Advances in medical sciences最新文献

{"title":"Performance of federated learning models in health services research: A systematic review and meta-analysis","authors":"Guosong Wu,&nbsp;Fengjuan Yang,&nbsp;Qingyang Wu","doi":"10.1016/j.advms.2026.07.003","DOIUrl":"10.1016/j.advms.2026.07.003","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to assess the performance of federated learning (FL) models and compare their performance with local and centralized models.</div></div><div><h3>Methods</h3><div>We conducted a systematic search of Ovid MEDLINE and PubMed from inception to June 10, 2025, to identify studies using patient data to train or validate FL algorithms and reporting at least one model performance outcome. Two reviewers independently screened articles and extracted data on study characteristics, FL frameworks and model training methodologies, and reported performance metrics. We summarized model performance using medians and interquartile ranges for federated, local, and centralized models. Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Diagnostic Test Accuracy Studies was followed.</div></div><div><h3>Results</h3><div>Thirteen studies involving 247 sites and 158,435 samples were included, with eight studies contributing to this meta-analysis. Most FL models (85%) used the Federated Averaging (FedAvg) algorithm for parameter aggregation across sites. FL model performance metrics were compared with local and centralized models within each machine learning task in each study. FL showed notable gains over local models, improving the AUC by 8.2%, F1 score by 7.9%, sensitivity by 4.1%, PPV by 26.1%, and PRAUC by 1.6%. Compared with centralized models, FL showed modest losses of 4.1% in AUC, 9.9% in F1 score, 9.3% in sensitivity, and 2.8% in PRAUC.</div></div><div><h3>Conclusions</h3><div>FL outperformed local models and demonstrated comparable performance to centralized models while preserving data privacy. Standardized reporting and improved methodological transparency are needed to support its broader application in health research.</div></div>","PeriodicalId":7347,"journal":{"name":"Advances in medical sciences","volume":"71 2","pages":"Pages 298-306"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148652892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploratory ultrasonographic evaluation of parasternal intercostal muscle asymmetry in hemiparesis following stroke: a case-control ultrasonographic study","authors":"Yunus Emre Doğan,&nbsp;Çiğdem Çınar,&nbsp;Kadriye Öneş,&nbsp;Burak Kütük,&nbsp;Muhsin Doran","doi":"10.1016/j.advms.2026.09.001","DOIUrl":"10.1016/j.advms.2026.09.001","url":null,"abstract":"<div><h3>Purpose</h3><div>Diaphragmatic weakness is a known cause of respiratory dysfunction in stroke. However, the role of extra-diaphragmatic muscles in this regard remains unclear. The aim of this study was to evaluate parasternal intercostal muscle thickness and asymmetry between the two sides in hemiparetic patients after stroke using ultrasonography and to provide exploratory and hypothesis-generating data regarding inspiratory muscle involvement and thoracic mechanical changes.</div></div><div><h3>Methods</h3><div>This prospective case-control study included 30 stroke patients and 30 healthy volunteers. Demographic data, parasternal intercostal muscle thickness measured by ultrasound, and pulmonary function test (PFT) results were recorded for all participants.</div></div><div><h3>Results</h3><div>Muscle thickness at both the end of expiration and the end of inspiration and thickening rates were found to be statistically significantly decreased on the paretic side compared with the non-paretic and dominant sides (p &lt; 0.050). No statistically significant difference was detected in terms of non-paretic and dominant muscle thickness and thickening rate (p &gt; 0.050). No statistically significant relationship was detected in the correlation analysis between paretic and non-paretic intercostal muscles of stroke patients and PFT parameters (p &gt; 0.050).