1.Inhibition of Epithelial-mesenchymal Transition Mechanism in Chronic Atrophic Gastritis Rats by Banxia Xiexintang via Regulating IL-17/ERK/C/EBPβ Signaling Pathway
Wenyu WU ; Xinyu ZENG ; Hao LI ; Weiqi SUN ; Jiahui REN ; Yang YU ; Tingting ZHOU ; Aili XU ; Wei WEI
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(4):1-10
ObjectiveThis study aimed to investigate the action mechanism by which Banxia Xiexintang (BXT) inhibits epithelial-mesenchymal transition (EMT) in chronic atrophic gastritis (CAG) rats by regulating the interleukin-17(IL-17)/extracellular regulated protein kinases(ERK)/CCAAT enhancer binding protein β(C/EBPβ)signaling pathway, thereby providing new theoretical evidence for the treatment of CAG with classic traditional Chinese medicine formulas. MethodsA CAG rat model was established by using the combined factor method. After successful modeling, the rats were randomly divided into the model group, low-, medium-, and high-dose groups (0.549, 1.098, 2.196 g·kg-1, respectively) of BXT, and the positive drug group (vitacoenzyme, 0.3 g·kg-1). A normal control group was also set up. After 8 weeks of intervention, the pathological changes of gastric tissue were evaluated. The enzyme-linked immunosorbent assay (ELISA) was used to detect the contents of IL-17, tumor necrosis factor-α (TNF-α), cyclooxygenase-2 (COX-2), and C/EBPβ in serum, as well as the contents of EMT markers in gastric mucosal tissue including E-cadherin, N-cadherin, and vimentin. The immunohistochemistry method was employed to determine the localization and protein expression levels of IL-17, p-ERK, and C/EBPβ in gastric mucosal tissue. Western blot was used to detect the protein expressions of C/EBPβ, ERK, and its phosphorylated form (p)-ERK in gastric mucosa. Real-time polymerase chain reaction (Real-time PCR) was applied to measure the mRNA expression levels of ERK, COX-2, and C/EBPβ in gastric mucosa. ResultsCompared with those in the normal control group, the rats in the model group showed gastric mucosal glandular atrophy and inflammatory cell infiltration. The protein and their related mRNA expressions of C/EBPβ, ERK, and p-ERK in gastric mucosa were significantly increased (P<0.05,P<0.01). The levels of IL-17, TNF-α, COX-2, and C/EBPβ in serum were significantly increased (P<0.01). The contents of N-cadherin and vimentin in gastric mucosal tissue were significantly increased, while the content of E-cadherin was significantly decreased (P<0.01). Compared with the model group, after intervention with different doses of BXT, the pathological damage of the gastric mucosa was improved to varying degrees. The protein and mRNA expressions of C/EBPβ, ERK, and p-ERK in gastric mucosa were significantly reduced (P<0.05,P<0.01). The levels of IL-17, TNF-α, COX-2, and C/EBP β in serum were significantly decreased (P<0.01). The contents of N-cadherin and vimentin in gastric mucosa tissue were decreased, while the content of E-cadherin was increased (P<0.05,P<0.01). ConclusionBXT can effectively improve the pathological damage of gastric mucosal tissue in CAG rats. Its action mechanism may be related to reducing the levels of IL-17 and TNF-α in serum, regulating the IL-17/ERK/C/EBPβ signaling pathway and inhibiting the EMT process.
2.Analysis of related causes and treatment of material exposure after cranioplasty: research progress
Lujuan XU ; Jihua WANG ; Yongjing HE ; Weiqi YANG
Chinese Journal of Plastic Surgery 2025;41(11):1213-1218
As a conventional surgical procedure for repairing skull defect areas using autologous or artificial materials, postoperative complications of cranioplasty remain a clinical challenge that needs to be addressed. Implant exposure is a common and severe complication not only may lead to surgical failure but also exhibits significant individual variations in clinical manifestations. Treatment method must be selected based on specific conditions, and the issue of whether to retain or remove the repair material still remains a subject of academic controversy. This article mainly summarized the characteristics, causes, retention of exposed repair materials and treatment method reported in recent years, aiming to provide reference for clinical diagnosis and treatment.
