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Iwata K, Suzawa K, Hashimoto K, Tanaka S, Shien K, Miyoshi K, Yamamoto H, Okazaki M, Sugimoto S, Toyooka S. Utility of neutrophil-to-lymphocyte ratio as an indicator of tumor immune status in non-small cell lung cancer. Jpn J Clin Oncol 2024; 54:895-902. [PMID: 38704243 PMCID: PMC11322889 DOI: 10.1093/jjco/hyae058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Accepted: 04/17/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND Neutrophil-to-lymphocyte ratio (NLR) has been reported as a prognostic biomarker in non-small cell lung cancer (NSCLC); however, the underlying biological rationale remains unclear. The present study aimed to explore the potential utility of NLR as a surrogate biomarker for immune response to cancer and to elucidate the underlying mechanism. METHODS This retrospective study included the medical records of 120 patients with NSCLC who underwent surgery at the study institution in 2012. NLR in peripheral blood was determined from blood test within 30 days before surgery. Tumor immune status was evaluated using immunohistochemical staining to identify CD3+, CD8+ and FOXP3+ tumor-infiltrating lymphocytes (TILs), and the relationship of NLR, with clinicopathologic characteristics including 5-year overall survival (OS), and the tumor immune status was investigated. The median values of NLR and TIL count were used as cutoff points. RESULTS The 5-year OS was significantly better in patients with low NLR (<2.2) than in those with high NLR (≥2.2) (70.1% vs. 56.8%, P = 0.042) and in patients with high CD3+ TIL count (≥242) than in those with low CD3+ TIL count (<242) (70% vs. 56.8%, P = 0.019). Additionally, the CD3+ TIL count was negatively correlated with preoperative NLR (P = 0.005). CONCLUSION NLR might potentially reflect the immune status of tumor microenvironment, explaining its impact on prognosis of patients with NSCLC.
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Affiliation(s)
- Kazuma Iwata
- Department of General Thoracic Surgery and Brest and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
| | - Ken Suzawa
- Department of General Thoracic Surgery and Brest and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
- Department of Thoracic Surgery, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
| | - Kohei Hashimoto
- Department of General Thoracic Surgery and Brest and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
- Department of Thoracic Surgery, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
| | - Shin Tanaka
- Department of General Thoracic Surgery and Brest and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
- Department of Thoracic Surgery, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
| | - Kazuhiko Shien
- Department of General Thoracic Surgery and Brest and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
- Department of Thoracic Surgery, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
| | - Kentaroh Miyoshi
- Department of General Thoracic Surgery and Brest and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
- Department of Thoracic Surgery, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
| | - Hiromasa Yamamoto
- Department of General Thoracic Surgery and Brest and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
- Department of Thoracic Surgery, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
| | - Mikio Okazaki
- Department of General Thoracic Surgery and Brest and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
- Department of Thoracic Surgery, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
| | - Seiichiro Sugimoto
- Department of General Thoracic Surgery and Brest and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
- Department of Thoracic Surgery, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
| | - Shinichi Toyooka
- Department of General Thoracic Surgery and Brest and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
- Department of Thoracic Surgery, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
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Chatziioannou E, Higuita LMS, Kreft S, Kandolf L, Dujovic B, Reinhardt L, Tamara E, Marquez-Rodas I, Fortuna ARFP, Nübling A, Niessner H, Forschner A, Garbe C, Popovic A, Mirjana B, Meier F, Eigentler T, Leiter U, Flatz L, Sinnberg T, Amaral T. Nomogram for predicting survival after first-line anti-PD-1-based immunotherapy in unresectable stage IV melanoma: a multicenter international study. ESMO Open 2024; 9:103661. [PMID: 39096893 PMCID: PMC11345525 DOI: 10.1016/j.esmoop.2024.103661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Revised: 07/04/2024] [Accepted: 07/05/2024] [Indexed: 08/05/2024] Open
Abstract
BACKGROUND The introduction of anti-programmed cell death protein 1 (PD-1) immunotherapy has revolutionized the treatment landscape for melanoma, enhancing both response rates and survival outcomes in patients with advanced stages of the disease. Despite these remarkable advances, a noteworthy subset of patients (40%-60%) does not derive advantage from this therapeutic approach. This study aims to identify key predictive factors and create a user-friendly predictive nomogram for stage IV melanoma patients receiving first-line anti-PD-1-based immunotherapy, improving treatment decisions. MATERIALS AND METHODS In this retrospective study, we included patients with unresectable stage IV melanoma who received first-line treatment with either anti-PD-1 monotherapy or anti-PD-1 plus anti-cytotoxic T-lymphocyte associated protein 4 between 2014 and 2018. We documented clinicopathological features and blood markers upon therapy initiation. By employing the random survival forest model and backward variable selection of the Cox model, we identified variables associated with progression-free survival (PFS) after the first-line anti-PD-1-based treatment. We developed and validated a predictive nomogram for PFS utilizing the identified variables. We assessed calibration and discrimination performance metrics as part of the evaluation process. RESULTS The study involved 719 patients, divided into a training cohort of 405 (56%) patients and a validation cohort of 314 (44%) patients. We combined findings from the random survival forest and the Cox model to create a nomogram that incorporates the following factors: lactate dehydrogenase (LDH), S100, melanoma subtype, neutrophil-to-lymphocyte ratio (NLR), body mass index, type of immune checkpoint inhibitor, and presence of liver or brain metastasis. The resultant model had a C-index of 0.67 in the training cohort and 0.66 in the validation cohort. Performance remained in different patient subgroups. Calibration analysis revealed a favorable correlation between predicted and actual PFS rates. CONCLUSIONS We developed and validated a predictive nomogram for long-term PFS in patients with unresectable stage IV melanoma undergoing first-line anti-PD-1-based immunotherapy.
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Affiliation(s)
- E Chatziioannou
- Center for Dermato-oncology, Department of Dermatology, Eberhard Karls University of Tübingen, Tübingen; Cluster of Excellence iFIT (EXC 2180) 'Image-Guided and Functionally Instructed Tumor Therapies', Tübingen
| | - L M Serna Higuita
- Department of Clinical Epidemiology and Applied Biostatistics, Eberhard Karls University of Tübingen, Tübingen
| | - S Kreft
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - L Kandolf
- Department of Dermatology, Faculty of Medicine, Military Medical Academy, Belgrade, Serbia
| | - B Dujovic
- Department of Dermatology, Faculty of Medicine, Military Medical Academy, Belgrade, Serbia
| | - L Reinhardt
- Skin Cancer Center at the University Cancer Center and National Center for Tumor Diseases, Dresden; Department of Dermatology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - E Tamara
- Department of Dermatology and Allergology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - I Marquez-Rodas
- Department of Medical Oncology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - A R F P Fortuna
- Department of Medical Oncology, University Hospital Center of Algarve, Faro, Portugal
| | - A Nübling
- Center for Dermato-oncology, Department of Dermatology, Eberhard Karls University of Tübingen, Tübingen
| | - H Niessner
- Center for Dermato-oncology, Department of Dermatology, Eberhard Karls University of Tübingen, Tübingen
| | - A Forschner
- Center for Dermato-oncology, Department of Dermatology, Eberhard Karls University of Tübingen, Tübingen
| | - C Garbe
- Center for Dermato-oncology, Department of Dermatology, Eberhard Karls University of Tübingen, Tübingen
| | - A Popovic
- Clinic for Medical Oncology, Clinical Center Nis, Niš, Serbia
| | - B Mirjana
- Clinic for Medical Oncology, Clinical Center Nis, Niš, Serbia
| | - F Meier
- Skin Cancer Center at the University Cancer Center and National Center for Tumor Diseases, Dresden; Department of Dermatology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - T Eigentler
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - U Leiter
- Center for Dermato-oncology, Department of Dermatology, Eberhard Karls University of Tübingen, Tübingen
| | - L Flatz
- Center for Dermato-oncology, Department of Dermatology, Eberhard Karls University of Tübingen, Tübingen; Department of Dermatology and Allergology, Kantonsspital St. Gallen, St. Gallen, Switzerland; Institute for Immunobiology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - T Sinnberg
- Center for Dermato-oncology, Department of Dermatology, Eberhard Karls University of Tübingen, Tübingen; Cluster of Excellence iFIT (EXC 2180) 'Image-Guided and Functionally Instructed Tumor Therapies', Tübingen; Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - T Amaral
- Center for Dermato-oncology, Department of Dermatology, Eberhard Karls University of Tübingen, Tübingen; Cluster of Excellence iFIT (EXC 2180) 'Image-Guided and Functionally Instructed Tumor Therapies', Tübingen.
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Taylor M, Evison M, Michael S, Obale E, Fritsch NC, Abah U, Smith M, Martin GP, Shackcloth M, Granato F, Grant SW. Pre-Operative Measures of Systemic Inflammation Predict Survival After Surgery for Primary Lung Cancer. Clin Lung Cancer 2024; 25:460-467.e7. [PMID: 38796323 DOI: 10.1016/j.cllc.2024.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 03/22/2024] [Accepted: 04/28/2024] [Indexed: 05/28/2024]
Abstract
BACKGROUND Measures of systemic inflammation (MSIs) have been developed and shown to help predict prognosis in patients with lung cancer. However, studies investigating the impact of MSIs on outcomes solely in cohorts of patients undergoing curative-intent resection of NSCLC are lacking. In the era of individualized therapies, targeting inflammatory pathways could represent a novel addition to the armamentarium of lung cancer treatment. METHODS A multicentre retrospective review of patients who underwent primary lung cancer resection between 2012 and 2018 was undertaken. MSIs assessed were neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), systemic immune inflammation index (SII), advanced lung cancer inflammation index (ALI), prognostic nutritional index (PNI) and haemoglobin albumin lymphocyte platelet (HALP) score. Cox regression analysis was performed to assess the impact of MSIs on overall survival. RESULTS A total of 5029 patients were included in the study. Overall 90-day mortality was 3.7% (n = 185). All MSIs were significantly associated with overall survival on univariable analysis. After multivariable Cox regression analyses, lower ALI (expressed as a continuous variable) (HR 1.000, 95% CI 1.000-1.000, P = .049) and ALI <366.43 (expressed as a dichotomous variable) (HR 1.362, 95% CI 1.137-1.631, P < .001) remained independently associated with reduced overall survival. CONCLUSIONS MSIs have emerged in this study as potentially important factors associated with survival following lung resection for NSCLC with curative intent. In particular, ALI has emerged as independently associated with long-term outcomes. The role of MSIs in the clinical management of patients with primary lung cancer requires further investigation.
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Affiliation(s)
- Marcus Taylor
- Department of Cardiothoracic Surgery, Manchester University Hospital Foundation Trust, Wythenshawe Hospital, Manchester, M23 9LT, UK.
| | - Matt Evison
- Department of Thoracic Oncology, Manchester University Hospital NHS Foundation Trust, Wythenshawe Hospital, Manchester, UK
| | - Sarah Michael
- Department of Cardiothoracic Surgery, Manchester University Hospital Foundation Trust, Wythenshawe Hospital, Manchester, M23 9LT, UK
| | - Emmanuel Obale
- Department of Cardiothoracic Surgery, Manchester University Hospital Foundation Trust, Wythenshawe Hospital, Manchester, M23 9LT, UK
| | - Nils C Fritsch
- Department of Cardiothoracic Surgery, Manchester University Hospital Foundation Trust, Wythenshawe Hospital, Manchester, M23 9LT, UK
| | - Udo Abah
- Department of Cardiothoracic Surgery, Liverpool Heart & Chest Hospital, Liverpool, L14 3PE, UK
| | - Matthew Smith
- Department of Cardiothoracic Surgery, Liverpool Heart & Chest Hospital, Liverpool, L14 3PE, UK
| | - Glen P Martin
- Division of Informatics, Imaging and Data Science, Faculty of Biology, Medicine and Health, Manchester Academic Heath Science Centre, University of Manchester, Manchester, UK
| | - Michael Shackcloth
- Department of Cardiothoracic Surgery, Liverpool Heart & Chest Hospital, Liverpool, L14 3PE, UK
| | - Felice Granato
- Department of Cardiothoracic Surgery, Manchester University Hospital Foundation Trust, Wythenshawe Hospital, Manchester, M23 9LT, UK
| | - Stuart W Grant
- Division of Cardiovascular Sciences, University of Manchester, ERC, Manchester University Hospitals Foundation Trust, Manchester, M23 9LT, UK
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Lee IH, Na J, Lee SJ. Preoperative and Postoperative Platelet-Lymphocyte Ratio Is a Prognostic Marker for Patients With Soft Tissue Sarcoma Treated With Curative Resection. In Vivo 2024; 38:2049-2057. [PMID: 38936914 PMCID: PMC11215597 DOI: 10.21873/invivo.13663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 04/12/2024] [Accepted: 04/18/2024] [Indexed: 06/29/2024]
Abstract
BACKGROUND/AIM Systemic inflammation has been implicated in the development and progression of cancer. Inflammatory markers have been identified as prognostic indicators in numerous malignancies. This study explored the prognostic relevance of the initial and postoperative neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) on relapse-free survival (RFS) and overall survival (OS) in patients with soft-tissue sarcoma (STS) who underwent curative resection. PATIENTS AND METHODS We included 89 patients with STS who underwent extensive and radical resection at the Kyungpook National University Chilgok Hospital between 2004 and 2018. Kaplan-Meier curves for RFS and OS were calculated using multivariate Cox proportional models. RESULTS A total of 67 (75.3%) patients demonstrated a high initial NLR (≥4.1) and 65 (75.3%) showed a high initial PLR (≥231). In the univariate and multivariate analyses, an elevated initial PLR ratio was significantly associated with a decreased RFS (p=0.017) and OS (p=0.003). Patients with a high PLR (PLR >231) had a median RFS of 24 months, whereas those with a low PLR (PLR ≤231) had a median RFS of 96 months. The median OS was 50 and 298 months for the high PLR and low PLR groups, respectively. Furthermore, a high postoperative PLR ratio was associated with a decreased RFS (p=0.001) and OS (p=0.038). CONCLUSION Preoperative and postoperative PLR ratio can be used as a cost-effective prognostic marker for oncologic outcomes in patients with STS who undergo surgery.
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Affiliation(s)
- In Hee Lee
- Department of Oncology/Hematology, Kyungpook National University Chilgok Hospital, Kyungpook National University School of Medicine, Kyungpook National University Cancer Research Institute, Daegu, Republic of Korea
| | - Jihyun Na
- Department of Hematology and Oncology, Ulsan University Hospital, Ulsan Medical School, Ulsan, Republic of Korea
| | - Soo Jung Lee
- Department of Oncology/Hematology, Kyungpook National University Chilgok Hospital, Kyungpook National University School of Medicine, Kyungpook National University Cancer Research Institute, Daegu, Republic of Korea;
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Ma X, Lu X, Jiang X, Wang J, Wang T, Zhang L. A nomogram combining prognostic nutritional index and platelet lymphocyte ratio predicts postoperative pulmonary infection following D2 radical gastrectomy for gastric cancer. NUTR HOSP 2024; 41:602-611. [PMID: 38726634 DOI: 10.20960/nh.05079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2024] Open
Abstract
Introduction Introduction: the prognostic nutritional index (PNI) and platelet-lymphocyte ratio (PLR) have been found to correlate with outcomes following radical gastrectomy for gastric cancer (GC). Objectives: to construct a nomogram combining PNI and PLR for individually forecasting the risk of postoperative pulmonary infection (POI) following D2 radical gastrectomy for GC. Methods: retrospectively, clinical data was gathered from 404 patients treated with D2 radical gastrectomy for GC. The study used multivariate logistic regression analysis to screen independent risk factors for POI after surgery. Subsequently, a nomogram was developed based on the above factors to forecast the POI probability accurately. Results: the multivariate logistic regression analysis identified age, PNI, PLR, CA199 level, ASA score, and ICU treatment as independent risk variables for POI following D2 radical gastrectomy (p < 0.001 or 0.05). The nomogram's area under the receiver operating characteristic curve (AUC) for predicting the risk of POI was 0.736 (95 % confidence interval (CI) = 0.678-0.794). The nomogram was internally validated using the bootstrap approach, involving repeated sampling 1000 times. The result yielded a concordance index (c-index) of 0.707 (95 % CI = 0.705-0.709). The calibration curves demonstrated an excellent concordance between the predicted values of the nomogram and the observed values. The nomogram's clinical value was shown to be high using decision analysis curves. Conclusions: a nomogram combining PNI and PLR is a dependable tool for forecasting the probability of POI following D2 radical gastrectomy for GC.
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Affiliation(s)
- Xinghao Ma
- Department of Clinical Nutrition. Lu'an Hospital. Anhui Medical University
| | - Xiumin Lu
- Department of Gastrointestinal Surgery. Lu'an Hospital. Anhui Medical University
| | - Xiaoyang Jiang
- Department of Clinical Nutrition. Lu'an Hospital. Anhui Medical University
| | - Jiajia Wang
- Department of Clinical Nutrition. Lu'an Hospital. Anhui Medical University
| | - Tingting Wang
- Department of Clinical Nutrition. Lu'an Hospital. Anhui Medical University
| | - Li Zhang
- Department of Clinical Nutrition. Lu'an Hospital. Anhui Medical University
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Fagarasan G, Seicean R, Bintintan V, Fagarasan V, Caziuc A, Andras D, Chira L, Dindelegan G. The Value of Preoperative C-Reactive Protein to Albumin Ratio as a Prognostic Biomarker in Colon Cancer Patients. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1054. [PMID: 39064483 PMCID: PMC11278571 DOI: 10.3390/medicina60071054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2024] [Revised: 06/19/2024] [Accepted: 06/24/2024] [Indexed: 07/28/2024]
Abstract
Inflammatory acute phase proteins have been reported to play a crucial role in cancer progression. Various hematologic and inflammatory markers and scores, such as the lymphocyte-to-monocyte ratio, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, systemic inflammation score (SIS), prognostic nutritional index (PNI), Glasgow prognostic score, and, more recently, the Naples prognostic score, have been reported as significant prognostic markers. The aim of this prospective study was to evaluate the prognostic significance of the C reactive protein-to-albumin ratio (CAR) in patients with colon cancer. Materials and Methods: We conducted a prospective observational study on a series of patients who underwent curative surgery for colon cancer. The C reactive protein-to-albumin ratio was determined preoperatively, and we evaluated the correlations between the CAR and various clinical and pathological parameters, as well as the correlation with Overall and Relapse-free survival. Furthermore, we compared the accuracy of the CAR with that of the Naples score. Results: One hundred and ten patients were included in the study. We set 0.4927 as the cut-off value for the CAR according to a receiver operating characteristic curve analysis. Based on the cut-off value, patients were divided into a low CAR group and a high CAR group. The preoperative CAR exhibited statistically significant correlation with tumor volume, T and N stage, number of positive lymph nodes, and grade of tumor differentiation. We also demonstrated a positive correlation between high CAR values and a higher Naples score (p = 0.0005), even when a subgroup analysis was performed for each group individually. Conclusions: The preoperative CAR is a useful prognostic marker in patients with colon cancer. These results may help to design strategies to personalize targeted management approaches among colon cancer patients.
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Affiliation(s)
| | - Radu Seicean
- First Surgical Clinic, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj Napoca, Romania; (G.F.); (V.B.); (V.F.); (A.C.); (D.A.); (L.C.); (G.D.)
