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At present, immune checkpoint inhibitors (ICIs) and tyrosine kinase inhibitors (TKIs) are used to treat advanced hepatocellular carcinoma (HCC), with limited therapeutic effects. Dendritic cell (DC) immunotherapy may be a feasible option following ICI/TKI therapy to increase patient survival. Seventy patients with HCC who received DC therapy were included in this study. DCs were propagated from peripheral blood monocytes and pulsed with tumor lysate. The phenotypes of peripheral white blood cells were analyzed prior to and after DC therapy. Among the 70 patients examined, 11 (15.7%) had an objective response (group A), 26 (37.1%) had stable disease and minor regression (group B), 21 (30.0%) had stable disease and minor progression (group C), and 12 (17.1%) had progressive disease (group D). Prior to DC therapy, patients in group A had a higher frequency of CD8⁺ T-cells and a lower neutrophil-to-lymphocyte ratio than patients in the other groups. After DC therapy, patients in groups A and B exhibited a significant increase or tendency to increase in the frequencies of CD3⁺, CD4⁺, and CD8⁺ T-cells. The 1-, 2-, and 3-year survival rates were 90.9%, 81.8%, and 63.3%, respectively, for group A patients; 76.9%, 50.5%, and 26.9% for group B patients, which were significantly better than the rates of 42.9%, 9.5%, and 4.8% for group C patients and 25%, 8.3%, and 0% for group D patients (p < 0.001). In conclusion, DC therapy following ICI/TKI therapy is feasible for patients with advanced HCC. Patients with objective or minor responses to DC therapy exhibited an increased frequency of T-cells and improved survival. Full article

Trace elements have nutritional and toxicological roles relevant to lipid metabolism and inflammation. In a secondary cross-sectional study, we examined 19 serum elements and blood biomarkers in 4026 adults from the SPES community biomonitoring programme in Campania, Italy. Low-density lipoprotein cholesterol (LDL-C) and neutrophil-to-lymphocyte ratio (NLR) were co-primary outcomes; systemic immune–inflammation index (SII) was secondary. Adjusted models used multiple imputation and false-discovery-rate (FDR) correction. Selenium, copper and zinc showed positive LDL-C associations among directly quantified concentrations, whereas the mercury association depended on assay availability and quantification. Models with untransformed LDL-C estimated differences of approximately 1–4 mg/dL per element-specific interquartile increase in log concentration. Copper and zinc estimates were smaller in an exploratory joint model. For mercury, LDL-C was higher with quantifiable rather than below-quantification concentrations, but the gradient within the quantified range was uncertain. All four primary-model LDL-C associations met both outcome-specific and combined co-primary FDR thresholds; no primary linear NLR association did. Copper, cobalt, molybdenum and antimony were associated with higher SII after outcome-specific FDR correction, with less consistent results across sensitivity analyses. These modest LDL-C differences warrant prospective investigation; the cross-sectional associations do not establish causal or individual clinical effects. Full article

Background/Objectives: This study aimed to evaluate the discriminative performance of routine systemic inflammation- and nutrition-based indices for distinguishing histopathologically confirmed gastric malignancy from non-malignant endoscopic findings. Methods: This retrospective case–control study included 211 patients who underwent upper gastrointestinal endoscopy with histopathological evaluation: 139 non-malignant endoscopic controls (129 benign/non-neoplastic and 10 premalignant findings) and 72 gastric malignancy cases. Premalignant lesions were not considered malignant outcomes. Discrimination was evaluated using univariable ROC analyses and multivariable logistic models. The fixed predictor set was assessed using 10-fold out-of-fold validation and 500-resample bootstrap optimism correction; a separate fully nested selection-inclusive audit was used to quantify uncertainty arising from variable selection. Results: NLR (AUC = 0.792), INR (AUC = 0.791), and SIRI (AUC = 0.783) showed the highest univariable discrimination. Among the variables retained in Model 1, higher ESR and RDW, lower MPV and HDL, higher INR values, and male sex showed statistically significant multivariable associations. Model 1 had an apparent AUC of 0.928 (95% CI, 0.890–0.959), a fixed-set 10-fold out-of-fold AUC of 0.890, and a bootstrap optimism-corrected AUC of 0.901. A fully nested selection-inclusive audit yielded an out-of-fold AUC of 0.873 and a bootstrap-corrected AUC of 0.869. Conclusions: Routine inflammation- and nutrition-related laboratory measures discriminated gastric malignancy from non-malignant endoscopic findings in this endoscopy-selected cohort. The model remains exploratory and requires prospective external validation. These data do not establish screening performance or diagnostic accuracy for early or asymptomatic gastric cancer. Full article

