European Journal of Medical Research最新文献

{"title":"J-shaped association between blood urea nitrogen-to-creatinine ratio and mortality in critically ill patients with acute pancreatitis: a retrospective cohort study using the MIMIC-IV database.","authors":"Yu Wan, Qiong Hu, Jing Shi, Limei Liu, Xiangsong Zhang, Jianjun Huang, Haijiu Wang","doi":"10.1186/s40001-025-02430-9","DOIUrl":"10.1186/s40001-025-02430-9","url":null,"abstract":"<p><strong>Background: </strong>Both blood urea nitrogen (BUN) and creatinine (Cr) are indicators of kidney function, and the BUN/Cr ratio has been identified as an independent prognostic marker for adverse outcomes in critically ill patients with various conditions. However, the relationship between the BUN/Cr ratio and long-term mortality in critically ill patients with acute pancreatitis (AP) remains unclear. Hence, the primary objective of this study was to determine the prognostic value of the BUN/Cr ratio in patients with AP.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using data from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. The primary exposure variable was the BUN/Cr ratio at intensive care unit (ICU) admission, and the primary outcome was 365-day all-cause mortality. Kaplan-Meier analyses and multivariate Cox proportional hazards models were used to assess this relationship, while restricted cubic spline (RCS) was used to explore potential non-linear associations. In addition, subgroup analyses were conducted to assess consistency between groups.</p><p><strong>Results: </strong>A total of 850 critically ill patients with AP were included, with a mean age of 59.61 years, 58.59% male, and an overall 365-day mortality rate of 20.94%. Patients in the highest BUN/Cr quartile had significantly higher mortality rates compared to those in lower quartiles. Multivariate Cox regression analysis demonstrated that, even after adjusting for potential confounders, an elevated BUN/Cr ratio remained an independent predictor of increased 28-day and 365-day mortality. RCS analysis confirmed a J-shaped relationship between the BUN/Cr ratio and 28-day and 365-day mortality, with a sharp increase in the risk of death above the 16.80 threshold. Subgroup analysis indicated that this association was consistent across various patient characteristics.</p><p><strong>Conclusion: </strong>This study identified a non-linear relationship between the BUN/Cr ratio and 365-day mortality in critically ill patients with AP, suggesting that the BUN/Cr ratio may serve as an easily accessible, cost-effective, and accurate prognostic marker for this population.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"185"},"PeriodicalIF":2.8,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of different pulse widths on acute tibial nerve stimulation for overactive bladder in cats.","authors":"Dongsheng Shang, Haoyu Sun, Han Deng, Gongyue Liu, Limin Liao, Xing Li","doi":"10.1186/s40001-025-02453-2","DOIUrl":"10.1186/s40001-025-02453-2","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to assess the effectiveness of different pulse widths in suppressing bladder overactivity using tibial nerve stimulation (TNS) in cats.</p><p><strong>Methods: </strong>Hook electrodes were implanted on the left tibial nerve. Cystometry was conducted by infusing either acetic acid (AA) or normal saline (NS). TNS was applied at intensities of 2-4 times the threshold (T) with pulse widths ranging from 60 to 624 µsec. Cystometrograms were used to evaluate the impact of different pulse widths on the micturition reflex.</p><p><strong>Results: </strong>Bladder capacity (BC) was significantly reduced to 49.71% ± 6.76% of the NS control level (8.58 ± 1.70 mL) due to AA-induced bladder overactivity (P < 0.001). During AA infusion, TNS at pulse widths of 60, 210, 420, and 624 µsec significantly increased BC to 70.65% ± 9.06%, 73.22% ± 6.28%, 73.79% ± 8.56%, and 76.25% ± 7.95% of the NS control level, respectively (P < 0.001). No significant differences were observed among the four pulse widths (P > 0.05). The threshold intensity (T) was higher at 60 µsec than at 624 µsec (P < 0.01), while T at 210 µsec, 420 µsec, and 624 µsec showed no significant differences (P > 0.05).</p><p><strong>Conclusions: </strong>All four pulse widths demonstrated inhibitory effects on bladder overactivity. However, no significant differences were observed among the four pulse widths.