Preoperative neutrophil-lymphocyte ratio predicts the risk of microvascular invasion in hepatocellular carcinoma: A meta-analysis

Zeng, Furong; Chen, Bin; Zeng, Jiling; Wang, Zhiming; Liang, Xiao; Deng, Guangtong

doi:10.1177/1724600819874487

Cited by 26 publications

(22 citation statements)

References 81 publications

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“…As for NLR, Zheng showed that there was a significant difference between MVI-positive and MVInegative group in NLR level using univariate analysis, but no difference was observed after multivariate analysis. 19 Li's study also conformed this point. 24 However, Yu and his team had a different opinion that NLR was a useful biomarker for predicting MVI in Notes: Categorical variables are expressed as frequency.…”

Section: Discussionsupporting

confidence: 52%

“…Inflammatory indices are reflective of the systematic inflammation which play an essential role in cancer development and progression. [19][20][21] Also, clinical studies showed that inflammatory indices can be used to predict the prognosis and the presence of MVI. [22][23][24][25][26][27] Therefore, it is necessary to combine inflammatory indices into the predictive models.…”

Section: Introductionmentioning

confidence: 99%

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<p>Nomogram For Preoperative Prediction Of Microvascular Invasion Risk In Hepatocellular Carcinoma</p>

Deng¹,

Yao²,

Zeng³

et al. 2019

CMAR

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To preoperatively predict the microvascular invasion (MVI) risk in hepatocellular carcinoma (HCC) using nomogram. Methods: A retrospective cohort of 513 patients with HCC hospitalized at Xiangya Hospital between January 2014 and December 2018 was included in the study. Univariate and multivariate analysis was performed to identify the independent risk factors for MVI. Based on the independent risk factors, nomogram was established to preoperatively predict the MVI risk in HCC. The accuracy of nomogram was evaluated by using receiver operating characteristic (ROC) curve, calibration curve and decision curve analysis (DCA). Results: Tumor size (OR=1.17, 95% CI: 1.11-1.23, p<0.001), preoperative AFP level greater than 155 ng/mL (OR=1.65, 95% CI: 1.13-2.39, p=0.008) and NLR (OR=1.14, 95% CI: 1.00-1.29, p=0.042) were the independent risk factors for MVI. Incorporating these 3 factors, nomogram was established with the concordance index of 0.71 (95% CI, 0.66-0.75) and well-fitted calibration curves. DCA confirmed that using this nomogram added more benefit compared with the measures that treat all patients or treat none patients. At the cutoff value of predicted probability ≥0.44, the model demonstrated sensitivity of 61.64%, specificity of 71.53%, positive predictive value (PPV) of 64.13%, and negative predictive value (NPV) of 69.31%. Conclusion: Nomogram was established for preoperative prediction of the MVI risk in HCC patients, and better therapeutic choice will be made if it was applied in clinical practice.

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Section: Discussionsupporting

confidence: 52%

Section: Introductionmentioning

confidence: 99%

<p>Nomogram For Preoperative Prediction Of Microvascular Invasion Risk In Hepatocellular Carcinoma</p>

Deng¹,

Yao²,

Zeng³

et al. 2019

CMAR

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“…I 2 and P value were used to evaluate the statistical heterogeneity. A fixed effects model was adopted with significant heterogeneity (I 2 ≤ 50% and P ≥ 0.1), while a random effects model was employed in all other instances (I 2 > 50% or P < 0.1) [22][23][24]. Risk ratio (RR) with 95% confidence interval (CI) was calculated for binary outcomes, mean difference (MD), or the standardized mean difference (SMD) with 95% CI for continuous outcomes and the hazard ratio (HR) for time-to-event outcomes.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic versus open gastrectomy for gastric cancer