3.Study on the value of the expression levels of TGF-β and Smad2 in platelets for the diagnosis and staging of patients with colorectal cancer
Huihui SHAO ; Linlin QU ; Ruibo LIU ; Wei XU ; Quan WANG ; Weiqi CUI ; Yuwen HUANG ; Haocheng LI ; Chunhe ZHAO ; Liang HE
Chinese Journal of Laboratory Medicine 2025;48(5):590-596
Objective:To analyze the values of platelet transforming growth factor-β (TGF-β) and SMAD family member 2 (Smad2) in patients′ peripheral platelets for CRC diagnosis and staging.Methods:Retrospective case-control study. Tumor tissues, paratumor tissues and peripheral blood samples were collected from 248 CRC patients (147 males, 101 females; age 21-93 years) diagnosed in the First Hospital of Jilin University from October 10th, 2020, to March 10th, 2025. Peripheral blood samples were also collected from 40 colorectal adenomatous polyp patients (21 males, 19 females; age 22-74 years) and 75 healthy individuals (43 males, 32 females; age 18-81 years) during the same period. Tissue homogenates and platelets were isolated using tissue disruption and gradient centrifugation, respectively. Total RNA was respectively extracted from tissues and platelets, and the expression levels of TGF-β and Smad2 were quantified by real-time fluorescence quantitative polymerase chain reaction (RT-qPCR) expressed as relative quantity 2 -ΔΔCt. Differences of TGF-β and Smad2 expression were compared between CRC tissues and adjacent tissues, as well as among CRC patients, polyp patients, and healthy controls. The relationship of platelet TGF-β and Smad2 expression with pathological features includingtumor stage, pathological type, and metastasis were analyzed. The efficiency of platelet TGF-β, Smad2, and their combination in diagnosing CRC was evaluated using receiver operating characteristic (ROC) curves. Results:The expression levels of TGF-β and Smad2 in CRC tumor tissues[1.09 (0.45, 2.00), 2.93 (0.78, 6.73)] were significantly higher than those in adjacent tissues[0.81 (0.27, 1.50), 1.29 (0.40, 2.63)] ( Z TGF-β=4.54, Z Smad2=6.67, both P<0.001). The expression levels of TGF-β and Smad2 in platelets of CRC patients[2.73(1.53, 4.38), 3.16 (1.58, 4.38)] were significantly higher than those in the colorectal polyp group[1.23(0.70, 2.54), 1.16(0.78, 2.27)] and the healthy control group[0.96(0.51, 1.88), 0.92 (0.55, 1.88)] ( H TGF-β=59.71, H Smad2=78.74, both P<0.001). Platelet TGF-β expression increased progressively with tumor stage (stage 1-4) ( P<0.05), while platelet Smad2 levels were higher in metastatic CRC compared with non-metastatic cases ( P<0.05). ROC curve analysis showed that the area under the curve (AUC) for diagnosing CRC when combining platelet TGF-β and Smad2 was 0.81[95%Confidence interval( CI) 0.77—0.86], which was 0.90 (95% CI 0.86—0.93) if adding serum carcinoembryonic antigen (CEA). Conclusion:Platelet TGF-β and Smad2 expression correlates with the diagnosis and staging of CRC, demonstrating potential as liquid biopsy biomarkers for colorectal malignancies.