Post-stroke shoulder-hand syndrome and hand edema can complicate inpatient rehabilitation and may reflect interactions between antioxidant, nutritional, inflammatory, and neuro-musculoskeletal factors. This single-center retrospective cohort study included 453 adults admitted for inpatient rehabilitation within 60 days after a first-ever unilateral ischemic or hemorrhagic stroke between 1 January 2018 and 31 December 2025. The primary exposure was the number of abnormal antioxidant-, nutritional-, and inflammation-related biomarkers, defined as serum zinc <70 µg/dL, albumin <3.5 g/dL, C-reactive protein ≥1.0 mg/dL, and neutrophil-to-lymphocyte ratio ≥3.0. The primary outcome was shoulder-hand syndrome or clinically significant hand edema during inpatient rehabilitation. In multivariable logistic regression with robust standard errors, each 1-unit increase in the number of abnormal biomarkers was associated with higher odds of the primary composite outcome (odds ratio, 1.43; 95% confidence interval, 1.15–1.77; p = 0.001). Directionally consistent associations were observed for shoulder-hand syndrome, clinically significant hand edema, Fugl–Meyer upper-extremity score at discharge, and poor upper-limb function at discharge. In a temporal sensitivity analysis excluding the 28 patients with the primary outcome already documented at PM&R admission (N = 425), biomarker profiling preceded the documented outcome in all 98 subsequent event cases, and the association remained (odds ratio, 1.42; 95% confidence interval, 1.12–1.79; p = 0.004). These findings indicate that a higher burden of abnormal antioxidant-, nutritional-, and inflammation-related biomarkers was associated with a clinical profile characterized by upper-limb complications and less favorable short-term motor function; the burden measure is not validated for prediction. Full article

Background: Systemic inflammatory indices derived from routine complete blood counts have been proposed as inexpensive biomarkers in gynecological malignancies. Their ability to discriminate tumor grade in endometrial cancer, however, has rarely been evaluated against routinely available clinical variables under rigorous validation. Methods: We retrospectively analyzed 225 women with endometrial cancer (166 low-grade, G1–G2; 59 high-grade, G3). Nine inflammatory indices were computed. Four feature sets were compared using a prespecified elastic-net logistic regression under repeated nested cross-validation (5 outer × 5 inner folds, 20 repetitions) with 5000 stratified bootstrap confidence intervals: a collinearity-reduced inflammatory panel, the full inflammatory panel, preoperative clinical variables (age, CA-125 and preoperative albumin), and their combination. Selection among nine classifiers was retained as an exploratory analysis. Because 66% of high-grade events were non-endometrioid, every analysis was repeated in three cohorts: the full cohort, endometrioid tumors only, and the subgroup with assessed hormone receptor status. Histologic subtype was deliberately excluded because non-endometrioid carcinomas are high-grade by definition. Model behavior was interpreted with TreeSHAP and cross-checked against permutation importance. Results: Of nine inflammatory indices, only the eosinophil-to-lymphocyte ratio remained statistically associated with grade after false discovery rate correction (AUC 0.626, 95% CI 0.543–0.705; q = 0.036), with all others showing negligible effect sizes (|r| < 0.08); its discrimination was nonetheless modest and insufficient for individual-level prediction. The inflammatory panel achieved AUC 0.533 (95% CI 0.443–0.621), within the range attainable by chance in this design (permutation p = 0.254). Preoperative clinical variables reached AUC 0.687 (95% CI 0.590–0.772) in the full cohort but 0.390 (0.257–0.524) in endometrioid tumors alone and 0.627 (0.485–0.765) in the receptor-assessed subgroup. Adding inflammatory indices to clinical variables did not improve discrimination (ΔAUC = −0.025, 95% CI −0.062 to +0.012; one-sided upper bound +0.007 against a prespecified margin of +0.05). The results were unchanged under an alternative grade dichotomization and after excluding patients with inconsistent blood-count entries. Conclusions: Most inflammatory indices did not demonstrate clinically useful discrimination between G3 and G1–G2 disease in this cohort, and did not add incremental discriminative value beyond the prespecified margin over routinely available preoperative clinical variables. The apparent discrimination of the clinical variables in the full cohort did not survive restriction to endometrioid histology, indicating that it reflected histologic composition rather than grade. Decision curve analysis on recalibrated probabilities showed that no model exceeded the treat-all strategy at thresholds below the prevalence of high-grade disease, and that, above it, any advantage over treating no one was small in the full cohort and absent within endometrioid tumors. Full article

