Clinical and Experimental Medicine最新文献

{"title":"Assessing the effectiveness of etoposide treatment in adult haemophagocytic lymphohistiocytosis: a systematic review and meta-analysis.","authors":"Tiankuo Gao, Dina Suolitiken, Chun Yang, Chaofan Wu, Lingbo He, Yini Wang","doi":"10.1007/s10238-025-01570-w","DOIUrl":"10.1007/s10238-025-01570-w","url":null,"abstract":"<p><p>Haemophagocytic lymphohistiocytosis (HLH) is a serious condition characterised by uncontrolled hyperinflammation. Etoposide has been used as a treatment option in paediatric HLH; however, its effectiveness and the necessity for adult induction therapy remain unclear. This systematic review and meta-analysis aimed to assess the effectiveness of etoposide-based induction therapy in adult HLH, focusing on overall response (OR). A systematic literature search was conducted to identify relevant studies on 11 December 2023, resulting in the inclusion of seven studies in the analysis. The pooled data demonstrated a significant improvement in OR with etoposide-based therapy in adult patients with HLH (1.95, 95% CI 1.51-2.53), compared with non-etoposide-treated patients. Furthermore, overall survival improved with etoposide treatment (1.25, 95% CI 1.03-1.52). Our analysis revealed the potential benefit of etoposide-based therapy in adult patients with HLH. Therefore, etoposide should be considered as a timely and early therapeutic option for the management of adult HLH.</p>","PeriodicalId":10337,"journal":{"name":"Clinical and Experimental Medicine","volume":"25 1","pages":"58"},"PeriodicalIF":3.2,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of the entosis-related prognostic signature and tumour microenvironment in hepatocellular carcinoma on the basis of bioinformatics analysis and experimental validation.","authors":"Chen Wu, Shixu Fang, Liangliang Wu, Zhengcheng Mi, Yao Yin, Yuan Liao, Yongxiang Zhao, Tinghua Wang, Jintong Na","doi":"10.1007/s10238-025-01580-8","DOIUrl":"10.1007/s10238-025-01580-8","url":null,"abstract":"<p><p>Liver cancer ranks among the deadliest cancers worldwide. Entosis, a recently uncovered method of cell death, has not yet been fully explored for its relevance to HCC. A bioinformatics analysis was performed to determine the expression and mutational landscapes of Entosis-related genes (ERGs). A subset of differentially expressed Entosis-related genes (DEERGs) was generated. A risk model for entosis was subsequently constructed employing LASSO and Cox regression methodologies. The correlations among ERGs, genes associated with risk, the developed risk model, and the immune context of the tumour were explored. Furthermore, the study investigated the varying drug sensitivities between high-risk and slight-risk patient groups. The expression patterns of four pivotal risk genes were delineated via qRT‒PCR and WB. A prognostic model comprising four DEERGs (KIF18A, SPP1, LCAT and TRIB3) was developed. The ability of this model to predict the survival outcomes of patients with HCC was confirmed through receiver operating characteristic curve analysis. Patients were grouped according to their risk assessments, revealing that the low-risk population demonstrated a more favourable survival outcome than did the high-risk population. The high-risk population presented reduced tumour stroma, immune and ESTIMATE scores, along with an increased proportion of cancer stem cells and tumour mutation burden. Additionally, a connection between the risk model and the responsiveness of various chemotherapy drugs as well as the efficacy of immunotherapies in patients was noted. These findings provide significant guidance for the development of targeted clinical treatment strategies. qRT‒PCR and WB analysis revealed that the gene expression of KIF18A and SPP1 were elevated in HCCLM3 cells compared with that in THLE2 cells; whereas, the expression level of LCAT and TIRB3 was decreased. The four genes KIF18A, SPP1, LCAT and TRIB3 could effectively predict the survival prognosis of patients with liver cancer. KIF18A and SPP1 were elevated in HCC tissues compared with that in THLE2 cells.