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Trotter TN, Shuptrine CW, Tsao LC, Marek RD, Acharya C, Wei JP, Yang XY, Lei G, Wang T, Lyerly HK, Hartman ZC. IL26, a Noncanonical Mediator of DNA Inflammatory Stimulation, Promotes TNBC Engraftment and Progression in Association with Neutrophils. Cancer Res 2020; 80:3088-3100. [PMID: 32366475 DOI: 10.1158/0008-5472.can-18-3825] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 05/23/2019] [Accepted: 04/29/2020] [Indexed: 01/19/2023]
Abstract
IL26 is a unique amphipathic member of the IL10 family of cytokines that participates in inflammatory signaling through a canonical receptor pathway. It also directly binds DNA to facilitate cellular transduction and intracellular inflammatory signaling. Although IL26 has almost no described role in cancer, our in vivo screen of inflammatory and cytokine pathway genes revealed IL26 to be one of the most significant inflammatory mediators of mammary engraftment and lung metastatic growth in triple-negative breast cancer (TNBC). Examination of human breast cancers demonstrated elevated IL26 transcripts in TNBC specimens, specifically in tumor cells as well as in Th17 CD4+ T cells within clinical TNBC specimens. IL26 did not have an autocrine effect on human TNBC cells, but rather its effect on engraftment and growth in vivo required neutrophils. IL26 enhanced mouse-derived DNA induction of inflammatory cytokines, which were collectively important for mammary and metastatic lung engraftment. To neutralize this effect, we developed a novel IL26 vaccine to stimulate antibody production and suppress IL26-enhanced engraftment in vivo, suggesting that targeting this inflammatory amplifier could be a unique means to control cancer-promoting inflammation in TNBC and other autoimmune diseases. Thus, we identified IL26 as a novel key modulator of TNBC metastasis and a potential therapeutic target in TNBC as well as other diseases reliant upon IL26-mediated inflammatory stimulation. SIGNIFICANCE: These findings identify IL26 as a unique, clinically relevant, inflammatory amplifier that enhances TNBC engraftment and dissemination in association with neutrophils, which has potential as a therapeutic target. GRAPHICAL ABSTRACT: http://cancerres.aacrjournals.org/content/canres/80/15/3088/F1.large.jpg.
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Affiliation(s)
| | | | - Li-Chung Tsao
- Department of Surgery, Duke University, Durham, North Carolina
| | - Robert D Marek
- Department of Pathology/Immunology, Duke University, Durham, North Carolina
| | | | - Jun-Ping Wei
- Department of Surgery, Duke University, Durham, North Carolina
| | - Xiao-Yi Yang
- Department of Surgery, Duke University, Durham, North Carolina
| | - Gangjun Lei
- Department of Surgery, Duke University, Durham, North Carolina
| | - Tao Wang
- Department of Surgery, Duke University, Durham, North Carolina
| | | | - Zachary C Hartman
- Department of Surgery, Duke University, Durham, North Carolina. .,Department of Pathology/Immunology, Duke University, Durham, North Carolina
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Inflammation-Based Scores Increase the Prognostic Value of Circulating Tumor Cells in Primary Breast Cancer. Cancers (Basel) 2020; 12:cancers12051134. [PMID: 32369910 PMCID: PMC7281016 DOI: 10.3390/cancers12051134] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 04/16/2020] [Accepted: 04/29/2020] [Indexed: 12/26/2022] Open
Abstract
A correlation between circulating tumor cells (CTCs) and monocytes in metastatic breast cancer (BC), where CTCs and monocyte-to-lymphocyte ratio (MLR) were predictors of overall survival (OS), was recently shown. Herein, we aimed to assess the association between CTCs and the complete blood count (CBC)-derived inflammation-based scores in 284 primary BC patients. CTCs were determined in CD45-depleted peripheral blood mononuclear cells by real time-PCR. This method allowed us to detect a subset of CTCs with an epithelial-to-mesenchymal transition phenotype (CTC EMT), previously associated with inferior outcomes in primary BC. In the present study, CTC EMT positivity (hazard ratio (HR) = 2.4; 95% CI 1.20–4.66, p = 0.013) and elevated neutrophil-to-lymphocyte ratio (NLR) (HR = 2.20; 95% CI 1.07–4.55; p = 0.033) were associated with shorter progression-free survival (PFS) in primary BC patients. Multivariate analysis showed that CTC EMT-positive patients with NLR ≥ 3 had 8.6 times increased risk of disease recurrence (95% CI 2.35–31.48, p = 0.001) compared with CTC EMT-negative patients with NLR < 3. Similarly, disease recurrence was 13.14 times more likely in CTC EMT-positive patients with MLR ≥ 0.34 (95% CI 4.35–39.67, p < 0.001). Given its low methodological and financial demands, the CBC-derived inflammation-based score determination could, after broader validation, significantly improve the prognostication of BC patients.