</div></div><div><h3>Conclusion</h3><div>Parasternal intercostal muscle thickness measurements show significant asymmetry between the two sides in hemiparetic patients after stroke. However, this asymmetry is not related to PFT and cannot be interpreted as a direct indicator of respiratory dysfunction. The findings may indicate localized inspiratory muscle involvement and thoracic mechanical changes.</div></div>","PeriodicalId":7347,"journal":{"name":"Advances in medical sciences","volume":"71 2","pages":"Pages 307-312"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148885888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of blood flow restriction and resistance training on bone health biomarkers and bone mineral density: a systematic review and meta-analysis","authors":"Gustavo Dias Bottari,&nbsp;Giulianna Faypher Morena Vieira da Silva,&nbsp;Tamy Colonetti,&nbsp;Maria Inês da Rosa,&nbsp;Fernanda Marçal de Lago,&nbsp;Joni Márcio de Farias,&nbsp;Antonio Jose Grande","doi":"10.1016/j.advms.2026.10.001","DOIUrl":"10.1016/j.advms.2026.10.001","url":null,"abstract":"<div><h3>Purpose</h3><div>Low-intensity resistance training combined with blood flow restriction (LIBFR) has been proposed as an alternative to conventional resistance training, but its effects on bone metabolism remain unclear. This review compared LIBFR with high-intensity resistance training (HIRT), low-intensity resistance training (LIRT) and non-exercise on bone formation and resorption markers and bone mineral density (BMD).</div></div><div><h3>Methods</h3><div>MEDLINE (PubMed), Cochrane Library (CENTRAL), EMBASE, APA and Global Health (EBSCO) were searched up to 20th May 2026 for clinical trials in adults assessing bone-specific alkaline phosphatase (BSAP), cross-linked C-telopeptides of type I collagen (CTX-I) or BMD. Risk of bias was assessed with RoB 2 and certainty of evidence with GRADE. Meta-analyses were performed where applicable.</div></div><div><h3>Results</h3><div>Eight studies (nine reports; n = 211 participants) were included. Compared with HIRT, LIBFR resulted in significantly lower BSAP (MD = −2.72 [95% CI −5.17 to −0.28]) and CTX-I (MD = −0.08 [95% CI −0.13 to −0.03]), with no difference in BMD. Compared with LIRT, BSAP and CTX-I did not differ, but BMD was significantly higher in a single study (MD = 0.04 [95% CI 0.03 to 0.05]). Compared with non-exercise, LIBFR significantly reduced CTX-I and BMD, with no difference in BSAP. The certainty of evidence was very low for all comparisons.</div></div><div><h3>Conclusion</h3><div>LIBFR reduced BSAP and CTX-I compared with HIRT, and CTX-I compared with non-exercise. BMD findings were mixed: higher versus LIRT, similar versus HIRT and lower versus non-exercise. Given the very low certainty of evidence, these findings should be interpreted with caution.</div></div>","PeriodicalId":7347,"journal":{"name":"Advances in medical sciences","volume":"71 2","pages":"Pages 369-384"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149102725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prothrombotic potential of diabetic patients with ischemic heart failure is associated with impaired left ventricular contractility and endothelial dysfunction","authors":"Karol Witold Nowak ,&nbsp;Aleksander Siniarski ,&nbsp;Alicia del Carmen Yika ,&nbsp;Aleksandra Karcinska ,&nbsp;Anna Matrejek ,&nbsp;Konrad Stepien ,&nbsp;Jadwiga Nessler ,&nbsp;Grzegorz Gajos ,&nbsp;Jaroslaw Zalewski","doi":"10.1016/j.advms.2026.01.003","DOIUrl":"10.1016/j.advms.2026.01.003","url":null,"abstract":"<div><h3>Purpose</h3><div>We sought to investigate whether left ventricular (LV) contractility and endothelial dysfunction in diabetic patients with ischemic heart failure (HF) are associated with enhanced thrombin generation and altered fibrin clot properties compared with individuals without HF.</div></div><div><h3>Materials and methods</h3><div>The study included 85 HF patients with type 2 diabetes (T2DM) and ischemic heart disease (IHD). Based on echocardiographic examination, 39 (45.9 %) patients were identified as having LV ejection fraction (LVEF) of &lt;40 % (HFrEF) while 46 patients (54.1 %) of ≥50 % (HFpEF). The control group (n = 43) consisted of diabetic and IHD participants without HF (non-HF). In all groups, endogenous thrombin potential (ETP), fibrin clot permeability (Ks), brachial artery flow-mediated dilation (FMD), and nitroglycerin-mediated dilatation (NMD) were assessed.