Platelet-lymphocyte ratio predicts poor prognosis in stage II / III colon and rectum cancer

Objective: There is an increasing number of studies in the literature reporting that serum platelet/lymphocyte ratio (PLR) can provide useful prognostic data for various cancers. In the present study, the effects of platelet-lymphocyte ratio on survival in stage II/III colorectal cancers (CRC) were examined. Material and Method:A total of 106 Stage II/III CRC patients who underwent curative surgery 2015-2020 were included in the study. Emergency cases and patients diagnosed with other than adenocarcinoma were excluded from the study. The demographic data of the patients, preoperative imaging and laboratory results, postoperative pathology reports, and patient follow-up examination data were obtained from hospital records. The relations between demographic, histopathological, hematological values and the prognosis was analyzed in terms of statistical significance. Results:Among the 106 patients, 62 (58.5%) were male and 44 (41.5%) were female. The mean age was 64.3±12.01 (23-89). The mean follow-up period was calculated as 24.6±15.8 (2-63) months. When the pathology reports were reviewed, it was found that the mean tumor diameter was 5.3±2.33 cm (2-17) and the mean metastatic lymph node was 1.8±2.4 (0-10). The PLR ratio was determined as a poor prognostic factor affecting survival in the cox regression analysis, in which preoperative complete blood count, c-reactive protein and albumin values, neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR), and PLR were compared, and was separated from other variables (P=0.002 CI= 95%). When variables such as age, clinical stage, and tumor diameter were included in the model, PLR was similarly found to be an important predictive variable (P= 0.002). When only NLR, LMR, and PLR were evaluated, PLR again came to the forefront with a significance value of P=0.01. Also, high neutrophil count, increased platelet distribution volume (PDW), advanced age, and perineural invasion (PNI) were found to be significant factors in predicting poor prognosis. Conclusions: High PLR is a poor prognostic factor for CRC patients. For this reason, it may be necessary to follow a more aggressive strategy in the management of postoperative treatment in patients who have high PLR

A rare breast tumor; Adenomyoepithelioma: a case report and review of the literature

Adenomyoepithelioma is rare benign breast neoplasia characterized by the proliferation of both epithelial and myoepithelial cells of themammary lobules and ducts. This tumour, which does not have specific risk factors and radiological findings, is mostly seen in advancedages. This tumour, which occurs with the biphasic proliferation of epithelial and myoepithelial cells, also contains normal breast lobules andducts. This tumour is very difficult to diagnose and includes many radiological and pathological pitfalls. Although malignant degenerationhas been reported in the literature, it is a rare condition. In this study, we present a rare case with radiologically suspicious findings andpathologically reported as adenomyoepithelioma

The relationship between body-mass index and Helicobacter pylori infection: a case-control study

Objective: Helicobacter pylori infection is one of the most common infections worldwide. There are different opinions in the literature aboutthe relationship between H. pylori and obesity. In this study, we investigated the relationship between body-mass index (BMI) and H. pyloriinfection.Material and Method: A cross-sectional study was conducted among patients who underwent endoscopic examinations at Tekirdağ NamıkKemal University Faculty of Medicine Hospital in 2019. The prevalence of H. pylori infection was examined by biopsy. The relationshipbetween BMI and H. pylori infection was analyzed.Results: 51.8% of the cases in our population were positive for H. pylori infection. On histopathological examination, acute and chronicinflammation findings were higher in H. pylori-positive cases compared to H. pylori-negative cases. The prevalence of H. pylori infectionwas higher in patients with high BMI than those with low BMI. Statistical analysis showed a significant relationship between BMI and theprevalence of H. pylori infection (p<0.001), and there was a positive linear correlation between these two parameters (r=0.542). When therisk factors were examined univariable, BMI was found to be a significant risk factor for H. pylori infection (p=0.008). Multivariable analysisresults revealed that BMI is an independent risk factor for H. pylori infection. (OR=1.32 (1.09-3.46), p=0.025).Conclusion: Our results showed that there is a significant relationship between BMI and H. pylori infection, and high BMI is an independentrisk factor for H. pylori infection

