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BACKGROUND: Breast cancer tends to respond differently to treatments, which are usually determined by clinicopathological characteristics. Several studies evaluated the role of the peripheral blood test as diagnostic and prognostic markers in several types of solid cancer and neutrophil-to-lymphocyte ratio (NLR) and platelet-tolymphocyte ratio (PLR) are two of them which already tested. However, the evidence in breast cancer is still lacking. AIM: Therefore, the study aimed to investigate the value of NLR and PLR as biomarkers concerning breast cancer stage. METHODS: A retrospective study was conducted using breast cancer patients’ medical records from 2014 to 2019 at Sanglah General Hospital. The histopathological records and complete blood counts of the patients were collected and analyzed risk analysis model, receiver operator characteristics analysis, and correlation of NLR and PLR with cancer staging analysis used correlation test. RESULT: One hundred five patients data were used in this study, with 35 subjects had early-stage breast cancer while 70 subjects had an advanced stage. Breast cancer staging with NLR and PLR showed significant associations (p < 0.001). Both NLR and PLR had area under the curve >0.7 (p < 0.001). The cutoff, sensitivity, and specificity values of NLR and PLR were 2.504 (71%; 70%) and 157.1 (73%; 70%). Advanced stage of breast cancer was mostly found in high NLR and PLR value with (OR: 4.231; CI = 1.791-9.995, p < 0.001) and (OR: 3.949; 95% CI = 1.679–9.287; p < 0.001). CONCLUSION: From this preliminary study, pretreatment NLR and PLR values might determine the breast cancer stage. Further research is needed to evaluate the association between grade and patient survival.
association between IQGAP3 expression and the clinical characters and prognosis. The relationship between IQGAP3 expression and sensitivity to radiation therapy was determined by subgroup analysis. Results: There was significant upregulation of IQGAP3 in breast cancer cell lines and human tumor tissues at both the mRNA and protein level compared to the normal ones. In addition, 110/257 (42.8%) of archived paraffin embedded breast cancer specimens had high protein expression of IQGAP3. High expression of IQGAP3 was significantly related to clinical stage (P ¼ 0.001), T category (P ¼ 0.002), N category (P ¼ 0.001), locoregional recurrence(P ¼ 0.002), distant metastasis (P ¼ 0.001), and vital status (P ¼ 0.001). Univariate and multivariate statistical analysis showed that IQGAP3 was an independent prognostic factor of the whole cohort breast cancer patients (P ¼ 0.003, P ¼ 0.001). Subgroup analysis revealed IQGAP3 expression correlates with radiation therapy resistance and was also an independent predictor for radiation therapy outcome. Conclusions: Our findings suggest that high IQGAP3 expression predicts poor prognosis and radiation therapy resistance in breast cancer. In addition, IQGAP3 may be a reliable novel biomarker to provide personalized prognostication and identify patients who can profit from more aggressive RT regimen for improving the survival of breast cancer patients.
Introduction. Stroke is the leading cause of disability and has a high mortality rate with most death occur in developing countries. Unfortunately, only a few informations available about strokes in developing countries, including Indonesia. Thus, this research aimed to provide a general overview of stroke patients from stroke unit in Bali, Indonesia.Methods. A cross-sectional study was carried out in Sanglah General Hospital, Denpasar Bali between August 2017 – January 2018 evaluating newly admitted stroke patients. There was no age limit, both male and female were enrolled. Data related to socio-demographic, risk factors, clinical features, and imaging result were extracted from medical records.Results. A total of 82 subjects were enrolled. Strokes were more common in males (61%) with most affected age group was 50-59 years (29.3%) and young stroke (age ≤45 years) accounted for 19.5% of the cases. Ischemic stroke (53.7%) was more common type encountered, and hypertension (76.8.3%) was leading risk factor. First-time stroke accounts for 80.5% while recurrent stroke accounts for 19.5% with 3.6% admitted for the ≥3 episodes. Overall, territories of middle cerebral artery including basal ganglia (25%) and internal capsule (20.5%) were frequently affected in ischemic stroke while lenticular-capsular (44.7) and lobar structure (18.4%) in hemorrhagic stroke. Typical chief clinical presentation was hemiparesis (42.7%) and altered consciousness (26.8%).Conclusions. Stroke tends to affect late adult with male predominance and hypertension as leading risk factor. Ischemic stroke was the most common type. There were differences in clinical presentations and anatomic site preferences between hemorrhagic and ischemic stroke.
Stroke is one of the leading causes of death and disability which involving a complex pathophysiology with multiple mechanisms. Rapid treatment is necessary to terminate the disease progression, hence minimizing CNS damage and subsequent disability. Stroke diagnostic process composed of history taking, neurological examination and supplemented with neuroimaging. Imaging modalities such as CT-scan or MRI are essential in establishing a definitive diagnosis of ischemic stroke. However, the high cost and limited number made them inaccessible for those who have low or middle income which will delay the diagnosis and treatment. On the other hand, blood biomarker has potential in either diagnostic or prognostic aspect of ischaemic stroke management. It has a promising potential to aid diagnosis, determine the subtype of stroke, predicting the outcome or early neurological deterioration, and recurrence. It also could potentially help to assess the risk of hemorrhagic transformation, treatment selection, as well as to detect salvageable ischemic penumbra. Although it could not replace neuroimaging, blood-based biomarker assessment had lower cost and faster result. However, despite its promising potential, none of the blood biomarkers is currently used in clinical practice. Therefore, further studies are needed to develop biomarkers or panels of biomarkers with better sensitivity and specificity. This review provides a highlight and summary of blood biomarkers based on their potential application in a clinical setting.
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