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Biologically driven cut-off definition of lymphocyte ratios in metastatic breast cancer and association with exosomal subpopulations and prognosis. Sci Rep 2020; 10:7010. [PMID: 32332763 PMCID: PMC7181663 DOI: 10.1038/s41598-020-63291-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 03/27/2020] [Indexed: 02/07/2023] Open
Abstract
High neutrophil to lymphocyte ratio (NLR) and monocyte to lymphocyte ratio (MLR) are respectively associated with systemic inflammation and immune suppression and have been associated with a poor outcome. Plasmatic exosomes are extracellular vesicles involved in the intercellular communication system that can exert an immunosuppressive function. Aim of this study was to investigate the interplay between the immune system and circulating exosomes in metastatic breast cancer (MBC). A threshold capable to classify patients according to MLR, NLR and PLR, was computed through a receiving operator curve analysis after propensity score matching with a series of female blood donors. Exosomes were isolated from plasma by ExoQuick solution and characterized by flow-cytometry. NLR, MLR, PLR and exosomal subpopulations potentially involved in the pre-metastatic niche were significantly different in MBC patients with respect to controls. MLR was significantly associated with number of sites at the onset of metastatic disease, while high levels of MLR and NLR were found to be associated with poor prognosis. Furthermore, exosomal subpopulations varied according to NLR, MLR, PLR and both were associated with different breast cancer subtypes and sites of distant involvement. This study highlights the nuanced role of immunity in MBC spread, progression and outcome. Moreover, they suggest potential interaction mechanisms between immunity, MBC and the metastatic niche.
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Azab B, Amundson JR, Cioci A, Stuart H, Yakoub D, Avisar E, Moffat F, Livingstone AS, Franceschi D. The Usefulness of the Pretreatment Neutrophil/Lymphocyte Ratio as a Predictor of the 5-Year Survival in Stage 1-3 Triple Negative Breast Cancer Patients. Breast Care (Basel) 2020; 16:43-49. [PMID: 33716631 DOI: 10.1159/000506463] [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: 10/29/2018] [Accepted: 01/16/2020] [Indexed: 11/19/2022] Open
Abstract
Background We have previously shown that the neutrophil/lymphocyte ratio (NLR) is a predictor of survival among breast cancer patients. The aim of this study was to determine the predictive value of NLR among different nodal and chemotherapy subgroups of triple negative breast cancer (TNBC). Methods Patients with stage 1-3 TNBC who underwent treatment from 2007 to 2014 and had blood counts prior to treatments were included. Patients were categorized into high (≥2) and low (<2) NLR groups. Primary outcomes were overall survival (OS) and disease-free survival (DFS). Results The average follow-up time was 54 months. The high NLR group had worse OS (HR 2.8, CI 1.3-5.9, p < 0.001) and DFS (HR 2.3, CI 1.2-4.2, p < 0.001) than the low NLR group. After adjusting for confounding variables, high NLR was an independent prognostic factor for both OS (HR 5.5, CI 2.2-13.7, p < 0.0001) and DFS (HR 5.2, CI 2.3-11.6, p < 0.0001). Categorization of TNBC patients by NLR (high vs. low) and nodal status (positive vs. negative) resulted in four groups with significantly different OS and DFS (log rank p < 0.0001). Significant improvements in OS (p < 0.001) and DFS (p < 0.001) were observed for patients who received chemotherapy and had high NLR but not for patients with low NLR (p = 0.65 and p = 0.07, respectively). Conclusion High pretreatment NLR is an independent predictor of poor OS and DFS among TNBC patients. Combining NLR and pN provides better risk stratification for TNBC patients. Chemotherapy appears to be beneficial only in patients with high NLR. Larger prospective studies are needed to validate these findings.