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Russo P, Milani F, De Iure A, Proietti S, Limongi D, Prezioso C, Checconi P, Zagà V, Novazzi F, Maggi F, Antonelli G, Bonassi S. Effect of Cigarette Smoking on Clinical and Molecular Endpoints in COPD Patients. Int J Mol Sci 2024; 25:5834. [PMID: 38892022 PMCID: PMC11172087 DOI: 10.3390/ijms25115834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 05/22/2024] [Accepted: 05/23/2024] [Indexed: 06/21/2024] Open
Abstract
Cigarette smoking is a primary contributor to mortality risks and is associated with various diseases. Among these, COPD represents a significant contributor to global mortality and disability. The objective of this study is to investigate the effect of smoking on a selected battery of variables, with an emphasis on DNA damage. A total of 87 elderly patients diagnosed with COPD, divided into three groups based on their smoking history (current, former, never-smokers), were evaluated using a cross-sectional approach. Clinical features including mortality and inflammatory/oxidative parameters (Lymphocytes/Monocytes, Neutrophils/Lymphocytes, Platelets/Lymphocytes ratio), SII, MDA, 8-Oxo-dG, and IL6 (ELISA assay), as well as DNA damage (comet assay), were investigated. Virus infection, i.e., influenza A virus subtype H1N1, JC polyomavirus (JCPyV), BK polyomavirus (BKPyV), and Torquetenovirus (TTV), was also tested. Current smokers exhibit higher levels of comorbidity (CIRS; p < 0.001), Platelets/Lymphocytes ratio (p < 0.001), systemic immune inflammation (p < 0.05), and DNA damage (p < 0.001). Former smokers also showed higher values for parameters associated with oxidative damage and showed a much lower probability of surviving over 5 years compared to never- and current smokers (p < 0.0017). This study showed a clear interaction between events which are relevant to the oxidative pathway and cigarette smoking. A category of particular interest is represented by former smokers, especially for lower survival, possibly due to the presence of more health problems. Our findings raise also the attention to other parameters which are significantly affected by smoking and are useful to monitor COPD patients starting a program of pulmonary rehabilitation (DNA damage, inflammation parameters, and selected viral infections).
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Affiliation(s)
- Patrizia Russo
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele University, Via di Val Cannuta 247, 00166 Rome, Italy; (P.R.); (F.M.); (S.P.); (D.L.); (C.P.); (P.C.); (S.B.)
- Clinical and Molecular Epidemiology, Istituto di Ricovero e Cura a Carattere Scientifico—IRCCS San Raffaele Roma, Via di Val Cannuta 247, 00166 Rome, Italy
| | - Francesca Milani
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele University, Via di Val Cannuta 247, 00166 Rome, Italy; (P.R.); (F.M.); (S.P.); (D.L.); (C.P.); (P.C.); (S.B.)
- Clinical and Molecular Epidemiology, Istituto di Ricovero e Cura a Carattere Scientifico—IRCCS San Raffaele Roma, Via di Val Cannuta 247, 00166 Rome, Italy
| | - Antonio De Iure
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele University, Via di Val Cannuta 247, 00166 Rome, Italy; (P.R.); (F.M.); (S.P.); (D.L.); (C.P.); (P.C.); (S.B.)
- Experimental Neurophisiology Lab, Istituto di Ricovero e Cura a Carattere Scientifico—IRCCS San Raffaele Roma, Via di Val Cannuta 247, 00166 Rome, Italy
| | - Stefania Proietti
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele University, Via di Val Cannuta 247, 00166 Rome, Italy; (P.R.); (F.M.); (S.P.); (D.L.); (C.P.); (P.C.); (S.B.)
- Clinical and Molecular Epidemiology, Istituto di Ricovero e Cura a Carattere Scientifico—IRCCS San Raffaele Roma, Via di Val Cannuta 247, 00166 Rome, Italy
| | - Dolores Limongi
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele University, Via di Val Cannuta 247, 00166 Rome, Italy; (P.R.); (F.M.); (S.P.); (D.L.); (C.P.); (P.C.); (S.B.)
- Laboratory of Microbiology, Istituto di Ricovero e Cura a Carattere Scientifico—IRCCS San Raffaele Roma, Via di Val Cannuta 247, 00166 Rome, Italy
| | - Carla Prezioso
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele University, Via di Val Cannuta 247, 00166 Rome, Italy; (P.R.); (F.M.); (S.P.); (D.L.); (C.P.); (P.C.); (S.B.)
- Laboratory of Microbiology, Istituto di Ricovero e Cura a Carattere Scientifico—IRCCS San Raffaele Roma, Via di Val Cannuta 247, 00166 Rome, Italy
| | - Paola Checconi
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele University, Via di Val Cannuta 247, 00166 Rome, Italy; (P.R.); (F.M.); (S.P.); (D.L.); (C.P.); (P.C.); (S.B.)
- Laboratory of Microbiology, Istituto di Ricovero e Cura a Carattere Scientifico—IRCCS San Raffaele Roma, Via di Val Cannuta 247, 00166 Rome, Italy
| | - Vincenzo Zagà
- Italian Society of Tabaccology (SITAB), Via G. Scalia 39, 00136 Rome, Italy;
| | - Federica Novazzi
- Department of Medicine and Surgery, University of Insubria, Via Ravasi 2, 21100 Varese, Italy;
| | - Fabrizio Maggi
- Istituto Nazionale Malattie Infettive Lazzaro Spallanzani, Via Portuense 292, 00149 Rome, Italy;
| | - Guido Antonelli
- Virology Laboratory, Department of Molecular Medicine, Sapienza University, Viale Porta Tiburtina 28, 00185 Rome, Italy;
- Microbiology and Virology Unit, Sapienza University Hospital Policlinico Umberto I, Viale del Policlinico 155, 00161 Rome, Italy
| | - Stefano Bonassi
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele University, Via di Val Cannuta 247, 00166 Rome, Italy; (P.R.); (F.M.); (S.P.); (D.L.); (C.P.); (P.C.); (S.B.)
- Clinical and Molecular Epidemiology, Istituto di Ricovero e Cura a Carattere Scientifico—IRCCS San Raffaele Roma, Via di Val Cannuta 247, 00166 Rome, Italy
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8
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Liu YC, Chuang SH, Chen YP, Shih YH. Associations of novel complete blood count-derived inflammatory markers with psoriasis: a systematic review and meta-analysis. Arch Dermatol Res 2024; 316:228. [PMID: 38787437 DOI: 10.1007/s00403-024-02994-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 04/15/2024] [Accepted: 04/26/2024] [Indexed: 05/25/2024]
Abstract
Psoriasis is an immune-mediated disorder which primarily affects skin and has systemic inflammatory involvement. Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and monocyte-to-lymphocyte ratio (MLR) are novel complete blood count (CBC)-derived markers which can reflect systemic inflammation. This study aimed to systematically investigate the associations of NLR, PLR, SII, and MLR with psoriasis. This study was performed in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. A comprehensive search of Pubmed, Embase, Scopus, and Google Scholar was conducted for relevant studies. Observational studies evaluating the correlations of NLR, PLR, SII, or MLR with psoriasis were included. The primary outcomes were the associations of these inflammatory markers with the presence and severity of psoriasis. The random-effect model was applied for meta-analysis. 36 studies comprising 4794 psoriasis patients and 55,121 individuals in total were included in the meta-analysis. All inflammatory markers were significantly increased in psoriasis groups compared to healthy controls (NLR: MD = 0.59, 95% CI: 0.47-0.7; PLR: MD = 15.53, 95% CI: 8.48-22.58; SII: MD = 111.58, 95% CI: 61.49-161.68; MLR: MD = 0.034, 95% CI: 0.021-0.048; all p < 0.001). Between-group mean differences in NLR and PLR were positively correlated with the mean scores of Psoriasis Area Severity Index (NLR: p = 0.041; PLR: p = 0.021). NLR, PLR, SII, and MLR are associated with the presence of psoriasis. NLR and PLR serve as significant indicators of psoriasis severity. These novel CBC-derived markers constitute potential targets in the screening and monitoring of psoriasis.
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Affiliation(s)
- Yu-Cheng Liu
- Department of General Medicine, Taipei Medical University Shuang Ho Hospital, New Taipei, 23561, Taiwan
| | - Shu-Han Chuang
- Division of General Practice, Department of Medical Education, Changhua Christian Hospital, Changhua, 50006, Taiwan
| | - Yu-Pin Chen
- Department of Orthopedics, Taipei Municipal Wan Fang Hospital, Taipei, 11696, Taiwan
- Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, 11031, Taiwan
| | - Yi-Hsien Shih
- Department of Dermatology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, 11031, Taiwan.
- Department of Dermatology, Taipei Medical University Shuang Ho Hospital, New Taipei City, 23561, Taiwan.
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9
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Choi H, Baek JH, Seo AN, Park SY, Kim HJ, Park JS, Choi GS, Kim JG, Kang BW. Systemic Inflammatory Response Following Preoperative Chemoradiotherapy Can Affect Oncologic Outcomes in MSI-H/dMMR Rectal Cancer. Chonnam Med J 2024; 60:105-112. [PMID: 38841607 PMCID: PMC11148308 DOI: 10.4068/cmj.2024.60.2.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 02/19/2024] [Accepted: 02/20/2024] [Indexed: 06/07/2024] Open
Abstract
Systemic inflammatory response (SIR) is a crucial determinant of disease progression and survival in patients with colorectal cancer. This study investigated the prognostic relevance of changes in the platelet count on survival and the predictive value of changes in the platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) on the pathological tumor response to preoperative chemoradiotherapy (CRT) in patients with microsatellite instability-high (MSI-H) rectal cancer. From 2011 to 2022, data of 46 consecutive patients with MSI-H rectal cancer who were treated with preoperative CRT followed by curative surgery at Kyungpook National University Chilgok Hospital (Daegu, South Korea) were retrospectively analyzed. A 235 cut-off value was used to define whether PLR was high or low. Any change in the PLR or NLR was calculated on the basis of subtracting the pre-CRT PLR or NLR from the post-CRT values. Both pre-CRT and post-CRT values of the NLR and PLR were not significantly associated with clinical outcomes. Simple logistic regression analysis showed that a change in the PLR following CRT was not significantly associated with survival outcomes; however, patients who maintained a high change in the PLR following CRT showed significantly better pathologic T-stage. No statistically significant association was noted between changes in the platelet count and clinical outcomes of patients. The results suggested that changes in the PLR following CRT are associated with pathologic T-stage of the group. However, the SIR markers showed no prognostic values on the survival outcomes of the patients with MSI-H/mismatch repair-deficient (dMMR) locally advanced rectal cancer (LARC).
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Affiliation(s)
- Hyukjin Choi
- Department of Oncology/Hematology, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Kyungpook National University Cancer Research Institute, Daegu, Korea
| | - Jin Ho Baek
- Department of Oncology/Hematology, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Kyungpook National University Cancer Research Institute, Daegu, Korea
| | - An Na Seo
- Department of Pathology, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Kyungpook National University Cancer Research Institute, Daegu, Korea
| | - Su Yeon Park
- Department of Surgery, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Kyungpook National University Cancer Research Institute, Daegu, Korea
| | - Hye Jin Kim
- Department of Surgery, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Kyungpook National University Cancer Research Institute, Daegu, Korea
| | - Jun Seok Park
- Department of Surgery, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Kyungpook National University Cancer Research Institute, Daegu, Korea
| | - Gyu Seog Choi
- Department of Surgery, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Kyungpook National University Cancer Research Institute, Daegu, Korea
| | - Jong Gwang Kim
- Department of Oncology/Hematology, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Kyungpook National University Cancer Research Institute, Daegu, Korea
| | - Byung Woog Kang
- Department of Oncology/Hematology, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Kyungpook National University Cancer Research Institute, Daegu, Korea
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10
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Dong Q, Zhao F, Li Y, Song F, Li E, Gao L, Xin Y, Shen G, Ren D, Wang M, Zhao Y, Liu Z, Xie Q, Liu Z, Li Z, Zhao J. The correlation between systemic inflammatory markers and efficiency for advanced gastric cancer patients treated with ICIs combined with chemotherapy. Immunology 2024; 172:77-90. [PMID: 38269606 DOI: 10.1111/imm.13759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 01/11/2024] [Indexed: 01/26/2024] Open
Abstract
Currently lacking research to explore the correlation between inflammatory markers and the efficacy of immune checkpoint inhibitors (ICIs) combined with chemotherapy in the treatment of advanced gastric cancer. This study is a retrospective study and included patients with advanced gastric cancer who receiving ICIs combined with chemotherapy from January 2020 to December 2022. We analysed the relationship between systemic inflammatory markers and the efficacy of ICIs combined chemotherapy and constructed a clinical prediction model. A nomogram was constructed based on the results of the bidirectional stepwise regression model. A total of 197 patients were enrolled in the training group, with a median follow-up period of time 26 months. Kaplan Meier analysis showed that the median OS of patients with low systemic immune-inflammatory index (SII) and low platelet to lymphocyte ratio (PLR) was superior to those with high SII and PLR. Univariate and multivariate Cox regression analysis showed that SII, NLR, PLR, and N stage as independent prognostic factors for OS. Adding SII to the conventional model improved the predictive ability of the 12-month OS. A total of 95 patients were included in the validation group, and external validation of the SII-based nomogram showed favourable predictive performance. Baseline SII, PLR, and N stage may serve as independent predictive factors for survival outcomes in advanced gastric cancer patients undergoing ICIs combined with chemotherapy. The SII-based nomogram can provide intuitive and accurate prognosis prediction of individual patients.
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Affiliation(s)
- Qiuxia Dong
- Research Center for High Altitude Medicine, Qinghai University, Xining, People's Republic of China
- Key Laboratory of Plateau Medicine, Ministry of Education, Qinghai University, Xining, People's Republic of China
- Qinghai Key Laboratory of Plateau Medical Application Foundation (Qinghai-Utah Joint Research key Laboratory for High Altitude Medicine), Qinghai University, Xining, People's Republic of China
- Qinghai Red Cross Hospital, The Second Ward of Oncology, Xining, People's Republic of China
| | - Fuxing Zhao
- Research Center for High Altitude Medicine, Qinghai University, Xining, People's Republic of China
- Key Laboratory of Plateau Medicine, Ministry of Education, Qinghai University, Xining, People's Republic of China
- Qinghai Key Laboratory of Plateau Medical Application Foundation (Qinghai-Utah Joint Research key Laboratory for High Altitude Medicine), Qinghai University, Xining, People's Republic of China
- Breast Disease Diagnosis and Treatment Center, Affiliated Hospital of Qinghai University, Affiliated Cancer Hospital of Qinghai University, Qinghai Provincial Clinical Research Center for Cancer, Qinghai Provincial Institute of Cancer Research, Xining, People's Republic of China
| | - Yuying Li
- Affiliated Hospital of Qinghai University, Affiliated Cancer Hospital of Qinghai University, The Second Ward of Oncology, Xining, People's Republic of China
| | - Feixue Song
- Department of Medical Oncology, The Second Hospital of Lanzhou University, Lanzhou, People's Republic of China
| | - Enxi Li
- Department of Medical Oncology, The Second Hospital of Lanzhou University, Lanzhou, People's Republic of China
| | - Lihong Gao
- The Fifth People's Hospital of Qinghai Province, The First Ward of Oncology, Xining, People's Republic of China
| | - Yuanfang Xin
- Qinghai Red Cross Hospital, The Second Ward of Oncology, Xining, People's Republic of China
| | - Guoshuang Shen
- Breast Disease Diagnosis and Treatment Center, Affiliated Hospital of Qinghai University, Affiliated Cancer Hospital of Qinghai University, Qinghai Provincial Clinical Research Center for Cancer, Qinghai Provincial Institute of Cancer Research, Xining, People's Republic of China
| | - Dengfeng Ren
- Breast Disease Diagnosis and Treatment Center, Affiliated Hospital of Qinghai University, Affiliated Cancer Hospital of Qinghai University, Qinghai Provincial Clinical Research Center for Cancer, Qinghai Provincial Institute of Cancer Research, Xining, People's Republic of China
| | - Miaozhou Wang
- Breast Disease Diagnosis and Treatment Center, Affiliated Hospital of Qinghai University, Affiliated Cancer Hospital of Qinghai University, Qinghai Provincial Clinical Research Center for Cancer, Qinghai Provincial Institute of Cancer Research, Xining, People's Republic of China
| | - Yi Zhao
- Breast Disease Diagnosis and Treatment Center, Affiliated Hospital of Qinghai University, Affiliated Cancer Hospital of Qinghai University, Qinghai Provincial Clinical Research Center for Cancer, Qinghai Provincial Institute of Cancer Research, Xining, People's Republic of China
| | - Zhen Liu
- Breast Disease Diagnosis and Treatment Center, Affiliated Hospital of Qinghai University, Affiliated Cancer Hospital of Qinghai University, Qinghai Provincial Clinical Research Center for Cancer, Qinghai Provincial Institute of Cancer Research, Xining, People's Republic of China
| | - Qiqi Xie
- Breast Disease Diagnosis and Treatment Center, Affiliated Hospital of Qinghai University, Affiliated Cancer Hospital of Qinghai University, Qinghai Provincial Clinical Research Center for Cancer, Qinghai Provincial Institute of Cancer Research, Xining, People's Republic of China
| | - Zhilin Liu
- Breast Disease Diagnosis and Treatment Center, Affiliated Hospital of Qinghai University, Affiliated Cancer Hospital of Qinghai University, Qinghai Provincial Clinical Research Center for Cancer, Qinghai Provincial Institute of Cancer Research, Xining, People's Republic of China
| | - Zitao Li
- Breast Disease Diagnosis and Treatment Center, Affiliated Hospital of Qinghai University, Affiliated Cancer Hospital of Qinghai University, Qinghai Provincial Clinical Research Center for Cancer, Qinghai Provincial Institute of Cancer Research, Xining, People's Republic of China
| | - Jiuda Zhao
- Research Center for High Altitude Medicine, Qinghai University, Xining, People's Republic of China
- Key Laboratory of Plateau Medicine, Ministry of Education, Qinghai University, Xining, People's Republic of China
- Qinghai Key Laboratory of Plateau Medical Application Foundation (Qinghai-Utah Joint Research key Laboratory for High Altitude Medicine), Qinghai University, Xining, People's Republic of China
- Breast Disease Diagnosis and Treatment Center, Affiliated Hospital of Qinghai University, Affiliated Cancer Hospital of Qinghai University, Qinghai Provincial Clinical Research Center for Cancer, Qinghai Provincial Institute of Cancer Research, Xining, People's Republic of China
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11
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Ertekin SS, Mangas C, Riquelme-Mc Loughlin C, Carrera C, Malvehy J, Puig S, Podlipnik S. Prognostic Value of the Neutrophil-to-lymphocyte Ratio, Platelet-to- lymphocyte Ratio and Monocyte-to-lymphocyte Ratio in Melanoma Patients: A Cohort Study. Acta Derm Venereol 2024; 104:adv27571. [PMID: 38655656 PMCID: PMC11064678 DOI: 10.2340/actadv.v104.27571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 02/14/2024] [Indexed: 04/26/2024] Open
Abstract
The prognostic value of the neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and monocyte-lymphocyte ratio in patients with melanoma has yielded controversial results in the literature. A retrospective single-centre cohort study was conducted from 1998 to 2020, including patients diagnosed with invasive melanoma. A total of 2,721 patients were included in the study. The median follow-up was 8.23 years (IQR 4.41-13.25). The median baseline neutrophil- lymphocyte ratio, platelet-lymphocyte ratio and monocyte-lymphocyte ratio values increased significantly (p < 0.001) with the increasing American Joint Committee on Cancer stage. The optimal cut-off values for neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and monocyte-lymphocyte ratio were determined as 2.1, 184 and 0.2, respectively. In the multivariate analysis, high levels of neutrophil-lymphocyte ratio (≥ 2.1), platelet-lymphocyte ratio (≥ 184) and monocyte-lymphocyte ratio (≥ 0.2) were independently associated with significantly shorter melanoma-specific survival (neutrophil-lymphocyte ratio: HR 1.30, 95% CI 1.06-1.60, p = 0.013; platelet-lymphocyte ratio: HR 1.37, 95% CI 1.06-1.76, p = 0.014; monocyte- lymphocyte ratio: HR 1.29, 95% CI 1.05-1.58, p = 0.015) and overall survival (neutrophil-lymphocyte ratio: HR 1.39, 95% CI 1.19-1.64, p < 0.001; platelet- lymphocyte ratio: HR 1.44, 95% CI 1.19-1.74, p < 0.001; monocyte-lymphocyte ratio: HR 1.42, 95% CI 1.21-1.66, p < 0.001). High levels of neutrophil- lymphocyte ratio and monocyte-lymphocyte ratio were also associated with poor relapse-free survival, while platelet-lymphocyte ratio was not. In conclusion, baseline neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and monocyte-lymphocyte ratio were identified as independent predictors for the prognosis of melanoma.