4.Expressions of peripheral blood related biological markers in elderly patients with Alzheimer's disease and intervention effect of selenium-rich food
Weiqi SUN ; Lingyu ZHU ; Xiaolei XU ; Ying LIU ; Hongmei LYU ; Yahui LAI
Journal of Jilin University(Medicine Edition) 2025;51(5):1333-1339
Objective:To detect the biological markers related to Alzheimer's disease(AD)in the peripheral blood of AD patients,and to explore the activities and levels of the antioxidant function indexes and the expressions of related genes and proteins in the blood of AD patients and the changes after intervention of selenium-rich food.Methods:The Mini-Mental State Examination(MMSE)combined with electroencephalogram or brain CT and clinician diagnosis were used for screening AD.Fifty-six elderly patients with AD aged 75-90 years old were selected.Among them,28 cases were selected as normal diet group for AD(AD group),and 28 cases were selected as dietary selenium intervention group(Se-AD group).The patients in Se-AD group were given daily dietary selenium supplementation(increaseing dietary selenium by 15-20 μg per day)for 3 months.Meanwhile,30 people with the same age were selected as healthy control group.The activities of serum superoxide dismutase(SOD),cholinesterase(CHE),and glutathione peroxidase(GSH-Px)and the levels of serum malondialdehyde(MDA),homocysteine(Hcy),and nitric oxide(NO)as well as reagent kit the levels of serum β-amyloid protein(Aβ),and microtubule-associated protein(Tau)and phosphorylated microtubule-associated protein(p-Tau)of the subjects in various groups were detected by and enzyme-linked immunosorbent assay(ELISA)method;the expression levels of apolipoprotein E4(ApoE4),presenilin 1(PS1),presenilin 2(PS2),cysteinyl aspartate specific proteinase 3(Caspase3),sorting associated protein receptor 1(SORL1),β-site amyloid precursor protein cleaving enzyme 1(BACE1),hypoxia-inducible factor 1(HIF1),nuclear factor-kappa B(NF-κB),β-amyloid precursor protein(APP),protein kinase C(PKC),and Aβ mRNA in peripheral blood of the subjects various groups were detected by real-time fluorescence quantitative PCR(RT-qPCR)method.Results:Compared with healthy control group,the serum SOD activities of the patients in Se-AD group and AD group were significantly decreased(P<0.05),while serum CHE activity and the levels of MDA and Hcy were significantly increased(P<0.05);the serum GSH-Px activity of the patients in AD group was significantly decreased(P<0.05),and the level of NO was significantly increased(P<0.05).Compared with Se-AD group,serum CHE activity and the level of Hcy of the patients in AD group were significantly increased(P<0.05).The expression levels of ApoE4,PS1,Caspase3,BACE1,NF-κB and APP mRNA of the patients in Se-AD group and AD group were significantly increased(P<0.05),and the expression levels of PKC mRNA were significantly decreased(P<0.05);the expression level of PS2 mRNA of the patients in AD group was significantly increased(P<0.05),and the expression levels of Aβ mRNA of the patients in Se-AD group and AD group were significantly increased(P<0.05).Conclusion:The activities of serum SOD,GSH-Px and CHE and the levels of MDA,Hcy and NO,the levels of Aβ,Tau and p-Tau proteins,and the expression levels of ApoE4,PS1,Caspase3,BACE1,NF-κB,PKC,PS2,Aβ and APP mRNA in peripheral blood of the AD patients may vary and can be used for clinical diagnosis of the AD patients.Selenium-rich food can improve AD to some extent,and its mechanism is related to reducing the oxidative damage of brain tissue and decreasing the expression of AD related genes PS2 and Aβ.
5.Effects of sulforaphane on the ferroptosis pathway and iron homeostasis in rats with diabetic retinopathy
Fa LIU ; Dan HAN ; Ziwei XU ; Kunying LU ; Weiqi ZHANG
Recent Advances in Ophthalmology 2025;45(11):870-876,882