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"186"},"PeriodicalIF":2.8,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The biomechanical study of different fixation techniques for combination fractures of atlas and axis: a finite element analysis.","authors":"Chao Liu, Kai Huang, Lei Dai, Xiaogang Huang, Xinjun Zhang","doi":"10.1186/s40001-025-02459-w","DOIUrl":"10.1186/s40001-025-02459-w","url":null,"abstract":"<p><p>Combination atlas-axis fractures are less studied but relatively common with a higher incidence of neurological deficits than isolated C1 or C2 fractures. Several authors focused on the treatment strategies, but there is no study to compare the stability of different fixation methods; neither not yet clear which technique represents the best choice and whether stabilization devices can be efficient and beneficial for complex atlantoaxial fractures. The aim of this study was to compare the biomechanical properties of three fixation techniques: atlantoaxial pedicle screws fixation (PSF), occipital-cervical fusion (OCF) and transarticular screw fixation (TSF) based on combination factures model. Our results showed the range of motion (ROM) of fracture model increased obviously than intact model. The ROM in flexion/extension and rotation of C0-C1 in PSF and TSF models were increased. The ROM of C1-C2 in all conditions in PSF, OCF and TSF models were decreased. The ROM of C2-C3 was decreased in OCF, but remains the same stage in PSF and TSF. These suggested that three surgical methods are effective for the combination fractures of atlas and axis, which can ensure good stability. It can properly increase the ROM of C0-C1 when using PSF. These findings would aid in the treatment of this complex fractures.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"184"},"PeriodicalIF":2.8,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic lavage in a purulent peritonitis model: impact on inflammatory proteins.","authors":"Erik Sinclair, Maria K Magnusson, Eva Angenete, Mattias Prytz, Viktor Tasselius, Lena Öhman, Eva Haglind","doi":"10.1186/s40001-025-02445-2","DOIUrl":"10.1186/s40001-025-02445-2","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic lavage is an effective, safe, and feasible treatment in patients with perforated diverticulitis with purulent peritonitis. Laparoscopic lavage was introduced without any detailed knowledge regarding the mechanisms of action. The aim of this study was to validate the reproducibility of an animal model of purulent peritonitis and to study the effect of laparoscopic lavage on inflammatory proteins in this model.</p><p><strong>Methods: </strong>Forty rats, divided into eight groups (n = 5) were operated. Six groups underwent cecal ligation and puncture (CLP) causing peritonitis and two groups underwent sham surgery. Three CLP and one sham group received laparoscopic lavage, while the remaining groups acted as time-matched controls. Samples of abdominal fluid and blood were collected after 1, 2 or 3 h and analyzed regarding 92 inflammatory proteins using Olink Target 96 Mouse exploratory panel.</p><p><strong>Results: </strong>Animals with peritonitis had higher levels of inflammatory proteins such as CCL3, IL17A and IL6 in abdominal fluid and serum compared to sham. The groups treated with laparoscopic lavage had lower levels of inflammatory proteins in both abdominal fluid and serum compared with untreated peritonitis groups, results were most distinct sampled after one hour.</p><p><strong>Conclusion: </strong>Our animal model is reproducible, and mimics perforated diverticulitis with purulent peritonitis with increased levels of inflammatory proteins in abdominal fluid and serum. The levels of several inflammatory proteins were lower following laparoscopic lavage treatment perhaps indicating the physiological effect of laparoscopic lavage. This model can be used to further explore the mechanisms involved in peritonitis and laparoscopic lavage treatment.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"180"},"PeriodicalIF":2.8,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11917159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting diabetic retinopathy based on routine laboratory tests by machine learning algorithms.","authors":"Xiaohua Wan, Ruihuan Zhang, Yanan Wang, Wei Wei, Biao Song, Lin Zhang, Yanwei Hu","doi":"10.1186/s40001-025-02442-5","DOIUrl":"10.1186/s40001-025-02442-5","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to identify risk factors for diabetic retinopathy (DR) and develop machine learning (ML)-based predictive models using routine laboratory data in patients with type 2 diabetes mellitus (T2DM).