Background Systemic inflammatory parameters, such as the elevator PLR (platelet-lymphocyte ratio), have been found to be associated with the prognosis in gastric cancer (GC); however, the results remain controversial. So we aimed to evaluate the prognostic role of the PLR in gastric cancer by conducting this meta-analysis. Methods We performed a systematic literature search in PubMed, Embase and the Cochrane Library. The hazard ratio (HR) /Odds Ratio (OR) and its 95% confidence (CI) of survival outcomes and clinicopathological parameters were calculated. Results A total of 49 studies (51 cohorts) with 28,929 GC patients were included in the final meta-analysis. The pooled results showed that elevated PLR was significantly associated with poor overall survival (OS) (HR: 1.37, 95% CI: 1.26–1.49, p < 0.001; I2 = 79.90%, Ph < 0.001) and disease-free survival (DFS) (HR 1.52, 95%CI 1.22–1.90, P < 0.001, I2 = 88.6%, Ph< 0.001) of GC patients. Furthermore, patients with elevated PLR had a higher risk of lymph node metastasis (OR = 1.17, 95% CI: 1.02–1.33, p = 0.023), serosal invasion (T3 + T4) (OR = 1.34, 95% CI: 1.10–1.64, p = 0.003) and increased advanced stage (III + IV) (OR = 1.20, 95% CI: 1.06–1.37, p = 0.004). Conclusions This meta-analysis demonstrated that elevated PLR was a prognostic factor for poor OS and DFS, and associated with clinicopathological parameters in patients with GC.
Background: Pretreatment PLR (platelet-lymphocyte ratio), was reported to be associated with the prognosis in gastric cancer (GC), but the results remain inconclusive. This meta-analysis aimed to investigate the prognostic potential of the pre-treatment PLR in gastric cancer.Methods: We performed a systematic literature search in PubMed, Embase and the Cochrane Library to identify eligible publications. The hazard ratio (HR) /Odds Ratio (OR) and its 95% confidence (CI) of survival outcomes and clinicopathological parameters were calculated.Results: A total of 49 studies (51 cohorts), collectting data from 28,929 GC patients, were included in the final analysis. The pooled results demonstrated that the elevated pre-treatment PLR was significantly associated with poor overall survival (OS) (HR: 1.37, 95% CI: 1.26-1.49, p < 0.001; I2= 79.90%, Ph < 0.001) and disease-free survival (DFS) (HR 1.52, 95%CI 1.22–1.90, P< 0.001, I2= 88.6%, Ph< 0.001). Furthermore, the patients with the elevated PLR had a higher risk of lymph node metastasis (OR = 1.17, 95% CI: 1.02–1.33, p=0.023), serosal invasion (T3 +T4) (OR = 1.34, 95% CI: 1.10–1.64, p=0.003) and increased advanced stage (III+IV) (OR = 1.20, 95% CI: 1.06–1.37, p=0.004).Conclusions: An elevated pre-treatment PLR was a prognostic factor for poor OS and DFS, and associated with poor clinicopathological parameters in GC patients .
The main purpose of this study was to build a prediction model for male breast cancer (MBC) patients to predict the possibility of distant metastasis. The Surveillance, Epidemiology, and End Results database was used to obtain data on patients with MBC. The patients were divided into a training set and a validation set at a ratio of 7:3. The risk variables of distant metastasis in the training set were determined by univariate and multivariate logistic regression analyses. And then we integrated those risk factors to construct the nomogram. The prediction nomogram was further verified in the verification set. The discrimination and calibration of the nomogram were evaluated by the area under the receiver operating characteristic curve, calibration plots, respectively. A total of 1974 patients (1381 in training set and 593 in validation set) were eligible for final inclusion, of whom 149 (7.55%) had distant metastasis at the diagnosed time. Multivariate logistic regression analyses presented that age, T stage, N stage, and hormone receptor status were independent risk factors for distant metastasis at initial diagnosis of male breast cancer. Finally, the 4 variables were combined to construct the nomogram. The area under the curve values for the nomogram established in the training set and validation set were 0.8224 (95%CI: 0.7796–0.8652) and 0.8631 (95%CI: 0.7937–0.9326), suggesting that the nomogram had good predictive power. The calibration plots illustrated an acceptable correlation between the prediction by nomogram and the actual observation, as the calibration curve was closed to the diagonal bisector line. An easy-to-use nomogram, being proven to be with reliable discrimination ability and accuracy, was established to predict distant metastasis for male patients with breast cancer using the easily available risk factors.
