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.
Breast cancer is the most common malignancy in women worldwide. Breast cancer is associated with a high mortality rate and health-related economic burden. Breast cancer patients have a low 5-year life expectancy when diagnosed at advanced stages. Besides, the emergence of chemoresistance in breast cancer has led to an intense search for alternative anticancer agents. One of the potential anticancer compounds is Piperine. Several studies had found that Piperine has anticancer effects such as anti-proliferation, induces apoptosis, anti-migration or anti-metastasis, chemo-enhancer or chemosensitizer, cytotoxic agents, anti-angiogenesis, immune response modulators, and self-renewal inhibitor for cancer stem cells. Several delivery agents such as PLGA, PEG-PLGA and liposomes have been studied to improve Piperine's delivery and have shown good results. Therefore, the combination of Piperine and nanoparticles is a potential anticancer agent, especially in breast cancer.
Background: Low-grade chronic inflammation may contribute to the development of atherosclerosis as well as hypertension by inducing the production of pro-inflammatory cytokines. Several studies have revealed a relationship between the microbiota living in the gut and the incidence of hypertension. Two of several gut microbiota that contributed, in this case, are Escherichia coli (E. coli) and Roseburia intestinalis (R. intestinalis). Therefore this study aimed to identify and quantify gut microbes namely R. intestinalis and E.coli in hypertensive patients in Bali, especially in Denpasar City. Methods: This research is a cross-sectional study located at South Denpasar Health Center I, Bali, and the Integrated Biomedical Laboratory, Faculty of Medicine, Universitas Udayana. The sample in this study were hypertensive patients who had been registered at South Denpasar Health Center I and who met the inclusion criteria and did not meet the exclusion criteria. The E. coli and R. intestinalis concentrations were assessed by conducting DNA isolation and RT-qPCR. Statistical analysis using univariate analysis, bivariate analysis using the Independent T-Test; Mann-Whitney Test; Chi-Square, and ROC analysis Results: There were 70 subjects included in this study. Thirty-one subjects were hypertensive patients and the other 39 patients were not hypertensive. The age of the subjects between the two groups was found statistically significant (p=0.007). We also found that comorbid were found mostly in hypertensive patients (p=0.009). Most of the comorbid experienced among them were cardiovascular diseases and diabetes mellitus. Hypertensive subjects had more E. coli concentration in their gut compared with non-hypertensive subjects (p=0.048), while R. intestinalis concentrations were similar in both groups (p>0.05). From the multivariate analysis, it was found that hypertensive patients tended to have a higher concentration of E. coli than non-hypertensive patients (p=0.012; 95% CI:0.055–0.417). Conclusion: E. coli concentration in the gut is independently associated with the incidence of hypertension, while R. intestinalis concentration is not.
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