</p><p><strong>Methods: </strong>Clinical data from 4259 T2DM inpatients at Beijing Tongren Hospital were analyzed, divided into a model construction data set (N = 3936) and an external validation data set (N = 323). Using 39 optimal variables, a prediction model was constructed using the eXtreme Gradient Boosting (XGBoost) algorithm and compared with four other algorithms: support vector machine (SVM), gradient boosting decision tree (GBDT), neural network (NN), and logistic regression (LR). The Shapley Additive exPlanation (SHAP) method was employed to interpret the XGBoost model. External validation was performed to assess model performance.</p><p><strong>Results: </strong>DR was present in 47.69% (N = 1877) of T2DM patients in the model construction data set. Among the models tested, the XGBoost model performed best with an AUC of 0.831, accuracy of 0.757, sensitivity of 0.754, specificity of 0.759, and F1-score of 0.752. SHAP explained feature importance for XGBoost model and identified key risk factors for DR. External validation yielded an accuracy of 0.650 for the XGBoost model.</p><p><strong>Conclusions: </strong>The XGBoost-based prediction model effectively assesses DR risk in T2DM patients using routine laboratory data, aiding clinicians in identifying high-risk individuals and guiding personalized management strategies, especially in medically underserved areas.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"183"},"PeriodicalIF":2.8,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do CRP gene variants and smoking elevate recurrent stroke risk in minor ischemic stroke patients?","authors":"Xiaofeng Li, Shina Song, Wenhui Jia, Zhijie Shi, Lihua Xie, Meilin Fan, Changxin Li","doi":"10.1186/s40001-025-02355-3","DOIUrl":"10.1186/s40001-025-02355-3","url":null,"abstract":"<p><strong>Background: </strong>Minor ischemic strokes, despite their initial mild symptoms, pose a significant risk of recurrence, potentially leading to severe disability. The role of C-reactive protein (CRP) gene variants in predicting the recurrent minor stroke, particularly their interaction with lifestyle factors such as smoking, remains unclear. We aimed to investigate the relationship of single-nucleotide polymorphisms (SNPs) in CRP gene with minor stroke recurrence, focusing on gene-environment interactions.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted using data from the stroke registry at Linfen People's Hospital, including 2032 first-time minor stroke patients (NIHSS score ≤ 5) admitted within 7 days of symptom onset from January 2019 to December 2022. Follow-up assessments were conducted every 3 months for one year. Based on recurrence during follow-up, participants were classified into Recurrence and Non-recurrence group. Genomic DNA was extracted for genotyping four CRP gene SNPs: rs1130864, rs1800947, rs2808632, and rs3093059. Genetic associations with the stroke recurrence were analyzed using additive, dominant, recessive genetic and allelic models. Generalized Multifactor Dimensionality Reduction (GMDR) was employed to explore the complex interaction of these SNPs with smoking status. Multivariate logistic regression was used to estimate the strength of these associations.</p><p><strong>Results: </strong>Our study recruited 261 participants who experienced recurrent minor strokes and 264 age- and sex-matched controls without recurrence. The A allele of rs2808632 (P = 0.002) and C allele of rs3093059 (P = 0.001) were significantly associated with an increased risk of stroke recurrence. Participants with the combined genotypes rs2808632 CA + AA and rs3093059 TC + CC had a 1.325-fold higher risk of recurrence when compared to those with the genotypes rs2808632 CC and rs3093059 TT (P = 0.003). Additionally, among smokers, the rs3093059 TC + CC genotypes were associated with a 2.467-fold increased risk of recurrence compared to non-smokers with TT genotype (P < 0.001).</p><p><strong>Conclusion: </strong>The rs2808632 and rs3093059 polymorphisms independently and interactively contribute to an increased risk of recurrent minor stroke. Furthermore, the interaction between rs3093059 SNP and smoking status significantly influenced stroke recurrence, highlighting the importance of considering both genetic and environmental factors in predicting the risk of minor stroke recurrence.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"179"},"PeriodicalIF":2.8,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11916976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of controlled decompression against conventional decompression methods for the management of severe traumatic brain injury patients: a meta-analysis.","authors":"Xinli Wang, Li Gu, Jianhui Sun, Bo Zhang, Guiyang Liu","doi":"10.1186/s40001-025-02428-3","DOIUrl":"10.1186/s40001-025-02428-3","url":null,"abstract":"<p><strong>Background: </strong>Severe traumatic brain injury (TBI) presents significant management challenges, with decompressive surgery being a critical intervention. This review aimed to evaluate the efficacy of controlled decompression versus conventional decompression techniques in managing severe TBI across multiple outcomes.