Image_2_The association between graded prognostic assessment and the prognosis of brain metastases after whole brain radiotherapy: a meta-analysis.tiff

IntroductionThis meta-analysis aims to provide evidence-based medical evidence for formulating rational treatment strategies and evaluating the prognosis of brain metastasis (BM) patients by assessing the effectiveness of the graded prognostic assessment (GPA) model in predicting the survival prognosis of patients with BM after whole-brain radiotherapy (WBRT).MethodsA comprehensive search was conducted in multiple databases, including the China Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), PubMed, Wanfang database, Cochrane Library, Web of Science, and Embase. Cohort studies that met the inclusion and exclusion criteria were selected. The quality of the included literature was evaluated using the Newcastle-Ottawa Scale, and all statistical analyses were performed with R version 4.2.2. The effect size (ES) was measured by the hazard ratio (HR) of overall survival (OS). The OS rates at 3, 6, 12, and 24 months of patients with BM were compared between those with GPAs of 1.5–2.5, 3.0, and 3.5–4.0 and those with GPAs of 0–1 after WBRT.ResultsA total of 1,797 participants who underwent WBRT were included in this study. The meta-analysis revealed a significant association between GPA and OS rates after WBRT: compared with BM patients with GPA of 0–1, 3-month OS rates after WBRT were significantly higher in BM patients with GPA of 1.5–2.5 (HR = 0.48; 95% CI: 0.40–0.59), GPA of 3 (HR = 0.38; 95% CI: 0.25–0.57), and GPA of 3.5–4 (HR = 0.28; 95% CI: 0.15–0.52); 6-month OS rates after WBRT were significantly higher in BM patients with GPA of 1.5–2.5 (HR = 0.48; 95% CI: 0.41–0.56), GPA of 3 (HR = 0.33; 95% CI: 0.24–0.45), and GPA of 3.5–4 (HR = 0.24; 95% CI: 0.16–0.35); 12-month OS rates after WBRT were significantly higher in BM patients with GPA of 1.5–2.5 (HR = 0.49; 95% CI: 0.41–0.58), GPA of 3 (HR = 0.48; 95% CI: 0.32–0.73), and GPA of 3.5–4 (HR = 0.31; 95% CI: 0.12–0.79); and 24-month OS rates after WBRT were significantly higher in BM patients with GPA of 1.5–2.5 (HR = 0.49; 95% CI: 0.42–0.58), GPA of 3 (HR = 0.49; 95% CI: 0.32–0.74), and GPA of 3.5–4 (HR = 0.38; 95% CI: 0.15–0.94).ConclusionBM patients with higher GPAs generally exhibited better prognoses and survival outcomes after WBRT compared to those with lower GPAs.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42023422914.</p

Image_1_The association between graded prognostic assessment and the prognosis of brain metastases after whole brain radiotherapy: a meta-analysis.tiff

IntroductionThis meta-analysis aims to provide evidence-based medical evidence for formulating rational treatment strategies and evaluating the prognosis of brain metastasis (BM) patients by assessing the effectiveness of the graded prognostic assessment (GPA) model in predicting the survival prognosis of patients with BM after whole-brain radiotherapy (WBRT).MethodsA comprehensive search was conducted in multiple databases, including the China Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), PubMed, Wanfang database, Cochrane Library, Web of Science, and Embase. Cohort studies that met the inclusion and exclusion criteria were selected. The quality of the included literature was evaluated using the Newcastle-Ottawa Scale, and all statistical analyses were performed with R version 4.2.2. The effect size (ES) was measured by the hazard ratio (HR) of overall survival (OS). The OS rates at 3, 6, 12, and 24 months of patients with BM were compared between those with GPAs of 1.5–2.5, 3.0, and 3.5–4.0 and those with GPAs of 0–1 after WBRT.ResultsA total of 1,797 participants who underwent WBRT were included in this study. The meta-analysis revealed a significant association between GPA and OS rates after WBRT: compared with BM patients with GPA of 0–1, 3-month OS rates after WBRT were significantly higher in BM patients with GPA of 1.5–2.5 (HR = 0.48; 95% CI: 0.40–0.59), GPA of 3 (HR = 0.38; 95% CI: 0.25–0.57), and GPA of 3.5–4 (HR = 0.28; 95% CI: 0.15–0.52); 6-month OS rates after WBRT were significantly higher in BM patients with GPA of 1.5–2.5 (HR = 0.48; 95% CI: 0.41–0.56), GPA of 3 (HR = 0.33; 95% CI: 0.24–0.45), and GPA of 3.5–4 (HR = 0.24; 95% CI: 0.16–0.35); 12-month OS rates after WBRT were significantly higher in BM patients with GPA of 1.5–2.5 (HR = 0.49; 95% CI: 0.41–0.58), GPA of 3 (HR = 0.48; 95% CI: 0.32–0.73), and GPA of 3.5–4 (HR = 0.31; 95% CI: 0.12–0.79); and 24-month OS rates after WBRT were significantly higher in BM patients with GPA of 1.5–2.5 (HR = 0.49; 95% CI: 0.42–0.58), GPA of 3 (HR = 0.49; 95% CI: 0.32–0.74), and GPA of 3.5–4 (HR = 0.38; 95% CI: 0.15–0.94).ConclusionBM patients with higher GPAs generally exhibited better prognoses and survival outcomes after WBRT compared to those with lower GPAs.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42023422914.</p