Background: Major depressive disorder (MDD) has frequently been associated with inflammation; however, the relationship between antidepressant-related side effects and inflammatory markers remains unclear. This study investigated the associations of antidepressant side effects with the neutrophil-to-lymphocyte ratio (NLR), monocyte-to-HDL ratio (MHR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), white blood cell (WBC) count, and C-reactive protein (CRP). Methods: The study included 60 patients aged 18–65 years who met DSM-5 criteria for MDD, had used antidepressants for at least one month, and developed side effects, together with 60 sociodemographically matched healthy controls. Complete blood count (CBC), CRP, and HDL levels were measured from venous blood samples, and NLR, MHR, MLR, and PLR were calculated. Patients completed the Udvalg Kliniske Undersøgelser (UKU) Side Effect Rating Scale, Clinical Global Impression Scale, Montgomery–Åsberg Depression Rating Scale (MADRS), and Hamilton Anxiety Scale (HAM-A). Only side effects considered medication-related according to the UKU causality assessment were included. Analyses were performed using SPSS 24.0. Results: Concentration problems correlated negatively with neutrophil levels and NLR. Sedation/drowsiness correlated positively with MHR and MLR, and increased dreaming correlated positively with platelet levels. Weight gain correlated positively with neutrophil, lymphocyte, and WBC counts and negatively with PLR. Erectile dysfunction correlated negatively with PLR, orgasmic dysfunction with monocyte levels, vaginal dryness with neutrophil levels, and physical dependence with NLR. Conclusions: Antidepressant-related side effects showed several uncorrected associations with peripheral inflammatory markers, none of which survived correction for multiple comparisons (Benjamini–Hochberg false discovery rate). As the first exploratory investigation of this relationship, these preliminary, hypothesis-generating findings may inform understanding of side-effect mechanisms and support future, adequately powered longitudinal studies aimed at enhancing treatment adherence and reducing relapse and chronicity. Full article

Background and Objectives: Malignant pleural effusion (MPE) severely impairs quality of life; chemical pleurodesis is the standard palliative modality, but the relative contributions of systemic inflammation, tube caliber, and mechanical pleural apposition to failure remain controversial. This study evaluated independent determinants of pleurodesis recurrence, hospital length of stay, and 30-day mortality using causal inference and mediation modeling. Materials and Methods: We conducted a retrospective cohort study of 140 patients undergoing chemical pleurodesis for symptomatic MPE. Pre-procedural inflammatory biomarkers, including the Neutrophil-to-Lymphocyte Ratio (NLR), tube caliber, administration method (bedside slurry vs. Video-Assisted Thoracoscopic Surgery [VATS] poudrage), and lung re-expansion status were recorded. Multivariable logistic regression with nomogram construction, 1:1 propensity score matching (PSM), inverse probability of treatment weighting (IPTW), and bootstrap structural equation modeling (SEM) mediation analysis were performed. Results: Pleurodesis recurrence occurred in 28.6% (n = 40) and 30-day mortality in 16.4% (n = 23) of patients. Non-expandable lung (adjusted odds ratio [aOR] = 9.89, 95% CI: 3.98–26.29, p < 0.001) and suboptimal catheter position (aOR = 3.80, 95% CI: 1.11–14.84, p = 0.407) were the strongest independent predictors of recurrence (C-index = 0.851); non-expandable lung also increased mortality 5.21-fold (p = 0.036). Large-bore tubes reduced matched odds of catheter malposition (OR = 0.096) and recurrence (OR = 0.405, p = 0.493) in the propensity-matched cohort, and VATS poudrage shortened hospital stay by 6.40 days (p = 0.074) versus slurry after weighting. Exploratory mediation analysis showed NLR’s direct effect on recurrence was non-significant (β = 0.0147, p = 0.5897); although summed indirect pathways accounted for a numerically larger share of the total effect, the bootstrap confidence interval for the total indirect effect crossed zero (β = 0.0330, 95% CI: −0.0155 to 0.0742), with only the pathway via catheter malposition individually excluding zero (β = 0.0126, 95% CI: 0.0014–0.0416), suggesting a plausible but unconfirmed mechanical-mediation trend. Patients with no comorbidities unexpectedly had higher mortality than those with multiple comorbidities (25.0% vs. 7.1%, p = 0.19), reflecting younger age and greater cachexia (albumin 28.14 ± 4.54 g/L) rather than comorbidity itself. Conclusions: Pleurodesis efficacy in MPE appears to be governed primarily by mechanical visceroparietal apposition; systemic inflammation showed no significant direct effect on recurrence, and its possible indirect, mechanically mediated contribution should be regarded as hypothesis-generating pending prospective confirmation. Clinicians managing high-risk patients (elevated NLR, non-expandable lung, or cachexia) should prioritize mechanical optimization—large-bore drainage, VATS poudrage, or early indwelling pleural catheter placement. Full article