et al. 2020

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Background:Compared with open gastrectomy (OG), laparoscopic gastrectomy (LG) for gastric cancer has achieved rapid development and popularities in the past decades. However, lack of comprehensive analysis in longterm oncological outcomes such as recurrence and mortality hinder its full support as a valid procedure. Therefore, there are still debates on whether one of these options is superior. Aim: To evaluate the primary and secondary outcomes of laparoscopic versus open gastrectomy for gastric cancer patients Methods: Two authors independently extracted study data. Risk ratio (RR) with 95% confidence interval (CI) was calculated for binary outcomes, mean difference (MD) or the standardized mean difference (SMD) with 95% CI for continuous outcomes, and the hazard ratio (HR) for time-to-event outcomes. Review Manager 5.3 and STATA software were used for the meta-analysis.Results: Seventeen randomized controlled trials (RCTs) involving 5204 participants were included in this metaanalysis. There were no differences in the primary outcomes including the number of lymph nodes harvested during operation, severe complications, short-term and long-term recurrence, and mortality. As for secondary outcomes, compared with the OG group, longer operative time was required for patients in the LG group (MD = 58.80 min, 95% CI = [45.80, 71.81], P < 0.001), but there were less intraoperative blood loss (MD = − 54.93 ml, 95% CI = [− 81.60, − 28.26], P < 0.001), less analgesic administration (frequency: MD = − 1.73, 95% CI = [− 2.21, − 1.24], P < 0.001; duration: MD = − 1.26 days, 95% CI = [− 1.40, − 1.12], P < 0.001), shorter hospital stay (MD = − 1.37 days, 95% CI = [− 2.05, − 0.70], P < 0.001), shorter time to first flatus (MD = − 0.58 days, 95% CI = [− 0.79, − 0.37], P < 0.001), ambulation (MD = − 0.50 days, 95% CI = [− 0.90, − 0.09], P = 0.02) and oral intake (MD = − 0.64 days, 95% CI = [− 1.24, − 0.03], P < 0.04), and less total complications (RR = 0.81, 95% CI = [0.71, 0.93], P = 0.003) in the OG group. There was no difference in blood transfusions (number, quantity) between these two groups. Subgroup analysis, sensitivity analysis, and the adjustment of Duval's trim and fill methods for publication bias did not change the conclusions. Conclusion:LG was comparable to OG in the primary outcomes and had some advantages in secondary outcomes for gastric cancer patients.LG is superior to OG for gastric cancer patients.

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“…Statistical heterogeneity was assessed with I 2 and P-value. A fixed effects model was adopted without significant heterogeneity (I 2 ≤ 50% and P ≥ 0.1), while a random effects model was employed in all other instances (I 2 > 50% or P < 0.1) (Zeng et al, 2019, Zeng et al, 2020. Weighted mean difference (WMD) with 95% confidence intervals (95% CI) was calculated for inflammatory markers.…”

Section: Discussionmentioning

confidence: 99%

Association of inflammatory markers with the severity of COVID-19

Zeng

Guo

Yin

et al. 2020

Preprint

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Background:The ongoing worldwide epidemic of Coronavirus Disease 2019 , caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has posed a huge threat to global public health. However, with regard to the effects of inflammatory markers on the severity of COVID-19, studies have reported associations that vary in strength and direction. Aims:In the meta-analysis, we aimed to provide an overview of the association of inflammatory markers with severity of COVID-19. Methods:The following databases were searched: PubMed, Embase, Cochrane Library, Wanfang database and CNKI (China National Knowledge Infrastructure) database until March 20, 2020. Weighted mean difference (WMD) and 95% confidence intervals (CIs) were pooled using random or fixed-effects models. Results: A total of 16 studies were included in our analysis comprising of 3962 patients with COVID-19. Random-effects results demonstrated that patients with COVID-19 in non-severe group had lower levels for CRP (WMD = -41.78 mg/l, 95% CI = [-52.43, -31.13], P < 0.001), PCT (WMD = -0.13 ng/ml, 95% CI = [-0.20, -0.05], P < 0.001), IL-6 (WMD = -21.32 ng/l, 95% CI = [-28.34, -14.31], P < 0.001), ESR (WMD = -8.40 mm/h, 95% CI = [-14.32, -2.48], P = 0.005), SAA (WMD = -43.35 μg/ml, 95% CI = [ -80.85, -5.85], P = 0.020) and serum ferritin (WMD = -398.80 mg/l, 95% CI = [-625.89, -171.71], P < 0.001), compared with those in severe group. Moreover, survivors had lower level for IL-6 than non-survivors with COVID-19 (WMD = -4.80 ng/ml, 95% CI = [-5.87, -3.73], P < 0.001). These results were consistent through sensitivity analysis and publication bias assessment. Conclusions:The meta-analysis highlights the association of inflammatory markers with the severity of COVID-19. Measurement of inflammatory markers might help clinicians to monitor and evaluate the severity and prognosis of COVID-19.

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Preoperative neutrophil-lymphocyte ratio predicts the risk of microvascular invasion in hepatocellular carcinoma: A meta-analysis

Cited by 26 publications

References 81 publications

<p>Nomogram For Preoperative Prediction Of Microvascular Invasion Risk In Hepatocellular Carcinoma</p>

<p>Nomogram For Preoperative Prediction Of Microvascular Invasion Risk In Hepatocellular Carcinoma</p>

Laparoscopic versus open gastrectomy for gastric cancer

Association of inflammatory markers with the severity of COVID-19

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