Objective To reveal the effects of sulforaphane(SFN)on the ferroptosis pathway and iron homeostasis in rats with diabetic retinopathy(DR).Methods A DR rat model was established by a single intraperitoneal injection of streptozotocin at 65 mg·kg-1.After modeling,the rats were randomly divided into six groups(n=12 per group):Group C(control group),DR group,0.5SFN group,1.0SFN group,2.0SFN group,and 2.0SFN+Erastin group.Group C con-sisted of non-intervention control rats,while the other groups were DR model rats.Groups C and DR were orally adminis-tered 0.5 g·L-1 sodium carboxymethyl cellulose(CMC-Na).The 0.5SFN,1.0SFN,and 2.0SFN groups were orally ad-ministered SFN at 0.5,1.0,and 2.0 mg·kg-1,respectively.The 2.0SFN+Erastin group was orally administered 2.0 mg·kg-1 SFN and simultaneously received a tail intravenous injection of the ferroptosis inducer Erastin at 10.0 mg·kg-1.The intervention lasted for 4 weeks.Fasting blood glucose(FPG)was measured with a glucometer,glycosylated hemoglo-bin(GHb)was detected by visible spectrophotometry,and fasting insulin(FINS)was measured by ELISA.Retinal tissues were subjected to hematoxylin-eosin(HE)staining and periodic acid-Schiff(PAS)staining.The level of reactive oxygen species(ROS)in the retina was detected using the DCFH-DA probe,malondialdehyde(MDA)was measured by the TBA method,and reduced glutathione(GSH)was assessed by spectrophotometry.Retinal Fe2+content was determined by spectrophotometry.The mRNA expression levels of ferritin heavy chain 1(FTH1),ferroportin 1(FPN1),transferrin re-ceptor(TFRC),glutathione peroxidase 4(GPX4),solute carrier family 7 member 11(SLC7A11),thioredoxin 1(Trx1),and thioredoxin-interacting protein(TXNIP)in the retina were detected by qRT-PCR.GPX4 protein expression in the retina was detected by Western blot.Results Compared with the DR group,the 0.5SFN,1.0SFN,and 2.0SFN groups showed decreased FPG and GHb,increased FINS,improved retinal morphology with reduced neovascular capillaries,decreased levels of ROS and MDA,increased GSH levels,decreased retinal Fe2+content,increased FTH1 and FPN1 mRNA levels,de-creased TFRC mRNA levels,increased retinal GPX4,SLC7A11,and Trx1 mRNA levels,decreased TXNIP mRNA levels,and increased retinal GPX4 protein levels(all P<0.05).Compared with the 2.0SFN group,the 2.0SFN+Erastin group showed increased FPG and GHb,decreased FINS,aggravated retinal damage with increased neovascular capillaries,elevat-ed levels of ROS and MDA,decreased GSH levels,increased retinal Fe2+content,decreased FTH1 and FPN1 mRNA levels,increased TFRC mRNA levels,decreased retinal GPX4,SLC7A11,and Trx1 mRNA levels,increased TXNIP mRNA levels,and decreased retinal GPX4 protein levels(all P<0.05).Conclusion SFN alleviates DR in rats by inhibiting the ferrop-tosis pathway and maintaining iron homeostasis.
6.Effects of sulforaphane on the ferroptosis pathway and iron homeostasis in rats with diabetic retinopathy
Fa LIU ; Dan HAN ; Ziwei XU ; Kunying LU ; Weiqi ZHANG
Recent Advances in Ophthalmology 2025;45(11):870-876,882
Objective To reveal the effects of sulforaphane(SFN)on the ferroptosis pathway and iron homeostasis in rats with diabetic retinopathy(DR).Methods A DR rat model was established by a single intraperitoneal injection of streptozotocin at 65 mg·kg-1.After modeling,the rats were randomly divided into six groups(n=12 per group):Group C(control group),DR group,0.5SFN group,1.0SFN group,2.0SFN group,and 2.0SFN+Erastin group.Group C con-sisted of non-intervention control rats,while the other groups were DR model rats.Groups C and DR were orally adminis-tered 0.5 g·L-1 sodium carboxymethyl cellulose(CMC-Na).The 0.5SFN,1.0SFN,and 2.0SFN groups were orally ad-ministered SFN at 0.5,1.0,and 2.0 mg·kg-1,respectively.The 2.0SFN+Erastin group was orally administered 2.0 mg·kg-1 SFN and simultaneously received a tail intravenous injection of the ferroptosis inducer Erastin at 10.0 mg·kg-1.The intervention lasted for 4 weeks.Fasting blood glucose(FPG)was measured with a glucometer,glycosylated hemoglo-bin(GHb)was detected by visible spectrophotometry,and fasting insulin(FINS)was measured by ELISA.Retinal tissues were subjected to hematoxylin-eosin(HE)staining and periodic acid-Schiff(PAS)staining.The level of reactive oxygen species(ROS)in the retina was detected using the DCFH-DA probe,malondialdehyde(MDA)was measured by the TBA method,and reduced glutathione(GSH)was assessed by spectrophotometry.Retinal Fe2+content was determined by spectrophotometry.The mRNA expression levels of ferritin heavy chain 1(FTH1),ferroportin 1(FPN1),transferrin re-ceptor(TFRC),glutathione peroxidase 4(GPX4),solute carrier family 7 member 11(SLC7A11),thioredoxin 1(Trx1),and