Journal of thoracic disease最新文献

{"title":"Construction of a multigenic diagnostic, prognostic, and immune infiltration model with methylation-associated regulators in esophageal squamous cell carcinoma.","authors":"Xing Liu, Feng Shen, Ting Wang, Jingru Li, Xiaowei Sheng, Yulan Deng, Xuewei Zhang, Bing Zhao, Ying Zhou, Peng Shang, Xinyi Shi, Zilong Zhao, Zhonglin Yu, Sarbajit Mukherjee, Anwaar Saeed, Jing Liu","doi":"10.21037/jtd-2025-341","DOIUrl":"10.21037/jtd-2025-341","url":null,"abstract":"<p><strong>Background: </strong>Methylation-related regulators may be involved in the prognostic prediction of esophageal squamous cell carcinoma (ESCC). Our study aimed to apply bioinformatics to screen methylation-related regulators for the construction of a prognostic model for patients with ESCC and to assess their diagnostic value and correlation with immune infiltration.</p><p><strong>Methods: </strong>Prognosis-related genes were identified from The Cancer Genome Atlas (TCGA) database. Methylation-associated genes were filtered using the GeneCards database. We used the least absolute shrinkage and selection operator (LASSO) and Cox proportional hazards regression to identify the prognostic indicators. We applied the single-sample gene set enrichment analysis (ssGSEA) to clarify the relationship between prognostic indicators and immune infiltration in patients with ESCC (n=82).</p><p><strong>Results: </strong>We constructed a prognostic model using methylation-related regulators homocysteine-inducible ER protein with ubiquitin-like domain 1 (<i>HERPUD1</i>), trans-2,3-enoyl-CoA reductase (<i>TECR</i>), melanoma antigen gene A11 (<i>MAGEA11</i>), and NOP2/Sun RNA methyltransferase 6 (<i>NSUN6</i>) to evaluate the prognosis of patients with ESCC. A higher prognostic risk score was associated with shorter overall survival (OS) in patients with ESCC [hazard ratio (HR) =5.77, 95% confidence interval (CI): 2.13-15.58; P<0.001]. Time-dependent area under the curve (AUC) analysis revealed that <i>HERPUD1, TECR, MAGEA11</i>, and <i>NSUN6</i> had high prognostic predictive value at different time points. Furthermore, we found that the combined diagnostic model based on <i>HERPUD1, TECR, MAGEA11</i>, and <i>NSUN6</i> had excellent diagnostic efficacy for ESCC (AUC =0.911; 95% CI: 0.888-0.935). Finally, the ssGSEA algorithm showed that <i>HERPUD1</i> was significantly positively correlated with immune infiltration at both the cellular and genetic levels, while <i>TECR</i> showed a significant negative correlation with immune infiltration levels.</p><p><strong>Conclusions: </strong>Our prognostic model, built with the methylation-related regulators <i>HERPUD1, TECR, MAGEA11</i>, and <i>NSUN6</i>, could effectively predict prognosis in patients with ESCC, enhance diagnostic efficacy, and reflect immune cell infiltration in their microenvironment. Our findings are hypothesis generating and larger confirmatory studies are needed to validate our results.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 4","pages":"2605-2622"},"PeriodicalIF":2.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120053","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":"Preventive effect of Lianhua Qingwen capsule on close contacts of seasonal influenza in residential environments: protocol for a multicenter, randomized, double-blind, placebo-controlled study.","authors":"Yangqing Zhan, Zhonghao Fang, Yinhong Hu, Jincan Luo, Lili Hou, Yilin Li, Qiexinhao Li, Yuyue Liu, Chuoqi Yang, Shiwei Liang, Kun Zhao, Nanshan Zhong, Zifeng Yang","doi":"10.21037/jtd-24-1542","DOIUrl":"10.21037/jtd-24-1542","url":null,"abstract":"<p><strong>Background: </strong>Seasonal influenza poses a high risk of death worldwide. Lianhua Qingwen (LHQW) is effective in shortening the time to symptom alleviation in patients with influenza, but there is a lack of convincing clinical trials targeting influenza prevention. This study aims to evaluate both efficacy and safety of LHQW in the preventing spread of seasonal influenza among close contacts under a cluster setting.