Serum calcium improved systemic inflammation marker for predicting survival outcome in rectal cancer

Zhuang, Zhuokai; Wang, Xiaolin; Huang, Meijin; Luo, Yanxin; Yu, Huichuan

doi:10.21037/jgo-20-479

Cited by 7 publications

(5 citation statements)

References 41 publications

(47 reference statements)

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“…Some studies have found that serum calcium levels can affect calcium signals within cells 9 , 10 and that changes in calcium ion levels can affect the body’s immune function. 11 , 13 In addition, evidence from a cohort study suggests that adequate serum calcium levels are associated with low levels of chronic inflammation. 14 Calcium ions involved in the immune defences against bacterial infections can be complex.…”

Section: Discussionmentioning

confidence: 99%

Serum Calcium Levels and in-Hospital Infection Risk in Patients with Acute Ischemic Stroke

Chen¹,

Liang²,

Zhang³

et al. 2022

NDT

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Purpose Stroke-associated infection (SAI) is one of the most common post-stroke complications, which may lead to a relatively poor prognosis. This study aims to explore the potential relationship between serum calcium levels and SAI. Patients and Methods This is a cross-sectional study involving 395 participants. SAI is a term that covers stroke-associated pneumonia (SAP), urinary tract infection (UTI), as well as other infections diagnosed during the first week after a stroke. Serum calcium levels were measured within 24 hrs of admission. To determine the association of serum calcium levels with the SAI, logistic regression models were calculated. An adjusted spline regression model was used to further confirm the relationship between the two. Results Among the total patients, SAI occurred in 107 (27.1%) patients. Serum calcium was associated with SAI and was independent of the SAI risk factors for age, admission NIHSS score, and intravascular therapy [adjusted OR 0.040 (95% CI = 0.005–0.291), p = 0.002]. Remarkably, this trend applies predominantly to serum calcium levels less than 2.25mmol/L (p= 0.005 for linearity). Conclusion Serum calcium levels are associated with the risk of SAI, when serum calcium is below normal (2.25mmol/L), the risk of SAI increases as serum calcium levels decrease.

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Section: Discussionmentioning

confidence: 99%

Serum Calcium Levels and in-Hospital Infection Risk in Patients with Acute Ischemic Stroke

Chen¹,

Liang²,

Zhang³

et al. 2022

NDT

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“…The last but not the least, a relation of sCa with mortality caused by non-cardiovascular diseases cannot be excluded in the present study. Abnormalities of sCa have been reported to be associated with stroke, cancer and infection, which would also contribute to increased mortality 8 23 24…”

Section: Discussionmentioning

confidence: 99%

Altered serum calcium homeostasis independently predicts mortality in patients with acute coronary syndrome: a retrospective observational cohort study

Zhu

Zhao

et al. 2021

BMJ Open

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ObjectivesSerum calcium levels (sCa) were reported to be associated with risk of cardiovascular diseases. The aim of this study was to analyse the association between sCa and long-term mortality in patients with acute coronary syndrome (ACS).DesignA retrospective observational cohort study.SettingSingle-centre study with participants recruited from the local area.ParticipantsA total of consecutive 13 772 patients with ACS were included in this analysis. Patients were divided based on their sCa profile (≤2.1 mmol/L, 2.1–2.2 mmol/L, 2.2–2.3 mmol/L, 2.3–2.4 mmol/L, 2.4–2.5 mmol/L,>2.5 mmol/L) and followed up for a median of 2.96 years (IQR 1.01–4.07).Primary outcomeLong-term all-cause mortality.ResultsDuring a median follow-up period of 2.96 years, patients with sCa ≤2.1 mmol/L had the highest cumulative incidences of all-cause mortality (16.7%), whereas those with sCa 2.4–2.5 mmol/L had the lowest cumulative incidences of all-cause mortality (3.5%). After adjusting for potentially confounding variables, the Cox analysis revealed that compared with the reference group (sCa 2.4–2.5 mmol/L), all the other groups had higher mortality except for the sCa 2.3–2.4 mmol/L group (HR, 1.32, 95% CI 0.93 to 1.87). Restricted cubic splines showed that the relationship between sCa and all-cause mortality seemed to be U shaped. The optimal sCa cut-off point, 2.35 mmol/L, was determined based on the shape of restricted cubic splines.ConclusionsAltered serum calcium homeostasis at admission independently predicts all-cause mortality in patients with ACS. In addition, a U-shaped relationship between sCa and all-cause mortality exists, and maintaining sCa at approximately 2.35 mmol/L may minimise the risk of mortality.