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Affiliation(s)
- Basem Azab
- Surgical Oncology, Sentara Healthcare, Hampton, Virginia, USA
| | - Julia R Amundson
- Department of Surgery, University of Chicago, Chicago, Illinois, USA
| | - Alessia Cioci
- Department of Surgical Oncology, University of Miami, Miami, Florida, USA
| | - Heather Stuart
- Department of Surgical Oncology, University of British Colombia, Vancouver, British Columbia, Canada
| | - Danny Yakoub
- Department of Surgical Oncology, University of Tennessee, Memphis, Tennessee, USA
| | - Eli Avisar
- Department of Surgical Oncology, University of Miami, Miami, Florida, USA
| | - Fredrick Moffat
- Department of Surgical Oncology, University of Miami, Miami, Florida, USA
| | - Alan S Livingstone
- Department of Surgical Oncology, University of Miami, Miami, Florida, USA
| | - Dido Franceschi
- Department of Surgical Oncology, University of Miami, Miami, Florida, USA
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Corbeau I, Jacot W, Guiu S. Neutrophil to Lymphocyte Ratio as Prognostic and Predictive Factor in Breast Cancer Patients: A Systematic Review. Cancers (Basel) 2020; 12:E958. [PMID: 32295078 PMCID: PMC7226461 DOI: 10.3390/cancers12040958] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 03/26/2020] [Accepted: 04/09/2020] [Indexed: 02/07/2023] Open
Abstract
Inflammatory blood markers (IBM), such as the neutrophil to lymphocyte ratio (NLR), have emerged as potential prognostic factors in various cancers, including breast cancer (BC), potentially allowing an easy, minimally invasive evaluation of a given cancer's prognosis and treatment outcome. We report here a systematic overview of the published data evaluating NLR as a prognostic factor or predictive factor for pathological complete response (PCR) and toxicity in early and advanced BC. A total of 45 articles were identified. NLR was found to be an independent prognostic factor for survival in most of the adjuvant treatment studies. However, no significant correlation was found between survival and NLR for early BC patients receiving neo-adjuvant chemotherapy (NACT) and advanced BC patients. Most studies failed to find a significant correlation between NLR and PCR after NACT. Finally, some data showed that IBM could be predictive of chemotherapy-related toxicity.
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Affiliation(s)
- Iléana Corbeau
- Department of Medical Oncology, Institut du Cancer de Montpellier (ICM), 208 Avenue des Apothicaires, 34 298 Montpellier, France; (W.J.); (S.G.)
- IRCM, INSERM U1194, Univerité de Montpellier, ICM, 208 Avenue des Apothicaires, 34 298 Montpellier, France
| | - William Jacot
- Department of Medical Oncology, Institut du Cancer de Montpellier (ICM), 208 Avenue des Apothicaires, 34 298 Montpellier, France; (W.J.); (S.G.)
- IRCM, INSERM U1194, Univerité de Montpellier, ICM, 208 Avenue des Apothicaires, 34 298 Montpellier, France
| | - Séverine Guiu
- Department of Medical Oncology, Institut du Cancer de Montpellier (ICM), 208 Avenue des Apothicaires, 34 298 Montpellier, France; (W.J.); (S.G.)
- IRCM, INSERM U1194, Univerité de Montpellier, ICM, 208 Avenue des Apothicaires, 34 298 Montpellier, France
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Ding N, Huang J, Li N, Yuan J, Wang S, Xiao Z. Roles of neutrophil/lymphocyte ratio in prognosis and in differentiation of potential beneficiaries in HER2-positive breast cancer with trastuzumab therapy. BMC Cancer 2020; 20:235. [PMID: 32192443 PMCID: PMC7082930 DOI: 10.1186/s12885-020-06750-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 03/12/2020] [Indexed: 11/30/2022] Open
Abstract
Background The relationship of neutrophil/lymphocyte ratio (NLR) to prognosis of HER2-positive breast cancer (BC) is not well studied. We aimed to assess the prognostic role of NLR in HER2-positive BC patients treated with or without trastuzumab. Methods The clinical data of 843 HER2-positive BC patients from July 2013 to July 2018 were collected. The difference among variables was calculated by chi-square test. The associations between clinicopathological factors, NLR and disease-free survival (DFS) were analyzed by univariate and multivariate analyses. Results Patients were divided into three groups. In group 1 containing 255 patients without trastuzumab treatment, pretreatment NLR showed no predictive value. Patients with trastuzumab treatment were divided into two groups on equal, according to pretreatment NLR values, low NLR (group 2) and high NLR (group 3). Patients in group 2 showed significantly higher 3-year DFS rate than patients in group 1 and group 3 (95.3% vs. 91.6% vs. 90.5%, respectively, P = 0.011); patients in the group 1 and group 3 had a similar 3-year DFS outcome. Multivariate analysis showed high pretreatment NLR was significantly associated with shorter DFS (HR = 2.917, 95% CI = 1.055–8.062, P = 0.039) in HER2-positive BC patients treated with trastuzumab. Conclusions Among HER2-positive trastuzumab-treated BC patients, low pretreatment NLR value was associated with better DFS, and it might help to differentiate potential beneficiaries of trastuzumab treatment.