</p><p><strong>Methods: </strong>This study is a randomized, double-blind, multicenter clinical trial to evaluate the preventive efficacy and safety of LHQW in close contacts in a residential environments; 1,884 close contacts will be enrolled in this trial at 72 centers in China, with a five-day duration of LHQW or placebo. All participants were randomized into the LHQW and placebo groups in a 1:1 ratio via the interactive web response system (IWRS), balanced by the stochastic minimization method. Participants are required to undergo three visits (on days 3, 5, and 9 after initiation of medication). At each visit, a throat swab is collected from the participant, and RT-PCR is used to detect influenza virus nucleic acid. Symptom scoring will be performed nightly for the duration of the trial. The primary efficacy outcome was the secondary infection risk in close contacts on day 9 (±1) after medication. Safety outcomes are the incidence and severity of adverse events. This study used a randomized, double-blind, multicenter design method to evaluate the efficacy and safety of LHQW for close contacts in a congregate setting with risks of seasonal influenza transmission, to provide a valuable reference for clinical application. The treatment period of this study was five days and 1,884 close contacts were enrolled. All cases were randomized into experimental and placebo groups as index cases, and each subject returned three times during the treatment period on days 3, 5 and 9 after drug or placebo treatment, respectively, and the corresponding examinations were performed to evaluate the effect of the drug. Symptom scoring will be performed nightly for the duration of the trial.</p><p><strong>Discussion: </strong>This trial is the first seasonal influenza prevention study of traditional Chinese medicines concerning prophylactic effects globally. Positive findings could demonstrate the efficacy of LHQW against seasonal influenza, which provides a new therapeutic option for infection prevention, symptom alleviation, cost reduction, and renewal of treatment guideline.</p><p><strong>Trial registration: </strong>The trial has been registered at Chinese Clinical Trial Registry (ChiCTR2300074385).</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 4","pages":"2623-2633"},"PeriodicalIF":2.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120187","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":"Impact of biopsy number and radiologic pattern on diagnostic yield and complications of transbronchial lung cryobiopsy in interstitial lung diseases: a multi-center retrospective study.","authors":"Ranxun Chen, Lulu Chen, Hui Ge, Qingqing Xu, Qi Zhao, Yingwei Zhang, Fanqing Meng, Hourong Cai, Shuhong Guan, Chong Li, Lingfeng Min, Bi Chen, Jinghong Dai","doi":"10.21037/jtd-2024-1933","DOIUrl":"10.21037/jtd-2024-1933","url":null,"abstract":"<p><strong>Background: </strong>Given that transbronchial lung cryobiopsy (TBLC) is recommended as a surrogate for surgical lung biopsy (SLB) in the diagnosis of interstitial lung disease (ILD), few studies have evaluated the optimal number of biopsy sample or the impact of radiologic pattern on the diagnostic yield and postoperative complications. This study aimed to investigate how biopsy sample number and radiologic patterns affect diagnostic yield and complications.</p><p><strong>Methods: </strong>We conducted a multi-center retrospective study including 334 consecutive ILD patients who underwent TBLC. The impact of number of biopsy sample and radiologic pattern on diagnosis yields and postoperative complications was assessed. Logistic regression analyses were used to explore the risk factors for complications.</p><p><strong>Results: </strong>The histopathologic and multidisciplinary discussion (MDD) diagnostic yields were 70.06% (234/334) and 86.23% (288/334). Moderate-severe bleeding and pneumothorax occurred in 39 (11.68%) and 29 (8.68%) cases, respectively. The MDD diagnostic yield was higher in patients with non-fibrotic pattern on high-resolution computed tomography (HRCT) compared to those with a fibrotic pattern (88.11% <i>vs</i>. 75.00%, P=0.02). However, the diagnostic yields or postoperative complications were comparable when obtaining three or more than three biopsy samples. Multiple lobe biopsy and number of biopsy samples were associated with bleeding [odds ratio (OR) =3.675, 95% confidence interval (CI): 1.414-9.553, P=0.008; OR =0.649, 95% CI: 0.470-0.895, P=0.009], while a fibrotic pattern increased the risk of pneumothorax (OR =3.479, 95% CI: 1.210-10.005, P=0.02).