Aim To analyze the effectiveness of amniotic fluid neutrophil gelatinase‐associated lipocalin and L‐type fatty acid‐binding protein as predictive factors for fetal inflammatory response syndrome. Methods We classified single pregnancy cases into the fetal inflammatory response syndrome and nonfetal inflammatory response syndrome groups. We collected amniotic fluid at vaginal delivery and cesarean section and compared the patient characteristics, maternal white blood cell count, C‐reactive protein level, and amniotic fluid interleukin‐6; neutrophil gelatinase‐associated lipocalin; and L‐type fatty acid‐binding protein levels between the groups. We further analyzed the relationship between L‐type fatty acid‐binding protein levels and neonatal clinical outcomes. Results We analyzed 129 pregnancies, of which 36 and 93 (27.9% and 72.1%, respectively) were classified into the fetal inflammatory response syndrome and nonfetal inflammatory response syndrome groups, respectively. We observed significant differences in the maternal white blood cell counts and amniotic fluid interleukin‐6 and neutrophil gelatinase‐associated lipocalin levels. On the multivariate analysis, the useful predictive factors were maternal white blood cell count and amniotic fluid interleukin‐6 and neutrophil gelatinase‐associated lipocalin levels. Furthermore, the level of L‐type fatty acid‐binding protein was significantly higher in the transient tachypnea of the newborn and postnatal respiratory support group than in the control group. Conclusions The maternal white blood cell count and amniotic interleukin‐6 and neutrophil gelatinase‐associated lipocalin levels were effective predictors of fetal inflammatory response syndrome. Amniotic fluid L‐type fatty acid‐binding protein level was an effective predictor of neonatal respiratory support.
Even when treated comprehensively by surgery, chemotherapy, and radiotherapy, soft-tissue sarcoma has an unfavorable outcome. Because soft-tissue sarcoma is rare, it is the subject of fewer clinicopathological studies, which are important for clarifying pathophysiology. Here, we examined tumor-associated macrophages in the intratumoral and marginal areas of sarcomas to increase our knowledge about the pathophysiology. Seventy-five sarcoma specimens (not limited to a single histological type), resected at our institution, were collected, and the number of CD68-, CD163-, and CD204-positive macrophages in the intratumoral and marginal areas was counted. We then performed statistical analysis to examine links between macrophage numbers, clinical factors, and outcomes. A high number of macrophages positive for all markers in both areas was associated with worse disease-free survival (DFS). Next, we divided cases according to the FNCLCC classification (Grade 1 and Grades 2/3). In the Grade 1 group, there was no significant association between macrophage number and DFS. However, in the Grade 2/3 group, high numbers of CD163- and CD204-positive macrophages in the marginal area were associated with poor DFS. By contrast, there was no significant difference between the groups with respect to high or low numbers of CD68-, CD163-, or CD204-positive macrophages in the intratumoral area. Multivariate analysis identified the number of CD163- and CD204-positive macrophages in the marginal area as an independent prognostic factor. Macrophage numbers in the marginal area of soft-tissue sarcoma may better reflect clinical behavior.
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