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Affiliation(s)
- Nianhua Ding
- Department of clinical laboratory, The First Hospital of Changsha, Changsha, China
| | - Juan Huang
- Department of Breast Surgery, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan, People's Republic of China, 410008
| | - Ningsha Li
- Department of clinical laboratory, The First Hospital of Changsha, Changsha, China
| | - Jiaqi Yuan
- Department of Breast Surgery, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan, People's Republic of China, 410008
| | - Shouman Wang
- Department of Breast Surgery, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan, People's Republic of China, 410008
| | - Zhi Xiao
- Department of Breast Surgery, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan, People's Republic of China, 410008. .,Clinical Research Center For Breast Cancer Control and Prevention In Human Province, Changsha, China.
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The prognostic role of inflammatory markers in patients with metastatic colorectal cancer treated with bevacizumab: A translational study [ASCENT]. PLoS One 2020; 15:e0229900. [PMID: 32142532 PMCID: PMC7059922 DOI: 10.1371/journal.pone.0229900] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 02/11/2020] [Indexed: 02/07/2023] Open
Abstract
Background In spite of demonstrating prognostic and possibly predictive benefit in retrospective cohorts and meta-analyses of cancer populations, including colorectal cancer (CRC), prospective evaluation of the relationship between neutrophil to lymphocyte ratio (NLR) and treatment outcomes in previously untreated mCRC patients receiving bevacizumab-based therapy has not yet been performed. Methods An open-label, single arm, multi-centre study. Patients received first-line bevacizumab plus XELOX or mFOLFOX6 (Phase-A) and continued bevacizumab plus FOLFIRI beyond first progression (Phase-B). Analyses included the association of NLR with phase A progression free survival (PFS) and overall survival (OS). A sub-study investigated the safety in patients with the primary in situ tumor. An exploratory sub-study examined relationships of circulating proteomic markers with PFS. Results Phase-A enrolled 128 patients; median age was 64 years (range: 26–84), 70 (55%) were female, 71 (56%) were PS-0 and 51 (40%) had primary in situ tumor. Fifty-three (41%) patients entered Phase-B. The median baseline (b) NLR was 3.2 (range: 1.5–20.4) with 32 (25%) patients having bNLR > 5. The PFS hazard ratio (HR) by bNLR > 5 versus ≤ 5 was 1.4 (95% CI: 0.9–2.2; p = 0.101). The median PFS was 9.2 months (95% CI: 7.9–10.8) for Phase-A and 6.7 months (95% CI: 3.0–8.2) for Phase-B. The HR for OS based on bNLR > 5 versus ≤ 5 was 1.6 (95% CI: 1.0–2.7; p = 0.052). The median OS was 25 months (95% CI: 19.2–29.7) for the full analysis set and 14.9 months for Phase-B. Baseline levels of nine proteomic markers showed a relationship with PFS. Treatment related toxicities were consistent with what has previously been published. There were 4 (3%) instances of GI perforation, of which, 3 (6%) occurred in the primary in situ tumor group. Conclusions Results from this study are aligned with the previously reported trend towards worse PFS and OS in patients with higher bNLR. Trial registration ClinicalTrials.gov: NCT01588990; posted May 1, 2012.
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Hoshimoto S, Hishinuma S, Shirakawa H, Tomikawa M, Ozawa I, Ogata Y. Validation and clinical usefulness of pre- and postoperative systemic inflammatory parameters as prognostic markers in patients with potentially resectable pancreatic cancer. Pancreatology 2020; 20:239-246. [PMID: 31862230 DOI: 10.1016/j.pan.2019.12.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 10/03/2019] [Accepted: 12/11/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Several preoperative systemic inflammatory parameters, such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), prognostic nutritional index (PNI), and Glasgow prognostic score, have been reported to be associated with the prognosis of solid tumors. In this study, we compared pre- and postoperative hematological inflammatory parameters and validated their prognostic significance in pancreatic cancer patients who underwent surgical resection. METHODS Clinical records from 211 consecutive pancreatic cancer patients who underwent surgical resection at our institution were retrospectively analyzed. The optimal cutoff values of hematological inflammatory parameters, including lymphocyte count, NLR, PLR, LMR, and PNI, were determined by time-dependent receiver-operating characteristic analysis. RESULTS The postoperative neutrophil count and serum albumin level were significantly decreased in patients who underwent pancreatoduodenectomy (PD group) and in those who underwent distal pancreatectomy (DP group) compared to the levels at baseline. The postoperative lymphocyte count, monocyte count, and platelet count were significantly increased in the DP group compared to those at baseline. As a result, the postoperative NLR and PNI significantly decreased in both groups. The multivariate analysis identified intraoperative peritoneal washing cytology, administration of adjuvant therapy, tumor size, extrapancreatic nerve plexus invasion, and preoperative PLR as independent prognostic factors for overall survival. CONCLUSIONS Systemic inflammatory responses were altered after pancreatic resection in pancreatic cancer patients. Preoperative PLR may be a useful prognostic marker in pancreatic cancer patients undergoing surgical resection.