</div></div><div><h3>Results</h3><div>HFrEF and HFpEF patients had less permeable fibrin clots than non-HF by 45.4 % and by 14.6 %, respectively (P &lt; 0.05 both). HFrEF patients had higher ETP by 14.4 % (P = 0.004), lower Ks by 16.9 % (P = 0.037) and lower NMD by 34.7 % (P = 0.001) without differences in FMD as compared with HFpEF. Multivariable analysis adjusted for fibrinogen levels showed that lower LVEF (β-coefficient −0.195, 95 % confidence interval [CI] for β-coefficient −0.385 to −0.015), reduced NMD (β-coefficient −0.230, 95 %CI -0.399 to −0.061), and increased total cholesterol level (β-coefficient 0.286, 95 %CI 0.108–0.464) influenced enhanced ETP in HF population.</div></div><div><h3>Conclusions</h3><div>In diabetic patients with IHD, the diagnosis of HF is associated with more dense fibrin clots. HF patients with reduced versus preserved LVEF have shown enhanced thrombin generation and reduced clot permeability. Impairment of both LV systolic and vascular vasodilator function affected thrombin generation.</div></div>","PeriodicalId":7347,"journal":{"name":"Advances in medical sciences","volume":"71 1","pages":"Pages 19-26"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146045988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mesothelin as a diagnostic biomarker in endometriosis: A cross-sectional study","authors":"Kamil Kiecka ,&nbsp;Aleksandra Zygula ,&nbsp;Anna Sankiewicz ,&nbsp;Mariusz Kuzmicki ,&nbsp;Slawomir Lawicki ,&nbsp;Michal Ciebiera ,&nbsp;Tadeusz Issat ,&nbsp;Jan Blaszczyk ,&nbsp;Krzysztof Cendrowski ,&nbsp;Ewa Gorodkiewicz ,&nbsp;Piotr Laudanski","doi":"10.1016/j.advms.2025.11.002","DOIUrl":"10.1016/j.advms.2025.11.002","url":null,"abstract":"<div><h3>Purpose</h3><div>Endometriosis is a prevalent gynecological condition often requiring invasive procedures for diagnosis. This study aimed to assess mesothelin (MSLN) as a potential non-invasive biomarker by analyzing its levels in peritoneal fluid (PF) and plasma.</div></div><div><h3>Materials/methods</h3><div>In a multicenter cross-sectional study, MSLN concentrations were measured using Surface Plasmon Resonance imaging (SPRi) biosensors in samples from women undergoing laparoscopy for pelvic pain or infertility.</div></div><div><h3>Results</h3><div>Significantly higher MSLN levels were observed in the PF of patients with endometriosis compared to controls (mean concentrations: 10.24 vs. 9.39 ​ng/mL, p ​= ​0.038). The elevation was particularly notable in patients with stage I and II endometriosis compared to the control group (mean concentrations: 10.83 vs. 9.39 ​ng/mL, p ​= ​0.049). No significant differences were observed in plasma.</div></div><div><h3>Conclusions</h3><div>Mesothelin in PF may be considered as a potential biomarker for endometriosis, especially in its early stages. Further studies are needed to confirm its diagnostic value.</div></div>","PeriodicalId":7347,"journal":{"name":"Advances in medical sciences","volume":"71 1","pages":"Pages 1-8"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145646923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Investigation of the effects of umbilical cord and adipose-derived mesenchymal stem cells on endoplasmic reticulum stress in cadmium-induced rat kidney” [Adv. Med. Sci. (2025 Oct) 70 (2) 284-290]","authors":"Bahar Kartal ,&nbsp;Uygar Saçik ,&nbsp;Güven Erbil","doi":"10.1016/j.advms.2025.12.001","DOIUrl":"10.1016/j.advms.2025.12.001","url":null,"abstract":"","PeriodicalId":7347,"journal":{"name":"Advances in medical sciences","volume":"71 1","pages":"Page 9"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145779815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myocardial ischemia detected by SPECT/CT in patients with coronary artery aneurysm or ectasia. Insights from Coronary Artery Ectasia Database – Poland (CARED-POL)","authors":"Mateusz Podolec ,&nbsp;Konrad Stępień ,&nbsp;Sylwia Iwańczyk ,&nbsp;Julia Kościanek ,&nbsp;Anna Matrejek ,&nbsp;Karolina Gutkowska ,&nbsp;Alicia del Carmen Yika ,&nbsp;Paweł Matusik ,&nbsp;Katarzyna Holcman ,&nbsp;Magdalena Kostkiewicz ,&nbsp;Jadwiga Nessler ,&nbsp;Jarosław Zalewski","doi":"10.1016/j.advms.2026.02.004","DOIUrl":"10.1016/j.advms.2026.02.004","url":null,"abstract":"<div><h3>Purpose</h3><div>A high rate of coronary microcirculation dysfunction has been recently demonstrated in coronary artery aneurysm or ectasia (CAAE) in invasive assessment. We sought to analyse the diagnostic value of single-photon emission computed tomography (SPECT/CT) in patients with CAAE and to link it with their angiographic characteristics.