Biomolecules & biomedicine最新文献

{"title":"Development and temporal validation of an interpretable XGBoost model for predicting cardiovascular death in patients with diabetic foot.","authors":"Xiaoling Wan, Ting Shi, Qiao Liu, Ying She, Jing Yu","doi":"10.17305/bb.2026.14337","DOIUrl":"10.17305/bb.2026.14337","url":null,"abstract":"<p><p>Patients with diabetic foot (DF) have a high risk of cardiovascular (CV) death, yet dedicated risk-prediction tools for this population are lacking. We developed and temporally validated an interpretable machine learning (ML) model for predicting CV death in patients with DF. This single-center retrospective cohort study included 2,835 patients admitted between February 2017 and May 2025. The development cohort comprised 2,325 patients, including 748 CV deaths, and was divided into training, internal validation, and held-out test sets; an independent temporal validation cohort included 510 patients, including 220 CV deaths. Nine supervised ML algorithms were compared using the area under the receiver operating characteristic curve (AUC). Extreme gradient boosting (XGBoost) showed the best overall performance. The optimal model, incorporating demographic and diabetes-related characteristics, routine laboratory parameters, and DF-specific features, achieved AUCs of 0.829 (95% confidence interval [CI]: 0.752-0.905) in internal validation, 0.844 (95% CI: 0.806-0.881) in the held-out test set, and 0.828 (95% CI: 0.789-0.868) in temporal validation. The model demonstrated good calibration and favorable net benefit on decision curve analysis. SHapley Additive exPlanations (SHAP) identified age, serum creatinine, glycated hemoglobin, triglycerides, and body mass index as the most influential predictors of increased model-predicted risk. This interpretable XGBoost model may support early identification and individualized risk stratification of patients with DF at high risk of CV death; however, prospective multicenter validation is required before clinical implementation.</p>","PeriodicalId":72398,"journal":{"name":"Biomolecules & biomedicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148498429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pretreatment stromal CD4⁺ T-cell density predicts favorable response to total neoadjuvant therapy in locally advanced rectal cancer.","authors":"Hatice Telci, Sabin Goktas Aydin, Taskın Erkinuresin, Sinan Can Tasan, Enes Ozluk, Emre Bozdag, Fatma Sahin, Erkan Somuncu","doi":"10.17305/bb.2026.14270","DOIUrl":"10.17305/bb.2026.14270","url":null,"abstract":"<p><p>Total neoadjuvant therapy (TNT) has become an important treatment strategy for locally advanced rectal cancer (LARC), increasing the need for pretreatment biomarkers that may predict major tumor response and support organ-preserving approaches. This study aimed to evaluate whether pretreatment stromal CD4⁺ and CD8⁺ T-cell densities, together with stromal tumor-infiltrating lymphocytes (TILs), are associated with response to TNT in patients with LARC. In this retrospective study, 45 patients with LARC who completed TNT were analyzed; pretreatment colonoscopic biopsy specimens were available for all patients, and paired post-treatment resection specimens were available for 40 surgically treated patients. CD4⁺ and CD8⁺ T-cell densities were assessed immunohistochemically in stromal hotspot areas and expressed as cells/mm², while stromal TILs were evaluated on hematoxylin-eosin sections. A favorable response was defined as tumor regression grade (TRG) 0-1 in surgically treated patients or clinical complete response in patients managed with a watch-and-wait strategy. Median pretreatment CD4⁺ T-cell density, CD8⁺ T-cell density, and stromal TIL percentage were 320 cells/mm², 64 cells/mm², and 30%, respectively. Receiver operating characteristic (ROC) analysis identified a pretreatment stromal CD4⁺ T-cell density cutoff of 410 cells/mm² for favorable response, with an area under the curve (AUC) of 0.68 (p=0.041). CD4⁺ T-cell density >410 cells/mm² was significantly associated with favorable response and remained independently associated with response in multivariable logistic regression analysis (odds ratio [OR]=5.05, 95% confidence