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Affiliation(s)
- Sojun Hoshimoto
- Department of Hepato-Biliary-Pancreatic Surgery, Tochigi Cancer Center, 4-9-13 Yohnan, Utsunomiya, Tochigi, 320-0834, Japan.
| | - Shoichi Hishinuma
- Department of Hepato-Biliary-Pancreatic Surgery, Tochigi Cancer Center, 4-9-13 Yohnan, Utsunomiya, Tochigi, 320-0834, Japan
| | - Hirofumi Shirakawa
- Department of Hepato-Biliary-Pancreatic Surgery, Tochigi Cancer Center, 4-9-13 Yohnan, Utsunomiya, Tochigi, 320-0834, Japan
| | - Moriaki Tomikawa
- Department of Hepato-Biliary-Pancreatic Surgery, Tochigi Cancer Center, 4-9-13 Yohnan, Utsunomiya, Tochigi, 320-0834, Japan
| | - Iwao Ozawa
- Department of Hepato-Biliary-Pancreatic Surgery, Tochigi Cancer Center, 4-9-13 Yohnan, Utsunomiya, Tochigi, 320-0834, Japan
| | - Yoshiro Ogata
- Department of Hepato-Biliary-Pancreatic Surgery, Tochigi Cancer Center, 4-9-13 Yohnan, Utsunomiya, Tochigi, 320-0834, Japan
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Pessini PGDS, Knox de Souza PR, Chagas CDS, Sampaio EG, Neves DS, Petri G, Fonseca FLA, da Silva EB. Hematological reference values and animal welfare parameters of BALB/C-FMABC ( Mus musculus) inoculated with Ehrlich tumor kept in the vivarium at ABC Medical School. Animal Model Exp Med 2020; 3:32-39. [PMID: 32318657 PMCID: PMC7167238 DOI: 10.1002/ame2.12099] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 11/25/2019] [Accepted: 12/13/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Biochemical and hematological parameters are important tools for assessing the physiological profile of vital organs, and can be recorded to create reference values used for clinical diagnosis of diseases. Many research laboratories lack the means to establish their own set of reference parameters for use in their research, and while there are articles in the literature that discuss laboratory parameters for healthy BALB/c mice, few studies address the evaluation of these parameters in pathological situations, such as in mice inoculated with Ehrlich tumor. METHOD BALB/c-FMABC mice previously inoculated with Ehrlich tumor were maintained under appropriate conditions. Blood samples were taken for analysis of hematological parameters using automated and semi-automated equipment to create a set of the animal welfare parameters for evaluation. RESULT Results were obtained for all the hematological parameters for all groups analyzed. These showed: statistically significant differences between the initial and final tumor weight; comparable initial tumour volume and weight; an increase in leukocytes in the 7-day group with a characteristic predominance of lymphocytes and neutrophils; statistically significant changes in RDW in the 21-day group and in the welfare parameters in the 28-day group. CONCLUSION The study successfully defined and established reference values for hematological and welfare parameters for all groups analyzed.
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Affiliation(s)
- Patrick Gabriel dos Santos Pessini
- Clinical Analysis Laboratory of the ABC University Health CenterSanto AndréBrazil
- Health Sciences Institute/Paulista University – UNIPSão PauloBrazil
| | | | | | - Emily Garcia Sampaio
- Clinical Analysis Laboratory of the ABC University Health CenterSanto AndréBrazil
| | - Daniel Santos Neves
- Clinical Analysis Laboratory of the ABC University Health CenterSanto AndréBrazil
| | - Giuliana Petri
- Clinical Analysis Laboratory of the ABC University Health CenterSanto AndréBrazil
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Neutrophil Extracellular Trap Formation Correlates with Favorable Overall Survival in High Grade Ovarian Cancer. Cancers (Basel) 2020; 12:cancers12020505. [PMID: 32098278 PMCID: PMC7072166 DOI: 10.3390/cancers12020505] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 02/12/2020] [Accepted: 02/17/2020] [Indexed: 02/06/2023] Open
Abstract
It is still a question of debate whether neutrophils, often found in the tumor microenvironment, mediate tumor-promoting or rather tumor-inhibiting activities. The present study focuses on the involvement of neutrophils in high grade serous ovarian cancer (HGSOC). Macroscopic features classify two types of peritoneal tumor spread in HGSOC. Widespread and millet sized lesions characterize the miliary type, while non-miliary metastases are larger and associated with better prognosis. Multi-omics and FACS data were generated from ascites samples. Integrated data analysis demonstrates a significant increase of neutrophil extracellular trap (NET)-associated molecules in non-miliary ascites samples. A co-association network analysis performed with the ascites data further revealed a striking correlation between NETosis-associated metabolites and several eicosanoids. The congruence of data generated from primary neutrophils with ascites analyses indicates the predominance of NADPH oxidase 2 (NOX)-independent NETosis. NETosis is associated with protein S100A8/A9 release. An increase of the S100A8/CRP abundance ratio was found to correlate with favorable survival of HGSOC patients. The analysis of additional five independent proteome studies with regard to S100A8/CRP ratios confirmed this observation. In conclusion, NET formation seems to relate with better cancer patient outcome.