</p>","PeriodicalId":10337,"journal":{"name":"Clinical and Experimental Medicine","volume":"25 1","pages":"55"},"PeriodicalIF":3.2,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11821697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Value of semi-quantitative scoring based on musculoskeletal ultrasound in diagnosis and disease assessment of gouty arthritis.","authors":"Panke Zhang, Dan Li, Dongyu Li","doi":"10.1007/s10238-025-01568-4","DOIUrl":"10.1007/s10238-025-01568-4","url":null,"abstract":"<p><p>To explore value of semi-quantitative scoring based on musculoskeletal ultrasound in diagnosis and disease assessment of gouty arthritis (GA). Ninety patients with suspected GA who received in our hospital from January 2022 to December 2023 were retrospectively selected as the study objects. The puncture results of joint synovial fluid or crystal material in the joint cavity were used as the gold standard, and the patients 'joint effusion, synovitis, bone erosion and tenosynovitis were counted. Compare the musculoskeletal ultrasound semi-quantitative score with the puncture results of joint synovial fluid or crystal material in the joint cavity to diagnose different pathological types of GA and evaluate the diagnostic efficiency of musculoskeletal ultrasound semi-quantitative score in diagnosing different pathological types of GA. Use correlation analysis to analyze the correlation between patients with the musculoskeletal ultrasound semi-quantitative score results, IL-6 and DAS28 scores, and typical musculoskeletal ultrasound and MRI examination results. There was no significant difference between the musculoskeletal ultrasound semi-quantitative score and the puncture results of joint synovial fluid or crystal material in the joint cavity. There was no significant difference between the examination results of different lesion types (P > 0.05). The puncture results of joint synovial fluid or crystal material in the joint cavity were used as the gold standard, the sensitivity of musculoskeletal ultrasound semi-quantitative scoring in diagnosing synovial thickening, joint effusion, bone erosion, and tendon/tendon sheath inflammation in GA patients was 92.86% (26/28), 96.00% (24/25), 95.24% (20/21), and 75.00% (12/16), respectively. The specificity values were 93.55% (58/62), 96.92% (63/65), 95.65% (66/69), and 98.65% (73/74) respectively. The accuracy rates were 93.33% (84/90), 96.67% (87/90), 95.56% (86/90), and 94.44% (85/90), respectively. According to Pearson linear correlation analysis, as the semi-quantitative scoring increased, there was a positive correlation with erythrocyte sedimentation rate, IL-6, and DAS28 scores (r = 0.729, 0.584, 0.773, P < 0.001). Observation of their serological indicators showed that there were significant differences in serological indicators between patients with different semi-quantitative scores (P < 0.05). Semi-quantitative scoring based on musculoskeletal ultrasound has high value in the diagnosis and assessment of gouty arthritis, and is worth further use.</p>","PeriodicalId":10337,"journal":{"name":"Clinical and Experimental Medicine","volume":"25 1","pages":"56"},"PeriodicalIF":3.2,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11821689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long non-coding RNAs (lncRNAs) in cancer development: new insight from STAT3 signaling pathway to immune evasion.","authors":"Lie Ma, XuQing Liu, R Roopashree, Syeda Wajida Kazmi, Saade Abdalkareem Jasim, K Phaninder Vinay, Ata Fateh, Fang Yang, Mansour Rajabivahid, Mahmoud Dehghani-Ghorbi, Reza Akhavan","doi":"10.1007/s10238-024-01532-8","DOIUrl":"10.1007/s10238-024-01532-8","url":null,"abstract":"<p><p>Overcoming cancer and enhancing patient survival are becoming increasingly challenging due to the uncontrolled growth and metastasis of colorectal cancer cells. In order to provide effective cancer treatment and minimize the malignancy of cancer cells, it is necessary to understand how complex signaling networks contribute to their invasion and proliferation. The signal transducer and activator of transcription 3 (STAT3) is a promising target due to its involvement in various cellular functions, including apoptosis, immunosuppression, cell invasion, migration, and proliferation. Dysregulation of STAT3 signaling is associated with diseases, particularly colorectal cancer. Long non-coding RNAs (lncRNAs), a subset of non-coding RNAs, are essential for the progression, apoptosis, and metastasis of CRC as they regulate key signaling pathways such as STAT3 signaling and contribute to gene regulation at the epigenetic, transcriptional, and post-transcriptional levels. Moreover, lncRNAs have a key function in regulating immune cells function through STAT3. In this study, we comprehensively reviewed the regulatory roles of different lncRNAs on STAT3 and the mutual effects of this pathway in various aspects of carcinogenesis, including proliferation, apoptosis, metastasis, drug resistance, and angiogenesis. Moreover, we investigate the effects of lncRNA/STAT3 axis on the function of different immune cells that play critical role in the tumor microenvironment.