interval [CI]: 1.21-20.83, p=0.026). In contrast, pretreatment CD8⁺ T-cell density and stromal TIL percentage were not significantly associated with response. In paired specimens, CD8⁺ T-cell density increased significantly after treatment (p<0.001), whereas CD4⁺ T-cell density and stromal TIL percentage did not change significantly. Lymphovascular invasion (LVI) and perineural invasion (PNI) were associated with non-favorable response. High pretreatment stromal CD4⁺ T-cell density may represent a candidate biomarker of favorable response to TNT in LARC, while the post-treatment increase in CD8⁺ T-cell density suggests a potential immunomodulatory effect of TNT; however, prospective validation in larger cohorts is required.</p>","PeriodicalId":72398,"journal":{"name":"Biomolecules & biomedicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148498402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inflammatory biomarkers for early prediction of severe acute pancreatitis: A systematic review and meta-analysis.","authors":"Kexin Zhang, Bohao Liu, Guipeng Zhang, Ying Zhang, Junjie Liu","doi":"10.17305/bb.2026.14408","DOIUrl":"https://doi.org/10.17305/bb.2026.14408","url":null,"abstract":"<p><p>Acute pancreatitis (AP) can rapidly progress to severe disease, making accurate early risk stratification essential for timely treatment. This systematic review and meta-analysis evaluated the predictive performance of inflammatory biomarkers for AP severity. PubMed, Web of Science, the Cochrane Library, and Embase were searched from inception to November 5, 2025, for diagnostic accuracy studies in adults with AP. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool, and diagnostic performance was pooled using bivariate or conventional random-effects models. Overall, 88 studies comprising 12,318 participants and evaluating 17 biomarkers were included. Polymorphonuclear neutrophil elastase (PMN-elastase) showed the strongest overall performance, with an area under the curve (AUC) of 0.96 within 1 day after admission and sensitivity and specificity of 0.93 and 0.94, respectively, at admission. Interleukin-6 (IL-6) also demonstrated strong early predictive performance, with an AUC of 0.93 within 1 day and sensitivity and specificity of 0.96 and 0.80, respectively, within 2 days. C-reactive protein (CRP) performed better during serial monitoring than during early assessment, reaching an AUC of 0.92 on day 5 and a diagnostic odds ratio (DOR) of 177.22 on day 6. The CRP-to-albumin ratio, procalcitonin, interleukin-8, carboxypeptidase B activation peptide, and neopterin showed moderate-to-high predictive performance. By contrast, the neutrophil-to-lymphocyte ratio and white blood cell count showed modest accuracy, whereas the platelet-to-lymphocyte ratio, erythrocyte sedimentation rate, and interleukin-10 had limited predictive value. PMN-elastase and IL-6 are promising biomarkers for early assessment of AP severity, whereas CRP is more suitable for dynamic monitoring. However, substantial methodological and clinical heterogeneity precludes direct ranking of biomarkers and highlights the need for standardized, prospective studies evaluating multimarker models.</p>","PeriodicalId":72398,"journal":{"name":"Biomolecules & biomedicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148474393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peripheral blood nucleated red blood cells predict short-term mortality and clinical outcomes in critically ill adults: A systematic review and meta-analysis.","authors":"Lijing Li, Yawen Lan, Changjiang Fan","doi":"10.17305/bb.2026.14398","DOIUrl":"10.17305/bb.2026.14398","url":null,"abstract":"<p><p>Peripheral blood nucleated red blood cells (NRBCs) are rarely detected in healthy adults but may appear during severe systemic inflammation, tissue hypoxia, and hematopoietic stress in critical illness. This meta-analysis aimed to evaluate the prognostic value of peripheral blood NRBCs for mortality and clinical outcomes in critically ill adults. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, was registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD420251250833), and included cohort studies identified through PubMed, Embase, the Cochrane Library, and Web of Science from inception to June 2, 2026. Study quality, risk of bias, and certainty of evidence were assessed using the Newcastle-Ottawa Scale (NOS), Quality In Prognosis Studies (QUIPS) tool, and Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Overall, 20 cohort studies including 17,691 critically ill adults were included. NRBC positivity was associated with higher 30-day mortality than NRBC negativity, both by odds ratio (OR = 3.14, 95% confidence interval [CI]: 2.13-4.62) and hazard ratio (HR = 1.55, 95% CI: 1.24-1.93). NRBC-positive patients also had longer total hospital stay (mean difference [MD] = 8.73 days, 95% CI: 2.14-15.33) and intensive care unit (ICU) stay (MD = 7.51 days, 95% CI: 3.29-11.73), whereas 90-day mortality was not significantly different between groups. Dose-response analysis showed a nonlinear positive association between increasing NRBC concentrations and 30-day mortality risk. Peripheral blood NRBCs may serve as an adjunctive marker of short-term prognosis and illness severity in critically ill adults, although substantial heterogeneity and very low certainty for several outcomes warrant cautious interpretation.</p>","PeriodicalId":72398,"journal":{"name":"Biomolecules & biomedicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148426800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative hemoglobin trajectories and transient hemodilution during cytoreductive surgery with hyperthermic intraperitoneal chemotherapy.","authors":"Kimia Ghafouri, Martin Ryll, Toby N Weingarten, Juraj Sprung, Travis E Grotz, Darrell R Schroeder, Atousa Deljou","doi":"10.17305/bb.2026.14404","DOIUrl":"https://doi.org/10.17305/bb.2026.14404","url":null,"abstract":"<p><p>Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal malignancies involves heated intraperitoneal cisplatin perfusion and liberal intravenous hydration, both of which may affect perioperative hemoglobin (Hb) concentrations. This study aimed to characterize Hb trajectories during HIPEC and determine whether these patterns differ between laparoscopic and open procedures. We retrospectively analyzed 186 HIPEC procedures performed between 2018 and 2023, including 107 laparoscopic and 79 laparotomy cases. Hb concentrations were assessed before HIPEC, from HIPEC initiation to the end of surgery, and on the first postoperative measurement. Changes were compared using two-way repeated-measures analysis of variance (ANOVA), and mixed-effects multivariable regression was used to identify factors associated with intra-to-postoperative Hb shifts. Laparoscopic procedures were shorter and associated with lower fluid administration and blood loss than laparotomy procedures (all p<0.001). Hb declined from baseline to intraoperative nadir in both groups, with reductions of -1.24 g/dL after laparoscopy and -1.62 g/dL after laparotomy (both p<0.001), followed by partial postoperative recovery of +0.84 g/dL and +0.62 g/dL, respectively (both p<0.001). Longer operative duration was associated with reduced postoperative Hb recovery in laparotomy cases (-0.12 g/dL/hour; p<0.040). HIPEC is associated with a modest intraoperative Hb decline followed by early partial recovery, a pattern consistent with transient intraprocedural hemodilution. Recognizing this trajectory may help contextualize intraoperative Hb values and support more nuanced transfusion decision-making.</p>","PeriodicalId":72398,"journal":{"name":"Biomolecules & biomedicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148426813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Malnutrition assessed by nutritional risk scores and major adverse cardiovascular and cerebrovascular events in older adults: A systematic review and meta-analysis.","authors":"Boyan Zhao, Liang Zhao, Rui Qie","doi":"10.17305/bb.2026.14341","DOIUrl":"10.17305/bb.2026.14341","url":null,"abstract":"<p><p>Major adverse cardio- and cerebrovascular events (MACCE) are critical determinants of clinical outcomes in older patients. However, the relationship between nutritional status and the prognosis of cardiovascular and cerebrovascular diseases remains underexplored. This meta-analysis investigates