The effects of desert dust storms, air pollution, and temperature on morbidity due to spontaneous abortions and toxemia of pregnancy: 5-year analysis

Epidemiological studies have suggested an association between particulate air pollution, increased temperatures, and morbidity related to pregnancy outcomes. However, the roles of desert dust storms and climatological factors have not been fully addressed. The objectives of the present study were to investigate the association between desert dust storms, particulate matter with a diameter <= 10 mu m (PM10), daily temperatures, and toxemia of pregnancy and spontaneous abortion in Gaziantep, South East Turkey. The study was conducted retrospectively at emergency department of two hospitals in Gaziantep city. Data from January 1, 2009, to March 31, 2014, were collected. Patients, who were diagnosed with toxemia of pregnancy and spontaneous abortion by radiological imaging modalities, were included in the study. Daily temperature ranges, mean temperature values, humidity, pressure, wind speed, daily PM10 levels, and records of dust storms were collected. A generalized additive regression model was designed to assess variable effects on toxemia of pregnancy and spontaneous abortion, while adjusting for possible confounding factors. Our findings demonstrated that presence of dust storms was positively associated with the toxemia of pregnancy both in outpatient admissions (OR=1.543 95% CI=1.186-2.009) and inpatient hospitalizations (OR=1.534; 95% CI=1.162-2.027). However, neither PM10 nor maximum temperature showed a marked association with spontaneous abortion or toxemia of pregnancy in our study population. Our findings suggest that desert dust storms may have an impact on the risk for adverse pregnancy outcomes such as toxemia of pregnancy. Health authorities should take necessary measures to protect pregnant women against detrimental effects of these storms

Matrix metalloproteinase-9, neuron-specific enolase, S100 B and tau protein levels in the patients with carbon monoxide poisoning

Background: S100B, NSE, MMP-9, and Tau protein levels increase in cases causing hypoxic cell damage. The diagnosis of the severity of carbon monoxide (CO) poisoning in the early period of these parameters was studied. Material and Methods: COHb level measurement was made using a signal capture CO-pulse oximeter (Masimo's SET Rainbow, Masimo's Co, USA) at the first admission of the patients. Then, COHb levels were confirmed by arterial blood gas(ABG) analysis. The patients were divided into two groups as mild and moderate-severe, according to their Glasgow coma scores (GCS) [Mild (14–15); Moderate (9–13) or Severe (3–8)]. The control group was composed of 16 healthy and non-smoking volunteers. Results: The serum S100B protein and MMP-9 values at 0 hr of admission in the hospital and 3hr of treatment were not significantly different in the patient group as compared to the control group. Tau protein levels were significantly higher in the patient group at 0 and 3 hours (p> 0.05) as compared to healthy person. Conclusion: There was no relationship between CO poisoning and MMP-9 and S100B protein levels. NSE and Tau protein were significantly higher in the patient group than the control group. Tau protein may be more useful marker as compared to neuron-specific enolase.Firat University Scientific Research Projects Management Uni

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

The Proportion of Tumour-Stroma in Metastatic Lymph Nodes is An Accurately Prognostic Indicator of Poor Survival for Advanced-Stage Colon Cancers

Benek, Suat/0000-0003-0774-7695WOS:000551024800001PubMed: 32696416The importance of tumour microenvironment in tumour behaviour has now become clearer. This study aimed to determine the prognostic effect of the proportion of tumour-stroma (PTS) in metastatic lymph nodes of advanced-stage colon cancers (CCs). We investigated PTS in positive lymph nodes of stage III-IV CC patients who underwent surgical treatment between 2004 and 2014. We used a standard approach in methodology. PTS was significantly associated with prognostic factors in the metastatic lymph nodes (perineural invasion [p = 0.031], lymphatic invasion [p = 0.032], invasive margin [p = 0.043], advanced pT [p = 0.020], and margin involvement [p = 0.034]). In addition, the correlations between PTS estimates (R = 0.704 to 0.617,p < 0.001), the reproducibility of the research (Kappa appa = 0.72-0.68) and the usefulness of the cut-off value (ROC: 50.33%; AUC = 0.752 [0.667-0.857]) were successful. In univariate analysis, 5-year survival was poor for RFS (p < 0.001), OS (p = 0.001) and LR (p = 0.013) in high PTS patients. Multivariate analysis confirmed that high PTS was an independent worse parameter for RFS (HR = 1.32, 95% CI: 1.17-2.55,p = 0.001) and OS (HR = 1.37, 95% CI: 1.25-1 - 2.56,p = 0.009). In this study, we showed that high PTS in metastatic lymph nodes was a successful prognostic marker for advanced-stage CCs. Also, the standard approach we used for the methodology was successful.Scientific Research Projects Coordination Unit of Kirikkale UniversityKirikkale University [2020/052]This work was supported by Scientific Research Projects Coordination Unit of Kirikkale University. Project number: 2020/052

