Introduction Immunothrombosis has recently been used to describe the responses/mechanisms in thrombosis. Systemic inflammatory markers are prognostic markers for a variety of thrombotic conditions; however, their potential value in predicting portal vein thrombosis (PVT) is unknown. This study aimed to establish an easy-to-use nomogram based on systemic inflammatory markers to predict portal vein thrombosis (PVT) in patients with liver cirrhosis. Patients and methods This retrospective study included 478 patients with cirrhosis between January 2013 and January 2021. Reputed systemic inflammatory markers (systemic immune-inflammation index [SII], neutrophil-to-lymphocyte ratio [NLR], monocyte-to-lymphocyte ratio [MLR], and platelet-to-lymphocyte ratio (PLR)) were measured, and the clinical data were recorded. The independent risk factors for PVT were determined using univariate analyses and multivariate logistic regression analyses, and a nomogram to predict the occurrence of PVT was established. The concordance index, receiver operating characteristic curves, and calibration plots were used to evaluate the performance of the model. Results A total of 239 patients with PVT and 239 patients without PVT were selected. In the univariate analysis, high SII, NLR, PLR, and MLR were significantly associated with PVT. NLR and PLR were independent risk factors for PVT ( P < 0.05) by multivariate analysis. The nomogram had good predictive efficiency for PVT in patients with cirrhosis, with an area under the receiver operating characteristic (AUROC) curves of 0.891 (95% CI 0.862–0.919) and the calibration curves fit as well, indicating that the nomogram had good clinical application value. Conclusions PVT in patients with cirrhosis is associated with increased levels of systemic inflammatory markers. We successfully developed a practical nomogram based on NLR and PLR to accurately predict PVT, which is a practical method helping clinicians rapidly and conveniently diagnose and guide the treatment of PVT in patients with cirrhosis. Key Messages The present study is the first report on a nomogram based on systemic inflammatory markers in patients with portal vein thrombosis (PVT). The nomogram had good predictive efficiency and a good clinical application value for predicting PVT in patients with cirrhosis.
Objective Patients with liver cirrhosis (LC) commonly exhibit hypercoagulability and tend to develop thrombosis. Neutrophil extracellular traps (NETs) are associated with a variety of thrombotic conditions, but their possible value in portal vein thrombosis (PVT) is not known. We assessed whether NETs promote thrombosis and contribute to the procoagulant state in patients with LC. Methods The circulating levels of NETs markers (myeloperoxidase, neutrophil elastase, citrullinated histone H3) were measured in 72 patients (median age, 55 years; 48 [66.7%] men) with LC from September 2020 to February 2021. Then they were divided into two groups: patients with or without PVT. NETs procoagulant activity was assessed based on thrombin–antithrombin complex (TAT complex) and Factor X. The levels of plasma markers were determined by ELISA. Results There were 28 patients with PVT and 44 patients without PVT. The levels of NETs markers and hypercoagulability markers in the plasma of cirrhosis patients with PVT were significantly higher than those of cirrhosis patients without PVT (p < 0.05). Additionally, the levels of the NETs markers correlated with TAT complex and Factor X (Spearman correlation rho >0.73, p < 0.0001). Conclusions Neutrophil extracellular traps seem to enhance procoagulant activity in LC patients with PVT; thus, they may be a practical predictor of PVT as well as a rapid and easy‐to‐use diagnostic and treatment guide for PVT in patients with cirrhosis.
Purpose The grave mortality rate of Pancreatic ductal adenocarcinoma (PDAC) is primarily due to metastasis. The objective of this investigation was to elucidate the role of LAMA3 in liver metastasis of PDAC, gauge its prognostic implications, and offer insights for therapeutic intervention in PDAC management. Methods We extracted information related to LAMA3 expression levels and associated clinicopathological parameters from TCGA and four GEO datasets. Clinicopathological analysis was conducted using UALCAN, while the Kaplan-Meier plotter was enlisted for evaluating LAMA3's prognostic impact in PDAC. Furthermore, we retrospectively harvested clinicopathological data and tissue specimens from 117 surgically treated PDAC patients at the Affiliated Hospital of Qingdao University. Employing tissue immunohistochemistry, we assessed LAMA3 expression, investigating its correlation with clinicopathological traits, clinical outcomes, and hepatic metastasis. Results (1) An amplified expression of LAMA3 was discerned in PDAC tissue compared to normal tissue in TCGA and GEO databases (all P < 0.001). High expression of LAMA3 is associated with poor OS and RFS of patients with PDAC (all P < 0.05). (2) Clinically, LAMA3 expression was significant enhanced in PDAC tissues compared to adjacent tissues (P < 0.001). (3) Tumor tissues from PDAC patients exhibiting liver metastasis had higher LAMA3 expression than those devoid of liver metastasis (P = 0.005). High LAMA3 expression was correlated with large tumor size (P = 0.007), and TNM stage (P = 0.002). (4) LAMA3 expression were independently associated with liver metastasis. (5) Both LAMA3 expression (P = 0.004) and liver metastasis (P = 0.001) were independent predictive factors for OS. Conclusion The expression of LAMA3 was elevated in the PDAC and it was a predictor for prognosis in PDAC patients. LAMA3 is an independent risk factor for liver metastasis in PDAC as well.
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