the association of commonly used nutritional scores with MACCE in older adults. A systematic search of the Cochrane Library, Embase, PubMed, and Web of Science was conducted up to November 28, 2025, to identify clinical studies examining nutritional scores and MACCE in older adults. The primary outcome was the risk of MACCE. Meta-analyses were performed using RStudio to pool hazard ratios (HRs) with their corresponding 95% confidence intervals (CIs) to quantify the association between various nutritional scores and MACCE. Our meta-analysis included 28 studies comprising 80,860 individuals. Data were stratified based on derivation from univariate or multivariate Cox regression. Pooled results from multivariate-adjusted data revealed that malnutrition, as assessed by the geriatric nutritional risk index (GNRI: HR [95% CI]: 1.38 [1.22, 1.55]), the prognostic nutritional index (PNI: 1.34 [1.02, 1.76]), and the nutritional risk index (NRI: 1.37 [1.08, 1.73]), was significantly associated with an elevated risk of MACCE. Furthermore, increasing scores on the controlling nutritional status (CONUT) index (1.19 [1.12, 1.26]) and decreasing scores on the GNRI (0.95 [0.93, 0.98]) and PNI (0.95 [0.93, 0.97]) were each significantly correlated with a higher risk of MACCE. In conclusion, nutritional scores demonstrate a significant association with the risk of MACCE and its secondary outcomes in the older population.</p>","PeriodicalId":72398,"journal":{"name":"Biomolecules & biomedicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immune-evasion-associated prognostic gene expression score stratifies survival and immune microenvironment features in breast cancer.","authors":"Bozhi Zhao, Hongyu Wang, Qunyu Hu, Shu Fang, Qihui Zhang, Yixin Cai, Yuansong Qu, Kexin Zhang, Dongwei Zhang","doi":"10.17305/bb.2026.14152","DOIUrl":"https://doi.org/10.17305/bb.2026.14152","url":null,"abstract":"<p><p>Breast cancer is characterized by marked prognostic and immune heterogeneity, and tumor immune evasion may contribute to variable responses to immunotherapy. This study aimed to characterize immune-evasion-associated transcriptomic patterns in breast cancer and to develop an exploratory prognostic score linked to immune microenvironment features. A curated set of 182 immune-evasion-associated genes (IEGs) was analyzed in The Cancer Genome Atlas Breast Invasive Carcinoma (TCGA-BRCA) cohort. Fifteen differentially expressed IEGs distinguished two molecular clusters with different overall survival (OS), pathway-enrichment profiles, and inferred immune-cell characteristics. To construct an immune-evasion-associated prognostic score (IEPS), all 182 IEGs were screened by univariate Cox regression, and 44 OS-associated candidates were further analyzed using least absolute shrinkage and selection operator (LASSO) Cox regression, yielding a 12-gene score. Using the TCGA-derived median cutoff, high IEPS was associated with poorer OS in TCGA-BRCA and remained associated with OS in the external Gene Expression Omnibus (GEO) GSE20685 cohort; however, discrimination was modest, with external 3-, 5-, and 10-year area under the curve (AUC) values of 0.560, 0.572, and 0.581, respectively. Adding IEPS to available clinicopathological variables produced only modest performance improvement. Exploratory prediction analysis of microarray 50-gene (PAM50) subtype analysis showed that IEPS differed across molecular subtypes, indicating that the score may partly capture subtype-related transcriptomic heterogeneity. Low-IEPS tumors showed more immune-active pathway and immune-cell signatures, whereas high-IEPS tumors were associated with relatively less active antitumor immune features. Protein disulfide isomerase family A member 3 (PDIA3), one IEPS gene, was selected for preliminary functional validation; small interfering RNA (siRNA)-mediated PDIA3 knockdown reduced proliferation, clonogenic growth, and migration of breast cancer cells in vitro. Overall, IEPS may represent an exploratory transcriptome-based indicator associated with prognosis and immune-related features in breast cancer, but it should not be interpreted as a clinically validated standalone or molecular subtype-independent prognostic tool. Further independent validation and immune-relevant mechanistic studies are required, particularly to clarify the role of PDIA3 in breast cancer immune evasion.