Background/Objectives: Traumatic subarachnoid hemorrhage (tSAH) is one of the most frequent intracranial findings in moderate-to-severe traumatic brain injury. This study evaluated whether integrating systemic inflammatory markers—white blood cell count (WBC), neutrophil count, neutrophil-to-lymphocyte ratio (NLR), and C-reactive protein (CRP)—with the Glasgow Coma Scale (GCS) and Injury Severity Score (ISS) improves the prediction of neurosurgical intervention in adult tSAH patients, compared with clinical scores alone. Methods: This single-center retrospective cohort study included 69 adult patients (age ≥ 18 years) with computed tomography (CT)-confirmed tSAH treated between January and December 2023. Patients younger than 18 years were excluded a priori given age-specific reference ranges for WBC and lymphocyte count. Neurosurgical intervention was defined as any cranial or therapeutic intracranial vascular procedure directly addressing the intracranial pathology; patients whose only procedure was unrelated to the intracranial injury were classified as non-surgical. Patients were stratified into surgery (n = 12) and no-surgery (n = 57) groups. Diagnostic accuracy was assessed by receiver operating characteristic (ROC) curve analysis with DeLong pairwise comparisons; logistic regression estimated odds ratios (ORs). Results: WBC (area under the curve [AUC] = 0.850), GCS (AUC = 0.831), and ISS (AUC = 0.827) were the strongest individual predictors; neutrophil count was also significant (AUC = 0.807), while NLR and CRP were not discriminatory. The combined WBC + GCS model achieved an AUC = 0.904 (sensitivity 75.0%, specificity 93.0%), without statistically significant superiority over either predictor alone (DeLong p = 0.571 and p = 0.455, respectively). In multivariable analysis, both WBC (OR = 3.951, p = 0.006) and GCS (OR = 0.331, p = 0.002) were independent predictors of neurosurgical intervention. A sensitivity analysis excluding the single endovascular-intervention case (n = 68) yielded materially unchanged results. Conclusions: WBC and GCS were independently associated with neurosurgical intervention in this exploratory adult tSAH cohort. The combined model showed numerically higher discrimination than either predictor alone, although this incremental difference was not statistically significant. Given the small event count, these findings should be regarded as hypothesis-generating; internal and external validation in larger cohorts is required before clinical application. Full article

