Purpose: This study aimed to assess the prognostic value of the postoperative serum carcinoembryonic antigen (CEA) levels/preoperative serum CEA levels ratio (CEA ratio) in colorectal cancer (CRC) patients with high preoperative serum CEA levels and to identify the optimal prognostic cutoff value. Patients and methods: The medical records of 187 CRC patients in a single center who underwent surgery between September 2012 and September 2014 were retrospectively reviewed. CEA ratio was defined as the ratio between the postoperative serum CEA and preoperative serum CEA. The optimal cutoff values for the CEA ratio were determined by time-dependent receiver operating characteristic (ROC) curve analyses. The Chi-square test or Fisher’s exact probability test were used to test the correlation between CEA ratio and clinicopathological characteristics. Univariate, multivariate, and subgroup Cox proportional hazards analysis were used to identify independent prognostic factors. Kaplan–Meier method was used for establishing survival curves. Results: The median follow-up time was 62 months (range 3–88 months). The optimal CEA ratio cutoff value closely related to disease-free survival was 0.295. In the Chi-square test, the CEA ratio was associated with pN stage (p=0.003) and postoperative CEA (p<0.001). In the multivariate analysis, the CEA ratio was an independent prognostic factor for disease-free survival (p=0.003, HR 2.300 [95% CI: 1.326–3.988]) and cancer-special survival (p=0.003, HR 2.525 [95% CI: 1.381–4.614]). The CEA ratio reflected the prognosis of CRC patients more accurately than postoperative CEA levels alone, and the CEA ratio of 0.295 was more likely to reflect the prognosis than other cutoff values. Conclusion: The CEA ratio is a simple and useful tool for further forecasting the prognosis of CRC patients with high preoperative CEA levels and may help develop strategies for the postoperative treatment of CRC patients.

Background: Colon adenocarcinoma (COAD) is still the main cause of cancer deaths worldwide. Although immunotherapy has made progress in recent years, there is still a need to improve diagnosis, prognosis, and treatment tools. UL-16 binding protein 1 (ULBP1) is a ligand that activates the receptor natural killer cell group 2 receptor D (NKG2D) and plays an important immunomodulatory role. We aimed to investigate the clinical significance of ULBP1 in COAD.Methods: We obtained the relevant data from The Cancer Genome Atlas (TCGA). A total of 438 patients with COAD were included in this study, with a mean age of 67.1 ± 13.03 years old, of which 234 (53.42%) were male. The diagnostic value of COAD tumor tissues and adjacent tissues was analyzed by ROC curve. Univariate and multivariate survival analysis investigated the prognostic value of ULBP1 gene, and Gene Set Enrichment Analysis (GSEA) curve was performed to analyze the biological process and enriched enrichment pathway of ULBP1 in COAD. Combination survival analysis investigated the combined prognostic effect of prognostic genes.Results:ULBP1 gene had a high diagnostic value in COAD [AUC (TCGA) = 0.959; AUC (Guangxi) = 0.898]. Up-regulated ULBP1 gene of patients with COAD predicted a worse prognosis compared to those patients with down-regulated ULBP1 gene (Adjusted HR = 1.544, 95% CI = 1.020–2.337, p = 0.040). The GSEA showed that ULBP1 was involved in the apoptotic pathway and biological process of T cell mediated cytotoxicity, regulation of natural killer cell activation, and T cell mediated immunity of COAD. The combination survival analysis showed that the combination of high expression of ULBP1, AARS1, and DDIT3 would increase the 2.2-fold death risk of COAD when compared with those of low expression genes.Conclusion: The immune-related ULBP1 gene had diagnostic and prognostic value in COAD. The combination of ULBP1, AARS1, and DDIT3 genes could improve the prognostic prediction performance in COAD.

Metabolic dysfunction-associated steatotic liver disease (MASLD) impacts >30 % of the world's population, imposing significant societal and familial burdens. Arterial stiffness is a known risk factor for various metabolic disorders, and early-onset MASLD may be linked to heightened arterial stiffness. However, studies investigating the link between arterial stiffness and MASLD are limited. This study utilized data from the NHANES database, focusing on young adults aged 20 to 45 years, spanning from 2005 to 2018. The Fatty Liver Index (FLI) was used to diagnose MASLD, and the estimated Pulse Wave Velocity (ePWV) was utilized to assess arterial stiffness. The association between MASLD and arterial stiffness was analyzed using weighted multiple logistic regression models and restricted cubic splines. Sensitivity analyses were performed to evaluate the stability of the observed relationship. The study included 5 522 participants, with 3 415 serving as controls and 2 107 diagnosed with MASLD. The two groups differed significantly in age, income, and comorbidities, including hypertension and diabetes. The mean ePWV was 6.79 (SD = 0.71) in the MASLD group and 6.33 (SD = 0.57) in the control group, respectively. Adjusted weighted logistic regression models revealed that individuals in the high ePWV group (ePWV ≥ 6.559) had a 2.39-fold increased risk of onset compared to those in the low ePWV group (ePWV < 6.559), with statistical significance (P < 0.05). Restricted cubic splines (RCS) also demonstrated a positive linear correlation between ePWV and MASLD. Sensitivity analysis validated the strong correlation between ePWV and MASLD, while subgroup analysis demonstrated a positive association between ePWV and MASLD across most subgroups (OR > 1). The study indicates a strong association between arterial stiffness, as measured by ePWV, and MASLD in young adults. The results suggest that targeting arterial stiffness could aid in preventing and managing MASLD.