thioredoxin-interacting protein(TXNIP)in the retina were detected by qRT-PCR.GPX4 protein expression in the retina was detected by Western blot.Results Compared with the DR group,the 0.5SFN,1.0SFN,and 2.0SFN groups showed decreased FPG and GHb,increased FINS,improved retinal morphology with reduced neovascular capillaries,decreased levels of ROS and MDA,increased GSH levels,decreased retinal Fe2+content,increased FTH1 and FPN1 mRNA levels,de-creased TFRC mRNA levels,increased retinal GPX4,SLC7A11,and Trx1 mRNA levels,decreased TXNIP mRNA levels,and increased retinal GPX4 protein levels(all P<0.05).Compared with the 2.0SFN group,the 2.0SFN+Erastin group showed increased FPG and GHb,decreased FINS,aggravated retinal damage with increased neovascular capillaries,elevat-ed levels of ROS and MDA,decreased GSH levels,increased retinal Fe2+content,decreased FTH1 and FPN1 mRNA levels,increased TFRC mRNA levels,decreased retinal GPX4,SLC7A11,and Trx1 mRNA levels,increased TXNIP mRNA levels,and decreased retinal GPX4 protein levels(all P<0.05).Conclusion SFN alleviates DR in rats by inhibiting the ferrop-tosis pathway and maintaining iron homeostasis.
7.Analysis of related causes and treatment of material exposure after cranioplasty: research progress
Lujuan XU ; Jihua WANG ; Yongjing HE ; Weiqi YANG
Chinese Journal of Plastic Surgery 2025;41(11):1213-1218
As a conventional surgical procedure for repairing skull defect areas using autologous or artificial materials, postoperative complications of cranioplasty remain a clinical challenge that needs to be addressed. Implant exposure is a common and severe complication not only may lead to surgical failure but also exhibits significant individual variations in clinical manifestations. Treatment method must be selected based on specific conditions, and the issue of whether to retain or remove the repair material still remains a subject of academic controversy. This article mainly summarized the characteristics, causes, retention of exposed repair materials and treatment method reported in recent years, aiming to provide reference for clinical diagnosis and treatment.
8.Study on the value of the expression levels of TGF-β and Smad2 in platelets for the diagnosis and staging of patients with colorectal cancer
Huihui SHAO ; Linlin QU ; Ruibo LIU ; Wei XU ; Quan WANG ; Weiqi CUI ; Yuwen HUANG ; Haocheng LI ; Chunhe ZHAO ; Liang HE
Chinese Journal of Laboratory Medicine 2025;48(5):590-596
Objective:To analyze the values of platelet transforming growth factor-β (TGF-β) and SMAD family member 2 (Smad2) in patients′ peripheral platelets for CRC diagnosis and staging.Methods:Retrospective case-control study. Tumor tissues, paratumor tissues and peripheral blood samples were collected from 248 CRC patients (147 males, 101 females; age 21-93 years) diagnosed in the First Hospital of Jilin University from October 10th, 2020, to March 10th, 2025. Peripheral blood samples were also collected from 40 colorectal adenomatous polyp patients (21 males, 19 females; age 22-74 years) and 75 healthy individuals (43 males, 32 females; age 18-81 years) during the same period. Tissue homogenates and platelets were isolated using tissue disruption and gradient centrifugation, respectively. Total RNA was respectively extracted from tissues and platelets, and the expression levels of TGF-β and Smad2 were quantified by real-time fluorescence quantitative polymerase chain reaction (RT-qPCR) expressed as relative quantity 2 -ΔΔCt. Differences of TGF-β and Smad2 expression were compared between CRC tissues and adjacent tissues, as well as among CRC patients, polyp patients, and healthy controls. The relationship of platelet TGF-β and Smad2 expression with pathological features includingtumor stage, pathological type, and metastasis were analyzed. The efficiency of platelet TGF-β, Smad2, and their combination in diagnosing CRC was evaluated using receiver operating characteristic (ROC) curves. Results:The expression levels of TGF-β and Smad2 in CRC tumor tissues[1.09 (0.45, 2.00), 2.93 (0.78, 6.73)] were significantly higher than those in adjacent tissues[0.81 (0.27, 1.50), 1.29 (0.40, 2.63)] ( Z TGF-β=4.54, Z Smad2=6.67, both P<0.001). The expression levels of TGF-β and Smad2 in platelets of CRC