Duodenal adenocarcinoma (DA) is an extremely rare and highly aggressive malignant tumor of the digestive system. Due to the lack of specific clinical characteristics, it is easy to misdiagnosis and miss diagnosis, and the lack of specific consensus and recommendation for treatment, so it often refers to stomach cancer and colorectal cancer. Now, we report a case of a patient with advanced DA who achieved complete remission (CR) after undergoing chemoradiotherapy combined with targeted therapy. The patient was pathologically diagnosed with DA after radical surgery in October 2020, and he failed to undergo adjuvant chemotherapy on time due to the COVID-19 outbreak. The patient found multiple lymph node liver and abdominal metastases 6 months after the operation. Considering the progression of the disease, XELOX regimen (oxaliplatin + capecitabine) chemotherapy was given for 1 cycle. After 1 cycle of treatment, the tumor markers remained elevated; the carcinoembryonic antigen (CEA) was 5.03 ng/ml (0–5 ng/ml), and the carbohydrate antigen 19-9 (CA19-9) was 747.30 U/ml (0–37 U/ml). The patient also developed intolerable capecitabine-related treatment-related adverse events (TRAEs), namely, hand–foot syndrome. For the above reasons, capecitabine was replaced as S-1 at cycle 2, and the chemotherapy regimen became SOX (oxaliplatin + S-1); bevacizumab injection was also added to the SOX regimen, and it was further treated regularly for 7 cycles with the regimen of SOX plus bevacizumab. Liver metastases showed a continuous narrowing trend throughout the treatment period; tumor markers also showed a downward trend. Finally, the patient achieved complete remission (CR) at cycle 7. After completion of chemotherapy, radiotherapy was administered to the resistant metastatic lymph nodes present in the patient’s abdominal cavity for a total of 10 times. However, the patient developed severe bone marrow suppression and obstructive jaundice during the course of radiotherapy and finally failed to complete the radiotherapy plan. Currently, the patient continued maintenance therapy with bevacizumab and S-1 and showed no recurrence or metastasis after review. In this case of advanced DA, we referred to both CRC and gastric cancer in the treatment regimen of the patient. At the same time, targeted drugs and radiotherapy were also added to the basis of chemotherapy, which has no clear consensus recommendation or case for reference in the treatment of advanced DA. Thankfully, the patient’s disease was controlled and remained stable after treatment with this regimen. Therefore, for patients with advanced DA who lack standardized treatment regimens and guidelines, the combination of chemotherapy with targeted therapy and radiotherapy may be one of the effective treatment modalities.
Background Nodular goiter is a common benign tumor in clinical practice, it refers to a simple diffuse goiter due to repeated progression, causing follicular epithelium to diffuse into focal hyperplasia and degeneration in parts. Finally, because of long-term hyperplastic lesions and degenerative diseases, alternately repeatedly gland nodules in different stages of development, which is essentially a benign lesion and there are few reports confirming metastasis. Case presentation: The patient was a 26-year-old female with a history of right lobe subtotal thyroidectomy for thyroid nodules one year prior. Postoperative pathological examination revealed a nodular goiter with cystic changes in the "right lobe thyroid tumor". This time, she was admitted to the hospital because of the discovery of bilateral neck mass for one month. Physical examination: multiple protruding masses were seen in the neck, and the largest mass was located on the right side of the neck with a length of about 2 cm. Ultrasound showed multiple isoechoic nodules were found bilaterally in the neck, most of which were located in the sternocleidomastoid muscle. CT scan of the neck showed multiple nodules below the right lobe of the thyroid and in the front of the neck, and thyroid implantation lesions were considered. During the last operation, it was confirmed that the mass was scattered and mostly not in the area of the previous operation, and the pathological diagnosis was consistent with nodular goiter.It is thought to be caused by distant metastasis of a benign tumour and this is a very rare case. Conclusions This case report suggests that nodular goiter, as a benign lesion, may also present with implantation or metastasis, which should be considered in clinical practice, Surgeons need to prevent nodular goiter implantation during surgery.
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