Background: Despite advances in surgical and perioperative care, early mortality and postoperative complications after isolated coronary artery bypass grafting (CABG) remain clinically relevant. Conventional risk models primarily reflect baseline clinical and operative characteristics and may not fully capture the dynamic immune-inflammatory response to cardiopulmonary bypass and surgical trauma. Hematologic indices derived from routine complete blood counts may provide a practical and low-cost assessment of this perioperative inflammatory burden. Methods: This single-center retrospective observational study included 650 adult patients who underwent isolated CABG between 2020 and 2024. Preoperative and postoperative monocyte-to-lymphocyte ratio (MLR), pan-immune-inflammation value (PIV), and delta neutrophil index (DNI) were evaluated. The primary outcome was in-hospital mortality, and the secondary outcome was a composite postoperative adverse event comprising prolonged mechanical ventilation, prolonged intensive care unit stay, prolonged inotropic support, pneumonia, or sepsis. Results: In-hospital mortality occurred in 52 patients (8.0%), and composite postoperative adverse events occurred in 221 patients (34.0%). Non-survivors were older and had higher clinical risk scores, lower ejection fraction, longer cardiopulmonary bypass and aortic cross-clamp times, and less favorable renal and inflammatory profiles. Preoperative and postoperative MLR, PIV, and DNI were significantly higher in non-survivors after false discovery rate correction. In univariable analyses, DNI showed the strongest associations with mortality; however, none of the immune-inflammatory indices remained independently associated with mortality or composite postoperative adverse events after multivariable adjustment. Among individual biomarkers, postoperative DNI showed the highest discrimination for in-hospital mortality (AUC 0.765, 95% CI 0.692–0.838), followed by preoperative DNI (AUC 0.738). Addition of postoperative DNI to the clinical mortality model increased the AUC from 0.805 to 0.815, although the incremental improvement was not statistically significant. Conclusions: Although perioperative MLR, PIV, and DNI were associated with adverse outcomes in unadjusted analyses, none remained independently associated with in-hospital mortality or composite postoperative adverse events after multivariable adjustment. Postoperative DNI showed the strongest individual discrimination for mortality; however, its addition to the clinical model resulted in only a small and statistically non-significant improvement in AUC. These findings indicate limited incremental prognostic value of the evaluated immune-inflammatory indices beyond established clinical and operative risk factors and do not support their use as stand-alone predictors after isolated CABG. Full article

Background/Objectives: Neonatal sepsis remains a major cause of morbidity and mortality worldwide, underscoring the critical need for early and accurate diagnostic biomarkers. This study aimed to evaluate the predictive value of the red cell distribution width-to-albumin ratio (RAR) for the diagnosis of neonatal sepsis and to compare its diagnostic performance with the C-reactive protein-to-albumin ratio (CAR) and other hematological parameters. Methods: This retrospective cohort study was conducted in the Neonatology Department of Karadeniz Technical University Faculty of Medicine between January 2015 and June 2025. A total of 874 neonates with a gestational age > 36 weeks were included: 411 with blood culture-confirmed sepsis (108 Gram-negative, 303 Gram-positive) and 463 healthy controls. Diagnostic performance was assessed using receiver operating characteristic (ROC) curve analysis, with optimal cut-off values determined by the Youden index. Results: RAR demonstrated modest diagnostic accuracy for neonatal sepsis, with an area under the curve (AUC) of 0.647 (95% CI: 0.61–0.69), a cut-off value of 5.108, sensitivity of 50.7%, and specificity of 76.7%. RAR was significantly elevated in the Gram-negative group compared with Gram-positive cases and controls (p < 0.001). However, the clinical significance of this subgroup difference requires further investigation. In multivariable logistic regression analysis, RAR remained independently associated with culture-confirmed neonatal sepsis after adjustment for gestational age, birth weight, sex, and mode of delivery (aOR = 2.190, 95% CI: 1.838–2.608, p < 0.001). Among all evaluated markers, CAR achieved the highest diagnostic performance (AUC: 0.981, sensitivity: 88.5%, specificity: 98.7%, PPV: 98.4%, NPV: 90.7%, LR+: 68.47), followed by C-reactive protein (AUC: 0.978), while neutrophil-to-lymphocyte ratio showed the lowest discriminatory ability (AUC: 0.592). Conclusions: RAR showed limited standalone discriminatory performance for culture-confirmed neonatal sepsis, although its association with sepsis remained significant after adjustment for relevant demographic and perinatal factors. CAR demonstrated significantly greater discriminatory performance than RAR. Further studies are needed to determine whether RAR provides incremental value when incorporated into multivariable diagnostic models. Full article