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Affiliation(s)
- Sümeyre Seda Ertekin
- Department of Dermatology, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain; Department of Dermatology, Koç University School of Medicine, Istanbul, Turkey
| | - Cristina Mangas
- Department of Dermatology, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain
| | | | - Cristina Carrera
- Department of Dermatology, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain; Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | - Josep Malvehy
- Department of Dermatology, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain; Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | - Susana Puig
- Department of Dermatology, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain; Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, Spain.
| | - Sebastian Podlipnik
- Department of Dermatology, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain; Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
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12
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Kim CA, Kim M, Jin M, Kim HK, Jeon MJ, Lim DJ, Kim BH, Kang HC, Kim WB, Shin DY, Kim WG. Prognostic Roles of Inflammatory Biomarkers in Radioiodine-Refractory Thyroid Cancer Treated with Lenvatinib. Endocrinol Metab (Seoul) 2024; 39:334-343. [PMID: 38572536 PMCID: PMC11066453 DOI: 10.3803/enm.2023.1854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 12/14/2023] [Accepted: 01/29/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGRUOUND Inflammatory biomarkers, such as the neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR), serve as valuable prognostic indicators in various cancers. This multicenter, retrospective cohort study assessed the treatment outcomes of lenvatinib in 71 patients with radioactive iodine (RAI)-refractory thyroid cancer, considering the baseline inflammatory biomarkers. METHODS This study retrospectively included patients from five tertiary hospitals in Korea whose complete blood counts were available before lenvatinib treatment. Progression-free survival (PFS) and overall survival (OS) were evaluated based on the median value of inflammatory biomarkers. RESULTS No significant differences in baseline characteristics were observed among patients grouped according to the inflammatory biomarkers, except for older patients with a higher-than-median NLR (≥2) compared to their counterparts with a lower NLR (P= 0.01). Patients with a higher-than-median NLR had significantly shorter PFS (P=0.02) and OS (P=0.017) than those with a lower NLR. In multivariate analysis, a higher-than-median NLR was significantly associated with poor OS (hazard ratio, 3.0; 95% confidence interval, 1.24 to 7.29; P=0.015). However, neither the LMR nor the PLR was associated with PFS. A higher-than-median LMR (≥3.9) was significantly associated with prolonged OS compared to a lower LMR (P=0.036). In contrast, a higher-than-median PLR (≥142.1) was associated with shorter OS compared to a lower PLR (P=0.039). CONCLUSION Baseline inflammatory biomarkers can serve as predictive indicators of PFS and OS in patients with RAI-refractory thyroid cancer treated with lenvatinib.
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Affiliation(s)
- Chae A Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Mijin Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Yangsan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Meihua Jin
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Korea
| | - Hee Kyung Kim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Min Ji Jeon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dong Jun Lim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Bo Hyun Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Yangsan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Ho-Cheol Kang
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Won Bae Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dong Yeob Shin
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Won Gu Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Uchida S, Sohda M, Tateno K, Watanabe T, Shibasaki Y, Nakazawa N, Kuriyama K, Sano A, Yokobori T, Sakai M, Ogawa H, Shirabe K, Saeki H. Usefulness of the preoperative inflammation-based prognostic score and the ratio of visceral fat area to psoas muscle area on predicting survival for surgically resected adenocarcinoma of the esophagogastric junction. Esophagus 2024; 21:157-164. [PMID: 38112929 DOI: 10.1007/s10388-023-01034-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 11/17/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND Sarcopenic obesity is associated with gastrointestinal cancer prognosis through systemic inflammation. However, in patients with adenocarcinoma of the esophagogastric junction (AEG), the relationship between the inflammation-based prognostic score (IBPS), muscle loss, visceral fat mass, and prognosis has not been sufficiently evaluated. We investigated the prognostic value of the preoperative IBPS and the visceral fat area ratio to the psoas muscle area (V/P ratio) in patients with AEG undergoing surgery. METHODS We retrospectively analyzed 92 patients with AEG who underwent surgery. The prognostic value of the preoperative neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio, systemic inflammation response index, C-reactive protein-to-albumin ratio, prognostic nutritional index, modified Glasgow Prognostic Score, and V/P ratio at the third lumbar vertebra was investigated using univariate and multivariate survival analyses. RESULTS Multivariate analysis revealed that a high pathological stage (p = 0.0065), high PLR (p = 0.0421), and low V/P ratio (p = 0.0053) were independent prognostic factors for poor overall survival (OS). When restricted to patients with body mass index (BMI) ≥ 25 kg/m2, a high V/P ratio was a poor prognostic factor (p = 0.0463) for OS. Conversely, when restricted to patients with BMI < 25 kg/m2, a low V/P ratio was a poor prognostic factor (p = 0.0021) for OS. CONCLUSIONS Both PLR and V/P ratios may be useful prognostic biomarkers in surgical cases of AEG. V/P ratio and BMI may provide an accurate understanding of the muscle and fat mass's precise nature and may help predict AEG prognosis.
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Affiliation(s)
- Shintaro Uchida
- Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, maebashi-shi, Gunma-ken, 371-8511, Japan
| | - Makoto Sohda
- Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, maebashi-shi, Gunma-ken, 371-8511, Japan.
| | - Kohei Tateno
- Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, maebashi-shi, Gunma-ken, 371-8511, Japan
| | - Takayoshi Watanabe
- Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, maebashi-shi, Gunma-ken, 371-8511, Japan
| | - Yuta Shibasaki
- Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, maebashi-shi, Gunma-ken, 371-8511, Japan
| | - Nobuhiro Nakazawa
- Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, maebashi-shi, Gunma-ken, 371-8511, Japan
| | - Kengo Kuriyama
- Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, maebashi-shi, Gunma-ken, 371-8511, Japan
| | - Akihiko Sano
- Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, maebashi-shi, Gunma-ken, 371-8511, Japan
| | - Takehiko Yokobori
- Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, maebashi-shi, Gunma-ken, 371-8511, Japan
| | - Makoto Sakai
- Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, maebashi-shi, Gunma-ken, 371-8511, Japan
| | - Hiroomi Ogawa
- Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, maebashi-shi, Gunma-ken, 371-8511, Japan
| | - Ken Shirabe
- Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, maebashi-shi, Gunma-ken, 371-8511, Japan
| | - Hiroshi Saeki
- Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, maebashi-shi, Gunma-ken, 371-8511, Japan
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14
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Baek JM, Cha H, Moon Y, Kim L, Kwak SM, Park ES, Nam HS. A Systemic Immune Inflammation Index and PD-L1 (SP142) Expression as a Potential Combined Biomarker of the Clinical Benefit of Chemo-Immunotherapy in Extensive-Stage Small-Cell Lung Cancer. J Clin Med 2024; 13:1521. [PMID: 38592329 PMCID: PMC10932321 DOI: 10.3390/jcm13051521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 03/02/2024] [Accepted: 03/03/2024] [Indexed: 04/10/2024] Open
Abstract
Background: No studies have identified combined biomarkers that may be more reasonable for the assessment of current chemo-immunotherapy in patients with extensive stage small-cell lung cancer (ES-SCLC). Methods: This study was conducted to investigate a combined biomarker with prognostic or predictive value in ES-SCLC. We determined the best independent prognostic biomarker among the four complete blood-count-derived inflammatory biomarkers (CBC-IBs). Subsequently, we analyzed the prognostic or predictive value of combining this independent CBC-IB with PD-L1 (SP142) expression. We prospectively assessed the SP142 analyses in tumor samples at diagnosis. Results: All in all, 55 patients with ES-SCLC were classified into four groups according to the systemic immune inflammation index (SII) (low/high) and SP142 (positive/negative). The best survival was observed in the low-SII/ SP142-positive group, whereas the worst survival was observed in the high-SII/SP142-negative group (p = 0.002). The combined SII-SP142 biomarker was better for predicting both survival and disease progression in patients with ES-SCLC. Conclusions: The combined SII-SP142 biomarker can be readily and universally obtained at a low cost in clinical practice, without requiring advanced genomics technology or specialized expertise. Although further studies are needed to confirm that the combined SII-SP142 biomarker is widely applicable, it should help clinicians to identify the best patients for combined chemotherapy with atezolizumab in ES-SCLC.
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Affiliation(s)
- Jong-Min Baek
- Department of General Surgery, Yeouido ST. Mary’s Hospital, The Catholic University of Korea, Seoul 07345, Republic of Korea;
| | - Hyungkeun Cha
- Division of Pulmonology, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon 22332, Republic of Korea; (H.C.); (S.M.K.); (E.S.P.)
| | - Yeonsook Moon
- Department of Laboratory Medicine, Inha University Hospital, Inha University School of Medicine, Incheon 22332, Republic of Korea;
| | - Lucia Kim
- Department of Pathology, Inha University Hospital, Inha University School of Medicine, Incheon 22332, Republic of Korea;
| | - Seung Min Kwak
- Division of Pulmonology, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon 22332, Republic of Korea; (H.C.); (S.M.K.); (E.S.P.)
| | - Eun Sun Park
- Division of Pulmonology, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon 22332, Republic of Korea; (H.C.); (S.M.K.); (E.S.P.)
| | - Hae-Seong Nam
- Division of Pulmonology, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon 22332, Republic of Korea; (H.C.); (S.M.K.); (E.S.P.)
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Pawaskar R, Huang KZ, Pham H, Nagrial A, Wong M, O’Neill S, Pleass H, Yuen L, Lam VWT, Richardson A, Pang T, Nahm CB. Systematic Review of Preoperative Prognostic Biomarkers in Perihilar Cholangiocarcinoma. Cancers (Basel) 2024; 16:698. [PMID: 38398089 PMCID: PMC10886549 DOI: 10.3390/cancers16040698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 02/03/2024] [Accepted: 02/05/2024] [Indexed: 02/25/2024] Open
Abstract
Perihilar cholangiocarcinoma (pCCA) is an uncommon malignancy with generally poor prognosis. Surgery is the primary curative treatment; however, the perioperative mortality and morbidity rates are high, with a low 5-year survival rate. Use of preoperative prognostic biomarkers to predict survival outcomes after surgery for pCCA are not well-established currently. This systematic review aimed to identify and summarise preoperative biomarkers associated with survival in pCCA, thereby potentially improving treatment decision-making. The Embase, Medline, and Cochrane databases were searched, and a systematic review was performed using the PRISMA guidelines. English-language studies examining the association between serum and/or tissue-derived biomarkers in pCCA and overall and/or disease-free survival were included. Our systematic review identified 64 biomarkers across 48 relevant studies. Raised serum CA19-9, bilirubin, CEA, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and tumour MMP9, and low serum albumin were most associated with poorer survival; however, the cutoff values used widely varied. Several promising molecular markers with prognostic significance were also identified, including tumour HMGA2, MUC5AC/6, IDH1, PIWIL2, and DNA index. In conclusion, several biomarkers have been identified in serum and tumour specimens that prognosticate overall and disease-free survival after pCCA resection. These, however, require external validation in large cohort studies and/or in preoperatively obtained specimens, especially tissue biopsy, to recommend their use.
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Affiliation(s)
- Rishaan Pawaskar
- Department of Upper GI Surgery, Westmead Hospital, Sydney, NSW 2145, Australia; (R.P.); (H.P.); (H.P.); (L.Y.); (V.W.T.L.); (A.R.); (T.P.)
| | | | - Helen Pham
- Department of Upper GI Surgery, Westmead Hospital, Sydney, NSW 2145, Australia; (R.P.); (H.P.); (H.P.); (L.Y.); (V.W.T.L.); (A.R.); (T.P.)
- Westmead Hospital, Sydney, NSW 2145, Australia;
- Surgical Innovations Unit, Westmead Hospital, Sydney, NSW 2145, Australia
| | - Adnan Nagrial
- Westmead Clinical School, Faculty of Medicine and Health Sciences, The University of Sydney, Sydney, NSW 2006, Australia; (A.N.); (M.W.)
- Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, NSW 2145, Australia;
| | - Mark Wong
- Westmead Clinical School, Faculty of Medicine and Health Sciences, The University of Sydney, Sydney, NSW 2006, Australia; (A.N.); (M.W.)
- Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, NSW 2145, Australia;
| | - Siobhan O’Neill
- Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, NSW 2145, Australia;
| | - Henry Pleass
- Department of Upper GI Surgery, Westmead Hospital, Sydney, NSW 2145, Australia; (R.P.); (H.P.); (H.P.); (L.Y.); (V.W.T.L.); (A.R.); (T.P.)
- Westmead Hospital, Sydney, NSW 2145, Australia;
- Surgical Innovations Unit, Westmead Hospital, Sydney, NSW 2145, Australia
- Westmead Clinical School, Faculty of Medicine and Health Sciences, The University of Sydney, Sydney, NSW 2006, Australia; (A.N.); (M.W.)
| | - Lawrence Yuen
- Department of Upper GI Surgery, Westmead Hospital, Sydney, NSW 2145, Australia; (R.P.); (H.P.); (H.P.); (L.Y.); (V.W.T.L.); (A.R.); (T.P.)
- Westmead Hospital, Sydney, NSW 2145, Australia;
- Surgical Innovations Unit, Westmead Hospital, Sydney, NSW 2145, Australia
- Westmead Clinical School, Faculty of Medicine and Health Sciences, The University of Sydney, Sydney, NSW 2006, Australia; (A.N.); (M.W.)
| | - Vincent W. T. Lam
- Department of Upper GI Surgery, Westmead Hospital, Sydney, NSW 2145, Australia; (R.P.); (H.P.); (H.P.); (L.Y.); (V.W.T.L.); (A.R.); (T.P.)
- Westmead Hospital, Sydney, NSW 2145, Australia;
- Surgical Innovations Unit, Westmead Hospital, Sydney, NSW 2145, Australia
- Westmead Clinical School, Faculty of Medicine and Health Sciences, The University of Sydney, Sydney, NSW 2006, Australia; (A.N.); (M.W.)
- Macquarie University Medical School, Macquarie University, Sydney, NSW 2145, Australia
| | - Arthur Richardson
- Department of Upper GI Surgery, Westmead Hospital, Sydney, NSW 2145, Australia; (R.P.); (H.P.); (H.P.); (L.Y.); (V.W.T.L.); (A.R.); (T.P.)
- Westmead Hospital, Sydney, NSW 2145, Australia;
- Surgical Innovations Unit, Westmead Hospital, Sydney, NSW 2145, Australia
| | - Tony Pang
- Department of Upper GI Surgery, Westmead Hospital, Sydney, NSW 2145, Australia; (R.P.); (H.P.); (H.P.); (L.Y.); (V.W.T.L.); (A.R.); (T.P.)
- Westmead Hospital, Sydney, NSW 2145, Australia;
- Surgical Innovations Unit, Westmead Hospital, Sydney, NSW 2145, Australia
- Westmead Clinical School, Faculty of Medicine and Health Sciences, The University of Sydney, Sydney, NSW 2006, Australia; (A.N.); (M.W.)
| | - Christopher B. Nahm
- Department of Upper GI Surgery, Westmead Hospital, Sydney, NSW 2145, Australia; (R.P.); (H.P.); (H.P.); (L.Y.); (V.W.T.L.); (A.R.); (T.P.)
- Westmead Hospital, Sydney, NSW 2145, Australia;
- Surgical Innovations Unit, Westmead Hospital, Sydney, NSW 2145, Australia
- Westmead Clinical School, Faculty of Medicine and Health Sciences, The University of Sydney, Sydney, NSW 2006, Australia; (A.N.); (M.W.)
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Elia S, Patirelis A, Hardavella G, Santone A, Carlea F, Pompeo E. The Naples Prognostic Score Is a Useful Tool to Assess Surgical Treatment in Non-Small Cell Lung Cancer. Diagnostics (Basel) 2023; 13:3641. [PMID: 38132225 PMCID: PMC10742842 DOI: 10.3390/diagnostics13243641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/05/2023] [Accepted: 12/06/2023] [Indexed: 12/23/2023] Open
Abstract
Different prognostic scores have been applied to identify patients with non-small cell lung cancer who have a higher probability of poor outcomes. In this study, we evaluated whether the Naples Prognostic Score, a novel index that considers both inflammatory and nutritional values, was associated with long-term survival. This study presents a retrospective propensity score matching analysis of patients who underwent curative surgery for non-small cell lung cancer from January 2016 to December 2021. The score considered the following four pre-operative parameters: the neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, serum albumin, and total cholesterol. The Kaplan-Meier method and Cox regression analysis were performed to evaluate the relationship between the score and disease-free survival, overall survival, and cancer-related survival. A total of 260 patients were selected for the study, though this was reduced to 154 after propensity score matching. Post-propensity Kaplan-Meier analysis showed a significant correlation between the Naples Prognostic Score, overall survival (p = 0.018), and cancer-related survival (p = 0.007). Multivariate Cox regression analysis further validated the score as an independent prognostic indicator for both types of survival (p = 0.007 and p = 0.010, respectively). The Naples Prognostic Score proved to be an easily achievable prognostic factor of long-term survival in patients with non-small cell lung cancer after surgical treatment.
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Affiliation(s)
- Stefano Elia
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy;
- Thoracic Surgery Unit, Tor Vergata University Hospital, 00133 Rome, Italy; (A.P.); (E.P.)
| | - Alexandro Patirelis
- Thoracic Surgery Unit, Tor Vergata University Hospital, 00133 Rome, Italy; (A.P.); (E.P.)
| | - Georgia Hardavella
- 9th Department of Respiratory Medicine, Athens Chest Diseases Hospital Sotiria, 11527 Athens, Greece;
| | - Antonella Santone
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy;
| | - Federica Carlea
- Thoracic Surgery Unit, Tor Vergata University Hospital, 00133 Rome, Italy; (A.P.); (E.P.)
| | - Eugenio Pompeo
- Thoracic Surgery Unit, Tor Vergata University Hospital, 00133 Rome, Italy; (A.P.); (E.P.)
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Gawiński C, Mróz A, Roszkowska-Purska K, Sosnowska I, Derezińska-Wołek E, Michalski W, Wyrwicz L. A Prospective Study on the Roles of the Lymphocyte-to-Monocyte Ratio (LMR), Neutrophil-to-Lymphocyte Ratio (NLR), and Platelet-to-Lymphocyte Ratio (PLR) in Patients with Locally Advanced Rectal Cancer. Biomedicines 2023; 11:3048. [PMID: 38002048 PMCID: PMC10669751 DOI: 10.3390/biomedicines11113048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 11/10/2023] [Accepted: 11/12/2023] [Indexed: 11/26/2023] Open
Abstract
Rectal cancer constitutes over one-third of all colorectal cancers (CRCs) and is one of the leading causes of cancer-related deaths in developed countries. In order to identify high-risk patients and better adjust therapies, new markers are needed. Systemic inflammatory response (SIR) markers such as LMR, NLR, and PLR have proven to be highly prognostic in many malignancies, including CRC; however, their roles in locally advanced rectal cancer (LARC) are conflicting and lack proper validation. Sixty well-selected patients with LARC treated at the Maria Sklodowska-Curie National Research Institute of Oncology in Warsaw, Poland, between August 2017 and December 2020 were prospectively enrolled in this study. The reproducibility of the pre-treatment levels of the SIR markers, their correlations with clinicopathological characteristics, and their prognostic value were evaluated. There was a significant positive correlation between LMR and cancer-related inflammatory infiltrate (r = 0.38, p = 0.044) and PD-L1 expression in tumor cells, lymphocytes, and macrophages (combined positive score (CPS)) (r = 0.45, p = 0.016). The PLR level was correlated with nodal involvement (p = 0.033). The SIR markers proved to be only moderately reproducible and had no significant prognostic value. In conclusion, the LMR was associated with local cancer-related inflammation and PD-L1 expression in tumor microenvironments. The validity of SIR indices as biomarkers in LARC requires further investigation.
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Affiliation(s)
- Cieszymierz Gawiński
- Department of Oncology and Radiotherapy, M. Skłodowska-Curie National Research Institute of Oncology, ul. Wawelska 15, 02-034 Warsaw, Poland;
| | - Andrzej Mróz
- Department of Pathology, M. Skłodowska-Curie National Research Institute of Oncology, ul. Roentgena 5, 02-781 Warsaw, Poland; (A.M.); (I.S.); (E.D.-W.)
| | - Katarzyna Roszkowska-Purska
- Department of Pathology, M. Skłodowska-Curie National Research Institute of Oncology, ul. Wawelska 15, 02-034 Warsaw, Poland;
| | - Iwona Sosnowska
- Department of Pathology, M. Skłodowska-Curie National Research Institute of Oncology, ul. Roentgena 5, 02-781 Warsaw, Poland; (A.M.); (I.S.); (E.D.-W.)
| | - Edyta Derezińska-Wołek
- Department of Pathology, M. Skłodowska-Curie National Research Institute of Oncology, ul. Roentgena 5, 02-781 Warsaw, Poland; (A.M.); (I.S.); (E.D.-W.)
| | - Wojciech Michalski
- Department of Computation Oncology, M. Skłodowska-Curie National Research Institute of Oncology, ul. Roentgena 5, 02-781 Warsaw, Poland;
| | - Lucjan Wyrwicz
- Department of Oncology and Radiotherapy, M. Skłodowska-Curie National Research Institute of Oncology, ul. Wawelska 15, 02-034 Warsaw, Poland;
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Ouyang H, Xiao B, Huang Y, Wang Z. Baseline and early changes in the neutrophil-lymphocyte ratio (NLR) predict survival outcomes in advanced colorectal cancer patients treated with immunotherapy. Int Immunopharmacol 2023; 123:110703. [PMID: 37536184 DOI: 10.1016/j.intimp.2023.110703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 07/21/2023] [Accepted: 07/22/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND Systemic inflammation plays a role in carcinogenesis and is related to overall survival in patients with different cancer types, including those treated with immune checkpoint blockade (ICB). The neutrophil-lymphocyte ratio (NLR) is calculated by circulating neutrophil to lymphocyte counts, which represents an indicator of the balance between the deleterious roles of neutrophilia and the beneficial roles of lymphocyte-mediated immunity. We hypothesized that the NLR may predict outcomes in metastatic colorectal cancer (mCRC) patients treated with immunotherapy. MATERIALS AND METHODS This retrospective study included 110 mCRC patients who were treated with immunotherapy at Sun Yat-sen University Cancer Center. Several inflammatory biomarkers were measured at baseline and after two cycles of treatment. The X-tile program was used to obtain the cutoff values. We examined the impact of both baseline and posttreatment inflammatory index levels on overall survival (OS). RESULTS In univariate analysis, both a low baseline NLR (P = 0.014) and a decreased NLR after 2 cycles of immunotherapy (P < 0.001) were considerably correlated with better OS. In multivariate analysis, age, liver metastasis, baseline lymphocyte-monocyte ratio (LMR), baseline NLR and early changes in NLR independently predicted OS. Patients with both a low baseline NLR and an early NLR reduction had the longest OS (median, 29.63 months). The best outcomes were remarkably observed in patients who had both an early NLR reduction and a high tumor mutational burden (TMB) (≥10 mut/Mb) (P < 0.0001). CONCLUSIONS Both a low baseline NLR and an early NLR reduction are significantly associated with a better prognosis in mCRC patients treated with immunotherapy. Further analysis indicated that the combination of NLR and TMB could obtain additional predictive power.
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Affiliation(s)
- Hui Ouyang
- State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, No. 651, Dongfeng East Road, Guangzhou, Guangdong 510060, People's Republic of China
| | - Bijing Xiao
- State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, No. 651, Dongfeng East Road, Guangzhou, Guangdong 510060, People's Republic of China
| | - Yan Huang
- State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, No. 651, Dongfeng East Road, Guangzhou, Guangdong 510060, People's Republic of China.
| | - Zhiqiang Wang
- State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, No. 651, Dongfeng East Road, Guangzhou, Guangdong 510060, People's Republic of China.
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Bao Q, Song L, Ma L, Wang M, Hou Z, Lin J, Li C. Prediction of postoperative hypokalemia in patients with oral cancer undergoing en bloc cancer resection: a retrospective cohort study. BMC Oral Health 2023; 23:663. [PMID: 37710182 PMCID: PMC10500799 DOI: 10.1186/s12903-023-03371-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 08/30/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND The factors associated with postoperative hypokalemia in patients with oral cancer remain unclear. We determined the preoperative factors associated with postoperative hypokalemia in patients with oral cancer following en bloc cancer resection and established a nomogram for postoperative hypokalemia prediction. METHODS Data from 381 patients with oral cancer who underwent en bloc cancer resection were retrospectively analyzed. Univariate and multivariate analyses were performed to identify the risk factors for postoperative hypokalemia. We used receiver operating characteristic (ROC) curves to quantify the factors' effectiveness. A nomogram was created to show each predictor's relative weight and the likelihood of postoperative hypokalemia development. The multinomial regression model's effectiveness was also evaluated. RESULTS Preoperative factors, including sex, preoperative serum potassium level, and preoperative platelet-to-lymphocyte ratio (PLR), were significantly associated with postoperative hypokalemia. Based on the ROC curve, the preoperative serum potassium and PLR cut-off levels were 3.98 mmol/L and 117, respectively. Further multivariate analysis indicated that female sex, preoperative serum potassium level < 3.98 mmol/L, and preoperative PLR ≥ 117 were independently associated with postoperative hypokalemia. We constructed a predictive nomogram with all these factors for the risk of postoperative hypokalemia with good discrimination and internal validation. CONCLUSIONS The predictive nomogram for postoperative hypokalemia risk constructed with these factors had good discrimination and internal validation. The developed nomogram will add value to these independent risk factors that can be identified at admission in order to predict postoperative hypokalemia.
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Affiliation(s)
- Qilin Bao
- Nutrition Department, West China Hospital of Stomatology, Sichuan University, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, No. 14, Section Three, Ren Min Nan Road, Chengdu, Sichuan, China
| | - Lei Song
- Nutrition Department, West China Hospital of Stomatology, Sichuan University, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, No. 14, Section Three, Ren Min Nan Road, Chengdu, Sichuan, China
| | - Liyuan Ma
- Medical Record Room, West China Hospital of Stomatology, Sichuan University, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, No. 14, Section Three, Ren Min Nan Road, Chengdu, Sichuan, China
| | - Meng Wang
- Medical Record Room, West China Hospital of Stomatology, Sichuan University, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, No. 14, Section Three, Ren Min Nan Road, Chengdu, Sichuan, China
| | - Zhaohuan Hou
- Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, No. 14, Section Three, Ren Min Nan Road, Chengdu, Sichuan, China
| | - Jie Lin
- Department of Oral Anesthesia, West China Hospital of Stomatology, Sichuan University, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, No. 14, Section Three, Ren Min Nan Road, Chengdu, Sichuan, China
| | - Chunjie Li
- Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, No. 14, Section Three, Ren Min Nan Road, Chengdu, Sichuan, China.
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20
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Zhang T, Liu W, Xu C. Correlation analysis of hemoglobin, albumin, lymphocyte, platelet score and platelet to albumin ratio and prognosis in patients with lung adenosquamous carcinoma. Front Oncol 2023; 13:1166802. [PMID: 37746281 PMCID: PMC10514357 DOI: 10.3389/fonc.2023.1166802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/23/2023] [Indexed: 09/26/2023] Open
Abstract
Objective To investigate the effect of hemoglobin, albumin, lymphocytes, platelet (HALP) score and platelet to albumin ratio (PAR) on prognosis of patients with lung adenosquamous carcinoma (ASC) after surgery. Patients and methods A total of 52 patients diagnosed with ASC after surgical resection were collected from Nanjing Chest Hospital from 2012 to 2021, and their general clinical data, pathological data and laboratory indexes were collected. The changes of Alb and Plt levels before and after surgery, HALP scores (hemoglobin albumin lymphocytes/platelets), and postoperative PAR, PLR, NLR were retrospectively analyzed, and their influence on the prognosis of patients with ASC was investigated. The cut-off value of △Alb, △Plt, postoperative PAR, PLR and NLR were determined by the receiver operating characteristic (ROC) curve, the optimal cut-off value of HALP score before and after surgery was calculated by using X-tile software, and the clinicopathological characteristics were compared between the high PAR and low PAR groups and between high HALP score and low HALP score group to analyze the factors influencing the prognosis of patients with ASC. Univariate and multivariate Cox proportional regression analyses were used to assess independent risk factors affecting overall survival (OS) and disease-free survival (DFS) in patients with ASC. Kaplan-Meier method was used to evaluate the correlation between OS, DFS and PAR and HALP score. Results A critical value of PAR was 7.40×10^9 and an area under the curve (AUC) of 0.737 (95%CI: 0.597-0.876, P = 0.004). The best cut-off value of the preoperative HALP score was 24.3. Univariate Cox analysis showed that the cut margin (P = 0.013), the degree of differentiation (P = 0.021), N stage (P = 0.049), △Plt (P = 0.010), △Alb (P = 0.016), PAR (P = 0.003), NLR (P = 0.025), PLR (P = 0.029), preoperative HALP score (P = 0.000) and post-operative HALP score (P = 0.010) were all associated with postoperative OS in ASC patients. Cut margin (P = 0.029), the degree of differentiation (P = 0.045), maximum tumor diameter (P = 0.018), N stage (P = 0.035), △Plt (P = 0.007), △Alb (P = 0.007), PAR (P = 0.004), NLR (P = 0.041), PLR (P = 0.030), preoperative HALP score (P = 0.000), and postoperative HALP score (P = 0.011) were related to postoperative DFS in ASC patients. Multivariate analysis revealed that PAR (HR: 6.877, 95%CI: 1.817-26.038, P = 0.005), differentiation degree (HR: 0.059, 95%CI: 0.006-0.591, P = 0.016) and preoperative HALP score (HR: 0.224, 95%CI: 0.068-0.733, P = 0.013) had significant effect on OS. Tumor maximum diameter (HR: 3.442, 95%CI: 1.148-10.318, P = 0.027) and preoperative HALP score (HR: 0.268, 95%CI: 0.085-0.847, P = 0.025) had significant influence on DFS. Conclusion PAR and preoperative HALP score were potentially useful biomarkers for evaluating the outcome of patients with postoperative ASC. PAR, the degree of differentiation and preoperative HALP score were independent prognostic factors for postoperative OS in ASC patients. Maximum tumor diameter and preoperative HALP score were independent prognostic factors for postoperative DFS in ASC patients.
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Affiliation(s)
- Tiantian Zhang
- Department of Respiratory Medicine, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
- Clinical Center of Nanjing Respiratory Diseases and Imaging, Nanjing Chest Hospital, Nanjing, Jiangsu, China
| | - Wei Liu
- Department of Respiratory Medicine, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
- Clinical Center of Nanjing Respiratory Diseases and Imaging, Nanjing Chest Hospital, Nanjing, Jiangsu, China
| | - Chunhua Xu
- Department of Respiratory Medicine, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
- Clinical Center of Nanjing Respiratory Diseases and Imaging, Nanjing Chest Hospital, Nanjing, Jiangsu, China
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Kartal M, Aksungur N, Korkut E, Altundaş N, Kara S, Öztürk G. Significance of the Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Preoperative Nutritional Index as Predictors of Morbidity in Patients Who Underwent Liver Resection for Alveolar Echinococcosis. Cureus 2023; 15:e44842. [PMID: 37809135 PMCID: PMC10560077 DOI: 10.7759/cureus.44842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2023] [Indexed: 10/10/2023] Open
Abstract
AIM We aimed to evaluate the significance of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and preoperative nutritional index (PNI) as predictors of morbidity in patients who underwent liver resection for alveolar echinococcosis. MATERIAL AND METHODS This single-center study was designed as a retrospective study after obtaining ethical committee approval. The files of patients hospitalized at Ataturk University Faculty of Medicine, Erzurum, Turkey, between 2010 and 2019 and who underwent resection or liver transplantation for liver alveolar cysts were reviewed. Demographic features, laboratory parameters (complete blood count and biochemical parameters), lesion localizations and characteristics, type of surgery, intraoperative and postoperative complications (morbidity), and mortality status were evaluated by scanning patients' files. Preoperative blood samples were taken the day before the surgery, which is the period farthest from surgical stress, to have more accurate results. By contrast, postoperative blood samples were taken on the first postoperative day when surgical stress was the highest. The differences between the morbidity groups, including NLR, PLR, and PNI, were compared. RESULTS Of the 172 patients in the study, 96 (55.8%) were female. The mean age of all patients was 48.51±15.57 (18-90). Perioperative complications were seen in 30 (17.4%) patients, while the morbidity and mortality rates of the study were 28.5% and 19.2%, respectively. Age, gender of patients, and preoperative laboratory parameters, including NLR, PLR, and PNI, did not affect morbidity. However, the presence of perioperative vascular injury (P=0.040) and complications (P=0.047), low postoperative lymphocyte rates (P=0.038), and high postoperative NLR were associated with increased morbidity. In addition, the mortality rate was significantly increased in patients with morbidity (P<0.001). CONCLUSION From the results of the present study, it was found that preoperative parameters did not affect morbidity, while increased postoperative NLR levels and decreased lymphocyte rates increased morbidity.
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Affiliation(s)
- Murat Kartal
- General Surgery, Atatürk University Research Hospital, Erzurum, TUR
| | - Nurhak Aksungur
- General Surgery, Atatürk University Research Hospital, Erzurum, TUR
| | - Ercan Korkut
- General Surgery, Atatürk University Faculty of Medicine, Erzurum, TUR
| | - Necip Altundaş
- General Surgery, Atatürk University Faculty of Medicine, Erzurum, TUR
| | - Salih Kara
- General Surgery, Atatürk University Research Hospital, Erzurum, TUR
| | - Gürkan Öztürk
- General Surgery, Atatürk University Faculty of Medicine, Erzurum, TUR
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Tanimura K, Takeda T, Yoshimura A, Honda R, Goda S, Shiotsu S, Fukui M, Chihara Y, Uryu K, Takei S, Katayama Y, Hibino M, Yamada T, Takayama K. Predictive Value of Modified Glasgow Prognostic Score and Persistent Inflammation among Patients with Non-Small Cell Lung Cancer Treated with Durvalumab Consolidation after Chemoradiotherapy: A Multicenter Retrospective Study. Cancers (Basel) 2023; 15:4358. [PMID: 37686634 PMCID: PMC10486354 DOI: 10.3390/cancers15174358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 08/23/2023] [Accepted: 08/28/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Durvalumab consolidation after chemoradiotherapy (CRT) is a standard treatment for locally advanced non-small cell lung cancer (NSCLC). However, studies on immunological and nutritional markers to predict progression-free survival (PFS) and overall survival (OS) are inadequate. Systemic inflammation causes cancer cachexia and negatively affects immunotherapy efficacy, which also reflects survival outcomes. PATIENTS AND METHODS We retrospectively investigated 126 patients from seven institutes in Japan. RESULTS The modified Glasgow Prognostic Score (mGPS) values, before and after CRT, were the essential predictors among the evaluated indices. A systemic inflammation-based prognostic risk classification was created by combining mGPS values before CRT, and C-reactive protein (CRP) levels after CRT, to distinguish tumor-derived inflammation from CRT-induced inflammation. Patients were classified into high-risk (n = 31) and low-risk (n = 95) groups, and the high-risk group had a significantly shorter median PFS of 7.2 months and an OS of 19.6 months compared with the low-risk group. The hazard ratios for PFS and OS were 2.47 (95% confidence interval [CI]: 1.46-4.19, p < 0.001) and 3.62 (95% CI: 1.79-7.33, p < 0.001), respectively. This association was also observed in the subgroup with programmed cell death ligand 1 expression of ≥50%, but not in the <50% subgroup. Furthermore, durvalumab discontinuation was observed more frequently in the high-risk group than in the low-risk group. CONCLUSION Combining pre-CRT mGPS values with post-CRT CRP levels in patients with locally advanced NSCLC helps to predict the PFS and OS of durvalumab consolidation after CRT.
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Affiliation(s)
- Keiko Tanimura
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daini Hospital, Kyoto 602-8026, Japan; (K.T.); (A.Y.)
| | - Takayuki Takeda
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daini Hospital, Kyoto 602-8026, Japan; (K.T.); (A.Y.)
| | - Akihiro Yoshimura
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daini Hospital, Kyoto 602-8026, Japan; (K.T.); (A.Y.)
| | - Ryoichi Honda
- Department of Respiratory Medicine, Asahi General Hospital, Asahi 289-2511, Japan;
| | - Shiho Goda
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto 605-0981, Japan; (S.G.); (S.S.)
| | - Shinsuke Shiotsu
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto 605-0981, Japan; (S.G.); (S.S.)
| | - Mototaka Fukui
- Department of Respiratory Medicine, Uji-Tokushukai Medical Center, Uji 611-0041, Japan; (M.F.); (Y.C.)
| | - Yusuke Chihara
- Department of Respiratory Medicine, Uji-Tokushukai Medical Center, Uji 611-0041, Japan; (M.F.); (Y.C.)
| | - Kiyoaki Uryu
- Department of Respiratory Medicine, Yao Tokushukai General Hospital, Yao 581-0011, Japan;
| | - Shota Takei
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (S.T.); (Y.K.); (T.Y.); (K.T.)
| | - Yuki Katayama
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (S.T.); (Y.K.); (T.Y.); (K.T.)
| | - Makoto Hibino
- Department of Respiratory Medicine, Shonan Fujisawa Tokushukai Hospital, Fujisawa 251-0041, Japan;
| | - Tadaaki Yamada
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (S.T.); (Y.K.); (T.Y.); (K.T.)
| | - Koichi Takayama
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (S.T.); (Y.K.); (T.Y.); (K.T.)
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23
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van der Laan P, van der Graaf WTA, Reijers SJM, Schrage YM, Hendriks JJH, Haas RL, van den Broek D, Steeghs N, van Houdt WJ. Elevated preoperative serum interleukin-6 level is predictive for worse postoperative outcome after soft tissue sarcoma surgery. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2023; 49:106926. [PMID: 37173151 DOI: 10.1016/j.ejso.2023.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 04/14/2023] [Accepted: 05/02/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND The pro-inflammatory cytokine interleukin-6 (IL-6) plays a role in cancer development and progression, but research into the predictive value of IL-6 on postoperative outcome in soft tissue sarcoma (STS) is scarce. The purpose of this study is to investigate the predictive value of serum IL-6 level for the achievement of assumed (post)operative outcome after STS surgery, the so-called textbook outcome. METHODS Preoperative IL-6 serum levels were collected in all patients with a STS at first presentation between February 2020 and November 2021. Textbook outcome was defined as a R0 resection, no complications, no blood transfusions, no reoperation within the postoperative period, no prolonged hospital stay, no hospital readmission within 90-days, and no mortality within 90-days. Factors associated with textbook outcome were determined by multivariable analysis. RESULTS Among 118 patients with primary, non-metastatic STS, 35.6% achieved a textbook outcome. Univariate analysis showed that smaller tumor size (p = 0.026), lower tumor grade (p = 0.006), normal hemoglobin (Hb, p = 0.044), normal white blood cell (WBC) count (p = 0.018), normal C-reactive protein (CRP) serum level (p = 0.002) and normal IL-6 serum level (p = 1.5 × 10-5) were associated with achieving textbook outcome after surgery. Multivariable analysis showed that elevated IL-6 serum level (p = 0.012) was significantly associated with not achieving a textbook outcome. CONCLUSIONS Increased IL-6 serum level is predictive for not achieving a textbook outcome after surgery for primary, non-metastatic STS.
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Affiliation(s)
- P van der Laan
- Department of Surgical Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, the Netherlands; Department of Medical Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, the Netherlands.
| | - W T A van der Graaf
- Department of Medical Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, the Netherlands; Department of Medical Oncology, Erasmus MC Cancer Institute, Dr. Molewaterplein 40, 3015 GD, Rotterdam, the Netherlands.
| | - S J M Reijers
- Department of Surgical Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, the Netherlands.
| | - Y M Schrage
- Department of Surgical Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, the Netherlands.
| | - J J H Hendriks
- Department of Medical Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, the Netherlands.
| | - R L Haas
- Department of Radiotherapy, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, the Netherlands; Department of Radiotherapy, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands.
| | - D van den Broek
- Department of Laboratory Medicine, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, the Netherlands.
| | - N Steeghs
- Department of Medical Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, the Netherlands.
| | - W J van Houdt
- Department of Surgical Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, the Netherlands.
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24
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So YK, Kim Z, Cheong TY, Chung MJ, Baek CH, Son YI, Seok J, Jung YS, Ahn MJ, Ahn YC, Oh D, Cho BH, Chung MK. Detection of Cancer Recurrence Using Systemic Inflammatory Markers and Machine Learning after Concurrent Chemoradiotherapy for Head and Neck Cancers. Cancers (Basel) 2023; 15:3540. [PMID: 37509202 PMCID: PMC10377662 DOI: 10.3390/cancers15143540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/03/2023] [Accepted: 07/06/2023] [Indexed: 07/30/2023] Open
Abstract
Pretreatment values of the neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) are well-established prognosticators in various cancers, including head and neck cancers. However, there are no studies on whether temporal changes in the NLR and PLR values after treatment are related to the development of recurrence. Therefore, in this study, we aimed to develop a deep neural network (DNN) model to discern cancer recurrence from temporal NLR and PLR values during follow-up after concurrent chemoradiotherapy (CCRT) and to evaluate the model's performance compared with conventional machine learning (ML) models. Along with conventional ML models such as logistic regression (LR), random forest (RF), and gradient boosting (GB), the DNN model to discern recurrences was trained using a dataset of 778 consecutive patients with primary head and neck cancers who received CCRT. There were 16 input features used, including 12 laboratory values related to the NLR and the PLR. Along with the original training dataset (N = 778), data were augmented to split the training dataset (N = 900). The model performance was measured using ROC-AUC and PR-AUC values. External validation was performed using a dataset of 173 patients from an unrelated external institution. The ROC-AUC and PR-AUC values of the DNN model were 0.828 ± 0.032 and 0.663 ± 0.069, respectively, in the original training dataset, which were higher than the ROC-AUC and PR-AUC values of the LR, RF, and GB models in the original training dataset. With the recursive feature elimination (RFE) algorithm, five input features were selected. The ROC-AUC and PR-AUC values of the DNN-RFE model were higher than those of the original DNN model (0.883 ± 0.027 and 0.778 ± 0.042, respectively). The ROC-AUC and PR-AUC values of the DNN-RFE model trained with a split dataset were 0.889 ± 0.032 and 0.771 ± 0.044, respectively. In the external validation, the ROC-AUC values of the DNN-RFE model trained with the original dataset and the same model trained with the split dataset were 0.710 and 0.784, respectively. The DNN model with feature selection using the RFE algorithm showed the best performance among the ML models to discern a recurrence after CCRT in patients with head and neck cancers. Data augmentation by splitting training data was helpful for model performance. The performance of the DNN-RFE model was also validated with an external dataset.
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Affiliation(s)
- Yoon Kyoung So
- Department of Otorhinolaryngology-Head & Neck Surgery, Inje University College of Medicine, Ilsan Paik Hospital, Goyang-Si 10380, Republic of Korea
| | - Zero Kim
- Medical AI Research Center, Samsung Medical Center, Seoul 06351, Republic of Korea
- Department of Data Convergence and Future Medicine, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea
| | - Taek Yoon Cheong
- Department of Otorhinolaryngology-Head & Neck Surgery, Inje University College of Medicine, Ilsan Paik Hospital, Goyang-Si 10380, Republic of Korea
| | - Myung Jin Chung
- Medical AI Research Center, Samsung Medical Center, Seoul 06351, Republic of Korea
- Department of Data Convergence and Future Medicine, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea
| | - Chung-Hwan Baek
- Department of Otolaryngology-Head & Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul 06351, Republic of Korea
| | - Young-Ik Son
- Department of Otolaryngology-Head & Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul 06351, Republic of Korea
| | - Jungirl Seok
- Center for Thyroid Cancer, Department of Otolaryngology-Head and Neck Surgery, Research Institute and Hospital, National Cancer Center, Goyang-si 10408, Republic of Korea
| | - Yuh-Seog Jung
- Center for Thyroid Cancer, Department of Otolaryngology-Head and Neck Surgery, Research Institute and Hospital, National Cancer Center, Goyang-si 10408, Republic of Korea
| | - Myung-Ju Ahn
- Divison of Hematology and Medical Oncology, Department of Medicine, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul 06351, Republic of Korea
| | - Yong Chan Ahn
- Department of Radiation Oncology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul 06351, Republic of Korea
| | - Dongryul Oh
- Department of Radiation Oncology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul 06351, Republic of Korea
| | - Baek Hwan Cho
- Department of Biomedical Informatics, CHA University School of Medicine, CHA University, Seongnam-Si 13488, Republic of Korea
- Institute of Biomedical Informatics, School of Medicine, CHA University, Seongnam-Si 13488, Republic of Korea
| | - Man Ki Chung
- Department of Otolaryngology-Head & Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul 06351, Republic of Korea
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25
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Allena N, Khanal S, Jog A, Duran MJ, Paulino S, Bojja S, Soliman M. Decoding the Chronic Obstructive Pulmonary Disease (COPD) Puzzle: Investigating the Significance of Exacerbation Scores in Triage Decision-Making. Cureus 2023; 15:e41975. [PMID: 37593292 PMCID: PMC10427510 DOI: 10.7759/cureus.41975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2023] [Indexed: 08/19/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a complex disease pathology of the lungs that has a significant impact on global health. It has been a major contributor to global mortality and morbidity, with COPD exacerbations posing a substantial economic burden on the healthcare systems. Appropriate triaging of patients with COPD exacerbation is crucial to reduce the burden of hospitalization, especially in the intensive care unit (ICU). Understanding the significance of exacerbation scores in triage decision-making is essential for improving outcomes and optimizing patient care. To aid this triage decision-making, several scoring systems have been developed. This review article aims to discuss the different scores, including assessment of Confusion, Urea, Respiratory rate, Blood pressure, and Age (≥65 years) (CURB-65); Dyspnoea, Eosinopenia, Consolidation, Acidaemia and atrial Fibrillation (DECAF), Neutrophil to lymphocyte ratio (NLR); Platelet-lymphocyte ratio (PLR); Pneumonia severity index/Pneumonia Patient Outcomes Research Team (PSI/PORT); and elevated BUN, Altered mental status, Pulse, Age (>65 years) (BAP-65), and their role in triaging COPD exacerbations. Proper triaging allows for the appropriate allocation of resources and timely interventions based on severity. Further research and validation are needed to establish the optimal use and integration of these scores in clinical practice, particularly in ICU settings.
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Affiliation(s)
| | - Sneha Khanal
- Internal Medicine, BronxCare Health System, Bronx, USA
| | - Abhishrut Jog
- Pulmonary Medicine, BronxCare Health System, Bronx, USA
| | - Maria J Duran
- Internal Medicine, Bronx Care Health System, Bronx, USA
| | | | | | - Maryam Soliman
- Pulmonary and Critical Care Medicine, BronxCare Health System, Bronx, USA
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26
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Yuce E. Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR) Can Predict Spontaneous Preterm Birth? J Inflamm Res 2023; 16:2423-2429. [PMID: 37313308 PMCID: PMC10259531 DOI: 10.2147/jir.s414305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 05/31/2023] [Indexed: 06/15/2023] Open
Abstract
Purpose To investigate the role of neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) in the prediction of spontaneous preterm birth. Patients and Methods Data was retrospectively collected from hospital record between February 2018 and November 2022. Pregnant women (n = 78) with a single pregnancy between 24 and 34 weeks of gestation, presented with labor pain, and had regular uterine contractions (threatened preterm labor - TPL) were included. Patients delivered within the first week after TPL were included in group 1 (n = 40) and who delivered after in group 2 (n = 38). Two groups were investigated for NLR and PLR values. Results The median cervical length among women who gave birth within a week was significantly lower (24.5 versus 30.0 p < 0.001). The median neutrophil-to-lymphocyte ratio among women who gave birth within a week was significantly higher (6.4 versus 4.5 p < 0.001). The median platelet-to-lymphocyte ratio among women who gave birth within a week was significantly higher (151 versus 131 p < 0.001). The cut-off values to predict preterm birth were >5 for NLR (sensitivity: 90%, specificity: 92.1%), >139 for PLR (sensitivity: 97.5%, specificity: 100%). Conclusion NLR and PLR values predict spontaneous preterm birth with high sensitivity and specificity. By predicting preterm birth, the pregnancy process can be managed sensitively and smoothly.
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Affiliation(s)
- Ebru Yuce
- Department of Gynecology and Obstetrics, Yuksek Ihtisas University, Faculty of Medicine, Ankara, Turkey
- Department of Gynecology and Obstetrics, Liv Hospital, Ankara, Turkey
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27
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Makita K, Hamamoto Y, Kanzaki H, Nagasaki K, Takata N, Tsuruoka S, Uwatsu K, Kido T. Factors affecting local control of bone metastases from radioresistant tumors treated with palliative external beam radiotherapy. Discov Oncol 2023; 14:74. [PMID: 37212949 DOI: 10.1007/s12672-023-00651-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 04/06/2023] [Indexed: 05/23/2023] Open
Abstract
BACKGROUND This study aimed to evaluate the factors that affect the local control (LC) of bone metastases from radioresistant carcinomas (renal cell carcinoma, hepatocellular carcinoma [HCC], and colorectal carcinoma [CRC]) treated with palliative external-beam radiotherapy (EBRT). METHODS AND MATERIALS Between January 2010 and December 2020, 211 bone metastases in 134 patients were treated with EBRT in two hospitals (a cancer center and university hospital). Based on follow-up CT, these cases were reviewed retrospectively to evaluate LC at the EBRT site. RESULTS The median EBRT dose (BED10) was 39.0 Gy (range, 14.4-66.3 Gy). The median follow-up time of the imaging studies was 6 months (range, 1-107 months). The 0.5-year overall survival and LC rates of the EBRT sites were 73% and 73%, respectively. Multivariate analysis revealed that the primary sites (HCC/CRC), low EBRT dose (BED10) (≤ 39.0 Gy), and non-administration of post-EBRT bone modifying agents (BMAs) and/or antineoplastic agents (ATs) were statistically significant factors that negatively affected the LC of EBRT sites. In the absence of BMAs or ATs, the EBRT dose (BED10) escalation from 39.0 Gy improved the LC of EBRT sites. Based on ATs administration, the LC of EBRT sites was significantly affected by tyrosine kinase inhibitors and/or immune checkpoint inhibitors. CONCLUSIONS Dose escalation improves LC in bone metastases from radioresistant carcinomas. Higher EBRT doses are needed to treat patients for whom few effective systemic therapies remain available.
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Affiliation(s)
- Kenji Makita
- Department of Radiology, Ehime University Graduate School of Medicine, 454 Shitsukawa, Toon, Ehime, 791-0295, Japan.
- Departments of Radiation Oncology, National Hospital Organization Shikoku Cancer Center, Kou-160, Minami-Umenomoto-Machi, Matsuyama, Ehime, 791-0280, Japan.
| | - Yasushi Hamamoto
- Departments of Radiation Oncology, National Hospital Organization Shikoku Cancer Center, Kou-160, Minami-Umenomoto-Machi, Matsuyama, Ehime, 791-0280, Japan
| | - Hiromitsu Kanzaki
- Departments of Radiation Oncology, National Hospital Organization Shikoku Cancer Center, Kou-160, Minami-Umenomoto-Machi, Matsuyama, Ehime, 791-0280, Japan
| | - Kei Nagasaki
- Departments of Radiation Oncology, National Hospital Organization Shikoku Cancer Center, Kou-160, Minami-Umenomoto-Machi, Matsuyama, Ehime, 791-0280, Japan
| | - Noriko Takata
- Department of Radiology, Ehime University Graduate School of Medicine, 454 Shitsukawa, Toon, Ehime, 791-0295, Japan
| | - Shintaro Tsuruoka
- Department of Radiology, Ehime University Graduate School of Medicine, 454 Shitsukawa, Toon, Ehime, 791-0295, Japan
| | - Kotaro Uwatsu
- Department of Radiology, Ehime University Graduate School of Medicine, 454 Shitsukawa, Toon, Ehime, 791-0295, Japan
| | - Teruhito Kido
- Department of Radiology, Ehime University Graduate School of Medicine, 454 Shitsukawa, Toon, Ehime, 791-0295, Japan
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Chatziioannou E, Leiter U, Thomas I, Keim U, Seeber O, Meiwes A, Boessenecker I, Gonzalez SS, Torres FM, Niessner H, Sinnberg T, Forschner A, Flatz L, Amaral T. Features and Long-Term Outcomes of Stage IV Melanoma Patients Achieving Complete Response Under Anti-PD-1-Based Immunotherapy. Am J Clin Dermatol 2023; 24:453-467. [PMID: 37142875 DOI: 10.1007/s40257-023-00775-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2023] [Indexed: 05/06/2023]
Abstract
BACKGROUND Immune checkpoint inhibition (ICI) has changed the melanoma treatment spectrum. Few studies have examined the characteristics and long-term outcomes of patients achieving complete response (CR) under ICI. MATERIALS AND METHODS We evaluated patients with unresectable stage IV melanoma treated with first-line ICI. The characteristics of those achieving CR were compared with those not achieving CR. Progression-free survival (PFS) and overall survival (OS) were assessed. Late-onset toxicities, response to second-line treatment, the prognostic value of clinicopathologic features, and blood markers were examined. RESULTS A total of 265 patients were included; 41 (15.5%) achieved CR, while 224 (84.5%) had progressive disease, stable disease, or partial response. At the therapy start, those who had CR were more likely to be older than 65 years of age (p = 0.013), have a platelet-to-lymphocyte ratio below 213 (p = 0.036), and have lower lactate dehydrogenase levels (p = 0.008) than those not achieving a CR. For those who discontinued therapy after CR, the median follow-up time after CR was 56 months (interquartile range [IQR] 52-58) and the median time from CR to therapy end was 10 months (IQR 1-17). Five-year PFS after CR was 79% and 5-year OS was 83%. Most complete responders had a normalization of S100 at the time of CR (p < 0.001). In simple Cox regression analysis, age below 77 years at CR (p = 0.04) was associated with better prognosis after CR. Eight patients received second-line ICI; disease control was seen in 63%. Late immune-related toxicities occurred in 25% of patients, most being cutaneous immune-related toxicities. CONCLUSIONS Response, according to the Response Evaluation Criteria in Solid Tumors (RECIST) criteria, is, until now, the most important prognostic factor, and CR is a valid surrogate marker for long-term survival in patients treated with ICI. Our results highlight the importance of investigating the optimal therapy duration in complete responders.
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Affiliation(s)
- Eftychia Chatziioannou
- Center for Dermato-Oncology, Department of Dermatology, Eberhard Karls University of Tuebingen, Liebermeisterstrasse 25, 72076, Tuebingen, Germany
| | - Ulrike Leiter
- Center for Dermato-Oncology, Department of Dermatology, Eberhard Karls University of Tuebingen, Liebermeisterstrasse 25, 72076, Tuebingen, Germany
| | - Ioannis Thomas
- Center for Dermato-Oncology, Department of Dermatology, Eberhard Karls University of Tuebingen, Liebermeisterstrasse 25, 72076, Tuebingen, Germany
| | - Ulrike Keim
- Center for Dermato-Oncology, Department of Dermatology, Eberhard Karls University of Tuebingen, Liebermeisterstrasse 25, 72076, Tuebingen, Germany
| | - Olivia Seeber
- Center for Dermato-Oncology, Department of Dermatology, Eberhard Karls University of Tuebingen, Liebermeisterstrasse 25, 72076, Tuebingen, Germany
| | - Andreas Meiwes
- Center for Dermato-Oncology, Department of Dermatology, Eberhard Karls University of Tuebingen, Liebermeisterstrasse 25, 72076, Tuebingen, Germany
| | - Isabell Boessenecker
- Center for Dermato-Oncology, Department of Dermatology, Eberhard Karls University of Tuebingen, Liebermeisterstrasse 25, 72076, Tuebingen, Germany
| | - Stephanie Sanchez Gonzalez
- Center for Dermato-Oncology, Department of Dermatology, Eberhard Karls University of Tuebingen, Liebermeisterstrasse 25, 72076, Tuebingen, Germany
| | - Francisco Merraz Torres
- Center for Dermato-Oncology, Department of Dermatology, Eberhard Karls University of Tuebingen, Liebermeisterstrasse 25, 72076, Tuebingen, Germany
| | - Heike Niessner
- Center for Dermato-Oncology, Department of Dermatology, Eberhard Karls University of Tuebingen, Liebermeisterstrasse 25, 72076, Tuebingen, Germany
- Cluster of Excellence iFIT (EXC 2180), Tuebingen, Germany
| | - Tobias Sinnberg
- Center for Dermato-Oncology, Department of Dermatology, Eberhard Karls University of Tuebingen, Liebermeisterstrasse 25, 72076, Tuebingen, Germany
- Cluster of Excellence iFIT (EXC 2180), Tuebingen, Germany
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Andrea Forschner
- Center for Dermato-Oncology, Department of Dermatology, Eberhard Karls University of Tuebingen, Liebermeisterstrasse 25, 72076, Tuebingen, Germany
| | - Lukas Flatz
- Center for Dermato-Oncology, Department of Dermatology, Eberhard Karls University of Tuebingen, Liebermeisterstrasse 25, 72076, Tuebingen, Germany
- Institute for Immunobiology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Teresa Amaral
- Center for Dermato-Oncology, Department of Dermatology, Eberhard Karls University of Tuebingen, Liebermeisterstrasse 25, 72076, Tuebingen, Germany.
- Cluster of Excellence iFIT (EXC 2180), Tuebingen, Germany.
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Esercan A, Demir I. Neutrophil/Lymphocyte and Platelet/Lymphocyte Ratio in Preterm Premature Rupture of Membranes. Cureus 2023; 15:e38664. [PMID: 37163192 PMCID: PMC10164351 DOI: 10.7759/cureus.38664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2023] [Indexed: 05/11/2023] Open
Abstract
AIM This study aimed to investigate maternal hematological laboratory parameters of pregnancies complicated with preterm premature rupture of membranes (PPROM) compared to mothers of healthy-term infants (control group). MATERIALS AND METHODS This case-control study included 158 mothers who were divided into PPROM (n=67) and control (n=91) groups, respectively. Laboratory parameters of platelet, lymphocyte, and neutrophil counts, neutrophil/lymphocyte ratio (NLR), and platelet/lymphocyte ratio (PLR) were recorded at the time of diagnosis for the PPROM group and at the time of hospital admission for birth for the control group. RESULTS NLR was significantly higher in the PPROM group than in the control group (p=0.001). The cutoff value of NLR to predict PPROM was 6.73 (AUC=0.671, 95% confidence interval=0.58-0.75, p=0.000). CONCLUSION A cheap and routine NLR blood test can be used to predict PPROM before labor.
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Affiliation(s)
- Alev Esercan
- Obstetrics and Gynecology, Şanlıurfa Education and Research Hospital, Şanlıurfa, TUR
| | - Ismail Demir
- Obstetrics and Gynecology, Şanlıurfa Education and Research Hospital, Şanlıurfa, TUR
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30
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Guo G, Hu X, Gao T, Zhou H, Li B, Zhou C, Yu B, Wang G. Potential impact of platelet-to-lymphocyte ratio on prognosis in patients with colorectal cancer: A systematic review and meta-analysis. Front Surg 2023; 10:1139503. [PMID: 37051571 PMCID: PMC10083474 DOI: 10.3389/fsurg.2023.1139503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 03/06/2023] [Indexed: 03/29/2023] Open
Abstract
BackgroundNumerous studies have confirmed that inflammation promotes the occurrence, development and prognosis of colorectal cancer (CRC).ObjectiveThis study focuses on the potentially prognostic value of the platelet-to-lymphocyte ratio (PLR) in CRC patients.Data SourcesThis study was registered at PROSPERO (ID: CRD42020219215). Relative studies were searched on PubMed, Cochrane Library, Embase, Web of Science, and clinical trial databases by two back-to-back reviewers. Study Selection and Intervention: Studies were screened according to the predetermined inclusion and exclusion criteria, comparing prognosis differences between low PLR levels and high PLR levels for CRC patients. Main Outcome Measures: Studies were integrated and compared to analyze the value of PLR in predicting overall survival (OS), progression-free survival (PFS), cancer-specific survival (CSS), disease-free survival (DFS) and recurrence-free survival (RFS) of CRC. Results: Outcomes were compared using Review Manager (version 5.4) software from Cochrane Collaboration. A total of 27 literary works, including 13,330 patients, were incorporated into our study. The final results showed that higher PLR levels had worse OS (hazard ratio [HR] = 1.40, 95% confidence interval [CI] = 1.21–1.62, P < 0.00001), DFS (HR = 1.44, 95% CI = 1.09–1.90, P = 0.01) and RFS (HR = 1.48, 95% CI = 1.13–1.94, P = 0.005) than lower PLR levels, respectively. However, there was no evidence of significance for PFS (HR = 1.14, 95% CI = 0.84–1.54, P = 0.40) and CSS (HR = 1.16, 95% CI = 0.88–1.53, P = 0.28) in the final meta-analysis.LimitationsOur study has the following limitations. First of all, we only included literature published in English, which means that some publication bias may be inevitable. In addition, our study used aggregate data, not individual data; furthermore, we did not define the exact cut-off value representing the PLR level.ConclusionAn elevated PLR seems to be an adverse prognostic factor affecting survival outcomes in patients with CRC. Meanwhile, more prospective studies are required to confirm our conclusion.PROSPERO ID: CRD42020219215.
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Affiliation(s)
- Ganlin Guo
- The Second Hospital of Hebei Medical University, Shijiazhuang, China
- The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xuhua Hu
- The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Tianyi Gao
- The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Huixian Zhou
- The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Baokun Li
- The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Chaoxi Zhou
- The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Bin Yu
- The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Guiying Wang
- The Second Hospital of Hebei Medical University, Shijiazhuang, China
- The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
- Correspondence: Guiying Wang
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Systemic inflammation with sarcopenia predicts survival in patients with gastric cancer. J Cancer Res Clin Oncol 2023; 149:1249-1259. [PMID: 35435489 DOI: 10.1007/s00432-022-03925-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 01/12/2022] [Indexed: 12/29/2022]
Abstract
OBJECTIVE The levels of platelet-related inflammation indicators and sarcopenia have been reported to affect the survival of patients with cancer. To evaluate the prognostic influence of platelet count (PLT), platelet lymphocyte ratio (PLR), and systemic immune inflammation index (SII), and SII combined with sarcopenia on the survival of patients with gastric cancer (GC). METHODS A total of 1133 patients with GC (812 male and 321 female, average age: 59.43 years) were evaluated. Receiver-operating characteristic curves were used to determine the best cutoff values of PLT, PLR, and SII, and univariate and multivariate Cox risk regression models were used to evaluate whether SII is an independent predictor of overall survival (OS). The prognostic SS (SII-sarcopenia) was established based on SII and sarcopenia. Finally, a comprehensive analysis of the prognostic SS was performed. RESULTS SII had the strongest prognostic effect. The SII and OS of patients with GC were in an inverted U-shape (adjusted HR = 1.07; 95% CI 0.97-1.19; adjusted P = 0.179). In patients with SII > 1800, SII was negatively correlated with OS (adjusted HR = 0.57; 95% CI 0.29-1.12; adjusted P = 0.102), however, there is no statistical difference. Interestingly, a high SS was associated with a poorer prognosis. The higher the SS score was, the worse the OS (P < 0.001). CONCLUSION SII is an independent prognostic indicator of GC, and high SII is related to poor prognosis. A higher SS score had worse survival. Thus, the prognostic SS is a reliable predictor of OS in patients with GC.
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The Pre-Treatment Platelet-to-Lymphocyte Ratio as a Prognostic Factor for Loco-Regional Control in Locally Advanced Rectal Cancer. Diagnostics (Basel) 2023; 13:diagnostics13040679. [PMID: 36832166 PMCID: PMC9955057 DOI: 10.3390/diagnostics13040679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 02/03/2023] [Accepted: 02/09/2023] [Indexed: 02/15/2023] Open
Abstract
Chronic inflammatory reactions have been proven to represent relevant mechanisms for the development and progression of cancer in numerous tumor entities. There is evidence that the platelet-to-lymphocyte ratio (PLR) is associated with the prognostic outcome. In rectal cancer, the prognostic role of this parameter has not yet been conclusively clarified. The aim of this study was to further clarify the prognostic significance of the pre-treatment PLR in patients with locally advanced rectal cancer (LARC). In the present study, 603 patients with LARC, who were treated with neoadjuvant chemoradiotherapy (nCRT) and subsequent surgical resection between 2004 and 2019, were retrospectively evaluated. The influence of clinico-pathological and laboratory factors on locoregional control (LC), metastasis-free survival (MFS) and overall survival (OS) was investigated. In univariate analyses, high PLR was significantly associated with worse LC (p = 0.017) and OS (p = 0.008). In multivariate analyses, the PLR remained an independent parameter for the LC (HR = 1.005, 95% CI: 1.000-1.009, p = 0.050). Pre-treatment lactate dehydrogenase (LDH) (HR: 1.005 95% CI:1.002-1.008; p = 0.001) and carcinoembryonic antigen (CEA) (HR: 1.006, 95% CI:1.003-1.009; p < 0.001) were independent predictors for MFS; additionally, age (HR: 1.052, 95% CI:1.023-1.081; p < 0.001), LDH (HR: 1.003, 95% CI:1.000-1.007; p = 0.029) and CEA (HR: 1.006, 95% CI:1.003-1.009; p < 0.001) independently predicted OS. Pre-treatment PLR before nCRT is an independent prognostic factor for LC in LARC, which could be used to further individualize tumor treatment.
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Makita K, Hamamoto Y, Kanzaki H, Nagasaki K, Takata N, Tsuruoka S, Uwatsu K, Kido T. Factors Affecting Survival and Local Control in Patients with Bone Metastases Treated with Radiotherapy. Med Sci (Basel) 2023; 11:medsci11010017. [PMID: 36810484 PMCID: PMC9944514 DOI: 10.3390/medsci11010017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/20/2023] [Accepted: 02/02/2023] [Indexed: 02/08/2023] Open
Abstract
The aim of this study was to evaluate the expected prognosis and factors affecting local control (LC) of the bone metastatic sites treated with palliative external beam radiotherapy (RT). Between December 2010 and April 2019, 420 cases (male/female = 240/180; median age [range]: 66 [12-90] years) with predominantly osteolytic bone metastases received RT and were evaluated. LC was evaluated by follow-up computed tomography (CT) image. Median RT doses (BED10) were 39.0 Gy (range, 14.4-71.7 Gy). The 0.5-year overall survival and LC of RT sites were 71% and 84%, respectively. Local recurrence on CT images was observed in 19% (n = 80) of the RT sites, and the median recurrence time was 3.5 months (range, 1-106 months). In univariate analysis, abnormal laboratory data before RT (platelet count, serum albumin, total bilirubin, lactate dehydrogenase, or serum calcium level), high-risk primary tumor sites (colorectal, esophageal, hepatobiliary/pancreatic, renal/ureter, and non-epithelial cancers), no antineoplastic agents (ATs) administration after RT, and no bone modifying agents (BMAs) administration after RT were significantly unfavorable factors for both survival and LC of RT sites. Sex (male), performance status (≥3), and RT dose (BED10) (<39.0 Gy) were significantly unfavorable factors for only survival, and age (≥70 years) and bone cortex destruction were significantly unfavorable factors for only LC of RT sites. In multivariate analysis, only abnormal laboratory data before RT influenced both unfavorable survival and LC of RT sites. Performance status (≥3), no ATs administration after RT, RT dose (BED10) (<39.0 Gy), and sex (male) were significantly unfavorable factors for survival, and primary tumor sites and BMAs administration after RT were significantly unfavorable factors for LC of RT sites. In conclusion, laboratory data before RT was important factor both prognosis and LC of bone metastases treated with palliative RT. At least in patients with abnormal laboratory data before RT, palliative RT seemed to be focused on the only pain relief.
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Affiliation(s)
- Kenji Makita
- Department of Radiology, Ehime University Graduate School of Medicine, 454 Shitsukawa, Toon 791-0295, Ehime, Japan
- Department of Radiation Oncology, National Hospital Organization Shikoku Cancer Center, Kou-160, Minami-Umenomoto-Machi, Matsuyama 791-0280, Ehime, Japan
- Correspondence: ; Tel.: +81-89-960-5371; Fax: +81-89-960-5375
| | - Yasushi Hamamoto
- Department of Radiation Oncology, National Hospital Organization Shikoku Cancer Center, Kou-160, Minami-Umenomoto-Machi, Matsuyama 791-0280, Ehime, Japan
| | - Hiromitsu Kanzaki
- Department of Radiation Oncology, National Hospital Organization Shikoku Cancer Center, Kou-160, Minami-Umenomoto-Machi, Matsuyama 791-0280, Ehime, Japan
| | - Kei Nagasaki
- Department of Radiation Oncology, National Hospital Organization Shikoku Cancer Center, Kou-160, Minami-Umenomoto-Machi, Matsuyama 791-0280, Ehime, Japan
| | - Noriko Takata
- Department of Radiology, Ehime University Graduate School of Medicine, 454 Shitsukawa, Toon 791-0295, Ehime, Japan
| | - Shintaro Tsuruoka
- Department of Radiology, Ehime University Graduate School of Medicine, 454 Shitsukawa, Toon 791-0295, Ehime, Japan
| | - Kotaro Uwatsu
- Department of Radiology, Ehime University Graduate School of Medicine, 454 Shitsukawa, Toon 791-0295, Ehime, Japan
| | - Teruhito Kido
- Department of Radiology, Ehime University Graduate School of Medicine, 454 Shitsukawa, Toon 791-0295, Ehime, Japan
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Sütcüoğlu O, Erdal ZS, Akdoğan O, Çeltikçi E, Özdemir N, Özet A, Uçar M, Yazıcı O. The possible relation between temporal muscle mass and glioblastoma multiforme prognosis via sarcopenia perspective. Turk J Med Sci 2023; 53:413-419. [PMID: 36945944 PMCID: PMC10388072 DOI: 10.55730/1300-0144.5599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 11/20/2022] [Indexed: 02/26/2023] Open
Abstract
BACKGROUND The optimal sarcopenia measurement method in patients with a diagnosis of glioblastoma multiforme (GBM) is unknown. It has been found that temporal muscle thickness (TMT) may reflect sarcopenia and be associated with survival, but the relationship between temporal muscle area (TMA) and GBM prognosis has never been evaluated before. The primary outcome of the study was to evaluate the relationship between TMA/TMT and overall survival (OS) time in newly diagnosed GBM patients. METHODS The data of patients who presented at the university hospital between January 2009 and January 2019 with a confirmed diagnosis of glioblastoma multiforme at the time of diagnosis were analyzed retrospectively. Temporal muscle thickness and TMA were measured retrospectively from preoperative MRIs of patients diagnosed with GBM. Due to the small number of patients and the failure to determine a cut-off value with acceptable sensitivity and specificity using ROC analysis, the median values were chosen as the cut-off value. The patients were basically divided into two according to their median TMT (6.6 mm) or TMA (452 mm2 ) values, and survival analysis was performed with the Kaplan-Meier analysis. RESULTS The median TMT value was 6.6 mm, and the median TMA value was 452 mm2 . The median overall survival (OS) was calculated as 25.8 months in patients with TMT < 6.6 mm, and 15.8 months in patients with TMT ≥ 6.6 mm (p = 0.29). The median overall survival (OS) of patients with TMA < 452mm2 was 26.3 months, and the group with TMA ≥ 452mm2 was 14.6 months (p = 0.06). The median disease-free survival was 18.3 months (%95 CI: 13.2-23.4) in patients with TMT < 6.6mm, while mDFS was 10.9 (%95 CI: 8.0-13.8) months in patients with TMT ≥ 6.6mm (p = 0.21). The median disease-free survival was found to be 21.0 months (%95 CI: 15.8-26.1) in patients with TMA < 452 mm2 and 10.5 months (%95 CI: 7.8-13.2) in patients with TMA ≥ 452 mm2 (p = 0.018). DISCUSSION No association could be demonstrated between TMT or TMA and OS of GBM patients. In addition, the median DFS was found to be longer in patients with low TMA. There is an unmet need to determine the optimal method of sarcopenia in GBM patients.
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Affiliation(s)
- Osman Sütcüoğlu
- Department of Medical Oncology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Zeynep Sezgi Erdal
- Department of Radiology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Orhun Akdoğan
- Department of Internal Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Emrah Çeltikçi
- Department of Neurosurgery, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Nuriye Özdemir
- Department of Medical Oncology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Ahmet Özet
- Department of Medical Oncology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Murat Uçar
- Department of Radiology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Ozan Yazıcı
- Department of Medical Oncology, Faculty of Medicine, Gazi University, Ankara, Turkey
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Zhang X, Zhang Q, Tang M, Zhang KP, Zhang XW, Song MM, Ruan GT, Sun Q, Li W, Xu HX, Cong MH, Deng L, Shi HP. Nutrition-inflammation marker enhances prognostic value to ECOG performance status in overweight or obese patients with cancer. JPEN J Parenter Enteral Nutr 2023; 47:109-119. [PMID: 35589385 DOI: 10.1002/jpen.2407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 04/02/2022] [Accepted: 05/16/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Overweight or obese cancer patients are more likely to develop a proinflammatory status. The aim of this study was to investigate whether the nutrition-inflammation marker can provide additional prognostic information on top of well-established Eastern Cooperative Oncology Group performance status (ECOG-PS) in overweight or obese patients with cancer. METHODS A total of 1667 overweight or obese cancer patients were enrolled in this study. We assessed the prediction accuracy of 10 nutrition-inflammation markers by time-dependent receiver operating characteristic (ROC) and elucidated their association with overall survival by the Kaplan-Meier method and a Cox model. RESULTS In this analysis, the majority of patients had a good performance status (ECOG-PS score ≤1; 88.3%). Both the area under ROC curves and the C-index of the lymphocyte-C-reactive protein ratio (LCR) demonstrated that LCR was the most significant nutrition-inflammation marker correlated with survival. In patients with good ECOG-PS, a low LCR was significantly associated with poorer prognosisand enhanced the predictive ability of one-year mortality. For specific tumor types, a low LCR was an independent prognostic factor for lung cancer, upper gastrointestinal cancer, and colorectal cancer, and it tended to be a significant predictor for breast cancer. In addition, those patients with a combined low LCR and poorer ECOG-PS (ECOG-PS score >1) showed the worst prognosis. CONCLUSION The LCR is more strongly associated with overall survival than other nutrition-inflammation markers, and it is able to further detect patients with worse prognosis on top of ECOG-PS in overweight or obese patients with cancer.
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Affiliation(s)
- Xi Zhang
- Department of Gastrointestinal Surgery and Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.,Department of Comprehensive Oncology, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
| | - Qi Zhang
- Department of Gastrointestinal Surgery and Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
| | - Meng Tang
- Department of Gastrointestinal Surgery and Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
| | - Kang-Ping Zhang
- Department of Gastrointestinal Surgery and Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
| | - Xiao-Wei Zhang
- Department of Gastrointestinal Surgery and Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
| | - Meng-Meng Song
- Department of Gastrointestinal Surgery and Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
| | - Guo-Tian Ruan
- Department of Gastrointestinal Surgery and Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
| | - Qiang Sun
- Laboratory of Cell Engineering, Institute of Biotechnology, Research Unit of Cell Death Mechanism, Chinese Academy of Medical Science, Beijing, China
| | - Wei Li
- Cancer Center of the First Hospital of Jilin University, Changchun, China
| | - Hong-Xia Xu
- Department of Clinical Nutrition, Daping Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Ming-Hua Cong
- Department of Comprehensive Oncology, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Li Deng
- Department of Gastrointestinal Surgery and Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
| | - Han-Ping Shi
- Department of Gastrointestinal Surgery and Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
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Gawiński C, Hołdakowska A, Wyrwicz L. Correlation between Lymphocyte-to-Monocyte Ratio (LMR), Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR) and Extramural Vascular Invasion (EMVI) in Locally Advanced Rectal Cancer. Curr Oncol 2022; 30:545-558. [PMID: 36661692 PMCID: PMC9857771 DOI: 10.3390/curroncol30010043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 12/29/2022] [Indexed: 01/03/2023] Open
Abstract
Rectal cancer constitutes around one-third of all colorectal cancers. New markers are required to optimize the treatment. Extramural vascular invasion (EMVI) is a magnetic resonance imaging (MRI)-based negative prognostic marker. Lymphocyte-to-monocyte ratio (LMR), neutrophil-to-lymphocyte ratio (NLR) or platelet-to-lymphocyte ratio (PLR) are blood-based systemic inflammatory response markers with proven prognostic value in many cancers, including CRC. We hypothesized whether there is a relationship between LMR, NLR, PLR and the presence of EMVI on pre-treatment MRI in patients with locally advanced rectal cancer (LARC). We conducted a retrospective analysis of 371 patients with LARC treated in the Maria Skłodowska-Curie National Research Institute of Oncology, Warsaw, Poland between August 2016 and December 2021. One hundred eighty-four patients were found eligible for the study. A correlation between the extension of the tumour, nodal status, clinical stage of the disease and the presence of EMVI was found (p < 0.001). The pre-treatment level of neutrophils, platelets and carcinoembryonic antigen (CEA) was significantly higher in the EMVI-positive population (p = 0.041, p = 0.01, p = 0.027, respectively). There were no significant differences regarding the level of LMR, NLR and PLR between the EMVI-positive and EMVI-negative population. LMR, NLR and PLR do not differentiate patients in terms of EMVI; neither of these parameters is a good predictor of the status of EMVI in LARC.
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Affiliation(s)
- Cieszymierz Gawiński
- Maria Sklodowska-Curie National Research Institute of Oncology, ul. Wawelska 15, 02-034 Warsaw, Poland
| | - Anna Hołdakowska
- Department of Radiology, National Research Institute of Oncology, ul. Roentgena 5, 02-781 Warsaw, Poland
| | - Lucjan Wyrwicz
- Department of Oncology and Radiotherapy, National Research Institute of Oncology, ul. Wawelska 15, 02-034 Warsaw, Poland
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Ryan KM, Lynch M, McLoughlin DM. Blood cell ratios in mood and cognitive outcomes following electroconvulsive therapy. J Psychiatr Res 2022; 156:729-736. [PMID: 36413934 DOI: 10.1016/j.jpsychires.2022.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 10/21/2022] [Accepted: 11/12/2022] [Indexed: 11/18/2022]
Abstract
Systemic inflammation is commonly reported in depression, with dysregulation of both the innate and adaptive arms of the immune system documented. Obtaining ratios of neutrophils, platelets, and monocytes to counts of lymphocytes (NLR, PLR, MLR, respectively) represents a low-cost and easily reproducible measure of an individual's inflammatory burden that can be calculated effortlessly from routine clinical full white blood cell counts. Electroconvulsive therapy (ECT) remains the most effective acute antidepressant treatment for depression but is often limited by its cognitive side-effects. Here, we examined differences in blood cell ratios in subgroups of depressed patients (unipolar/bipolar, psychotic/non-psychotic, early-onset/late-onset) and ECT-related subgroups (responder/non-responder, remitter/non-remitter). We also explored the relationships between blood cell ratios and depression severity and immediate cognitive outcomes post-ECT. Our results show baseline NLR was raised in patients with psychotic depression. In the entire group of patients, significant negative correlations were noted between the PLR and SII and baseline HAM-D24 score, signifying that lower systemic inflammation is associated with more severe depressive symptoms. Significant positive correlations were noted between various blood cell ratios and mean time to recovery of orientation in the entire group of patients and in depression subgroups, indicating that increased peripheral inflammation is linked to worse cognitive outcomes post-ECT. Overall, our results suggest that assessment of blood cell ratios could be useful for predicting mood changes in patients at risk of developing depressive episodes or relapse following successful treatment or for identifying those at risk for cognitive side-effects following ECT.
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Affiliation(s)
- Karen M Ryan
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin 2, Ireland; Department of Psychiatry, Trinity College Dublin, St. Patrick's University Hospital, James Street, Dublin 8, Ireland
| | - Marie Lynch
- Department of Psychiatry, Trinity College Dublin, St. Patrick's University Hospital, James Street, Dublin 8, Ireland
| | - Declan M McLoughlin
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin 2, Ireland; Department of Psychiatry, Trinity College Dublin, St. Patrick's University Hospital, James Street, Dublin 8, Ireland.
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Hrubaru I, Motoc A, Moise ML, Miutescu B, Citu IM, Pingilati RA, Popescu DE, Dumitru C, Gorun F, Olaru F, Erdelean I, Forga M, Nicolae N, Citu C. The Predictive Role of Maternal Biological Markers and Inflammatory Scores NLR, PLR, MLR, SII, and SIRI for the Risk of Preterm Delivery. J Clin Med 2022; 11:jcm11236982. [PMID: 36498555 PMCID: PMC9738289 DOI: 10.3390/jcm11236982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 11/23/2022] [Accepted: 11/25/2022] [Indexed: 11/29/2022] Open
Abstract
In many countries, preterm birth, defined as birth before 37 completed weeks of gestation, is the primary cause of infant death and morbidity. An increasing body of research suggests that inflammation (both clinical and subclinical) plays a significant role in inducing preterm labor or developing pregnancy problems that lead to premature birth. Consequently, the purpose of this research was to determine the predictive value of the Neutrophil-Lymphocyte Ratio (NLR), derived Neutrophil-Lymphocyte Ratio (dNLR), Monocytes-to-Lymphocyte Ratio (MLR), Platelets-to-Lymphocyte Ratio (PLR), Systemic immune-inflammation index (SII), and systemic inflammatory response index (SIRI), for premature delivery. A retrospective study analyzed a total of 243 eligible pregnancies that resulted in a preterm birth during 2020 and 2021. A control group without a history of preterm birth was matched by age and trimester of laboratory analysis at a 1:1 ratio. Although the number of comorbidities was similar among study groups, the body-mass index estimated for the week of gestation was significantly higher among the patients from the prematurity group, as well as the prevalence of urinary tract infections and smoking. Laboratory data showed that patients with a preterm birth had significantly higher white blood cell count and monocytes, but significantly lower lymphocytes, platelets, and hemoglobin. The NLR, dNLR, PLR, and MLR scores showed to be significantly higher among patients from the prematurity group, but SII and SIRI were not significantly different between the study groups. It was observed that the AUC values of NLR, dNLR, PLR, and MLR were higher than 0.600, respectively NLR had the highest value among the tested scores (AUC = 0.694) and the highest sensitivity in this study (71%). The highest sensibility was achieved by dNLR, with 70%, and an AUC value of 0.655 (p-value = 0.022). PLR had the second-highest AUC value (0.682) and the best score in terms of sensitivity (70%) and sensibility (69%) (p-value = 0.015). Lastly, MLR had the lowest significant AUC score (0.607) and lowest sensitivity/sensibility. The significant cut-off values for the inflammatory scores were 9.0 for NLR, 9.8 for dNLR, 250 for PLR, and 4.07 for MLR. After evaluating the importance of these inflammatory scores, further clinical applications should be conducted to confirm the results and improve therapy and care to reduce the burden of premature deliveries.
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Affiliation(s)
- Ingrid Hrubaru
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Andrei Motoc
- Department of Anatomy and Embryology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Marius Liviu Moise
- Department of Radiology, “Premiere” Hospital—“Regina Maria”, Calea Aradului 113, 300643 Timisoara, Romania
- Correspondence:
| | - Bogdan Miutescu
- Department of Gastroenterology and Hepatology, “Premiere” Hospital—“Regina Maria”, Calea Aradului 113, 300643 Timisoara, Romania
| | - Ioana Mihaela Citu
- Department of Internal Medicine I, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Raja Akshay Pingilati
- Malla Reddy Institute of Medical Sciences, Suraram Main Road 138, Hyderabad 500055, India
| | - Daniela-Eugenia Popescu
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Department of Neonatology, Premiere Hospital, Regina Maria Health Network, 300645 Timisoara, Romania
| | - Catalin Dumitru
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Florin Gorun
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Flavius Olaru
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Izabella Erdelean
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Marius Forga
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Nicoleta Nicolae
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Cosmin Citu
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
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Reisoğlu A, Turgut A, Filibeli M, İncesu M, Yalçın E, Parlar O, Parlar O. Analysis of the factors affecting mortality after non-traumatic major lower extremity amputations. ACTA ORTHOPAEDICA ET TRAUMATOLOGICA TURCICA 2022; 56:377-383. [PMID: 36567540 PMCID: PMC9885639 DOI: 10.5152/j.aott.2022.22096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the prognostic factors affecting mortality after major lower extremity amputations in patients with diabetes mellitus and peripheral vascular disease. METHODS For this retrospective study, 484 patients (345 male, 139 female) who were previously diagnosed with diabetes mellitus and peripheral vascular disease and underwent first-time nontraumatic major lower extremity amputations between January 2008 and January 2021 were included. The mean age of the patients was 64.2 ± 13.8 (20-114). In 32.4% of patients, peripheral vascular disease was the underlying cause, whereas diabetes mellitus was responsible for the etiology in 67.6% of patients. About 68.8% of patients had below-knee amputations, whereas 2.9% had bilateral below-knee amputations, 27.1% had above-knee amputations, and 1.2% had hip disarticulation performed. Gender, age, amputation level, amputation etiologies, Charlson comorbidity index, need for blood transfusion, and laboratory findings such as hemoglobin, platelet, albumin, erythrocyte sedimentation rate, C-reactive protein, sodium, potassium, and neutrophil to lymphocyte ratio levels were recorded preoperatively and at the time of discharge. Patients were grouped as died ≤1 month, ≤3 months, ≤6 months, and ≤12 months or alive. RESULTS Advanced age, female gender, high Charlson comorbidity index, blood transfusion requirement, proximal amputation level, preoperative low platelet, preoperative low albumin, and parameters such as low hemoglobin, low erythrocyte sedimentation rate, high sodium, low platelet, low albumin, high C-reactive protein, and high neutrophil to lymphocyte ratio at time of discharge were seen to have a statistically significant effect on mortality at 1 month, 3 months, 6 months, and 12 months postoperatively. Preoperative high C-reactive protein had a statistically significant effect on mortality at 1 and 3 months postoperatively, whereas low C-reactive protein had a statisti cally significant effect on mortality at 6 months postoperatively. High potassium at the time of discharge was associated with mortality at 6 and 12 months postoperatively. CONCLUSION This study has shown us that mortality rates are affected by modifiable parameters at the time of discharge such as hemoglo bin, sodium, potassium, platelet, and albumin, and normalization of these parameters before discharge could reduce the rates of mortality in the postoperative period. LEVEL OF EVIDENCE Level IV, Prognostic Study.
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Sokolov DA, Kozlov IA. Information Value of Calculated Hematological Indices in the Assessment of Cardiac Risk in Oncological Surgery. MESSENGER OF ANESTHESIOLOGY AND RESUSCITATION 2022. [DOI: 10.21292/2078-5658-2022-19-5-6-13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
Abstract
The objective: to study information value of the neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) in the cardiac risk assessment in abdominal oncological surgery.Subjects and Methods. 94 patients of 68 [62‒73] years old who underwent elective surgery were examined.Results. Cardiovascular comortbidity was diagnosed in 69 (73.4%) patients. 11 (11.7%) perioperative cardiovascular complications were registered. Cardiac mortality was 4.3%. Hematological indices were not associated with cardiovascular diseases (NLR: OR = 0.59‒1.42; 95% CI 0.14‒2.60; p = 0.29‒0.74, PLR: OR = 0.99‒1.00; 95% CI 0.97‒1.01; p = 0.31‒0.99). NLR and PLR were not predictors of cardiovascular complications (OR = 0.67; 95% CI 0.19‒2.37; p = 0.46 and OR = 1.00; 95% CI 0.99‒1.01; p = 0.68) and cardiac death (OR = 0.21; 95% CI 0.01‒8.05; p = 0.23 and OR = 0.99; 95% CI 0.98‒1.01; p = 0.79).Conclusion. NLR and PLR cannot be recommended for the cardiac risk assessment in abdominal oncological surgery.
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Affiliation(s)
- D. A. Sokolov
- Yaroslavl State Medical University; Regional Clinical Hospital
| | - I. A. Kozlov
- M. F. Vladimirsky Moscow Regional Research Clinical Institute
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Zhao J, Pan Y, Sheng Y, Sun J. Relationship between PLR and Clinicopathological Characteristics of Patients with Advanced NSCLC and Its Predictive Value for the Efficacy of Chemotherapy and Prognosis. Emerg Med Int 2022; 2022:5811219. [PMID: 36213000 PMCID: PMC9546687 DOI: 10.1155/2022/5811219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 09/07/2022] [Indexed: 11/25/2022] Open
Abstract
Objective To investigate the relationship between blood platelet-to-lymphocyte ratio (PLR) and clinicopathological characteristics of patients with advanced non-small cell lung cancer (NSCLC) and evaluate the value of PLR for predicting the efficacy of chemotherapy and prognosis. Methods The clinical data of 175 patients with advanced NSCLC diagnosed from March 2017 to December 2018 in our hospital were retrospectively analyzed, and the data of 175 healthy subjects from our hospital physical examinations were included. The platelet was detected by using a blood cell analyzer to calculate PLR. According to the average PLR value (197) before chemotherapy, 175 patients were divided into the low PLR group (=78) and the high PLR group (=97). The relationship between the expression levels of PLR and clinicopathologic features was analyzed, and the Kaplan-Meier survival curve was used to analyze the relationship between the expression levels of PLR and prognosis. Results The results showed that prechemotherapy PLR levels were significantly higher in NSCLC compared with the healthy subjects (P < 0.05). After 4 cycles of chemotherapy, the PLR levels were significantly lower than those during prechemotherapy (P < 0.05). The proportion of TNM (IV) stage cases in the low PLR group was lower than that in the high PLR group (P < 0.05). The total effective rate of the first-line chemotherapy was 46.9% (82/175). The effective rate of IIIb staging was higher than that in IV staging (P < 0.05), and the effective rate of the low PLR group was higher than that in the high PLR group (P < 0.05). Multivariate logistic analysis showed that TNM stage 4 and high PLR level were the independent risk factors for the efficacy of the first-line chemotherapy in patients with advanced NSCLC (P < 0.05), and the high PLR level was an independent risk factor affecting the prognosis of patients with advanced NSCLC. The median overall survival (OS) of patients with the low PLR group was 20.8 months, higher than the 12.0 months of patients with the high PLR group (P < 0.05). Conclusion PLR might have a certain clinical significance for predicting the TNM staging of NSCLC and can provide important diagnostic and prognostic results for patients.
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Affiliation(s)
- Jianming Zhao
- Department of Thoracic Surgery, Jinhua Guangfu Hospital, Jinhua, Zhejiang 321001, China
| | - Yiping Pan
- Department of Thoracic Surgery, Jinhua Guangfu Hospital, Jinhua, Zhejiang 321001, China
| | - Yu Sheng
- Department of Thoracic Surgery, Jinhua Guangfu Hospital, Jinhua, Zhejiang 321001, China
| | - Jun Sun
- Department of Thoracic Surgery, Jinhua Guangfu Hospital, Jinhua, Zhejiang 321001, China
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KARAYİĞİT A, ÖZDEMİR DB, DİZEN H, ÜNAL B. Factors independently associated with prognosis in patients operated for pancreatic cancer: Assessing the role of various parameters including red cell distribution width, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2022. [DOI: 10.32322/jhsm.1137856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objective: We aimed to assess whether, among other parameters, preoperative red cell distribution width (RDW), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) values were associated with prognosis in patients operated for pancreatic cancer (PC).
Material and Method: This retrospective cohort was conducted from February 1, 2016 to February 1, 2021 at the general surgery department of a university hospital in Turkey. A total of 75 patients histologically diagnosed with PC who had undergone surgery were included in the study.
Results: The PLR values of patients with poorly differentiated and undifferentiated tumors were found to be higher than those with moderately and highly differentiated tumors. Also, there was a significant relationship between PLR values and the length of hospital stay. PLR values increased as the length of hospital stay increased. There was a statistically significant positive correlation between CA 19-9 levels and NLR and PLR. High total bilirubin level was related with increased risk of death, while adjuvant chemotherapy recipients had 4.049-fold lower risk of death than those without adjuvant chemotherapy.
Conclusion: Our results indicate that preoperative NLR, PLR and RDW cannot be used as prognostic indicators of mortality in patients with operated PC, but high PLR appears to be associated with lower level of tumor differentiation and prolonged hospital stay. We also found that high total bilirubin was a poor prognostic factor, while adjuvant chemotherapy was a good prognostic factor. Further multicenter, prospective studies with larger sample sizes will help to verify these results.
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Affiliation(s)
- Ahmet KARAYİĞİT
- ADANA ŞEHİR EĞİTİM VE ARAŞTIRMA HASTANESİ, CERRAHİ ONKOLOJİ KLİNİĞİ
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Diagnostic value of platelet-to-lymphocyte ratio in patients with solitary pulmonary nodules. KARDIOCHIRURGIA I TORAKOCHIRURGIA POLSKA = POLISH JOURNAL OF CARDIO-THORACIC SURGERY 2022; 19:117-121. [PMID: 36268479 PMCID: PMC9574589 DOI: 10.5114/kitp.2022.119758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 04/28/2022] [Indexed: 11/05/2022]
Abstract
Introduction Nodules detected in the lung parenchyma should be considered as malignant until proven otherwise, and the necessary tests should be performed for diagnosis. Aim To calculate the preoperative platelet-to-lymphocyte ratio (PLR) in patients with malignant lung nodules and to investigate the diagnostic value of this ratio in determining the histopathology of the nodule. Material and methods Ninety-one patients who were operated on for a malignant nodule in the lung between September 2010 and September 2020 were included in the study. The PLR was calculated by dividing the absolute platelet count by the absolute lymphocyte count. These values were compared with the histopathological diagnoses of the resected tumor tissue. Patients with primary lung malignancy were classified as group 1 (n = 54), and lung metastases of other organs were classified as group 2 (n = 37). Results The mean PLR was 127.27 ±46.82 in the first group and 183.56 ±93.49 in the second group. There was a statistically significant difference in PLR values between the two groups, and PLR was higher in group 2. There was no statistically significant difference between the two groups in terms of lymph node positivity, nodule size and SuvMax values. A moderately strong, significant and same-sided correlation was observed between nodule size and SuvMax values in the first group of patients (r = 0.48, p = 0.001) Conclusions PLR values less than 89.41 indicate that the histopathological result may be a lung-derived malignancy. However, in cases where the PLR is detected above 165.6, it would be appropriate to interpret another previously detected malignancy as metastasis to the lung.
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Azghar A, Bensalah M, Berhili A, Slaoui M, Mouhoub B, El Mezgueldi I, Nassiri O, El Malki J, Maleb A, Seddik R. Value of hematological parameters for predicting patients with severe coronavirus disease 2019: a real-world cohort from Morocco. J Int Med Res 2022; 50:3000605221109381. [PMID: 35854474 PMCID: PMC9340338 DOI: 10.1177/03000605221109381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective Coronavirus disease 2019 (COVID-19) is a viral disease caused by severe acute
respiratory syndrome coronavirus 2. The clinical manifestations and the
evolution of patients with COVID-19 are variable. In addition to respiratory
involvement, COVID-19 leads to systemic involvement and can affect the
hematopoietic system. This study aimed to evaluate the prognostic value of
hematological and hemocytometric parameters in predicting the severity of
patients with COVID-19. Methods We performed a retrospective study at Mohammed VI university Hospital from 1
March to 11 November 2020. We collected demographic characteristics and
hematological findings of incident COVID-19 cases. Results A total of 245 patients were included in our study. We found that the rate of
lymphopenia was significantly reduced in patients who were severely affected
by COVID-19. Additionally, the rate of neutrophilia, the neutrophil side
fluorescence light signal, monocyte fluorescent intensity, monocyte size,
the neutrophil-to-lymphocyte ratio, the platelet-to-lymphocyte ratio, and
the lymphocyte-to-monocyte ratio were significantly elevated in patients who
were severely affected by COVID-19. Conclusions These results are consistent with the literature regarding the predictive
value of these markers. A prospective validation in a large population with
a longer follow-up is required.
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Affiliation(s)
- Ali Azghar
- Hematology Laboratory, Mohammed VI University Hospital Center, Oujda, Morocco.,Faculty of Medicine and Pharmacy, Mohammed 1st University, Oujda, Morocco
| | - Mohammed Bensalah
- Hematology Laboratory, Mohammed VI University Hospital Center, Oujda, Morocco.,Faculty of Medicine and Pharmacy, Mohammed 1st University, Oujda, Morocco
| | - Abdelilah Berhili
- Hematology Laboratory, Mohammed VI University Hospital Center, Oujda, Morocco.,Faculty of Medicine and Pharmacy, Mohammed 1st University, Oujda, Morocco
| | - Mounia Slaoui
- Hematology Laboratory, Mohammed VI University Hospital Center, Oujda, Morocco.,Faculty of Medicine and Pharmacy, Mohammed 1st University, Oujda, Morocco
| | - Boutaina Mouhoub
- Hematology Laboratory, Mohammed VI University Hospital Center, Oujda, Morocco.,Faculty of Medicine and Pharmacy, Mohammed 1st University, Oujda, Morocco
| | - Imane El Mezgueldi
- Hematology Laboratory, Mohammed VI University Hospital Center, Oujda, Morocco.,Faculty of Medicine and Pharmacy, Mohammed 1st University, Oujda, Morocco
| | - Oumaima Nassiri
- Hematology Laboratory, Mohammed VI University Hospital Center, Oujda, Morocco.,Faculty of Medicine and Pharmacy, Mohammed 1st University, Oujda, Morocco
| | - Jalila El Malki
- Hematology Laboratory, Mohammed VI University Hospital Center, Oujda, Morocco.,Faculty of Medicine and Pharmacy, Mohammed 1st University, Oujda, Morocco
| | - Adil Maleb
- Microbiology Laboratory, Mohammed VI University Hospital Center, Oujda, Morocco.,Faculty of Medicine and Pharmacy, Mohammed 1st University, Oujda, Morocco
| | - Rachid Seddik
- Hematology Laboratory, Mohammed VI University Hospital Center, Oujda, Morocco.,Faculty of Medicine and Pharmacy, Mohammed 1st University, Oujda, Morocco
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Hernandez-Ainsa M, Velamazan R, Lanas A, Carrera-Lasfuentes P, Piazuelo E. Blood-Cell-Based Inflammatory Markers as a Useful Tool for Early Diagnosis in Colorectal Cancer. Front Med (Lausanne) 2022; 9:843074. [PMID: 35795635 PMCID: PMC9252519 DOI: 10.3389/fmed.2022.843074] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 05/30/2022] [Indexed: 12/24/2022] Open
Abstract
Background Systemic inflammation seems to be involved in the pathogenetic pathways of colorectal cancer (CRC). Analytical markers that reflect the inflammatory status, such as neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) or systemic immune-inflammation index (SII), have been proposed as tools for the prognosis of CRC. Nevertheless, their use for diagnosis has been scarcely investigated. Aims To analyze the ability of these markers and of a new marker combining SII and hemoglobin concentration, named NP/LHb = [neutrophils x platelets]/[lymphocytes x hemoglobin], as tools for CRC diagnosis. Furthermore, we studied their association with CRC-related variables. Methods Case-control study including 214 CRC patients and 214 controls without CRC, matched by age (±5 years) and sex. We collected demographic, CRC-related and laboratory variables to calculate NLR, PLR, SII, and NP/LHb. In the case group, the laboratory variables were collected at two different period times, 6 months (IQR 4–8) before the CRC diagnosis and at the time of the diagnosis. ROC analysis was performed to evaluate the discriminatory accuracy of each index and we calculated Se, Sp, PPV, NPV, and OR to identify the diagnostic performance of each positive marker. Results NP/LHb showed high Sp (92.06%) and PPV (87.50%) to diagnose patients with CRC. This index exhibited an OR of 14.52 (8.26–25.52) and the best area under the curve (AUC: 0.78) for a positive CRC diagnosis. We found significant differences in all indices according to the presence of CRC, observing the highest values in CRC patients at time of diagnosis, in comparison with the analysis performed in the previous months to diagnosis or with control patients. There were significant differences in all ratios according to TNM stages (p < 0.05). PLR, SII and NP/LHb (but not NLR) showed significant differences according to tumor location (p < 0.05). Right-sided colon cancers presented the highest values, in comparison with left-sided and rectal cancers. Conclusions Systemic inflammatory cell ratios (especially NP/LHb) change over time with the development of CRC, so they could be useful in its early diagnosis. We suggest that they could be routinely measured in patients with suspicion of CRC, to identify those ones with a higher risk of cancer, considering the high positive predictive value they have shown in our study.
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Affiliation(s)
- Maria Hernandez-Ainsa
- Service of Digestive Diseases, University Clinic Hospital, Zaragoza, Spain
- Aragón Health Research Institute (IIS Aragón), Zaragoza, Spain
- *Correspondence: Maria Hernandez-Ainsa
| | - Raul Velamazan
- Service of Digestive Diseases, University Clinic Hospital, Zaragoza, Spain
- Aragón Health Research Institute (IIS Aragón), Zaragoza, Spain
| | - Angel Lanas
- Service of Digestive Diseases, University Clinic Hospital, Zaragoza, Spain
- Aragón Health Research Institute (IIS Aragón), Zaragoza, Spain
- Department of Medicine, Psychiatry and Dermatology, University of Zaragoza, Zaragoza, Spain
- Biomedical Research Networking Center in Hepatic and Digestive Diseases (CIBERehd), Madrid, Spain
| | - Patricia Carrera-Lasfuentes
- Aragón Health Research Institute (IIS Aragón), Zaragoza, Spain
- Biomedical Research Networking Center in Hepatic and Digestive Diseases (CIBERehd), Madrid, Spain
| | - Elena Piazuelo
- Aragón Health Research Institute (IIS Aragón), Zaragoza, Spain
- Biomedical Research Networking Center in Hepatic and Digestive Diseases (CIBERehd), Madrid, Spain
- Aragón Health Sciences Institute (IACS), Zaragoza, Spain
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Leng J, Wu F, Zhang L. Prognostic Significance of Pretreatment Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, or Monocyte-to-Lymphocyte Ratio in Endometrial Neoplasms: A Systematic Review and Meta-analysis. Front Oncol 2022; 12:734948. [PMID: 35651788 PMCID: PMC9149577 DOI: 10.3389/fonc.2022.734948] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 03/31/2022] [Indexed: 01/28/2023] Open
Abstract
Aim Neutrophil–lymphocyte ratio (NLR), platelet–lymphocyte ratio (PLR), or monocyte–lymphocyte ratio (MLR) has been shown to be related to the poor prognosis of cervical cancer, ovarian cancer, breast cancer, and other malignant tumors, but their role in predicting the prognosis of endometrial cancer is still controversial. Therefore, we conducted this meta-analysis to evaluate the effectiveness of NLR more accurately, PLR, or MLR in predicting the prognosis of endometrial cancer (EC). Methods This review systematically searched for relevant publications in databases of the Cochrane Library, PubMed, EMBASE, CNKI, WanFang, VIP, and CBM. Pooled hazard ratios (HR) with 95% confidence intervals (95% CI) were determined and used to explore the association between inflammatory biomarkers (NLR, PLR, and MLR) and overall survival (OS), progression-free survival (PFS), and disease-free survival (DFS) in a random-effects model. We also conducted subgroup analysis and publication bias in this meta-analysis. Stata 12.0 was used for statistical analysis. Results This meta-analysis contained 14 eligible studies including 5,274 patients. Our results showed that NLR or PLR was associated with OS [NLR: HR, 2.51; 95% CI, 1.70–3.71; p <0.001 in univariate analysis (Ua); HR, 1.87; 95% CI, 1.34–2.60; p <0.001 in multivariate analysis (Ma); PLR: HR, 2.50; 95% CI, 1.82–3.43; p <0.001 in Ua; HR, 1.86; 95% CI, 1.22–2.83; p = 0.004 in Ma], but MLR was not associated with OS (HR, 1.44; 95% CI, 0.70–2.95; p = 0.325 in Ua; HR, 1.01; 95% CI, 0.39–2.60; p =0.987 in Ma). A further subgroup analysis found that the correlations were not affected by race, cutoff value, sample size, or treatment. Our meta-analysis showed that NLR or PLR was associated with DFS (NLR: HR, 2.50; 95% CI, 1.38–4.56; p =0.003 in Ua; HR, 2.06; 95% CI, 1.26–3.37, P =0.004 in Ma; PLR: HR, 1.91; 95% CI, 1.30–2.81; p = 0.001 in Ua), and NLR was associated with PFS only in the univariate analysis (HR, 1.71; 95% CI, 1.04–2.81; p =0.035 in Ua; HR, 1.79; 95% CI, 0.65–4.89; P =0.257 in Ma), but MLR was not associated with DFS (HR, 0.36; 95% CI, 0.03–4.13; p =0.409 in Ua). Conclusions Our results indicated that pretreatment NLR and PLR were biomarkers of poor prognosis in patients with endometrial cancer. The results indicated that NLR or PLR was associated with OS and disease-free survival DFS, and NLR was associated with PFS only in univariate analysis, but MLR was not associated with OS or DFS.
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Affiliation(s)
- Jiali Leng
- Division of Obstetrics and Gynecology, The Second Hospital of Jilin University, Jilin University, Changchun, China
| | - Fei Wu
- Division of Obstetrics and Gynecology, The Second Hospital of Jilin University, Changchun, China
| | - Lihui Zhang
- Division of Obstetrics and Gynecology, The Second Hospital of Jilin University, Changchun, China
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Otasevic V, Mihaljevic B, Milic N, Stanisavljevic D, Vukovic V, Tomic K, Fareed J, Antic D. Immune activation and inflammatory biomarkers as predictors of venous thromboembolism in lymphoma patients. Thromb J 2022; 20:20. [PMID: 35439998 PMCID: PMC9016935 DOI: 10.1186/s12959-022-00381-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 04/12/2022] [Indexed: 12/21/2022] Open
Abstract
Background Lymphomas are characterized by elevated synthesis of inflammatory soluble mediators that could trigger the development of venous thromboembolism (VTE). However, data on the relationship between specific immune dysregulation and VTE occurrence in patients with lymphoma are scarce. Therefore, this study aimed to assess the association between inflammatory markers and the risk of VTE development in patients with lymphoma. Methods The erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lactate dehydrogenase (LDH), total protein (TP), and albumin were assessed in 706 patients with newly diagnosed or relapsed lymphoma. Data were collected for all VTE events, while the diagnosis of VTE was established objectively based on radiographic studies. ROC (receiver operating characteristic) curve analysis was performed to define the optimal cutoff values for predicting VTE. Results The majority of patients was diagnosed with aggressive non-Hodgkin lymphoma (58.8%) and had advanced stage disease (59.9%). Sixty-nine patients (9.8%) developed VTE. The NLR, PLR, ESR, CRP, and LDH were significantly higher in the patients with lymphoma with VTE, whereas the TP and albumin were significantly lower in those patients. Using the univariate regression analysis, the NLR, PLR, TP, albumin, LDH, and CRP were prognostic factors for VTE development. In the multivariate regression model, the NLR and CRP were independent prognostic factors for VTE development. ROC curve analysis demonstrated acceptable specificity and sensitivity of the parameters: NLR, PLR, and CRP for predicting VTE. Conclusion Inflammatory dysregulation plays an important role in VTE development in patients with lymphoma. Widely accessible, simple inflammatory parameters can classify patients with lymphoma at risk of VTE development. Supplementary Information The online version contains supplementary material available at 10.1186/s12959-022-00381-3.
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Affiliation(s)
- Vladimir Otasevic
- Lymphoma Center, Clinic for Hematology, University Clinical Center of Serbia, Belgrade, Serbia
| | - Biljana Mihaljevic
- Lymphoma Center, Clinic for Hematology, University Clinical Center of Serbia, Belgrade, Serbia.,Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Natasa Milic
- Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Dejana Stanisavljevic
- Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Vojin Vukovic
- Lymphoma Center, Clinic for Hematology, University Clinical Center of Serbia, Belgrade, Serbia
| | - Kristina Tomic
- Lymphoma Center, Clinic for Hematology, University Clinical Center of Serbia, Belgrade, Serbia
| | | | - Darko Antic
- Lymphoma Center, Clinic for Hematology, University Clinical Center of Serbia, Belgrade, Serbia. .,Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
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Peng SM, Ren JJ, Yu N, Xu JY, Chen GC, Li X, Li DP, Yang J, Li ZN, Zhang YS, Qin LQ. The prognostic value of the Naples prognostic score for patients with non-small-cell lung cancer. Sci Rep 2022; 12:5782. [PMID: 35388133 PMCID: PMC8986824 DOI: 10.1038/s41598-022-09888-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 03/15/2022] [Indexed: 11/20/2022] Open
Abstract
The Naples prognostic score (NPS) is an effective inflammatory and nutritional scoring system widely applied as a prognostic factor in various cancers. We aimed to analyze the prognostic value of the NPS in patients diagnosed with non-small-cell lung cancer (NSCLC). We prospectively collected 395 patients diagnosed with NSCLC between January 2016 and December 2018 in two university-affiliated hospitals. Patients were divided into three groups according to their pretreatment NPS (Group 0: NPS = 0; Group 1: NPS = 1–2; Group 2: NPS = 3–4). Kaplan–Meier survival curves indicated that patients with higher NPS had a poorer overall survival (OS) and progress-free survival (PFS) (both P < 0.05). NPS was further confirmed as an independent prognostic factors of OS and PFS by multivariable survival analysis (both P < 0.05). Furthermore, stratifying by TNM stage, NPS also has significant predictive performance for OS and PFS in both early (I–IIIA) and advanced (IIIB–IV) stage NSCLC (all P < 0.05). The time-dependent receiver operating characteristic curve analysis demonstrated that NPS was more superior to other prognostic factors in predicting OS and PFS. In conclusion, NPS may serve as an effective indicator to predict OS and PFS in NSCLC patients regardless of TNM stage.
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Affiliation(s)
- Si-Min Peng
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China
| | - Jin-Jin Ren
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China
| | - Na Yu
- Department of Oncology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Jia-Ying Xu
- State Key Laboratory of Radiation Medicine and Protection, School of Radiation Medicine and Protection, Soochow University, Suzhou, China
| | - Guo-Chong Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China
| | - Xiaodong Li
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China.,Department of Oncology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Da-Peng Li
- Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Jing Yang
- Department of Clinical Nutrition, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Zeng-Ning Li
- Department of Nutrition, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yu-Song Zhang
- Department of Oncology, The Second Affiliated Hospital of Soochow University, Suzhou, China.
| | - Li-Qiang Qin
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China.
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The Survival Relationship between Preoperative Inflammation Markers and Patients with Special Pathological Types of Gastric Cancer. Can J Gastroenterol Hepatol 2022; 2022:5715898. [PMID: 35340978 PMCID: PMC8956443 DOI: 10.1155/2022/5715898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 01/25/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The preoperative PLR is closely associated with prognosis of gastric cancer. This aims to research whether the PLR could predict overall survival (OS) of gastric cancer (GC) patients with SRC component. METHODS The data were collected from Harbin Medical University Cancer Hospital between January 2001 and December 2013 in China. The patients were diagnosed with GC by pathologic examination, which contained SRC component in pathological organization. PLR is obtained from peripheral blood markers (platelets/lymphocytes). RESULTS There is a difference in OS between high PLR group and low group, which is verified by Kaplan-Meier analysis and log-rank tests (P < 0.001). Moreover, multivariate analysis prove PLR was independent prognostic factor for GC (HR = 1.384, 95% (CI): 1.048-1.828; P = 0.022). The preoperative PLR in stage I + II (P = 0.033), stage III (P < 0.001), SRC component lower than 50% (P < 0.001), SRC component equal to or higher than 50% (P = 0.044), and R0 resection (P < 0.001) GC are still effective. CONCLUSION PLR is a simple, useful, and repeatable predictor of OS in gastric cancer of stages I-III with SRC component and may help clinicians identify patients with high risk and develop a more reasonable follow-up plan.
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50
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Role of Platelet to Lymphocyte Ratio and Red Cell Distribution Width in Predicting Postoperative Complications in Patients with Acute Mesenteric Ischemia. Ann Vasc Surg 2022; 84:298-304. [PMID: 35247535 DOI: 10.1016/j.avsg.2022.01.036] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 12/20/2021] [Accepted: 01/26/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND The predictive values of the platelet to lymphocyte ratio (PLR) and red cell distribution width (RDW) have been demonstrated in different types of abdominal surgery. The aim of this study was to investigate the interest of the preoperative PLR and RDW as predictors of 30-day postoperative complications in patients with acute mesenteric ischemia (AMI). METHODS Clinical data of 105 AMI patients were retrospectively reviewed. Postoperative complications were evaluated by the Clavien-Dindo classification. The cutoff values for neutrophil to lymphocyte ratio (NLR), PLR, and RDW were determined by receiver operating characteristic curves. Univariate and multivariate analyses evaluating the risk factors for postoperative complications were performed. RESULTS In the univariate analyses, advanced age, female, anemia, high white blood cell (WBC), high PLR, high NLR, high RDW, Charlson comorbidity index (CCI) score ≥2, and bowel resection were associated with the postoperative complications. A multivariable analysis revealed that advanced age, high PLR, high RDW, and bowel resection were independent predictors of postoperative complications. CONCLUSIONS The PLR and RDW might play important roles in evaluation of the risk of postoperative complications in AMI patients. The preoperative PLR and RDW are simple and useful predictors of postoperative complications in AMI patients.
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