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Neutrophile-to-lymphocyte,lymphocyte-to-monocyte,and platelet-tolymphocyte ratios as prognostic and response biomarkers for resectable locally advanced gastric cancer

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World Journal of Gastrointestinal Oncology 2022年第7期14卷 1307-1323页

作者： Tiago Cruz Tomás Ines Eiriz marina vitorino Rodrigo Vicente Joao Gramaca Alicia Guadalupe Oliveira Paulo Luz Mafalda Baleiras Ana Sofia Spencer Luísa Leal Costa Patrícia Liu Joana Mendonca Magno Dinis Teresa Padrao Marisol Correia Goncalo Atalaia Michelle Silva Teresa Fiúza Department of Medical Oncology Hospital Professor Doutor Fernando Fonseca EPEAmadora 2720-276Portugal Department of Medical Oncology Centro Hospitalar Barreiro-Montijo EPEBarreiro 2830-003Portugal Department of Medical Oncology Hospital do Espírito Santo deÉvora EPEÉvora 7000-811Portugal Department of Medical Oncology Centro Hospitalar Universitário do Algarve EPEAlgarve 8000-386Portugal Department of Medical Oncology Hospital São Francisco XavierCentro Hospitalar Lisboa Ocidental EPELisboa 1449-005Portugal Department of Medical Oncology Hospital Santo António dos CapuchosCentro Hospital Lisboa Central EPELisboa 1169-050Portugal Department of Medical Oncology Hospital BeatrizÂngeloLoures 2674-514Portugal Department of Medical Oncology Centro Hospitalar de Trás-os-Montes e Alto Douro EPEVila Real 5000-508Portugal Department of Medical Oncology Hospital da Senhora da Oliveira EPEGuimarães 4835-044Portugal Department of Medical Oncology Hospital Garcia de Orta EPEAlmada 2805-267Portugal Department of Medical Oncology Hospital da LuzLisboa 1500-650Portugal Department of Medical Oncology Hospital Distrital de Santarém EPESantarém 2005-177Portugal

BACKGROUND Perioperative fluorouracil plus leucovorin,oxaliplatin,and docetaxel(FLOT)improves prognosis in locally advanced gastric cancer(LAGC).Neutrophil-to-lymphocyte(NLR),lymphocyte-tomonocyte(LMR),and platelet-to-lymphocyte(PLR)ratios are prognostic biomarkers but not predictive *** To assess blood ratios’(NLR,LMR and PLR)potential predictive response to FLOT and survival outcomes in resectable LAGC *** This was a multicentric retrospective study investigating the clinical potential of NLR,LMR,and PLR in resectable LAGC patients,treated with at least one preoperative FLOT cycle,from 12 Portuguese *** were compared through non-parametric Mann-Whitney *** operating characteristic curve analysis defined the cut-off values as:High PLR>141 for progression and>144 for mortality;high LMR>3.56 for T stage regression(TSR).Poisson and Cox regression models the calculated relative risks/hazard ratios,using NLR,pathologic complete response,TSR,and tumor regression grade(TRG)as independent variables,and overall survival(OS)as the dependent *** This study included 295 patients(mean age,63.7 years;59.7% males).NLR was correlated with survival time(r=0.143,P=0.014).PLR was associated with systemic progression during FLOT(P=0.022)and mortality(P=0.013),with high PLR patients having a 2.2-times higher risk of progression[95% confidence interval(CI):0.89-5.26]and 1.5-times higher risk of mortality(95%CI:0.92-2.55).LMR was associated with TSR,and high LMR patients had a 1.4-times higher risk of achieving TSR(95%CI:1.01-1.99).OS benefit was found with TSR(P=0.015)and partial/complete TRG(P<0.001).Patients without TSR and with no evidence of pathological response had 2.1-times(95%CI:1.14-3.96)and 2.8-times(95%CI:1.6-5)higher risk of *** Higher NLR is correlated with longer survival *** LMR patients have a higher risk of decreasing T stage,whereas high PLR patients have higher odds of progressing under FLOT a

关键词： Gastric cancer Perioperative fluorouracil plus leucovorin,oxaliplatin,and docetaxel Neutrophil-to-lymphocyte Lymphocyte-to-monocyte Platelet-to-lymphocyte Tumor regression grade

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Epidural Abscess Related to Brucellar Spondylodiscitis Diagnosis by Polymerase Chain Reaction(PCR)

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Advances in Infectious Diseases 2019年第3期9卷 238-242页

作者： Mariana Costa marina vitorino Beatriz Porteiro Whine Pedro Marinela Major Joao Machado Department of Internal Medicine Hospital Professor Dr.Fernando da Fonseca EPEAmadoraPortugal

The localized forms of brucellosis, particularly osteoarticular, by their symptomatology usually nonspecific, still continue to be a diagnosis challenge, being fundamental to raise a high degree of suspicion based on a careful epidemiological history. The authors describe the case of a 69 year old farmer that was admitted due to an insidious lower back pain with irradiation to the left lower limb accompanied by nocturnal sweating, anorexia and weight loss. The imaging studies revealed a spondylodiscitis in L3-L4 with an associated epidural abscess. The diagnosis of brucellosis was brought on by the occupational exposure to sheep and was confirmed by a positive PCR to Brucella in the product gathered by aspiration from the epidural abscess and also by the serology (ELISA and Rose Bengal). Despite the initial therapy with doxycycline, rifampicin and gentamycin (the last one for 1 week), the patient had a clinical and imagiologic worsening, determining surgical decompression. After the surgery, antiobiotherapy with doxycyline and rifampicin was maintained and a cycle of gentamicin was started, this time for a month, with a favorable clinical evolution.

关键词： Lower Back Pain Spondylodiscitis Brucellosis PCR

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