</div></div><div><h3>Methods</h3><div>We analyzed 79 patients with CAAE without coronary artery disease who underwent coronary angiography assessed with quantitative coronary angiography (QCA). In all patients SPECT/CT with technetium agents was performed to assess the presence of reversible myocardial perfusion defect.</div></div><div><h3>Results</h3><div>The presence of reversible defect was found in 27 (34.2%) of the included patients. Patients with reversible defect were characterized by more frequent diabetes (55.6 vs 25%, P = 0.007). They were more often treated with insulin (14.8 vs 1.9%, P = 0.026) and non-insulin hypoglycemic drugs (40.7 vs 19.2%, P = 0.043). In patients with reversible defect there was a higher number of multiple CAAE (14.8 vs 5.8%, P = 0.044) without other significant differences in CAAE diameters. The percentage of reversible perfusion defect was inversely associated with distal reference diameter of CAAE (R = −0.342, P = 0.031). In the multivariable analysis, only diabetes was independently associated with presence of reversible perfusion defect (odds ratio [OR] 3.525, 95% confidence interval [CI] 1.240-10.019, P = 0.018).</div></div><div><h3>Conclusions</h3><div>As has been shown for the first time in a high percentage of CAAE patients without coronary artery disease, a reversible perfusion defect in SPECT/CT is observed, which may explain their high symptomaticity. Diabetes, but not CAAE diameters, is the independent predictor of reversible perfusion defect.</div></div>","PeriodicalId":7347,"journal":{"name":"Advances in medical sciences","volume":"71 1","pages":"Pages 88-94"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147300617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Canaloplasty ab externo: evaluation of its standalone benefits vs. combined with phacoemulsification in managing open-angle glaucoma","authors":"Jakub Błażowski,&nbsp;Anna Charytonowicz,&nbsp;Joanna Konopińska","doi":"10.1016/j.advms.2026.03.001","DOIUrl":"10.1016/j.advms.2026.03.001","url":null,"abstract":"<div><h3>Purpose</h3><div>This literature review was prepared in order to evaluate and compare the outcomes of canaloplasty (CP) performed externally (<em>ab externo</em>) and phacocanaloplasty (PCP) in glaucoma management in patients with coexisting cataracts.</div></div><div><h3>Methods</h3><div>A literature search was conducted using PubMed, Google Scholar, Scopus, Web of Science, and Embase. Two independent reviewers screened and evaluated the identified studies.</div></div><div><h3>Results</h3><div>A total of 6 papers were included into this review. The analysis involved 711 eyes treated with CP and 475 eyes treated with PCP, with surgical success defined as achieving intraocular pressure (IOP) of 21 mmHg either with medications (qualified success) or without medications (complete success). Both CP and PCP significantly reduced IOP and the need for medications, though PCP showed a higher cumulative surgical success rate than CP.</div></div><div><h3>Conclusions</h3><div>PCP offers improved outcomes compared to standalone CP.</div></div>","PeriodicalId":7347,"journal":{"name":"Advances in medical sciences","volume":"71 1","pages":"Pages 106-113"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147375756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subureteric injection in complex vesicoureteral reflux in pediatric patients: a retrospective observational study","authors":"Çiğdem Arslan Alıcı ,&nbsp;Baran Tokar","doi":"10.1016/j.advms.2026.01.001","DOIUrl":"10.1016/j.advms.2026.01.001","url":null,"abstract":"<div><h3>Purpose</h3><div>This study evaluated the effectiveness of subureteric injection (SUI) compared to ureteral reimplantation in treating vesicoureteral reflux (VUR) among children, focusing on whether SUI reduces the need for surgical interventions, especially in complex cases.