</p>","PeriodicalId":10337,"journal":{"name":"Clinical and Experimental Medicine","volume":"25 1","pages":"53"},"PeriodicalIF":3.2,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11813976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of BIM gene deletion in ALK-mutated Non-small cell lung cancer treated with alectinib.","authors":"Shuang Hou, Weijun Zhang, Wei Pang, Haiqun Xia, Jinyun Tan, Qingfang Huang, Ping Yang","doi":"10.1007/s10238-025-01579-1","DOIUrl":"10.1007/s10238-025-01579-1","url":null,"abstract":"<p><p>Alectinib, as a first-line therapeutic option for advanced ALK mutation-positive non-small-cell lung cancer (NSCLC), is now widely used in the clinic. However, the associated mechanisms of resistance are unknown. The first documented case of ALK-mutated NSCLC's resistance to alectinib is herein reported in relation to BIM gene deletion status. In particular, cell inhibition assay (CCK8 assay), cell transfection, fluorescence microscopy, RT-PCR, cell proliferation assay, cell migration assay and western blotting were undertaken for exploring the link between BIM status and alectinib resistance. Clinical cases showed that the BIM gene was absent in alectinib-resistant tumor tissues. Further experimental validation yielded that NSCLC with deleted BIM genes were less sensitive to aleitinib. BIM gene deletion can increase resistance to alectinib, and the potential efficacy of a combination of BIM sensitizer and alectinib to overcome alectinib resistance can be explored.</p>","PeriodicalId":10337,"journal":{"name":"Clinical and Experimental Medicine","volume":"25 1","pages":"54"},"PeriodicalIF":3.2,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11814009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experts consensus on 3D-printing template-assisted CT-guided radioactive iodine-125 seed implantation for recurrent soft tissue carcinoma in China.","authors":"Min Li, Xuemin Li, Bin Qiu, Yi Chen, Ping Jiang, Haitao Sun, Yuliang Jiang, Suqing Tian, Kaixian Zhang, Zhe Wang, Ruoyu Wang, Xuequan Huang, Mingwei Huang, Jianguo Zhang, Bin Huo, Xiaodong Huo, Zhe Ji, Junjie Wang","doi":"10.1007/s10238-025-01575-5","DOIUrl":"10.1007/s10238-025-01575-5","url":null,"abstract":"<p><p>Permanent radioactive iodine-125 seed implantation (RISI), known as radioactive seed implantation, is a minimally invasive internal radiation technique. This method involves implanting ¹²⁵I seeds (4.5 × 0.8 mm, encapsulated in a nickel-titanium alloy) into tumors under image guidance. The radionuclide continuously releases low energy γ-rays, effectively killing tumor cells. RISI delivers high local doses with minimal damage to surrounding normal tissues. It is performed through image-guided percutaneous puncture, accompanied by high precision, minimal trauma, and rapid recovery. In Western countries, RISI is primarily utilized for early-stage prostate cancer. In 2002, Professor Junjie Wang introduced computed tomography (CT)-guided technology for RISI, expanding its indications to head and neck, thoracic, abdominal, pelvic, and spinal tumors. In 2014, he proposed the concept of image-guided interventional brachytherapy, advancing minimally invasive brachytherapy. In 2015, he integrated three-dimensional 3D-printing template (3D-PT) with CT-guided technology, significantly enhancing the precision, quality, and efficiency of RISI, and introduced the concept of stereotactic brachytherapy. Over nearly 20 years, RISI has developed into a standardized procedure, involving preoperative planning, intraoperative optimization, and postoperative verification, highlighting its role in comprehensive cancer treatment. The main treatments for soft tissue sarcoma (STS) include surgery or surgery combined with radiotherapy and chemotherapy. However, STS is prone to local recurrence, and effective treatments are lacking after recurrence. Experts have conducted extensive trials on RISI for the treatment of recurrent STS (r-STS), accumulating significant clinical experience. This study aimed to establish standards and consensus on 3D-PT-assisted CT-guided RISI for the treatment of r-STS.