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Hu Y, Wang S, Ding N, Li N, Huang J, Xiao Z. Platelet/Lymphocyte Ratio Is Superior to Neutrophil/Lymphocyte Ratio as a Predictor of Chemotherapy Response and Disease-free Survival in Luminal B-like (HER2 -) Breast Cancer. Clin Breast Cancer 2020; 20:e403-e409. [PMID: 32201163 DOI: 10.1016/j.clbc.2020.01.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Revised: 01/09/2020] [Accepted: 01/20/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND The neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) have been associated with the prognosis in breast cancer (BC). The relationship of the NLR and PLR with chemotherapy sensitivity and prognosis in luminal B-like (human epidermal growth factor receptor 2-negative [HER2-]) BC are not well studied. PATIENTS AND METHODS The clinical data from 980 patients with luminal B-like (HER2-) BC from June 2012 to June 2016 were collected. The differences among the variables were calculated using the χ2 test. The associations among the clinicopathologic factors, pretreatment NLR, pretreatment PLR, and disease-free survival (DFS) were analyzed using Kaplan-Meier curves and Cox analyses. RESULTS The median follow-up was 37 months (range, 5-77 months). For the 480 patients who had received neoadjuvant chemotherapy, low pretreatment PLR values were associated with higher pathologic complete response (pCR) rates compared with the high PLR group (15.8% for low vs. 9.2% for high PLR group; P = .027). Multivariate analyses showed that larger tumors, a greater number of lymph nodes involved, a high Ki-67 score, and a high PLR were independent prognostic factors of worse outcomes for the patients with luminal B-like (HER2-) BC. The risk of metastasis and/or recurrence was greater for the high PLR group than for the low PLR group (hazard ratio, 1.576; 95% confidence interval, 1.039-2.390; P = .032). The pretreatment NLR showed no such associations among this cohort of patients. CONCLUSIONS The results of the present study have shown that the pretreatment PLR is superior to the NLR as a predictor of pCR and DFS outcomes in patients with luminal B-like (HER2-) BC. A low pretreatment PLR was associated with higher pCR rates after neoadjuvant chemotherapy and was an independent predictive factor for better DFS outcomes among patients with luminal B-like (HER2-) BC.
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Affiliation(s)
- Yuanping Hu
- Department of Breast Surgery, Xiangya Hospital, Central South University, Changsha, China
| | - Shouman Wang
- Department of Breast Surgery, Xiangya Hospital, Central South University, Changsha, China
| | - Nianhua Ding
- Department of Clinical Laboratory, First Hospital of Changsha, Changsha, China
| | - Ningsha Li
- Department of Clinical Laboratory, First Hospital of Changsha, Changsha, China
| | - Juan Huang
- Department of Breast Surgery, Xiangya Hospital, Central South University, Changsha, China
| | - Zhi Xiao
- Department of Breast Surgery, Xiangya Hospital, Central South University, Changsha, China; Department of Breast Surgery, Clinical Research Center for Breast Cancer Control and Prevention in Hunan Province, Changsha, China.