patients[2.73(1.53, 4.38), 3.16 (1.58, 4.38)] were significantly higher than those in the colorectal polyp group[1.23(0.70, 2.54), 1.16(0.78, 2.27)] and the healthy control group[0.96(0.51, 1.88), 0.92 (0.55, 1.88)] ( H TGF-β=59.71, H Smad2=78.74, both P<0.001). Platelet TGF-β expression increased progressively with tumor stage (stage 1-4) ( P<0.05), while platelet Smad2 levels were higher in metastatic CRC compared with non-metastatic cases ( P<0.05). ROC curve analysis showed that the area under the curve (AUC) for diagnosing CRC when combining platelet TGF-β and Smad2 was 0.81[95%Confidence interval( CI) 0.77—0.86], which was 0.90 (95% CI 0.86—0.93) if adding serum carcinoembryonic antigen (CEA). Conclusion:Platelet TGF-β and Smad2 expression correlates with the diagnosis and staging of CRC, demonstrating potential as liquid biopsy biomarkers for colorectal malignancies.
9.Pathogenesis of flunarizine-induced parkinsonism from gut-brain axis perspective
Nan DING ; Lixin PAN ; Changlin LIAN ; Zhifeng XU ; Yukai WANG ; Fen ZHANG ; Guanghua ZHAO ; Xiaojue LIANG ; Wenjie LAI ; Weiqi ZENG ; Jingjuan CHEN ; Guohua ZHANG
Chinese Journal of Neuromedicine 2024;23(4):333-339
Objective:To explore the pathogenesis of flunarizine-induced parkinsonism from gut-brain axis perspective.Methods:Thirty male C57BL/6 mice were randomly divided into control group and flunarizine group ( n=15). Mice in the control group were given 0.1 mL 50% polyethylene glycol 400+50% saline by gavage once/d for 2 weeks, while mice in the flunarizine group were given 6 mg/mL flunarizine+50% polyethylene glycol 400+50% saline by gavage at a daily dose of 30 mg/kg for 2 weeks. Body mass was recorded 1, 3, 5, 7, 10 and 14 d after drug administration, and motor function was assessed by rotarod test 14 d after drug administration; 16s RNA sequencing was performed in the feces to observe the intestinal flora; intestinal transit function was detected by Evans blue by gavage; and then, the mice were sacrificed and homogenate or frozen sections (brain and intestinal tissues) were prepared; dopamine-ergic neuron expression was detected by Western blotting; RT-qPCR was applied to detect the expressions of inflammatory factors in the substantia nigra, and immunofluorescent staining was used to detect the expressions of ZO-1 and Claudin-5 in the intestinal epithelial tissues. Results:Compared with the control group, the flunarizine group had lower body mass ratio 1, 3, 5, 7, 10 and 14 d after drug administration (ratio to body mass before drug administration). Compared with the control group, the flunarizine group had significantly shortened residence time in rod rotating and lower rotational speed when falling ( P<0.05). Compared with the control group, the flunarizine group had decreased tyrosine hydroxylase protein in the substantia nigra without significant difference ( P>0.05). Compared with the control group, the flunarizine group had significantly increased interleukin-6 and tumor necrosis factor-α in the substantia nigra (1.00±0.00 vs. 2.79±0.83; 1.00±0.00 vs. 3.39±1.37), significantly lower intestinal Evans blue propulsion rate (80.67%±4.51% vs. 50.67%±6.03%), and statistically decreased ZO-1 and Claudin-5 expressions in the colonic epithelial tissues (27.01±1.41 vs. 16.32±2.83; 37.00±2.80 vs. 24.52±2.12, P<0.05). Totally, 576 microorganisms were noted in both control group and flunarizine group, 744 in the control group alone, and 634 in the flunarizine group alone. The intestinal flora β diversity indices in the 2 groups were significantly different based on weighted Unifrac-principle coordinates analysis (PCoA, PCoA1: 39.88%; PCoA2: 30.69%). Compared with the control group, the microbial colony structure of mice in flunarizine group was dominated by phylum thick-walled bacteria and phylum warty microbacteria, and by families Muribaculaceae, Lachnospiraceae and Akkermansiaceae. Compared with the control group, the flunarizine group had significantly decreased relative abundance of Ackermannia spp. and Lactobacillus spp. in the intestinal flora ( P<0.05). Conclusion:Flunarizine may contribute to the pathogenesis of DIP by causing structural disturbances in the intestinal flora and inducing neuroinflammation based on the gut-brain axis.
