Prognostic value of serum bilirubin in southern Chinese patients with advanced nasopharyngeal carcinoma

Yao, Ji‐Jin; Kou, Jia; Peng, Qifeng; Dong, Jun; Zhang, Wangjian; Lawrence, Wayne R.; Zhang, Fan; Zhou, Guan Qun; Wang, Siyang; Sun, Ying

doi:10.1016/j.cca.2018.05.058

Cited by 10 publications

(4 citation statements)

References 28 publications

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“…Although high bilirubin has long been seen as an indicator of liver dysfunction, recent studies have confirmed that serum bilirubin has potential protective effects against various diseases, including malignant tumors, through antioxidative actions, inhibiting tumor cell proliferation and metastasis and inducing tumor cell apoptosis. [ 40 ] According to studies by Inoguchi et al, [ 41 ] bilirubin levels relate to mortality in patients with malignant tumors in a U-shaped curve, with the lowest mortality occurring at total bilirubin concentrations around 1.2mg/dL (normal range is 0.1–1mg/dL), which aligns with our findings. However, excessively high bilirubin levels can induce tumor cell apoptosis, releasing intracellular contents that can exacerbate hyperkalemia in patients, which is disadvantageous for patient survival.…”

Section: Discussionsupporting

confidence: 90%

Development and Validation of an Interpretable Machine Learning Model for Early Prognosis Prediction in ICU Patients with Malignant Tumors and Hyperkalemia

Bu,

Jiang,

et al. 2024

Medicine

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This study aims to develop and validate a machine learning (ML) predictive model for assessing mortality in patients with malignant tumors and hyperkalemia (MTH). We extracted data on patients with MTH from the Medical Information Mart for Intensive Care-IV, version 2.2 (MIMIC-IV v2.2) database. The dataset was split into a training set (75%) and a validation set (25%). We used the Least Absolute Shrinkage and Selection Operator (LASSO) regression to identify potential predictors, which included clinical laboratory indicators and vital signs. Pearson correlation analysis tested the correlation between predictors. In-hospital death was the prediction target. The Area Under the Curve (AUC) and accuracy of the training and validation sets of 7 ML algorithms were compared, and the optimal 1 was selected to develop the model. The calibration curve was used to evaluate the prediction accuracy of the model further. SHapley Additive exPlanations (SHAP) and Local Interpretable Model-agnostic Explanations (LIME) enhanced model interpretability. 496 patients with MTH in the Intensive Care Unit (ICU) were included. After screening, 17 clinical features were included in the construction of the ML model, and the Pearson correlation coefficient was <0.8, indicating that the correlation between the clinical features was small. eXtreme Gradient Boosting (XGBoost) outperformed other algorithms, achieving perfect scores in the training set (accuracy: 1.000, AUC: 1.000) and high scores in the validation set (accuracy: 0.734, AUC: 0.733). The calibration curves indicated good predictive calibration of the model. SHAP analysis identified the top 8 predictive factors: urine output, mean heart rate, maximum urea nitrogen, minimum oxygen saturation, minimum mean blood pressure, maximum total bilirubin, mean respiratory rate, and minimum pH. In addition, SHAP and LIME performed in-depth individual case analyses. This study demonstrates the effectiveness of ML methods in predicting mortality risk in ICU patients with MTH. It highlights the importance of predictors like urine output and mean heart rate. SHAP and LIME significantly enhanced the model’s interpretability.

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Section: Discussionsupporting

confidence: 90%

Development and Validation of an Interpretable Machine Learning Model for Early Prognosis Prediction in ICU Patients with Malignant Tumors and Hyperkalemia

Bu,

Jiang,

et al. 2024

Medicine

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“…27 Yao et al found that indirect bilirubin of more than 7.15 mmol/L is associated with better Progression-Free Survival/PFS (HR 0.51, 95% CI 0.36-0.72, p<0.001), OS (HR 0.60, 95% CI 0.39-0.90, p=0.012) and DMFS (HR 0.54, 95% CI 0.35-0.85, p=0.006). While direct bilirubin >2.76 mmol/L is associated with superior PFS (HR 0.60 95% CI 0.43-0.83, p=0.002) [28]. In our study, the majority of all bilirubin indexes were shown within normal limits.…”