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Muñoz-Montaño W, Cabrera-Galeana P, Alvarado-Miranda A, Villarreal-Garza C, Mohar A, Olvera A, Bargallo-Rocha E, Lara-Medina F, Arrieta O. Prognostic Value of the Pretreatment Neutrophil-to-Lymphocyte Ratio in Different Phenotypes of Locally Advanced Breast Cancer During Neoadjuvant Systemic Treatment. Clin Breast Cancer 2020; 20:307-316.e1. [PMID: 32305297 DOI: 10.1016/j.clbc.2019.12.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 11/23/2019] [Accepted: 12/31/2019] [Indexed: 11/16/2022]
Abstract
PURPOSE Neutrophils are among the key cellular players in the inflammatory milieu produced in patients with breast cancer (BC), and strong evidence exists in terms of the prognostic value of assessing the neutrophil-to-lymphocyte ratio (NLR) in patients with BC. In this study we sought to determine whether the baseline NLR correlates with pathological complete response (pCR), disease-free survival (DFS), and overall survival (OS) in patients with locally advanced BC in the neoadjuvant chemotherapy (NAC) setting. METHODS We analyzed the pretreatment NLR from the first blood count of patients treated from 2007 to 2015 in terms of pCR, DFS, and OS in patients with locally advanced BC. Patients received standard medical care based on national guidelines. RESULTS A total of 1519 patients were included in the study. Median age was 49 years (22-88). The cutoff point for NLR was 2.0. NLR was not associated with pCR or DFS. However, patients with high NLR had worse OS in the presence of triple-negative BC (105.9 months; 95% confidence interval [CI], 100.2-111.5] vs. 98.7 months; 95% CI, 91.1-106.3; P = .029), Her2 overexpression (114.0 months; 95% CI, 110.5-118.0 vs. 100.8 months; 95% CI 95.7-105.9; P = .019), and residual disease after NAC for both phenotypes. Multivariate analysis showed that NLR was independently associated with OS (hazard ratio, 1.4; 95% CI, 1.02-1.95; P = .037). CONCLUSIONS Pretreatment NLR in patients with locally advanced BC correlates with OS as an independent prognostic factor. This influence depends on phenotype and residual disease. Routine assessment of this parameter could be an easy and affordable tool for defining prognosis.
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Affiliation(s)
| | | | | | | | - Alejandro Mohar
- Breast Epidemiology Unit, National Institute of Cancer, Mexico City, Mexico
| | - Alejandro Olvera
- Medical School, National Autonomous University of Mexico, Mexico City, Mexico
| | | | | | - Oscar Arrieta
- Research Unit, National Institute of Cancer, Mexico City, Mexico.
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Fujimoto Y, Inoue N, Morimoto K, Watanabe T, Hirota S, Imamura M, Matsushita Y, Katagiri T, Okamura H, Miyoshi Y. Significant association between high serum CCL5 levels and better disease-free survival of patients with early breast cancer. Cancer Sci 2019; 111:209-218. [PMID: 31724785 PMCID: PMC6942441 DOI: 10.1111/cas.14234] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 10/10/2019] [Accepted: 10/25/2019] [Indexed: 12/26/2022] Open
Abstract
Analysis of anticancer immunity aids in assessing the prognosis of patients with breast cancer. From 250 operated breast cancers, we focused on serum levels of C‐C motif chemokine ligand 5 (CCL5), which is involved in cancer immune reactions. Serum levels of CCL5 were measured using a cytometric bead‐based immunoassay kit and CCL5 expression in cancer cells was determined using immunohistochemical staining. In addition, mRNA in cancer and stromal cells was analyzed by microdissection and comparison with the public dataset. Disease‐free survival (DFS) of patients with high CCL5 levels (cut‐off, 13.87 ng/mL; n = 192) was significantly better than those with low CCL5 levels (n = 58; hazard ratio, 0.20; 95% confidence interval, 0.10‐0.39; P < .0001). An improved overall survival was observed in patients with high CCL5 levels compared to those with low CCL5 levels (P = .024). On the contrary, high immunohistochemical expression of CCL5 in cancer cells was significantly associated with decreased DFS. As serum CCL5 levels did not correlate with CCL5 expression in cancer cells and the relative expression of mRNA CCL5 was elevated in stromal cells in relation to cancer cells, serum CCL5 might be derived not from cancer cells, but from stromal cells. Expression of CCL5 in serum, but not in cancer cells, might contribute to improved patient prognosis mediating through not only immune reaction, but through other mechanisms. Determination of circulating CCL5 levels could be useful for predicting patient prognosis.