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“…We divided the patients with rLN 5 mm and NLR 3 according to the previous studies 4,14 . The comparison between different predictive models shown in Table 5 was assessed through Akaike information criterion (AIC) likelihood ratio (LR), as previously described 7 …”

Section: Methodsmentioning

confidence: 99%

“… 4 , 14 The comparison between different predictive models shown in Table 5 was assessed through Akaike information criterion (AIC) likelihood ratio (LR), as previously described. 7 …”

Section: Methodsmentioning

confidence: 99%

“…3 Many systemic inflammation indexes, such as neutrophillymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), have been suggested as prognostic markers of colorectal cancer in many studies. [4][5][6] However, their predictive values are still controversial and with high variability, 7,8 suggesting a dramatic heterogeneity among cancer populations and the predictive accuracy could be improved by combining with other markers. 4 It has been well established that the number of evaluated lymph nodes (LNs) correlates with better outcomes in node-negative colorectal cancers.…”

Section: Introductionmentioning

confidence: 99%

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Radiological lymph‐node size improves the prognostic value of systemic inflammation index in rectal cancer with pathologically negative nodes

Peng

Liu

et al. 2023

Cancer Medicine

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Background The relationship between the radiological lymph node (rLN) size and survival outcome in node‐negative rectal cancer is still uncertain. In this study, we aimed to explore the role of enlarged rLN in predicting the survival of node‐negative rectal cancers. Methods We retrospectively reviewed the records of 722 node‐negative rectal cancer who underwent curative resection. Factors associated with DFS (disease‐free survival) and CSS (cancer‐specific survival) were assessed with univariate and multivariate analysis. Survival analysis was performed according to presence with or without enlarged rLN. Combining rLN with NLR as a new index‐inflammation immune score (IIS) for predicting survival. Comparing different models to assess the predictive powers. Results A total of 119 patients had tumor recurrence and 73 patients died due to cancer. Patients with enlarged rLN (≥5 mm) was significantly associated with better DFS (HR:0.517, 95%CI:0.339–0.787, p = 0.002) and CSS (HR:0.43, 95%CI:0.242–0.763, p = 0.004). The risk factors of recurrence were rLN, neutrophil‐lymphocyte ratio (NLR), CEA level, and distance from the anal verge. The risk of recurrence increased by 1.88‐ and 2.83‐fold for the high score in IIS compared with the low and intermediate score group (All p < 0.001). Similarly, the high score in IIS also increased the risk of cancer‐specific death. In the model comparison, the AIC and LR were improved by including the rLN into the NLR model for DFS and CSS prediction (All p < 0.05). Conclusions Node‐negative rectal cancer patients with enlarged rLN had a better survival outcome. IIS might be a more comprehensive and complete inflammation immune index for survival prediction.

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Serum calcium improved systemic inflammation marker for predicting survival outcome in rectal cancer

Cited by 7 publications

References 41 publications

Serum Calcium Levels and in-Hospital Infection Risk in Patients with Acute Ischemic Stroke

Serum Calcium Levels and in-Hospital Infection Risk in Patients with Acute Ischemic Stroke

Altered serum calcium homeostasis independently predicts mortality in patients with acute coronary syndrome: a retrospective observational cohort study

Radiological lymph‐node size improves the prognostic value of systemic inflammation index in rectal cancer with pathologically negative nodes

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