Inflammatory conditions play part in the progression of malignancies, and markers signifying growth of these factors can indicate prognosis. Neutrophil-to-lymphocyte (NLR) is used as a marker of subclinical inflammation that may become an integral part of workup to indicate prognosis and associated pathology. This study aims to explore the association of NLR ratio with clinical characteristics, radiological assessment and staging, histopathology, and disease outcomes of breast cancer. A retrospective cohort study was conducted in a tertiary care center to include breast cancer patients that were diagnosed between January 2001 and December 2020. Data including tumor size, lymph nodes, metastasis, histological grading, ER/PR/HER2-neu status, molecular subtypes, clinical staging); nodal findings (sentinel and axillary); pathology from frozen section; and disease outcomes were assessed. Multivariable regression and Kaplan-Meier survival curves were employed to indicate the association of NLR with breast cancer features and disease-free survival. A total of 2050 patients had a median age of 50 years, median NLR levels of 2.14, most common pathology ductal followed by lobular, and most common site of metastasis being lungs followed by bones. Disease-free rate was 7.6%, and a recurrence rate of 1.8%, while 1.6% deaths were reported. NLR was found associated with age, treatment outcomes, tumor size, lymph nodes, metastasis and clinical staging. Other positive correlations were with Ki67 proliferation index, molecular subtypes, and tumor size on frozen section (at transverse and craniocaudal dimensions). Negative correlations were seen with estrogen and progesterone receptors. However, NLR was not found predictable of disease-free survival (P = .160). Significant predictors of disease-free survival were histological grading, ER, PR status, molecular subtype, and Ki67 proliferation index. NLR being a readily available marker has shown novel findings in its association with tumor staging, disease outcomes and characteristics of breast malignancy.
Introduction: The association between allergy and cancer is contradictory, whereas some forms of cancer have inverse associations with allergy. Allergic rhinitis (AR) is the most prevalent form of allergy, and lung cancer is one of the most prevalent forms of cancer, with the highest percentage of mortality. Recent studies report a positive association between asthma and lung cancer, although that, too, is not conclusive yet. However, AR has a positive association with asthma; therefore, our research question was to explore whether there is any correlation between AR and lung cancer epidemiologically. Methods and Results: Seven eligible articles were found to be eligible for this systematic review and meta-analysis, including 4663 cases and 9056 controls, five from the USA and one each from Canada and Germany. Pooled analysis [OR: 0.56; 95% CI: 0.45-0.70; p-value<0.00001], and [RR: 0.63; 95% CI: 0.51-0.77; p-value<0.00001] depicted a strong inverse relationship between AR and lung cancer. Among small-cell and non-small-cell lung cancer, the inverse association was stronger with Small-cell lung cancer (SCLC): [OR: 0.58, 95% CI: 0.46-0.73], and [RR: 0.64, 95% CI: 0.53-0.77], with a p-value <0.00001; however, this finding was only based on one study among females. The study in Canada (OR: 0.35 and RR: 0.38) and in Germany (OR: 0.18 and RR: 0.19) had lower OR and RR values compared to the studies in the USA (OR 0.62 and RR 0.69). However, two studies in Canada and Germany were the outlier studies in our study, and sensitivity analyses reduced the heterogeneity from 64% to 27% (for OR) and 72% to 40% (for RR) while analyses were conducted eliminating those studies. No low-quality studies were obtained. Conclusion: New epidemiological studies are required to observe the current scenario more comprehensively.
Background: Esophageal cancer is the eighth most prevalent cancer globally. Previously, several biomarkers have been used to predict the prognosis, although with variable reliability. Interestingly, it is noted that changes in liver function tests levels before and after neoadjuvant treatment are predictive in terms of cancer recurrence. Objectives: The objectives of the current study were to associate novel markers, including aspartate aminotransferase-to-platelet ratio (APRI) and aspartate aminotransferase-to-alanine aminotransferase ratio (AAR) with survival in esophageal malignancy. Materials and Methods: A retrospective study in a tertiary care hospital (single-center) included 951 patients having diagnosed esophageal carcinoma of any age group. Results: The median (interquartile range) age of study participants were 50 (38–60) years, including 43% males and 57% female patients, while the median (interquartile range) levels of AAR and APRI were 0.97 (0.81–1.25) and 0.19 (0.13–0.29), respectively. AAR was found to be higher in dysphagia for solids only and dysphagia for both liquids and solids rather than liquids only ( P =0.002), while other associations included well-differentiated tumor grade ( P =0.011), finding of esophageal stricture on esophagogastroduodenoscopy ( P =0.015), and characteristic of mass on computerized tomography scan being both circumferential and mural ( P =0.005). APRI was found to be higher in adenocarcinoma ( P =0.038), and finding of circumferential±ulcerated mass on esophagogastroduodenoscopy ( P <0.001). On survival analysis, adenocarcinoma ( P <0.001), luminal narrowing ( P =0.002), AAR greater than 1.0 ( P =0.006), and APRI greater than 0.2 ( P =0.007) were found to be poor survival predictors. On Cox proportional hazards regression, APRI was found to be more associated with poor survival than AAR (Hazard ratio: 1.682, 1.208–2.340, P =0.002). Conclusion: This study correlated clinical and pathological features of esophageal malignancy with noninvasive markers of hepatic function.
Objective: The objective of this study was to determine the frequency of wound infection among patients with abdominal surgeries and to compare the surgical site infection following elective versus emergency abdominal surgeries in a tertiary care hospital. Subjects and methods: All patients who fulfilled the inclusion criteria in the Department of General Surgery were included in the study. After taking informed written consent history was taken, clinical examination and patients were divided into two groups: group A (elective abdominal surgery) and group B (emergency abdominal surgery), patients in both groups were compared for the outcome that is surgical site infection. Result: A total of 140 patients who underwent abdominal surgery were included. Wound infection in abdominal surgeries was noted in 26 patients (18.6%), in group A wound infection was noted in 7 (5%), while in group B wound infection was seen in 19 (13.6%). Conclusion: The rate of wound infection in patients with abdominal surgeries was not low among the study population and the rate of wound infection was higher in emergency abdominal surgeries as compared with elective abdominal surgeries.
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