The baseline characteristics of the included studies.

The baseline characteristics of the included studies.</p

Additional file 1 of The association between schizophrenia and white blood cells count: a bidirectional two-sample Mendelian randomization study

Supplementary Material 1: Supplementary Tables 5–1

Fig 2 -

Forest plots of the relationship between the PNI and survival outcomes: A. OS B. DMFS C. PFS.</p

Prognostic and clinicopathological value of poly (adenosine diphosphate-ribose) polymerase expression in breast cancer: A meta-analysis

<div><p>Background</p><p>Previous studies have shown that the poly (adenosine diphosphate-ribose) polymerase (PARP) level is a promising indicator of breast cancer. However, its prognostic value remains controversial. The present meta-analysis evaluated the prognostic value of PARP expression in breast cancer.</p><p>Materials and methods</p><p>Eligible studies were retrieved from the PubMed, Web of Science, Embase, and Cochrane Library databases through July 20, 2016. Studies investigating PARP expression as well as reporting survival data in breast cancer were included. Two independent reviewers carried out all literature searches. The pooled relative risk (RR) and hazard ratio (HR) with 95% confidence interval (95% CI) were applied to assess the association between PARP expression and the clinicopathological features and survival outcome in breast cancer.</p><p>Results</p><p>A total of 3506 patients from eight eligible studies were included. We found that higher PARP expression indicated a worse clinical outcome in early stage breast cancer, with a HR of 3.08 (95% CI, 1.14–8.29, P = 0.03) for disease-free survival and a HR of 1.82 (95% CI, 1.20–2.76; P = 0.005) for overall survival. Moreover, increased PARP expression was significantly associated with higher nuclear grade (RR, 1.51; 95% CI, 1.12–2.04; P = 0.008) in breast cancer. A similar correlation was detected in triple-negative breast cancer (TNBC; RR, 1.81; 95% CI, 1.04–3.17; P = 0.04).</p><p>Conclusions</p><p>Our findings indicated that elevated PARP expression correlated with worse prognosis in early stage breast cancer. Furthermore, high PARP expression was associated with higher nuclear grade and TNBC.</p></div

Data availability.

(XLSX)</p

Fig 3 -

Sensitivity analyses of HRs: A. OS B. DMFS C. PFS.</p

Forest plots for enrolled studies showing that there were no associations between PARP expression and (A) ER expression (positive vs. negative), (B) PR expression (positive vs. negative), (C) HER2 expression (positive vs. negative), and (D) Ki67 level (high vs. low).

Forest plots for enrolled studies showing that there were no associations between PARP expression and (A) ER expression (positive vs. negative), (B) PR expression (positive vs. negative), (C) HER2 expression (positive vs. negative), and (D) Ki67 level (high vs. low).</p

Forest plots for enrolled studies showing positive associations between the PARP expression level and (A) nuclear grade (3 vs. 1 and 2) and (B) triple-negative breast cancer (TNBC) (positive vs. negative).

<p>Forest plots for enrolled studies showing positive associations between the PARP expression level and (A) nuclear grade (3 vs. 1 and 2) and (B) triple-negative breast cancer (TNBC) (positive vs. negative).</p