</p><p><strong>Conclusions: </strong>This study showed that obtaining three biopsy samples is appropriate to achieve an adequate diagnostic yield, while procedure methods are associated with complications. Further well-designed studies are required to standardize TBLC procedures.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 4","pages":"2295-2305"},"PeriodicalIF":2.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119437","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":"Association between reactive cutaneous capillary endothelial proliferation and the efficacy of camrelizumab in esophageal cancer: a retrospective cohort study.","authors":"Yuzi Qiu, Gelan Su, Lan Zhang, Haiyan Fan, Huijin Zhao, Chunyan Wang, Lulu Liu, Bo Chen, Xiaoming Li, Shengmian Li","doi":"10.21037/jtd-2025-366","DOIUrl":"10.21037/jtd-2025-366","url":null,"abstract":"<p><strong>Background: </strong>Reactive cutaneous capillary endothelial proliferation (RCCEP) is a common immune-related adverse event (irAE) related to camrelizumab. This study sought to investigate the relationship between RCCEP and the treatment efficacy of camrelizumab in esophageal cancer (EC), and to explore the risk factors for RCCEP.</p><p><strong>Methods: </strong>This retrospective study collected the data of patients with EC who were treated with camrelizumab between November 2019 and November 2023. The patients were divided into RCCEP-negative groups and RCCEP-positive groups based on the occurrence of RCCEP. Subsequently, the Chi-squared test was applied to analyze the differences in objective response rate (ORR) and disease control rate (DCR) between the two groups. The association between progression-free survival (PFS) or overall survival (OS), and RCCEP was analyzed by the log-rank test. The factors associated with RCCEP were analyzed using univariable and multivariable Logistic regression analyses. Data cutoff was on February 2, 2024.</p><p><strong>Results: </strong>In total, 397 patients were included in this study, of whom 128 (32.24%) suffered from RCCEP. There were no significant differences in the baseline characteristics of the patients in the RCCEP-negative and RCCEP-positive groups. Among the patients with RCCEP, seven had grade 3 RCCEP, and none had grade 4 or 5 RCCEP. Compared with the patients without RCCEP, those with RCCEP had a significantly higher ORR (71.09% <i>vs.</i> 43.87%, P<0.001) and DCR (94.53% <i>vs.</i> 72.49%, P<0.001). In the multivariate Cox analysis, RCCEP was found to be independently associated with longer PFS (P<0.001) and OS (P<0.001). In the univariate Cox analysis of patients with RCCEP, neither RCCEP time nor grade was associated with prolonged PFS and OS. The multivariable logistic regression analysis revealed that more camrelizumab treatment cycles was significantly associated with a higher risk of RCCEP [odds ratio (OR) =1.24; 95% confidence interval (CI): 1.16-1.31] and camrelizumab combined with antiangiogenic therapy was significantly associated with a lower risk of RCCEP (OR =0.24; 95% CI: 0.07-0.86).</p><p><strong>Conclusions: </strong>In the EC patients treated with camrelizumab, those with RCCEP had significantly better outcomes in terms of the ORR, DCR, PFS, and OS than those without RCCEP. The emergence of RCCEP may serve as a potential predictor for the therapeutic efficacy of camrelizumab in the treatment of EC. More camrelizumab treatment cycles and not receiving combined anti-angiogenic therapy were independent risk factors for RCCEP.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 4","pages":"2453-2472"},"PeriodicalIF":2.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119956","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":"Biocompatibility of a novel lung sealant based on functionalized polyoxazolines in an ovine model of parenchymal lung injury.","authors":"Bob P Hermans, Shoko Vos, Wilson W L Li, Erik H F M van der Heijden, Harry van Goor, Ad F T M Verhagen, Richard P G Ten Broek","doi":"10.21037/jtd-24-1733","DOIUrl":"10.21037/jtd-24-1733","url":null,"abstract":"<p><strong>Background: </strong>A lung sealant based on a porcine gelatin carrier impregnated with N-hydroxysuccinimide ester functionalized poly(2)oxazolines (NHS-POx) and nucleophilically activated polyoxazolines (NU-POx) was shown to be efficacious for lung sealing <i>ex-vivo</i> and <i>in-vivo</i>. In the current study, we investigated the local biocompatibility by assessing inflammation, healing, and biodegradability in an ovine model of superficial parenchymal lung injury.