Background: This study was mainly to explore and study the potential application of lipoxygenases (ALOX) family genes in the diagnostic and prognostic values of colon adenocarcinoma (COAD). Methods: Data sets related to the ALOX genes of COAD were obtained from The Cancer Genome Atlas and the University of California, Santa Cruz Xena browser. Then, the relevant biological information was downloaded from the public data platform. Finally, the bioinformatics technologies and clinical verification were employed to comprehensively analyze the potential values of ALOX genes. Results: The Pearson correlation analysis indicated that there were correlations among ALOXE3, ALOX5, ALOX12, and ALOX12B. The diagnostic receiver operating characteristic (ROC) curves suggested that ALOXE3 and ALOX12 had significant diagnosis in COAD: ALOXE3; P< 0.001, area under curve (AUC) 95%CI:=0.818 (0.773– 0.862) and ALOX12; P< 0.001, AUC 95%CI=0.774 (0.682– 0.807). Besides, the verification study indicated that ALOX12 had a diagnostic value in COAD. Finally, our multivariate survival analysis and comprehensive prognosis of ALOX genes in COAD suggested that the ALOXE3 and ALOX12 were associated with COAD overall survival: ALOXE3; P=0.025, HR 95%CI=1.765 (1.074– 2.901), ALOX12; P=0.046, HR 95%CI=1.680 (1.009– 2.796), and the low expression of ALOXE3 and ALOX12 had a favorable prognosis of COAD (all P< 0.05); on the contrary, the high regulation of them increased the risk of death. Conclusion: In our study, we observed that the mRNA expressions of ALOX genes were associated with the diagnosis and prognosis of COAD. The results of the diagnostic analysis suggested that ALOX12 might have a diagnosis value in COAD. Besides, our comprehensive prognosis analysis indicated that ALOXE3 combined ALOX12 might serve as potential prognosis biomarkers for COAD.

Background: Depression is a significant focus in mental health research, emerging as a pressing public health concern globally. The Planetary Health Diet Index (PHDI), recently proposed by The Lancet to balance health and environmental sustainability, remains unclear in its role in preventing depression—our study aims to investigate this association and seeks to optimize this dietary index.Methods: A cross-sectional analysis was conducted using 2005–2018 NHANES data from 27,868 participants. Dietary quality was measured using PHDI-US, and depressive symptoms were assessed with the Patient Health Questionnaire-9 (PHQ-9; score ≥10 indicating depressive symptoms). Associations between dietary indices and depressive symptoms were analyzed using multivariable logistic regression and restricted cubic splines. Machine learning identified key PHDI-US components, leading to the recalibration of PHDI-US to create PHDI-Fruits.Findings: Except for the Dietary Inflammatory Index (DII), the PHDI-US, HEI-2020, AHEI, and MEDI all demonstrated protective effects against depression. However, the benefits of PHDI-US were weaker compared to the other indices, particularly among participants with high adherence. Among the components of PHDI-US, fruits had the most significant impact. After recalibrating the PHDI-Fruits component, its ability to reduce depression incidence improved substantially, surpassing that of the other dietary indices.Interpretation: Optimizing the preventive effect of PHDI on depression, the recalibrated PHDI-Fruits significantly enhances its ability to prevent depression, effectively improving the applicability of PHDI in populations affected by depression.

Background: Aging is accompanied by muscle loss. In older adults with cancer sarcopenia (OACS), systemic inflammation, reduced food intake, and reduced physical activity led to a poor prognosis. This study was to investigate the prognostic ability of the inflammatory Geriatric Nutritional Risk Index (GNRI), which combines patient's inflammation, diet status, and physical activity status to predict overall survival of OACS.Methods: This prospective multi‐center study enrolled 637 OACS, with an average age of 72.78 ± 5.98 years, of which 408 (64.1%) were males. We constructed the Inflammatory Functional Prognostic Index (IFPI) of OACS based on inflammatory GNRI scores, reduced food intake, and reduced physical activity. According to the IFPI, OACS was divided into high‐, moderate‐, and low‐risk groups. Univariate and multivariate survival analyses analyzed the prognostic ability of the clinical parameters.Results: Compared with OACS with a high GNRI score, the 1‐, 3‐, and 5‐year hazard ratios (95% confidence interval) of OACS with a low GNRI score was 1.816 (1.076–3.063), 1.678 (1.118–2.518), and 1.627 (1.101–2.407), respectively. This result was consistent with that of the calibration curve. The subgroup analysis showed that the low GNRI score had a significant positive relation with patients with gastrointestinal cancer (P_interaction < 0.001). Notably, the survival analysis of IFPI showed that the mortality risk of moderate‐ and high‐risk patients was 1.722‐and 2.509‐fold higher, respectively, than that of low‐risk patients.Conclusion: The GNRI score was a short‐term and long‐term inflammatory prognostic indicator for OACS. The IFPI score could improve patient survival prediction.