Background: Inflammation plays a key role in the onset of hypertension and left ventricular hypertrophy (LVH); large-scale studies on inflammatory markers in hypertension-related LVH are lacking. This study aims to investigate the relationship between inflammatory markers and LVH in hypertensive patients and evaluate their clinical diagnostic value. Methods: The present cross-sectional study included 21,486 patients diagnosed with hypertension from a China Hospital. Six inflammatory indices are calculated based on complete blood counts, including the aggregate index of systemic inflammation (AISI), Systemic Inflammation Response Index (SIRI), Systemic Immune Inflammation Index (SII), Neutrophil-to-Lymphocyte Ratio (NLR), Neutrophil-to-Platelet Ratio (NPR) and the Platelet-to-Lymphocyte Ratio (PLR). Multivariate logistic regression models, receiver operating characteristic (ROC) curves, the area under the curve (AUC), the net reclassification improvement (NRI), the improved discriminant index (IDI), decision curve analysis (DCA), sensitivity analysis and subgroup analysis were performed. Results: Levels of all inflammatory indices were significantly higher in hypertensive patients with LVH compared to those without LVH. Following multivariate adjustment, the odds of prevalent LVH increased by 76%, 48% and 39% for each one-standard-deviation increase in SII, NLR and AISI, respectively. After incorporating SII into the traditional risk factor model, the AUC of the combined diagnostic model increased significantly to 0.750, with an NRI of 0.437 and an IDI of 0.047. The AUC values for the combined models incorporating NLR, AISI, SIRI, PLR and NPR were 0.736, 0.728, 0.726, 0.720 and 0.719, respectively. Conclusions: In hypertensive patients, inflammatory indices, particularly SII, demonstrate a significant association with LVH and may provide incremental value for risk stratification beyond traditional risk factors. Further studies are needed to evaluate the clinical efficacy of these indices in management LVH. Full article

(1) Background/Objective: Routine blood tests may provide useful information at different stages of epithelial ovarian cancer (EOC) management. This study evaluated continuous lactate dehydrogenase (LDH), carbohydrate antigen 125 (CA125), and neutrophil-to-lymphocyte ratio (NLR) values for diagnostic discrimination in epithelial ovarian cancer (EOC) and, separately, triple-positive status in relation to platinum resistance and survival. (2) Methods: This retrospective study included 238 patients with EOC and 238 individually matched patients with benign ovarian lesions. Continuous biomarkers were entered into logistic regression models for diagnosis. Triple-positive status was defined as LDH > 195.5 U/L, CA125 > 35.37 U/mL, and NLR > 2.63. Logistic regression was used for platinum resistance and Cox regression for progression-free survival (PFS) and overall survival (OS). Bootstrap internal validation was performed for the diagnostic models and PFS nomogram. (3) Results: The continuous LDH + CA125 + NLR model yielded an AUC of 0.873, with 75.97% sensitivity and 88.66% specificity; AUCs were 0.751 in early-stage and 0.958 in advanced-stage EOC. Adding NLR to LDH + CA125 did not significantly improve the AUC overall or within stage groups. Triple-positive status was associated with platinum resistance (adjusted OR = 3.488, 95% CI 1.504–8.087; p = 0.004), shorter PFS (adjusted HR = 3.109, 95% CI 1.772–5.456; p < 0.001), and shorter OS in advanced-stage EOC (adjusted HR = 3.538, 95% CI 1.385–9.038; p = 0.008). The PFS nomogram had a bootstrap-corrected C-index of 0.7521. (4) Conclusions: The continuous three-marker model showed diagnostic discrimination in this selected surgical cohort, while triple-positive status was associated with platinum resistance and adverse survival outcomes. External validation is needed. Full article