</p><p><strong>Methods: </strong>Three groups, NHS-POx, fibrin patch (TachoSil^®) and untreated control, are randomly applied to superficial lesions (3 mm depth) on the right lung (n=3/lung) of adult female domestic sheep, which are sacrificed for blinded histological assessment at 5, 14, and 42 days (n=4 animals per term). Semi-quantitative scoring (scale 0-4) was performed on immune cell subtypes (polymorphonuclear cells, lymphocytes, plasma cells, macrophages, giant cells, necrosis) and biomaterial response (fibrosis, neovascularization, fatty infiltrate). Post-hoc analysis was performed for a suspected labeling mistake and adapted datasets were obtained (6 weeks).</p><p><strong>Results: </strong>The total cell response score was significantly higher for NHS-POx <i>vs.</i> control [score: 11.5 (range, 9-13) <i>vs.</i> 7 (range, 6-8), P=0.005] at 5 days, and for fibrin patch <i>vs.</i> control [score: 14 (range, 12-17) <i>vs.</i> 7 (range, 5-8), P=0.02] at 2 weeks. At 6 weeks, cell response was similar between groups (P=0.22), with outliers due to granulomatous inflammation to residual patch (n=1 fibrin patch and n=1 mix-up sample likely fibrin patch). Wound healing, fibrosis, and neovascularization were similar across groups, showing local pleural thickening. NHS-POx patch showed mesothelial coverage at 2 weeks and was macro- and microscopically completely degraded at 6 weeks with replacement of the patch material with extracellular matrix (adapted data).</p><p><strong>Conclusions: </strong>The NHS-POx patch shows a comparable to favorable biocompatibility profile compared to fibrin patch, and is a potent candidate for clinical lung sealing applications.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 4","pages":"2140-2158"},"PeriodicalIF":2.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119960","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":"Complexity in aortic arch surgery and laws of diminishing return.","authors":"Jeffrey Shuhaiber","doi":"10.21037/jtd-2025-328","DOIUrl":"10.21037/jtd-2025-328","url":null,"abstract":"","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 4","pages":"1798-1801"},"PeriodicalIF":2.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119991","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":"COVID-19 and anticoagulation: evidence from a meta-analysis of randomized controlled trials.","authors":"Yanan Zhou, Yanping Yang, Ying Wang, Dongni Hou, Yuanlin Song","doi":"10.21037/jtd-2025-407","DOIUrl":"10.21037/jtd-2025-407","url":null,"abstract":"","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 4","pages":"2741-2743"},"PeriodicalIF":2.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120068","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":"mTOR and autophagy in acute lung injury pathogenesis and therapeutic potential.","authors":"Zihan Yi, Jiahao Liu, Lanying Shen, Yue Hu","doi":"10.21037/jtd-24-1817","DOIUrl":"10.21037/jtd-24-1817","url":null,"abstract":"<p><p>Acute lung injury (ALI) poses a significant clinical challenge due to its high morbidity and mortality rates. Current treatment options are limited in their efficacy, necessitating the exploration of novel therapeutic targets. The mammalian target of rapamycin (mTOR), a crucial regulator of various cellular processes, has been implicated in the pathogenesis of ALI. Autophagy, a tightly regulated cellular degradation process controlled by mTOR, plays a pivotal role in the pathogenesis of ALI and cellular homeostasis. Mounting evidence also suggests that the mTOR pathway and autophagy play crucial roles in the pathogenesis and regulation of ALI. Herein, we reviewed the current understanding of how mTOR signaling and autophagy intersect in the context of ALI, with a focus on their roles across different cell types. This analysis highlights their dual roles in either promoting pulmonary injury or providing protection, depending on the specific cell types and different ALI models. Insights into the intricate balance between mTOR-mediated pathways and autophagic responses provide a foundation for developing targeted therapeutic strategies aimed at alleviating ALI through the modulation of these pathways. This review underscores the therapeutic potential of targeting mTOR and autophagy, presenting innovative and promising approaches for improving the clinical management and outcomes of ALI.