</p><p><strong>Methods: </strong>A comprehensive search of electronic databases (PubMed Central, SCOPUS, EMBASE, Chinese national knowledge infrastructure, Cochrane trial registry, WHO trials platform) was conducted to identify studies comparing controlled decompression with conventional methods in severe TBI patients. Pooled analysis was done using a random-effects model with inverse variance technique.</p><p><strong>Results: </strong>Thirteen studies were included. Controlled decompression significantly reduced mortality (OR 0.498, 95% CI 0.321-0.773, p = 0.002), postoperative complications (OR 0.283, 95%CI: 0.205-0.390, p < 0.0001), cerebral infarction (OR 0.488, 95% CI 0.293-0.813, p = 0.006), and brain swelling (OR 0.409, 95% CI 0.252-0.661, p < 0.0001). Improvements were also observed in favorable outcomes (OR 1.822, 95% CI 1.211-2.740, p = 0.004), prognosis (OR 2.488, 95%CI 1.292-4.792, p = 0.006), and total effective rate (OR 6.549, 95% CI 1.852-23.153, p = 0.004). Minimal heterogeneities were found across outcomes, although the quality of evidence was downgraded to low due to higher risk of bias across most studies.</p><p><strong>Conclusions: </strong>Controlled decompression significantly improves outcomes in severe TBI patients compared to conventional methods. Future high-quality, multicenter randomized controlled trials are recommended to confirm these findings and guide clinical practice.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"181"},"PeriodicalIF":2.8,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating allergen-specific IgE distribution and correlations in chronic urticaria: a retrospective study in Shanghai, China.","authors":"Jiaqin Zhang, Yijie Tang, Dandan Yang, Jiajie Yu","doi":"10.1186/s40001-025-02437-2","DOIUrl":"10.1186/s40001-025-02437-2","url":null,"abstract":"<p><strong>Background: </strong>Chronic urticaria (CU) is a persistent skin condition characterized by recurring episodes triggered by diverse allergens and a multifaceted causative nature. The present study aimed to retrospectively explore the distribution patterns and correlations of specific IgE (sIgE) antibodies with various allergens among patients with CU.</p><p><strong>Methods: </strong>For this purpose, the present study enrolled 820 patients with CU treated at Shanghai Skin Disease Hospital from July 2020 to September 2023. Serum samples were assessed for allergen sIgE antibodies via an immunodiagnostic assay. Chi-square tests were used to examine the differences in allergen sIgE antibody distribution across the sex and age groups. Spearman's correlation analysis was used to investigate the correlations between different allergens.</p><p><strong>Results: </strong>Among the 820 patients with CU, 705 presented positive results for at least one sIgE antibody. Concerning sex, no significant disparities were observed in food allergen distribution; however, males presented notably higher storage mites and Aspergillus levels than females. Age stratification revealed that adolescents had significantly higher positivity rates for milk, egg yolk, house dust mites, storage mites, cat and dog dander, and timothy grass than adults and elderly patients. The correlation coefficient between house dust mites and storage mites reached 0.81. However, correlations among distinct food allergens mostly remained below 0.3, barring sesame and mixed fruits, which was a weak correlation (r = 0.31). The correlations between food and inhaled allergens ranged from 0.3 to 0.5, suggesting a relatively weak association.</p><p><strong>Conclusions: </strong>There were no sex disparities in the distribution of ingestible allergens, yet adolescents presented higher positivity rates than the other age groups. The associations among food allergens, as well as food and inhaled allergens, were relatively weak. Trial registration Retrospectively registered.