Disease markers
-
Review Meta Analysis
Prognostic Significance of Pretreatment Apolipoprotein A-I as a Noninvasive Biomarker in Cancer Survivors: A Meta-Analysis.
Numerous studies have reported the prognostic significance of serum apolipoprotein A-I (ApoA-I) in various cancers, but the results have been inconsistent. The current meta-analysis was performed to investigate the association between ApoA-I level and prognosis in human malignancies. ⋯ A total of 14 studies involving 9295 patients were included. The results indicated that low ApoA-I level was significantly associated with poor overall survival (OS) (HR = 0.52, 95% CI: 0.44-0.61). Significant relationships between the ApoA-I level and OS were specifically detected in nasopharyngeal carcinoma (NPC, HR = 0.63, 95% CI: 0.54-0.73), colorectal cancer (CRC, HR = 0.48, 95% CI: 0.19-0.76), and hepatocellular carcinoma (HCC, HR = 0.46, 95% CI: 0.27-0.65). The subgroup analyses for OS also further confirmed the prognostic significance of the ApoA-I level in cancers. Moreover, lower Apo A-I was associated with unfavorable cancer-specific survival (CSS, HR: 0.47, 95% CI: 0.19-0.76) in cancers, and low ApoA-I level was clearly associated with inferior total time to recurrence (TTR, HR: 0.43, 95% CI: 0.29-0.58) in HCC, poorer locoregional recurrence-free survival (LRFS) and distant metastasis-free survival (DMFS) (HR: 0.58, 95% CI: 0.42-0.74 for LRFS; HR: 0.65, 95% CI: 0.41-0.89 for DMFS) in NPC, and shorter disease-free survival (DFS, HR: 0.64, 95% CI: 0.43-0.84) in cancers. Conclusions. Low ApoA-I level might be an unfavorable prognostic factor in multiple malignancies, and serum ApoA-I could serve as a noninvasive marker to predict cancer prognosis.
-
Acute kidney injury (AKI) is a common complication, impacting short- and long-term patient outcomes. Although the application of the classification systems for AKI has improved diagnosis, early clinical recognition of AKI is still challenging, as increments in serum creatinine may be late and low urine output is not always present. The role of urinary biochemistry has remained unclear, especially in critically ill patients. ⋯ In this review, we will discuss factors affecting the fractional excretion of sodium (FeNa) and fractional excretion of urea (FeU). We believe that the frequent assessment of urinary biochemistry and microscopy can be useful in evaluating the likelihood of AKI reversibility. The availability of early injury biomarkers could help guide clinical interventions.
-
Acute respiratory distress syndrome (ARDS) is an acute-onset hypoxic condition with radiographic bilateral lung infiltration. It is characterized by an acute exudative phase combining diffuse alveolar damage and lung edema followed by a later fibroproliferative phase. Despite an improved understanding of ARDS pathobiology, our ability to predict the development of ARDS and risk-stratify patients with the disease remains limited. ⋯ After a short description of ARDS pathobiology, here, we review the scientific evidence that supports the value of various ARDS biomarkers with regard to their major biological roles in ARDS-associated lung injury and/or repair. Ongoing research aims at identifying and characterizing novel biomarkers, in order to highlight relevant mechanistic explorations of lung injury and repair, and to ultimately develop innovative therapeutic approaches for ARDS patients. This review will focus on the pathophysiologic, diagnostic, and therapeutic implications of biomarkers in ARDS and on their utility to ultimately improve patient care.
-
Review Meta Analysis
The diagnostic accuracy of HE4 in lung cancer: a meta-analysis.
The diagnostic value of serum HE4 in patients with lung cancer remains controversial. Thus, we performed a systematic review and meta-analysis to assess the diagnostic accuracy of serum HE4 for lung cancer. We conducted a comprehensive literature search in PubMed, EMBASE, Chinese National Knowledge Infrastructure (CNKI), and WANFANG databases between Jan. 1966 and Nov. 2014. ⋯ The summary estimates for serum HE4 in the diagnosis of lung cancer in these studies were pooled SEN 0.72 (95% CI: 0.68-0.75), SPE 0.85 (95% CI: 0.81-0.88), PLR 4.68 (95% CI: 3.23-6.78), NLR 0.31 (95% CI: 0.24-0.39), and DOR 17.14 (95% CI: 9.72-30.20), and the area under the curve (AUC) was 0.8557. This meta-analysis indicated that serum HE4 is a potential tool in the diagnosis of lung cancer. In addition, considering the high heterogeneity and potential publication bias, further studies with rigorous design and large sample size are needed in the future.
-
Sepsis is a leading cause of death in the United States and worldwide. Early recognition and effective management are essential for improved outcome. However, early recognition is impeded by lack of clinically utilized biomarkers. ⋯ In addition, new results from our laboratory are presented regarding the involvement of the complement factor, mannose-binding lectin, in septic shock patients. Future clinical studies are needed to obtain the complete profiles of complement factors/their activated products during the course of sepsis development. We anticipate that the results of these studies will lead to a multipanel set of sepsis biomarkers which, along with currently used laboratory tests, will facilitate earlier diagnosis, timely treatment, and improved outcome.