Section: Discussionsupporting

confidence: 43%

Laboratory Profiles of Nasopharyngeal Carcinoma Patients

Aroeman¹,

Nazar²,

Dewi³

2021

Advances in Health Sciences Research

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Nasopharyngeal Carcinoma (NPC) is one of the most common head and neck malignant neoplasms worldwide. Laboratory profile is rarely evaluated in Indonesia as a prognostic consideration. The aim of this research is to describe the laboratory profile of NPC patients. This is descriptive research using a total sampling method from 2016-to 2020. The general characteristics and laboratory profiles are collected from Nasopharyngeal Cancer Registry. The data collected will be presented in tables as frequency and percentages. More than half of the participants were male (68.27%), aged more than 45 years old (65.38%). The majority of the subjects reported a KPS of more than 80 (84.94%). Most of the participants showed WHO type III (47.57%). Bone (42.22%) was the most common metastases site. Normal hemoglobin (57.14%), leukocyte (57.99%), thrombocyte (91.36%), ALP (81.82%), AST (89.66%), ALT (61.26%), direct bilirubin (76.00%), indirect bilirubin (63.30%), total bilirubin (86.60%) and urea (84.10%) levels were found in most of our subjects. Calcium <8.6 mg/dL (92.21%) and creatinine >1.5 mg/dL (69.2%) were observed in most cases. This study indicated a worse prognosis by anemia, leukocytosis, and a high De Ritis ratio. In comparison, a better prognosis is predicted by low ALP levels, high calcium, direct bilirubin, and total bilirubin. In addition, pretreatment laboratory profiles should be assessed to predict the prognosis of patients with NPC.

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“…In addition to vascular endothelial growth factor, the related biomarkers also include peripheral blood circulating endothelial cells. It has been found that the binding of vascular endothelial cell-specific heparin to growth factors can promote the formation of new blood vessels in vivo (20,21). The high expression of VEGF is regarded as one of the potential markers of early metastasis of nasopharyngeal carcinoma, which often indicates lymph node metastasis, recurrence, and poor prognosis of nasopharyngeal carcinoma.…”

Section: Discussionmentioning

confidence: 99%

[Retracted] The Treatment Combining Antiangiogenesis with Chemoradiotherapy Impinges on the Peripheral Circulation Vascular Endothelial Cells and Therapeutic Effect in the Patients with Locally Advanced Nasopharyngeal Carcinoma

Gong

Wang

et al. 2022

BioMed Research International

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This study was implemented for the evaluation on the circulating endothelial cells’ (CECs) clinical significance in the locally advanced nasopharyngeal carcinoma treatment with endostatin-combined chemoradiotherapy. This study enrolled 47 patients with locally advanced nasopharyngeal carcinoma who were hospitalized from May 9, 2012 to March 10, 2013. These patients were split up into the observation group (25 patients) and control group (22 patients). Patients in the observation group received the endostatin combined with induction chemotherapy and subsequently with concurrent chemoradiotherapy with endostatin. Patients in the control group were treated with inductive chemotherapy followed by concurrent chemoradiotherapy. CECs in peripheral blood were conducted separately before or after inductive chemotherapy and additionally in the end of concurrent chemoradiotherapy. The CEC values of the observation group showed significant statistical differences ( p < 0.05 ) before or after different therapies, whereas those data in the control group were not statistically different. And, the mostly importantly, the CEC values in the observation group and control group turned out a statistical difference. The combination of endostatin and chemoradiotherapy significantly reduced parameters of peripheral blood CECs in these patients. According to the CEC parameters’ variety that we observed in the combined therapies, this study demonstrated that the CECs might be a clinical clue to evaluate this antiangiogenic chemoradiotherapy. And the clinical value of CECs will be further determined along with increasing comparative studies and clinical long-term efficacy observation.

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Prognostic value of serum bilirubin in southern Chinese patients with advanced nasopharyngeal carcinoma

Abstract: Pretreatment IBIL and DBIL are potentially independent prognostic factors for patients with advanced NPC.

Cited by 10 publications

References 28 publications

Development and Validation of an Interpretable Machine Learning Model for Early Prognosis Prediction in ICU Patients with Malignant Tumors and Hyperkalemia

Development and Validation of an Interpretable Machine Learning Model for Early Prognosis Prediction in ICU Patients with Malignant Tumors and Hyperkalemia

Laboratory Profiles of Nasopharyngeal Carcinoma Patients

[Retracted] The Treatment Combining Antiangiogenesis with Chemoradiotherapy Impinges on the Peripheral Circulation Vascular Endothelial Cells and Therapeutic Effect in the Patients with Locally Advanced Nasopharyngeal Carcinoma

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