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"182"},"PeriodicalIF":2.8,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comprehensive review of the clinical presentation, diagnosis, and treatment of calcineurin inhibitor-induced pain syndrome.","authors":"Toufik Abdul-Rahman, Ranferi Eduardo Herrera-Calderón, Jann Ludwig Mueller-Gomez, Maximillian Wolfson, Marcos Lisbona-Buzali, Tamara Mena-Guerrero, Muhammad Hamza Shah, Andrea Paola Munoz-Villalvazo, Mrinmoy Kundu, Marija Zivcevska, Ogungbemi Evelyn Faith, Andrew Awuah Wireko, Ana Luisa Ek, Inibehe Ime Okon, Athanasios Alexiou","doi":"10.1186/s40001-025-02357-1","DOIUrl":"10.1186/s40001-025-02357-1","url":null,"abstract":"<p><p>Calcineurin inhibitor-induced pain syndrome (CIPS), a rare but recognized complication of calcineurin inhibitor (CNI) therapy in transplant recipients, presents as severe bilateral lower extremity pain. This syndrome, first described in 1989, primarily affects patients receiving tacrolimus or cyclosporine. Proposed mechanisms include intraosseous vasoconstriction, bone marrow edema, and altered bone metabolism, possibly involving TRSK channels and NFAT signaling. The diagnosis relies on clinical history, characteristic pain patterns, and imaging findings such as bone marrow edema on MRI. The management of CIPS revolves around reducing or discontinuing the offending CNI while maintaining immunosuppression. Alternative immunosuppressants like mammalian target rapamycin (mTOR) inhibitors or mycophenolate mofetil are considered to mitigate symptoms. Symptomatic relief includes calcium channel blockers, bisphosphonates, and analgesics like NSAIDs or opioids. Physical therapy and close monitoring are also integral to improving outcomes and managing chronic pain effectively in affected transplant recipients. This review synthesizes current knowledge on CIPS, highlighting diagnostic challenges, treatment options, and areas for future research to optimize clinical management and enhance patient outcomes.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"177"},"PeriodicalIF":2.8,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiomics and prognostic nutritional index for predicting postoperative survival in esophageal carcinoma.","authors":"Weiwei Luo, Jindong Dong, Jiaying Deng, Tong Tong, Xiangxun Chen, Yichun Wang, Fan Wang, Liyang Zhu","doi":"10.1186/s40001-025-02358-0","DOIUrl":"10.1186/s40001-025-02358-0","url":null,"abstract":"<p><strong>Background: </strong>Surgery offers the potential for a radical cure and prolonged survival in individuals diagnosed with esophageal squamous cell carcinoma (ESCC). However, survival rates exhibit significant variability among patients. Accurately assessing surgical outcomes remains a critical challenge. This study aimed to evaluate the predictive value of preoperative radiomics and the prognostic nutritional index for individuals with ESCC and to develop a comprehensive model for estimating postoperative overall survival (OS) in these patients.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 466 patients with ESCC from two medical centers. The dataset was randomly divided into a training cohort (TC, hospital 1, 246 cases), an internal validation cohort (IVC, hospital 1, 106 cases), and an external validation cohort (EVC, hospital 2, 114 cases). Radiological features were extracted after delineating the region of interest, followed by the application of the least absolute shrinkage and selection operator (LASSO) regression to identify optimal radiomics features and compute the radiomics score (RS). Independent prognostic factors identified via Cox regression analysis were incorporated with the RS to construct a combined nomogram. The predictive performance of the model was evaluated using the concordance index, time-dependent receiver operating characteristic (ROC) curves, calibration plots, and decision curve analysis.</p><p><strong>Results: </strong>The predictive model, which integrated preoperative radiomics, the prognostic nutritional index, and tumor-node-metastasis (TNM) staging to estimate the 3 year OS rate, achieved area under the ROC curve (AUC) values of 0.812, 0.786, and 0.810 in the TC, IVC, and EVC, respectively, demonstrating excellent prognostic accuracy. These values surpassed the AUCs of the TNM staging model in the TC, IVC, and EVC, which were 0.717, 0.612, and 0.699, respectively. The combined model's concordance indexes in the TC, IVC, and EVC were 0.780, 0.760, and 0.764, respectively. Calibration and decision curves highlighted the nomogram's superior calibration and clinical utility.</p><p><strong>Conclusion: </strong>This study developed a predictive model by combining radiomics with the prognostic nutritional index, enabling the estimation of OS in postoperative patients with ESCC. This model holds promise as a tool for preoperative risk stratification.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"178"},"PeriodicalIF":2.8,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}