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 4","pages":"2679-2692"},"PeriodicalIF":2.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120079","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":"Prospects of immune checkpoint inhibitor in combination with chemotherapy or chemoradiation in esophago-gastric cancers.","authors":"Takeo Fujita, Daisuke Kajiyama, Yuto Kubo, Kazuma Sato","doi":"10.21037/jtd-2024-2157","DOIUrl":"10.21037/jtd-2024-2157","url":null,"abstract":"","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 4","pages":"1790-1794"},"PeriodicalIF":2.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120219","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":"Relationship between perioperative plasma neutrophil gelatinase-associated lipocalin level and acute kidney injury after acute type A aortic dissection.","authors":"Rutao Guo, Suwei Chen, Yipeng Ge, Yongliang Zhong, Chengnan Li, Zhiyu Qiao, Haiou Hu, Junming Zhu","doi":"10.21037/jtd-24-1804","DOIUrl":"10.21037/jtd-24-1804","url":null,"abstract":"<p><strong>Background: </strong>Acute type A aortic dissection (ATAAD) is a prevalent and life-threatening emergency in cardiovascular surgery. Acute kidney injury (AKI) is a common perioperative complication of ATAAD. The mechanism of occurrence is multi-factor. The traditional assessment of renal function might be postponed and better biomarkers are needed to predict AKI. This study simultaneously evaluated perioperative plasma neutrophil gelatinase-associated lipocalin (NGAL) levels during ATAAD surgery to predict the risk of postoperative.</p><p><strong>Methods: </strong>Total of 104 ATAAD patients were included in this research. Blood samples were collected from the patients at different time points: before surgery (T1), at the end of hypothermic circulatory arrest (HCA) (T2), at the end of cardiopulmonary bypass (CPB) (T3), 24 hours post-operation (T4), and 48 hours post-operation (T5). The patients were grouped based on whether the AKI occurred after surgery, and we compared levels of plasma NGAL across different time points. Additionally, we constructed a multivariate logistic regression model using preoperative and intraoperative data from the patients, incorporating plasma NGAL as a predictor to assess its predictive capability.</p><p><strong>Results: </strong>Based on Kidney Disease: Improving Global Outcomes (KDIGO) criteria, the occurrence of AKI among the 104 ATAAD patients was found to be 39.4% (41 out of 104). Within this group, 12 patients were categorized as KDIGO stage 1, 11 as stage 2, and 18 as stage 3; additionally, 14 patients required continuous renal replacement therapy (CRRT). Plasma NGAL levels were elevated at all measured time points for AKI patients compared to non-AKI group. Subgroup analysis revealed that plasma NGAL levels in patients with severe AKI (sAKI) consistently exceeded those in mild AKI (mAKI) cases, while no significant difference was observed between mAKI and non-AKI groups. Plasma NGAL demonstrated predictive capability for sAKI at each time point, with an area under the curve (AUC) of 0.739 [95% confidence interval (CI): 0.616-0.861; P<0.001] recorded at T5. Independent risk factors for postoperative AKI in ATAAD patients included preoperative ejection fraction [odds ratio (OR): 0.90; 95% CI: 0.81-0.99; P=0.043], D-dimer level (OR: 1.05; 95% CI: 1.01-1.09; P=0.01), and plasma NGAL level (OR: 1.02; 95% CI: 1.01-1.04; P=0.01).</p><p><strong>Conclusions: </strong>The perioperative levels of plasma NGAL in patients who developed AKI after ATAAD were notably elevated compared to those without AKI. Furthermore, plasma NGAL demonstrated strong predictive capability for severe postoperative AKI.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 4","pages":"2126-2139"},"PeriodicalIF":2.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120224","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}