</p>","PeriodicalId":72398,"journal":{"name":"Biomolecules & biomedicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Indole-3-carbinol attenuates DNCB-induced atopic dermatitis in mice by reducing inflammation and IL-4/IL-13 expression.","authors":"Rabbia Kalim, Arham Shabbir, Hafsa Nasr, Aisha Mobashar, Abdulelah Alhazza, Hamoud Alotaibi, Mona Al Hamod, Saleh Alfuraih, Ali F Almutairy, Sulaiman M Alnasser, Waad Alrohily, Ashfaq Ahmad","doi":"10.17305/bb.2026.14424","DOIUrl":"10.17305/bb.2026.14424","url":null,"abstract":"<p><p>Atopic dermatitis (AD), commonly known as atopic eczema, is a chronic inflammatory skin disease. Indole-3-carbinol (I3C), a phytochemical naturally occurring in Brassica vegetables, has been traditionally used in folk medicine for inflammatory and metabolic disorders. This study investigated the immunomodulatory and anti-inflammatory effects of I3C in a mouse model of 1-chloro-2,4-dinitrobenzene (DNCB)-induced atopic dermatitis. Atopic dermatitis was induced by DNCB sensitization on days 0 and 3. Following disease confirmation on day 7, mice received daily oral or topical administrations of I3C or prednisolone from day 7 to day 19. Macroscopic evaluations included dorsal skin and ear thickness measurements. Histopathological changes were assessed using hematoxylin and eosin staining, and hematological parameters were also analyzed. Gene expression of interleukin (IL)-4 and IL-13 in ear tissue was quantified by real-time polymerase chain reaction (RT-qPCR). Computational molecular docking was performed to determine I3C's affinity for both cytokines. The data indicated that I3C attenuated DNCB-induced AD-like symptoms following both oral and topical administration. Treatment with I3C also resulted in reduced ear thickness. Hematological analysis revealed significantly decreased total leukocyte counts (TLC) and a general downward numerical trend in differential leukocyte count (DLC) parameters in I3C-treated groups. Histopathological evaluation confirmed that I3C ameliorated skin thickening and reduced inflammatory cell infiltration. Furthermore, IL-4 and IL-13 expression levels were decreased in I3C-treated groups. Molecular docking analysis demonstrated moderate binding affinities of -5.1 kcal/mol and -5.3 kcal/mol with IL-4 and IL-13, respectively. In conclusion, findings from this exploratory study suggest that I3C treatment ameliorated DNCB-induced atopic dermatitis in mice, evidenced by reductions in ear thickness and IL-4/IL-13 mRNA expression. Molecular docking analysis demonstrated moderate binding affinities of I3C toward IL-4 and IL-13, providing supportive evidence of potential ligand-protein interactions.</p>","PeriodicalId":72398,"journal":{"name":"Biomolecules & biomedicine","volume":" ","pages":"2393-2406"},"PeriodicalIF":0.0,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13667953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Triglyceride-glucose index is independently associated with left ventricular outflow tract obstruction in hypertrophic cardiomyopathy.","authors":"Tolga Kunak, Özkan Kayhan, Ayşegül Ülgen Kunak","doi":"10.17305/bb.2026.14428","DOIUrl":"10.17305/bb.2026.14428","url":null,"abstract":"<p><p>Insulin resistance and metabolic dysregulation are increasingly recognized as contributors to myocardial remodeling and phenotypic heterogeneity in hypertrophic cardiomyopathy (HCM). While the triglyceride-glucose (TyG) index offers a simple surrogate marker of insulin resistance, its relationship with left ventricular outflow tract (LVOT) obstruction in HCM patients remains underexplored. This study aimed to investigate the association between the TyG index and LVOT obstruction in a retrospective observational cohort of 124 adult HCM patients. LVOT obstruction was defined as a resting or provoked gradient of ≥30 mmHg. Clinical, laboratory, and echocardiographic data were systematically evaluated. The TyG index was computed from fasting triglyceride and glucose levels. Multivariable logistic regression analysis, with the TyG