10.Establishment and validation of a laboratory-based multiparameter model for predicting bone marrow metastasis in malignant tumors
Haocheng LI ; Wei XU ; Zhonghua DU ; Lin SONG ; Dan LIU ; Huihui SHAO ; Chunhe ZHAO ; Weiqi CUI ; Linlin QU
Chinese Journal of Laboratory Medicine 2024;47(11):1248-1255
Objective:To establish and validate the prediction model for bone marrow metastasis (BMM) in malignant tumors by screening out laboratory multiparameters.Methods:This case-control study collected 444 cases of malignant tumor patients who were hospitalized in the First Hospital of Jilin University from March 2018 to March 2024, including 243 cases for model establishment set and 201 cases for model validation set. The model establishment set was divided into BMM positive group (81 cases) and BMM negative group (162 cases), and the model validation set was divided into positive group (67 cases) and a negative group (134 cases). We collected patients′ clinical information such as gender, age, clinical diagnosis, and results of 47 laboratory tests including routine blood analysis, coagulation, liver function, tumor markers, potassium, sodium, chloride, and calcium ion tests, bone marrow morphology, and bone marrow biopsy. BMM was taken as the outcome event, differencial variables were analyzed using inter group comparisons, the correlation among parameters was analyzed using Pearson correlation analysis, the risk factors for BMM were analyzed using multivariate conditional logistic regression analysis, to establish logistic model, followed by efficiency evaluation on BMM predictive model using receiver operating characteristic (ROC) curves.Results:In the model establishment set, Pearson correlation analysis of 28 parameters that differed between the BMM positive and negative groups revealed that the correlation coefficients of 17 parameters, including mean platelet volume (MPV), hematocrit (HCT), hemoglobin (HGB), and prothrombin time (PT), were no more than 0.6 ( P<0.05). Further multivariate conditional logistic regression analysis demonstrated that MPV, HGB, HCT, PT, red cell distribution width (RDW), platelet count (PLT), alkaline phosphatase (ALP), chloride (Cl -), and mean erythrocyte hemoglobin concentration (MCHC) were the risk factors of BMM occurence in malignancy [MPV ( OR=9.929, 95% CI 2.688-71.335), HCT ( OR=8.232, 95% CI 6.223-9.841), HGB ( OR=4.300, 95% CI 1.947-16.577), PT ( OR=3.738, 95% CI 1.359-11.666), RDW ( OR=1.995, 95% CI 1.275-3.807), ALP ( OR=1.025, 95% CI 1.012-1.045), PLT ( OR=1.014, 95% CI 1.002-1.031), MCHC ( OR=0.724, 95% CI 0.523-0.880) and Cl -( OR=0.703, 95% CI 0.472-0.967)]. In the model establishment set, combiation of risk factors provided an AUC of 0.943 (95% CI 0.898-0.987, P<0.001), a sensitivity of 86.3%, and a specificity of 89.2% for BMM prediction. In the model validation set, the AUC was 0.924 (95% CI 0.854-0.960, P<0.001), with a sensitivity and specificity of 86.7% and 83.8%, respectively. Conclusion:This study built and validated a multiple-parameter model for BMM, which may facilitate the timely detection of BMM and provide reference for decision making of bone marrow aspiration.

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