Background Some studies have investigated the prognostic value exhibited by the Prognostic Nutritional Index (PNI) in patients suffering diffuse large B-cell lymphoma (DLBCL), but varying results were obtained. In order to determine the specific prognostic value more accurately, a meta-analysis was conducted in this study. Methods Literatures were searched from the China National Knowledge Infrastructure (CNKI), Wanfang, PubMed, Embase, the Cochrane Library, and Web of Science. Pooled hazard ratio (HR) and the 95% confidence interval (CI) were calculated to assess the association between PNI and the overall survival (OS) and the progression-free survival (PFS) of patients with DLBCL. Results Based on seven studies with a total number of 1311 patients, our meta-analysis revealed that low PNI may meant poor OS (HR = 2.14, 95% CI 1.66–2.75, p < 0.001) and poor PFS (HR = 1.75, 95% CI 1.36–2.25, p = 0.438). Subgroup analysis showed that, in Asians, low PNI was correlated to poor OS (pooled HR = 2.06 95% CI 1.59–2.66) and poor PFS (pooled HR = 1.66, 95% CI 1.28–2.15). Similar results were obtained from one European study, which is the only study performed outside of Asia from our literature search. Conclusion For patients with DLBCL, low PNI may be interpreted as adverse prognosis. More data from European patients are required in this study to avoid analysis bias.

Objectives: To study the correlations among helicobacter pylori infection, gastrin and colorectal cancer in patients aged over 50 years old. Methods: In this study, the patients diagnosed with colorectal cancer treated in the department of digestion of our hospital together with the healthy subjects undergoing colonoscopy for health examination without pathologic findings from August 2016 to July 2019 were enrolled in colorectal cancer or control group. The blood sample was taken in fasting state, and anti-H. pylori IgG and anti-CagA antibodies as well as the level of serum gastrin were measured for all the participants. In addition, the information of each participant including age, gender, obesity, smoking history, alcohol consumption, diabetes mellitus was recorded and analyzed. Results: Four hundred and twenty-eight patients were enrolled in the colorectal group and 207 healthy subjects were enrolled in the control group. There were not significant differences in the positive rate of Ig G and Cag A and family history between the two groups (p>0.05), but there were significant differences in gastrin level, obesity, smoking history, alcohol consumption and diabetes mellitus between the two groups (p<0.05). In addition, the multivariable analysis showed that obesity, smoking history, alcoholism and diabetes mellitus have the strongest influence on the formation of colorectal cancer, while the level of gastrin didn’t show the influence. Conclusions: No significant correlations among H. pylori infection, the level of gastrin, and the occurrence of CRC in patients with a minimum age of 50 years, suggesting elder colorectal cancer patients may have a different carcinogenic mechanism from those younger patients. doi: https://doi.org/10.12669/pjms.36.5.1993 How to cite this:Luan C, Liu Z, Li Y, Dong T. Association among helicobacter pylori infection, gastrin level and colorectal cancer in patients aged 50 years and over. Pak J Med Sci. 2020;36(5):---------. doi: https://doi.org/10.12669/pjms.36.5.1993 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Alkylators and nucleoside analogs were the main drugs for treatingchronic lymphoblastic leukemia (CLL), which have been replaced by monoclonal antibodies, such as rituximab in the past 10 years for refractory or relapsed CLL. The first-line immunochemotherapy regimen, rituximab combined with nucleoside analogs, significantly increased CLL patients’ first-reaction rate and improved progression-free survival. Despite the long-lasting remissions by the use of chemoimmunotherapy, most CLL patients will relapse eventually. The obinutuzumab (GA101), an updated CD20 antibody, that is thought to achieve a more durable response with unique molecular and functional characteristics. Obinutuzumab is a humanized, monoclonal type II CD20 antibody modified by glycoengineering. The glycoengineered Fc portion enhances the binding affinity to the FcγRIII receptor on immune effector cells, resulting in increased antibody-dependent cellular cytotoxicity and phagocytosis. In addition, the type II antibody binding characteristics of obinutuzumab to CD20 lead to an efficient induction of direct non-apoptotic cell death. This review summarizes the results of clinical studies using obinutuzumab and looks forward to its further application in treating CLL clinically.

Background: Prognostic nutritional index (PNI) is calculated based on serum albumin concentration and absolute lymphocyte count, and its prognostic value has been established in various human malignancies. However, whether PNI can be applied in predicting the prognosis of patients with diffuse large B-cell lymphoma (DLBCL) remains to be clarified. The aim of the present study is to explore the prognostic value of baseline PNI in DLBCL. Methods: We retrospectively reviewed the medical records of 98 patients with DLBCL treated at the Southeast University-affiliated Zhongda Hospital between January 2013 and November 2019. The optimal cut-off value of PNI was determined using a receiver operating characteristic (ROC) curve and the Youden index. The relationship of high and low PNI with the clinical characteristics of the patients and prognosis were analyzed. Results: Patients with low PNI tended to have a worse event-free survival (EFS) and overall survival (OS) (EFS, P=0.029; OS, P<0.001). For patients treated with R-CHOP（Rituximab-cyclophosphamide, doxorubicin, vincristine, and prednisone), PNI proved to be predictive for survival (EFS, P= 0.020; OS, P<0.001), while no significant effect was found in DLBCL patients who received CHOP chemotherapy (EFS, P=0.639; OS, P=0.114). Multivariate analysis showed that PNI was an independent risk factor for OS and EFS of all 98 DLBCL patients after adjusting for model a (OS: adjust for age, gender, body mass index, performance status, B symptoms, international prognostic index, hemoglobin；EFS：adjust for age, gender, Ann Arbor stage, international prognostic index, lactate dehydrogenase, treatment, absolute lymphocyte count, hemoglobin). PNI remained an independent risk factor for both OS and EFS in patients after adjusting for model b (adjust for all items). Conclusion: PNI is a simple and useful marker to predict survival outcome in DLBCL patients, and low PNI is an independent predictor of a better outcome in terms of EFS and OS outcome in DLBCL, suggesting that PNI is an effective prognostic factor in patients with DLBCL.