index scaled per 0.1-unit increment, was used to assess independent associations. Receiver operating characteristic (ROC) curve analysis determined discriminatory performance. Patients with obstructive HCM exhibited significantly higher TyG index values compared to those without obstruction (9.07 ± 0.25 vs. 8.76 ± 0.21, p<0.001). The TyG index maintained an independent association with LVOT obstruction after adjusting for relevant clinical and echocardiographic covariates (per 0.1-unit increase: OR 1.84, 95% CI 1.40-2.42, p<0.001). Furthermore, the TyG index demonstrated moderate correlations with both resting (r=0.519, p<0.001) and provoked (r=0.557, p<0.001) LVOT gradients. ROC analysis indicated good discriminatory performance (AUC: 0.826, 95% CI: 0.752-0.901), with a cut-off value of 8.75 yielding 87.9% sensitivity and 47.0% specificity. In conclusion, the TyG index was independently associated with LVOT obstruction in HCM patients, with higher values observed in those with the obstructive phenotype. This suggests a potential link between metabolic status and disease manifestation in HCM. Given its cost-effectiveness and accessibility, the TyG index may offer valuable complementary clinical insights. However, this association requires cautious interpretation, and prospective studies are essential to establish its clinical and prognostic utility.</p>","PeriodicalId":72398,"journal":{"name":"Biomolecules & biomedicine","volume":" ","pages":"2372-2380"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13667989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148364284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survival after breast-conserving surgery versus mastectomy in mammary Paget disease: A propensity-matched SEER population-based analysis.","authors":"İsmail Zİhnİ, Mehmet Zafer Sabuncuoğlu","doi":"10.17305/bb.2026.14512","DOIUrl":"https://doi.org/10.17305/bb.2026.14512","url":null,"abstract":"<p><p>Mastectomy has traditionally been the dominant surgical approach for mammary Paget disease, but its survival advantage over breast-conserving surgery (BCS) remains uncertain. We compared breast cancer-specific survival (BCSS) and overall survival (OS) after mastectomy versus BCS in a population-based SEER cohort. Female patients with mammary Paget disease diagnosed between 2000 and 2022 were identified; after exclusions, 641 surgically treated patients were included, of whom 323 underwent BCS and 318 underwent mastectomy. The primary treatment-strategy effect was estimated using inverse-probability-of-treatment weighting, with radiotherapy excluded from the propensity model as a mediator on the BCS pathway. A 1:1 propensity-matched cohort served as a sensitivity analysis. Survival was assessed using Kaplan-Meier analysis, multivariable Cox regression, Aalen-Johansen competing-risk estimation, Fine-Gray modelling, and additional robustness analyses. After matching, 228 pairs were analyzed. Five-year BCSS was 95.8% after BCS and 94.1% after mastectomy; corresponding ten-year estimates were 93.4% and 92.2% (log-rank p = 0.72). Ten-year cumulative incidence of breast cancer-specific death was 6.3% versus 7.4%, respectively, after accounting for competing non-cancer mortality. OS did not differ significantly between groups (p = 0.46). Mastectomy was not associated with improved BCSS in the primary weighted analysis (hazard ratio 1.19, 95% confidence interval 0.66-2.14, p = 0.56) or the matched sensitivity analysis (hazard ratio 1.30, 95% confidence interval 0.58-2.88, p = 0.52). Findings were concordant across competing-risk, overlap-weighted, parsimonious, penalized, and age-stratified models. In this SEER-based, propensity-adjusted analysis, mastectomy was not associated with a detectable survival advantage over BCS in women with mammary Paget disease. These findings support BCS as a reasonable option in selected patients, while prospective studies incorporating margin status, receptor biology, local recurrence, and patient-reported outcomes are needed.</p>","PeriodicalId":72398,"journal":{"name":"Biomolecules & biomedicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148364213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}