</div></div><div><h3>Method</h3><div>We retrospectively analysed 132 children diagnosed with VUR. We divided the patients into two groups: Group 1 - only VUR cases (n = 65) and Group 2 - complex cases (n = 67). We diagnosed VUR and complex pathologies by voiding cystourethrography (VCUG) and cystoscopic examination. VUR was graded according to the International Reflux Study Committee classification system. SUI and intravesical ureteroneocystostomy (UNC) were used as surgical treatment methods.</div></div><div><h3>Results</h3><div>In Group 2, complex pathologies included duplex renal collecting systems (1.6 %), bladder diverticulum (11.4 %), bladder trabeculation (27.8 %), and posterior urethral valves (18 %). SUI was performed in 48.5 % of patients, with 22.7 % requiring reimplantation after SUI, while 28.8 % underwent direct reimplantation. Success rates of SUI (65.6 %) and reimplantation (70.6 %) were similar (p = 0.68), though lower in children aged 0–2 years with high-grade VUR (45 % for Grade 5) and renal scarring (48 %). Mean recurrence times were 8.4 ± 3.2 months for SUI and 9.1 ± 3.8 months for reimplantation.</div></div><div><h3>Conclusions</h3><div>The success of SUI and ureteral reimplantation was comparable in both simple and complex cases, suggesting SUI is a viable first-line option, particularly in patients older than 2 years with low-grade reflux. However, further studies are needed to confirm these findings.</div></div>","PeriodicalId":7347,"journal":{"name":"Advances in medical sciences","volume":"71 1","pages":"Pages 40-45"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146002837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bone marrow involvement in breast cancer: a retrospective cohort study","authors":"Dawid Sigorski ,&nbsp;Michał Wilk ,&nbsp;Maciej Michalak ,&nbsp;Katarzyna Pieniuk-Faszyńska ,&nbsp;Zygmunt Kozielec ,&nbsp;Tomasz Lewandowski ,&nbsp;Aneta Lebiedzińska","doi":"10.1016/j.advms.2026.03.006","DOIUrl":"10.1016/j.advms.2026.03.006","url":null,"abstract":"<div><h3>Purpose</h3><div>The incidence of bone marrow metastases is a rarely described manifestation of metastatic breast cancer (BC).</div></div><div><h3>Material and methods</h3><div>Clinical, laboratory and histopathological data were retrospectively analyzed in 50 women with histopathologically confirmed BC metastasis.</div></div><div><h3>Results</h3><div>The median age was 68.3 years, and 60% of patients had an ECOG performance status of 0–1. Most cases were BC of no special type (n = 47; 94%), primary in 70% (n = 35). The luminal Human Epidermal Growth Factor Receptor 2 (HER2) – was the predominant biological subtype (n = 35; 70%). The most common indications for trephine biopsy were anemia and thrombocytopenia. Synchronous bone metastases occurred in most patients. Biological type 4conversion was seen in 16 cases (32%) and included luminal converting into triple negative BC (n = 6; 37.5%) and luminal HER2+ into luminal HER2– BC (n = 3; 18.75%). The median of overall survival (OS) was 9.2 months (95% CI: 6.3 – 14.9). High lactate dehydrogenase level (p = 0.023) and thrombocytopenia (p &lt; 0.001) correlated with a shorter median OS. In multivariate analysis, low levels of platelets correlated with a lower median OS (p &lt; 0.001). A positive correlation occurred between lymphocytes (p &lt; 0.001), monocytes (p &lt; 0.001) and the percentage of bone marrow infiltration. Higher neutrophil-to-lymphocyte ratio was associated with shorter survival (p = 0.02).</div></div><div><h3>Conclusions</h3><div>Bone marrow metastases indicate a poor prognosis. The high rate of receptor conversion highlights the importance of re-evaluating tumor biology after BC progression which may increase the scope of systemic treatment options and improve the prognosis.</div></div>","PeriodicalId":7347,"journal":{"name":"Advances in medical sciences","volume":"71 1","pages":"Pages 130-137"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147525271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}