Clinical role of CD274 (PD-L1) and CD3+ lymphocytes in predicting high risk in advanced colorectal cancer patients receiving neoadjuvant chemotherapy

In cancer research, the mechanism underlying the immune response to a tumour has been of great interest. In this study, we investigated the role of CD274 (programmed cell death-ligand 1 – PD-L1) and CD3+ tumour-infiltrating lymphocytes (TILs) in the prognosis of advanced colorectal cancer (CRC) patients treated with neoadjuvant chemotherapy. We retrospectively examined primary tumour specimens from stage III/IV CRC patients operated on between 2008 and 2018. We found a significant association between these biomarkers and pT stage (PD-L1, p = 0.020; CD3+TILs, p = 0.025), tumour grade (PD-L1, p = 0.005; CD3+TILs, p = 0.004), positive surgical margin (PD-L1, p = 0.001; CD3+TILs, p = 0.001), MSI (PD-L1, p < 0.001; CD3+TILs, p < 0.001), etc. We also discovered that these biomarkers are independent risk factors for MSI (PD-L1, OR = 1.84 [1.27–4.02], p = 0.003; CD3+TILs, OR = 1.92 [1.31–4.35], p = 0.008). Univariate analysis results revealed that patients with high PD-L1, low CD3+TIL, and both showed poor relapse-free survival (RFS) and poor overall survival (OS) (PD-L1: RFS, p = 0.008 and OS, p = 0.001; CD3+TILs: RFS, p = 0.003 and OS, p = 0.005; PD-L1 and CD3+TILs: RFS, p < 0.001 and OS, p < 0.001). The results of the multivariate analysis showed that the combined use of high PD-L1 and low CD3+TILs was a better predictor of poor RFS and OS (PD-L1 and CD3+TILs: RFS, hazard ratio – HR, = 2.85 [95% CI: 1.36–3.84], p < 0.001); OS, HR = 2.74 [1.32–3.71], p < 0.001). We also found a high PD-L1 parameter as another independent overall and relapse-free survival parameter. Our findings suggest that a combination of high PD-L1 and low CD3+TIL can reliably predict poor survival in CRC patients receiving chemotherapy. Therefore, these biomarkers may be promising for the planning and execution of appropriate targeted therapies

PD-1 and PD-L2 expression predict relapse risk and poor survival in patients with stage III colorectal cancer

Background Immune responses have long been an area of interest in cancer research. In this study, the effects of programmed cell death-1 (PD-1) and its ligand (PD-L2) on the prognosis of colorectal cancer (CRC) were investigated. Methods Primary tumour specimens of stage III CRC patients operated between 2002 and 2013 were assessed for PD-1 and PD-L2 expression and various clinicopathological and prognostic factors. Results We observed a significant relationship between poor prognostic factors and PD-1/PD-L2 expression. These biomarkers were also found to serve as independent risk factors for LIR and MSI. In univariate analysis, relapse-free survival (RFS) and overall survival (OS) rates were found to be poor in PD-1 and PD-L2 positive patients. In multivariate analysis, these biomarkers were found to serve as independent poor prognostic factors for RFS and OS. Conclusions Our data indicate that PD-1 and PD-L2 may serve as independent prognostic survival parameters for CRC patients and may be employed for the design of targeted theapies.Kirikkale Universit