Background and Objectives: Systemic inflammation and nutritional impairment may influence outcomes after permanent pacemaker implantation, but the prognostic value of composite indices in degenerative complete atrioventricular block remains unclear. We evaluated the associations of routinely available inflammatory and nutritional indices with long-term all-cause mortality in this population. Materials and Methods: This retrospective, single-center study included 272 patients who underwent permanent pacemaker implantation for isolated complete atrioventricular block attributed to degenerative conduction system disease between August 2020 and July 2024. Baseline laboratory values were used to calculate the prognostic nutritional index (PNI), geriatric nutritional risk index (GNRI), neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, systemic immune-inflammation index, systemic inflammation response index, and pan-immune-inflammation value. The primary endpoint was all-cause mortality during follow-up. Discriminatory performance was assessed using receiver operating characteristic (ROC) analysis, and independent associations were evaluated using multivariable Cox regression. Results: During a mean follow-up of 27.8 ± 16.6 months, 69 patients (25.4%) died. Compared with survivors, non-survivors were older and had lower hemoglobin, lymphocyte count, albumin, estimated glomerular filtration rate, GNRI, LMR, and PNI values, whereas C-reactive protein, NLR, and SIRI values were higher. PNI had the numerically highest AUC for mortality prediction (AUC: 0.720, 95% CI: 0.648–0.793; p < 0.001), corresponding to moderate discriminatory performance, whereas GNRI showed fair discrimination (AUC: 0.677, 95% CI: 0.589–0.766; p < 0.001). In multivariable Cox regression, PNI remained independently associated with mortality (HR: 0.945, 95% CI: 0.909–0.982; p = 0.004). Conclusions: Among the evaluated inflammatory and nutritional indices, PNI demonstrated the numerically highest discriminatory performance and remained independently associated with long-term all-cause mortality. PNI may therefore serve as a readily available adjunct to clinical risk stratification in patients undergoing permanent pacemaker implantation for degenerative complete atrioventricular block; however, external validation is required. Full article

Background: The relationship between acute fibrinous and organizing pneumonia (AFOP) and organizing pneumonia (OP) remains debated, and direct comparative evidence is limited. We aimed to delineate their differences across clinical, radiological, histological, and immunophenotypic dimensions. Methods: We conducted a retrospective study of 85 consecutive patients with pathologically confirmed AFOP (n = 49) or OP (n = 36). Clinical data, radiological patterns, laboratory findings, and immunohistochemical profiles of alveolar epithelial, macrophage, lymphocyte, vascular, and mesenchymal markers were comprehensively compared. Results: The two groups were comparable in demographics, clinical symptoms, and dominant radiological patterns. However, median C-reactive protein (CRP; 80.45 vs. 12.65 mg/L, p < 0.001) and neutrophil-to-lymphocyte ratio (NLR; 4.56 vs. 2.42, p = 0.013) were higher in AFOP, with CRP demonstrating an apparent area under the curve (AUC) of 0.798 for discriminating AFOP from OP in this derivation cohort. After Benjamini–Hochberg correction for multiple comparisons, CD68 was significantly higher, and CD38 was significantly lower in AFOP than in OP. Trends were also observed for CD163, surfactant protein A (SP-A), and CD34, but these did not remain statistically significant after correction. All three deaths and all cases requiring mechanical ventilation occurred in the AFOP group, though these differences were not statistically significant. Conclusions: Despite clinical and radiological overlap, AFOP and OP exhibit distinct systemic inflammatory responses and pulmonary immunophenotypes, with AFOP characterized by macrophage-predominant inflammation and qualitatively fewer CD34+ microvessels within fibrin balls. These immunophenotypic findings are descriptive and require further validation. Full article

Background: The prognostic value of preoperative inflammatory and nutritional biomarkers in colorectal cancer has been extensively investigated, but their association with metastatic lymph node burden remains insufficiently explored. This study evaluated whether routinely available biomarkers are associated with the number of metastatic lymph nodes in patients undergoing colorectal cancer resection. Methods: We retrospectively analyzed 935 consecutive patients who underwent colorectal cancer surgery between 2020 and 2024. Preoperative hemoglobin, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and Prognostic Nutritional Index (PNI) were assessed. Negative binomial regression was used to model metastatic lymph node count, with sensitivity analyses accounting for surgical setting and total lymph node yield. Results: In the fully adjusted primary model, tumor location (p = 0.021), PNI (adjusted IRR 1.024; p = 0.045), mucinous component (adjusted IRR 1.768; p = 0.026), and lymphovascular invasion (adjusted IRR 2.197; p = 0.012) were associated with metastatic lymph node burden, whereas NLR and PLR were not. After additional adjustment for total lymph node yield, the associations with PNI, mucinous component, and tumor location were attenuated, while lymphovascular invasion remained independently associated with greater nodal burden (adjusted IRR 2.376; p = 0.007). Conclusions: Lymphovascular invasion showed the most robust association with metastatic lymph node burden. Although PNI showed a modest association in the primary model, it provided no significant incremental improvement in model fit, while tumor-location associations were sensitive to model specification. These findings require validation in independent cohorts. Full article