfócitos , Masculino , Neoplasias Pancreáticas/cirurgia , Período Pós-Operatório , Período Pré-Operatório , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Taxa de Sobrevida
19.
Isr Med Assoc J ; 21(10): 658-661, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31599506

RESUMO

BACKGROUND: The incidence of Clostridium difficile-associated diarrhea (CDAD) is increasing and is associated with significant morbidity and mortality. Therefore, there is a need to find new tools to determine the severity of the disease. OBJECTIVES: To investigate the prognostic values of inflammatory markers such as mean platelet volume (MPV), neutrophil-lymphocyte ratio (NLR), and C-reactive protein (CRP) in patients with CDAD. METHODS: The study comprised of 100 patients diagnosed with CDAD. The study included an additional control group of 69 patients with diarrhea who were negative for C. difficile toxin. The control group was age- and sex-matched and hospitalized at the same time period. NLR and MPV were obtained from complete blood count results. Serum CRP levels were measured by the latex particle enhanced immunoturbidimetric assay. Blood samples for all inflammatory markers were collected at time of diagnosis and prior to initiating the antibiotic therapy. Demographic, clinical, laboratory, and prognostic data were collected from medical records for a period of 90 days from the initial diagnosis of CDAD. RESULTS: The mean age of the CDAD group was 68.6 ± 21.5 years compared to 65.6 ± 24.5 in the control group (P = 0.29). Our findings show that patients with CDAD had significantly higher NLR, MPV and serum CRP levels compared to the control group (P < 0.001)). Moreover, significantly higher levels were observed when CDAD was fatal (P < 0.001). CONCLUSIONS: Elevated NLR, MPV, and serum CRP levels may serve as biomarkers for prediction of recurrence and mortality in patients with CDAD.


Assuntos
Infecções por Clostridium/sangue , Infecções por Clostridium/complicações , Clostridium difficile/patogenicidade , Diarreia/microbiologia , Inflamação/sangue , Inflamação/microbiologia , Idoso , Biomarcadores/sangue , Proteína C-Reativa/metabolismo , Infecções por Clostridium/diagnóstico , Diarreia/sangue , Feminino , Humanos , Linfócitos/metabolismo , Masculino , Volume Plaquetário Médio/estatística & dados numéricos , Neutrófilos/metabolismo , Prognóstico , Fatores de Risco , Índice de Gravidade de Doença
20.
Medicine (Baltimore) ; 98(43): e17537, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31651856

RESUMO

Neutrophil-to-lymphocyte ratio (NLR) serves as a strong prognostic indicator for patients suffering from various diseases. Neutrophil activation promotes the recruitment of a number of different cell types that are involved in acute and chronic inflammation and are associated with cancer treatment outcome. Measurement of NLR, an established inflammation marker, is cost-effective, and it is likely that NLR can be used to predict the development of metabolic syndrome (MS) at an early stage. MS scores range from 1 to 5, and an elevated MS score indicates a greater risk for MS. Monitoring NLR can prevent the risk of MS.A total of 34,013 subjects were enrolled in this study. The subjects (score 0-5) within the 6 groups were classified according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria, and all anthropometrics, laboratory biomarkers, and hematological measurements were recorded. For the 6 groups, statistical analysis and receiver operating characteristic (ROC) curves were used to identify the development of MS.Analysis of the ROC curve indicated that NLR served as a good predictor for MS. An MS score of 1 to 2 yielded an acceptable discrimination rate, and these rates were even higher for MS scores of 3 to 5 (P < .001), where the prevalence of MS was 30.8%.NLR can be used as a prognostic marker for several diseases, including those associated with MS.


Assuntos
Linfócitos/metabolismo , Síndrome Metabólica/sangue , Síndrome Metabólica/diagnóstico , Neutrófilos/metabolismo , Medição de Risco/métodos , Adulto , Biomarcadores/sangue , Feminino , Humanos , Contagem de Linfócitos , Masculino , Síndrome Metabólica/etiologia , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Curva ROC , Estudos Retrospectivos , Fatores de Risco
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA