Usefulness of postoperative serum translocator protein as a predictive marker for delirium after breast cancer surgery in elderly women

Lu, Guowen; Chou, Y.; Jin, Wan-Ling; Su, Xiaobao

doi:10.1177/0300060520910044

Cited by 6 publications

(5 citation statements)

References 39 publications

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“…Six of the studies were performed in the UK [ 9 , 17 , 20 , 21 ], four in other European countries [ 16 , 18 , 26 , 27 ] and one each in China [ 22 ] and USA [ 25 ]. The number of eligible patients included per study varied enormously from 56 [ 25 ] to 1698 [ 27 ].…”

Section: Resultsmentioning

confidence: 99%

“…Expression of TP, a marker of inflammation, was associated with increased stage and grade of tumour in postoperative patients only; levels were undetectable pre-operatively [ 22 ]. Therefore, it is difficult to elicit how much of this is due simply to the process of surgical treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Four studies made a direct comparison between measurement of biomarkers in an older compared to a younger cohort (Table 1) [9,[16][17][18][19]. The remaining eight studies measured a biomarker in an older cohort alone (Table 2) [20][21][22][23][24][25][26][27].…”

Section: General Characteristics Of the Studiesmentioning

confidence: 99%

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Biology of primary breast cancer in older women beyond routine biomarkers

et al. 2021

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Purpose There are numerous biomarkers which may have potential predictive and prognostic significance in breast cancer. This is extremely important in older adults, who may opt for less aggressive therapy. This work outlines the literature on biological assessment outside of standard biomarkers (defined as ER, PgR, HER2, Ki67) in women ≥ 65 years with primary operable invasive breast cancer, to determine which additional biomarkers are relevant to outcome in older women. Methods Medline and Embase databases were searched. Studies were eligible if included ≥ 50 patients aged ≥ 65 years; stratified results by age; measured a biomarker outside of standard assay and reported patient data. Results A total of 12 studies were appraised involving 5000 patients, measuring 28 biomarkers. The studies were extremely varied in methodology and outcome but three themes emerged: 1. Differences in biomarker expression between younger and older women, indicating that breast cancer in older women is generally less aggressive compared to younger women; 2. Relationship of biomarker expression with survival, suggesting biomarkers which may exclusively predict response to primary treatment in older women; 3. Association of biomarker with chemotherapy, suggesting that older patients should not be declined chemotherapy based on age alone. Conclusion There is evidence to support further investigation of B-cell lymphoma (BCL2), liver kinase (LK)B1, epidermal growth factor receptor (EGFR), cytoplasmic cyclin-E, mucin (MUC)1 and cytokeratins (CKs) as potential predictive or prognostic markers in older women with breast cancer undergoing surgery. Studies exploring these biomarkers in larger cohorts and in women undergoing non-operative therapies are required.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Biology of primary breast cancer in older women beyond routine biomarkers

et al. 2021

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“…Eighteen studies investigated the association between CRP serum concentration at hospital admission and delirium during hospitalization (10, 13,17,19,20,23,25,35,38,41,46,47,49,50,55,57,63,65). Mean CRP serum concentrations at hospital admission were reported in 15 studies, with a difference of 41.39 mg/L between the means that is greater in patients who developed delirium than in those who did not (10, 13,17,19,20,23,25,35,38,41,49,50,55,57,65). High heterogeneity was observed between these 15 studies, with a p-value of < 0.00001 for chi-square, I 2 of 98%, and p < 0.00001 for the total overall effect (Figure 2).…”

Section: Higher Crp Serum Concentration At Hospital Admission Is Asso...mentioning

confidence: 99%

Meta-analysis of serological biomarkers at hospital admission for the likelihood of developing delirium during hospitalization

Bassi¹,

Rohrs²,

Nicholas³

et al. 2023

Front. Neurol.

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ImportanceIdentifying biomarkers that, at hospital admission, predict subsequent delirium will help to focus our clinical efforts on prevention and management.ObjectiveThe study aimed to investigate biomarkers at hospital admission that may be associated with delirium during hospitalization.Data sourcesA librarian at the Fraser Health Authority Health Sciences Library performed searches from 28 June 2021 to 9 July 2021, using the following sources: Medline, EMBASE, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Cochrane Methodology Register, and the Database of Abstracts of Reviews and Effects.Study selectionThe inclusion criteria were articles in English that investigated the link between serum concentration of biomarkers at hospital admission and delirium during hospitalization. Exclusion criteria were single case reports, case series, comments, editorials, letters to the editor, articles that were not relevant to the review objective, and articles concerning pediatrics. After excluding duplicates, 55 studies were included.Data extraction and synthesisThis meta-analysis followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) protocol. Independent extraction, with the consensus of multiple reviewers, was used to determine the final studies included. The weight and heterogeneity of the manuscripts were calculated using inverse covariance with a random-effects model.Main outcome(s) and measure(s)Differences in mean serum concentration of biomarkers at hospital admission between patients who did and did not develop delirium during hospitalization.ResultsOur search found evidence that patients who developed delirium during hospitalization had, at hospital admission, significantly greater concentrations of certain inflammatory biomarkers and one blood–brain barrier leakage marker than patients who did not develop delirium during hospitalization (differences in the mean: cortisol: 3.36 ng/ml, p < 0.0001; CRP: 41.39 mg/L, p < 0.00001; IL-6: 24.05 pg/ml, p < 0.00001; S100β 0.07 ng/ml, p < 0.00001). These differences were independent of other confounding variables such as the patient's severity of illness. A significantly lower serum concentration, at hospital admission, of acetylcholinesterase (difference in the means −0.86 U/ml, p = 0.004) was also associated with an increased vulnerability to developing delirium during hospitalization.Conclusion and relevanceOur meta-analysis supports the hypothesis that patients with hypothalamic-pituitary axis dysfunction, increased blood–brain barrier permeability, and chronic overload of the cholinergic system, at hospital admission, are more vulnerable to developing delirium during hospitalization.

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“…Therefore, further secondary outcomes will explore behavioral indicators (postoperative cognitive decline or POCD and delirium) and biological markers (interleukin-6 [IL6], C-reactive protein [CRP], neutrophil gelatinase-associated lipocalin [NGAL], and translocator protein [TPSO]) with established neuroinflammatory underpinnings [16][17][18][19][20] to see whether the primary pain outcome has a statistical relationship to these neuroinflammatory-related metrics. The exploratory electroencephalogram (EEG) analyses will also be conducted to see whether either entropy [21], alpha power [22], or delta/alpha power ratio [23,24] can provide neuroinflammatory markers, which could correlate with postoperative pain outcomes.…”

Section: Introductionmentioning

confidence: 99%

Live and Recorded Music Interventions to Reduce Postoperative Pain: Protocol for a Nonrandomized Controlled Trial

Harding¹,

Wal-Huisman²,

Leeuwen³

2023

JMIR Res Protoc

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Background Postoperative patients who were previously engaged in the live musical intervention Meaningful Music in Healthcare reported significantly reduced perception of pain than patients without the intervention. This encouraging finding indicates a potential for postsurgical musical interventions to have a place in standard care as therapeutic pain relief. However, live music is logistically complex in hospital settings, and previous studies have reported the more cost-effective recorded music to serve as a similar pain-reducing function in postsurgical patients. Moreover, little is known about the potential underlying physiological mechanisms that may be responsible for the reduced pain perceived by patients after the live music intervention. Objective The primary objective is to see whether a live music intervention can significantly lower perceived postoperative pain compared to a recorded music intervention and do-nothing control. The secondary objective is to explore the neuroinflammatory underpinnings of postoperative pain and the potential role of a music intervention in mitigating neuroinflammation. Methods This intervention study will compare subjective postsurgical pain ratings among 3 groups: live music intervention, recorded music intervention, and standard care control. The design will take the form of an on-off nonrandomized controlled trial. Adult patients undergoing elective surgery will be invited to participate. The intervention is a daily music session of up to 30 minutes for a maximum of 5 days. The live music intervention group is visited by professional musicians once a day for 15 minutes and will be asked to interact. The recorded music active control intervention group receives 15 minutes of preselected music over headphones. The do-nothing group receives typical postsurgical care that does not include music. Results At study completion, we will have an empirical indication of whether live music or recorded music has a significant impact on postoperative perceived pain. We hypothesize that the live music intervention will have more impact than recorded music but that both will reduce the perceived pain more than care-as-usual. We will moreover have the preliminary evidence of the physiological underpinnings responsible for reducing the perceived pain during a music intervention, from which hypotheses for future research may be derived. Conclusions Live music can provide relief from pain experienced by patients recovering from surgery; however, it is not known to what degree live music improves the patients’ pain experience than the logistically simpler alternative of recorded music. Upon completion, this study will be able to statistically compare live versus recorded music. This study will moreover be able to provide insight into the neurophysiological mechanisms involved in reduced pain perception as a result of postoperative music listening. Trial Registration The Netherlands Central Commission on Human Research NL76900.042.21; https://www.toetsingonline.nl/to/ccmo_search.nsf/fABRpop?readform&unids=F2CA4A88E6040A45C1258791001AEA44 International Registered Report Identifier (IRRID) PRR1-10.2196/40034

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Usefulness of postoperative serum translocator protein as a predictive marker for delirium after breast cancer surgery in elderly women

Cited by 6 publications

References 39 publications

Biology of primary breast cancer in older women beyond routine biomarkers

Biology of primary breast cancer in older women beyond routine biomarkers

Meta-analysis of serological biomarkers at hospital admission for the likelihood of developing delirium during hospitalization

Live and Recorded Music Interventions to Reduce Postoperative Pain: Protocol for a Nonrandomized Controlled Trial

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