</p>","PeriodicalId":10337,"journal":{"name":"Clinical and Experimental Medicine","volume":"25 1","pages":"52"},"PeriodicalIF":3.2,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11811234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143381755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacogenomic insights: IL-23R and ATG-10 polymorphisms in Sorafenib response for hepatocellular carcinoma.","authors":"Asmaa M El-Sheshtawy, Rehab H Werida, Monir Hussein Bahgat, Shahira El-Etreby, Noha A El-Bassiouny","doi":"10.1007/s10238-025-01576-4","DOIUrl":"10.1007/s10238-025-01576-4","url":null,"abstract":"<p><p>Hepatocellular carcinoma (HCC) is the most common primary liver cancer. Sorafenib is the first FDA-approved systemic therapy for advanced HCC. This study investigates the influence of IL-23R (rs7517847) and ATG-10 (rs10514231) genetic polymorphisms on Sorafenib response, survival outcomes, average tolerable dose, and adverse events. This prospective open-label cohort study included 100 HCC patients, assessing IL-23R and ATG-10 genotypes via real-time polymerase chain reaction (RT-PCR). Patient's responses were evaluated using modified RECIST criteria. Statistical analyses evaluated the association of genetic variants with response, progression-free survival (PFS), overall survival (OS), average tolerable Sorafenib dose, and adverse events. IL-23R TT carriers had the highest Sorafenib response rate (80%) compared to GT (13.3%) and GG (6.7%) (P = 0.021), while ATG-10 TT carriers had a 13.9-fold increased response likelihood (P = 0.001). The T allele in ATG-10 significantly predicted longer PFS (P = 0.025) and OS (P = 0.011), suggesting a potential prognostic role. IL-23R GG carriers received significantly higher Sorafenib doses than TT (P = 0.0174) and GT (P = 0.0227), whereas ATG-10 had no effect on dosage. However, its CT genotype was significantly associated with a higher risk of Hand-Foot Syndrome (P = 0.012), and independent of dose (P = 0.0018). IL-23R and ATG-10 polymorphisms influence Sorafenib response, survival, and tolerability in HCC patients. Genetic screening may improve personalized treatment strategies by optimizing Sorafenib efficacy and minimizing toxicity.This trial was registered on clinicaltrials.gov with registration number NCT06030895, registered on \"September 11th, 2023,\" retrospectively.</p>","PeriodicalId":10337,"journal":{"name":"Clinical and Experimental Medicine","volume":"25 1","pages":"51"},"PeriodicalIF":3.2,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11807022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of CD4⁺ T cell-derived cytokines in the pathogenesis of uveitis.","authors":"Tingting Meng, Lili Nie, Ying Wang","doi":"10.1007/s10238-025-01565-7","DOIUrl":"10.1007/s10238-025-01565-7","url":null,"abstract":"<p><p>Uveitis refers to a diverse group of inflammatory diseases that affecting the uveal tract, comprising the iris, ciliary body, and choroid, with potential repercussions ranging from visual impairment to blindness. The role of autoimmunity in uveitis etiology is complex and still under investigation. CD4⁺ T cells intricately regulate immune responses in uveitis through their diverse subtypes: Th1, Th2, Th17, Treg (T regulatory), and Tfh (follicular T helper) cells. Each T cell subtype secretes specific cytokines with either pathogenic or protective implications in uveitis. Th1 cells, characterized by IFN-γ secretion and T-bet expression, drive type 1 immune responses against intracellular pathogens. Conversely, Th2 cells, which produce interleukin (IL)-4, IL-5, and IL-13 and express the transcription factor GATA3, mediate type 2 immune responses to larger extracellular threats like helminths. Th17 cells, generating IL-17 and IL-22 and controlled by RORγt, engage in type 3 immune responses against select pathogens. Tfh cells, releasing IL-21 and governed by Bcl6, aid B cell antibody production. Conversely, Tregs, identified by Foxp3, exert regulatory functions in immune homeostasis. This review delves into the roles of CD4⁺ T cell-derived cytokines in uveitis, emphasizing their intricate involvement in disease progression and resolution. Insight into these mechanisms might guide therapeutic approaches targeting CD4⁺ T cell responses in uveitis management.</p>","PeriodicalId":10337,"journal":{"name":"Clinical and Experimental Medicine","volume":"25 1","pages":"49"},"PeriodicalIF":3.2,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11799126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world effectiveness and retention rate of upadacitinib in patients with rheumatoid arthritis: results from a multicentre study.","authors":"Caterina Baldi, Stefano Gentileschi, Francesca Li Gobbi, Massimiliano Cazzato, Andrea Delle Sedie, Carla Gaggiano, Emilio D'Ignazio, Gemma Lepri, Chiara De Lorenzo, Carlotta Nannini, Laura Niccoli, Anna Panaccione, Luca Di Cato, Andrea Di Matteo, Andrea Picchianti-Diamanti, Serena Guiducci, Bruno Frediani, Maurizio Benucci","doi":"10.1007/s10238-025-01578-2","DOIUrl":"10.1007/s10238-025-01578-2","url":null,"abstract":"<p><p>This study evaluates upadacitinib (UPA) effectiveness and drug retention rate (DRR) in patients with rheumatoid arthritis (RA). Multicentre prospective observational study. Consecutive patients with RA receiving UPA were evaluated at 0, 3, 6, 12, 18, and 24 months of treatment. Key outcomes included UPA DRR and changes in clinical and serological measures over time. The study included 215 patients (72.6% female sex, mean age 60.1 ± 11.7 years). The DRR of UPA was 91.6% (95% CI 88.0-95.4%) at 6 months, 84.6% (95% CI 79.8-89.7%) at 12 months, 80.3% (95% CI 75.0-86.0%) at 18 months and 80% (95% CI 75.0-86.0%) at 24 months. UPA DRR was similar between monotherapy and methotrexate combination (p = 0.47), and across different treatment lines (p = 0.58). A statistically significant improvement from baseline was observed over 24 months considering erythrocyte sedimentation rate, C-reactive protein (CRP), Health Assessment Questionnaire (HAQ), Disease Activity Score (DAS)28-CRP, Physician's (Ph) and Patient's (Pt) Global Assessment (GA), Visual Analogue Scale (VAS) Pain, Simplified and Clinical Disease Activity Index (SDAI and CDAI) (p < 0.00 for all of them). Patients discontinuing UPA were more likely to be male (p = 0.02), with a longer disease duration (p = 0.03), higher baseline values of VAS Pain (p < 0.00), PtGA (p < 0.00), PhGA (p < 0.00), CDAI (p < 0.00), SDAI (p < 0.00) and corticosteroid dosage (p = 0.04). This study confirms UPA effectiveness in managing RA in the real-world practice, demonstrating sustained drug retention and improvements in clinical and laboratory measures over time. Also, UPA could be a valuable option for patients with multi-refractory RA and when monotherapy is preferred.</p>","PeriodicalId":10337,"journal":{"name":"Clinical and Experimental Medicine","volume":"25 1","pages":"50"},"PeriodicalIF":3.2,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11799029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinicopathologic predictors of renal response and survival in newly diagnosed multiple myeloma with renal injury: a retrospective study.","authors":"Wei Wei, Haotian Shi, Haimin Chen, Xiaoling Chen, Rong Peng, Wenjun Yu, Lixia Wu, Nian Zhou, Wenhao Zhao, Weiwei Xu, Yan Zhou, Jingjing Yu, Daolin Wei, Fan Zhou","doi":"10.1007/s10238-025-01571-9","DOIUrl":"10.1007/s10238-025-01571-9","url":null,"abstract":"<p><p>Renal impairment (RI) is a common complication of multiple myeloma (MM), which is associated with poor prognosis. Here, we revealed the association between regular examination data and RI incidence, RI response and survival in newly diagnosed multiple myeloma (NDMM) patients. A retrospective analysis was conducted on the initial clinical data of 647 NDMM patients, comprising 193 patients (29.83%, 193/647) with RI and 454 (70.17%, 454/647) without RI at diagnosis. Logistic regression analyses, both univariate and multivariate, were performed to identify the independent influencing factors of RI with bootstrap techniques and resampling. The model used to predict the RI response was established using the support vector machine-recursive feature elimination (SVM-RFE) machine learning algorithms. Six variables identified by multi-factorial logistic regression analysis were independently associated with the incidence of RI, including the secreted monoclonal immunoglobulin of IgG type (33.16% vs. 52.64%), deregulated serum free κ/λ light chain (58.12% vs. 33.93%), elevated serum calcium (> 2.65 mmol/L, 31.61% vs. 11.01%), elevated urea (≥ 8.3 mmol/L, 92.23% vs. 20.26%), elevated uric acid (≥ 340 μmol/L, 74.61% vs. 35.46%), and ISS (International Staging System) stage of III (90.16% vs. 31.50%). The lactate dehydrogenase (≥ 250 U/L; HR = 1.786, P = 0.005) and CKD (chronic kidney disease) stage (G4-G5; HR = 5.830, P = 0.016) were the independent adverse factors of the overall survival of NDMM patients with RI. In addition, this study provided a model to predict the response of RI using 5 clinical features, including calcium, Durie-Salmon (DS) stage, creatinine level before treatment, age and gender. The sensitivity, specificity, area under the curve (AUC) and accuracy were 86.75%, 51.15%, 78.30% and 72.99% in the training group, while 79.31%, 52.94%, 72.40% and 69.57% in the validation group. In conclusion, this study clarified the relationship between clinicopathologic characteristics and the incidence of renal injury, response and survival of NDMM patients, supporting clinical decision-making, and offering significant clinical application value.</p>","PeriodicalId":10337,"journal":{"name":"Clinical and Experimental Medicine","volume":"25 1","pages":"48"},"PeriodicalIF":3.2,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11794406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}