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Affiliation(s)
- Yukie Fujimoto
- Division of Breast and Endocrine Surgery, Department of Surgery, Hyogo College of Medicine, Nishinomiya, Japan
| | - Natsuko Inoue
- Division of Breast and Endocrine Surgery, Department of Surgery, Hyogo College of Medicine, Nishinomiya, Japan
| | - Koji Morimoto
- Osaka Ryokuryo High School, Fujiidera, Japan.,Department of Surgery, National Hospital Organization Osaka National Hospital, Osaka, Japan.,Biofunctional Synthetic Chemistry Laboratory, RIKEN Cluster for Pioneering Research, Wako, Japan
| | - Takahiro Watanabe
- Department of Surgical Pathology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Seiichi Hirota
- Department of Surgical Pathology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Michiko Imamura
- Division of Breast and Endocrine Surgery, Department of Surgery, Hyogo College of Medicine, Nishinomiya, Japan
| | - Yosuke Matsushita
- Division of Genome Medicine, Institute for Genome Research, Tokushima University, Tokushima, Japan
| | - Toyomasa Katagiri
- Division of Genome Medicine, Institute for Genome Research, Tokushima University, Tokushima, Japan
| | - Haruki Okamura
- Laboratory of Tumor Immunology and Cell Therapy, Hyogo College of Medicine, Nishinomiya, Japan
| | - Yasuo Miyoshi
- Division of Breast and Endocrine Surgery, Department of Surgery, Hyogo College of Medicine, Nishinomiya, Japan
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Zheng WF, Zhan J, Chen A, Ma H, Yang H, Maharjan R. Diagnostic value of neutrophil-lymphocyte ratio in preeclampsia: A PRISMA-compliant systematic review and meta-analysis. Medicine (Baltimore) 2019; 98:e18496. [PMID: 31861035 PMCID: PMC6940150 DOI: 10.1097/md.0000000000018496] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Neutrophil-lymphocyte ratio (NLR) is one of the markers of systemic inflammation. Recent studies have associated NLR with diagnosis of preeclampsia (PE). However, due to small sample sizes and different research design, the diagnostic value of NLR in PE patients is not well understood. In this study, we evaluate the potential diagnostic value of NLR in PE. METHODS We searched PubMed, Embase, Cochrane Library, the Chinese National Knowledge Infrastructure (CNKI) databases, Wanfang data, VIP database and China Biomedical Literature Database systematically for relevant literatures up to May 20, 2018. All analyses were conducted using Meta-DiSc1.4 and Stata 12.0 software. Sensitivity, specificity and other measures of accuracy of NLR for the diagnosis of PE were pooled. Meta-regression was performed to identify the sources of heterogeneity. RESULTS This meta-analysis included a total of 7 studies. The pooled sensitivity and specificity were 0.74 (95% CI 0.71-0.76) and 0.64 (95%CI 0.61-0.68), positive likelihood ratio, 2.62 (95%CI1.79-3.84); negative likelihood ratio, 0.34 (95%CI 0.24-0.48); diagnostic odds ratio, 8.44 (95%CI 4-17.78), and area under the curve was 0.82. Meta regression showed that sample size was the main source of heterogeneity. Deeks funnel plot showed that there was no statistical significance for the evaluation of publication bias (P = .16). CONCLUSION Current evidence suggests that the diagnostic accuracy of NLR has unsatisfactory specificity but acceptable sensitivity for diagnosis of PE. Further large-scale prospective studies are required to validate the potential applicability of using NLR alone or in combination other markers as PE diagnostic biomarker and explore potential factors that may influence the accuracy of NLR for PE diagnosis.
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65
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Hoshimoto S, Hishinuma S, Shirakawa H, Tomikawa M, Ozawa I, Ogata Y. Outcomes in patients with pancreatic cancer as a secondary malignancy: a retrospective single-institution study. Langenbecks Arch Surg 2019; 404:975-983. [PMID: 31768632 DOI: 10.1007/s00423-019-01841-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 11/06/2019] [Indexed: 01/08/2023]
Abstract
PURPOSE This study aimed to evaluate the clinicopathological features and oncological outcomes of pancreatic cancer (PC) patients with prior malignancies (2nd primary PC) compared with those of patients without any prior malignancies in their history (1st primary PC). METHODS We retrospectively reviewed clinical data from 185 PC patients undergoing surgical resection. Patients were divided into the 1st and 2nd primary PC groups. RESULTS Forty-three patients (23.2%) had a history of prior malignancy. The 2nd primary PC group was significantly older than the 1st primary PC group (mean, 72.1 vs. 65.9 years, respectively, P < 0.001) and was more frequently asymptomatic compared to the 1st primary PC group (67.4 vs. 31.0%, respectively, P < 0.001). The tumor size was larger, and extrapancreatic nerve plexus invasion, venous invasion, and lymph node metastasis were more frequently observed in the 1st primary PC group. The rate of adjuvant therapy administration was lower in 2nd primary PC patients (72.5 vs. 51.2%, P = 0.009). In the survival analysis, no significant difference in overall or disease-free survival was found between the two groups (16.8 vs. 16.4 months, P = 0.725, and 8.7 vs. 9.3 months, P = 0.284, respectively). CONCLUSION Despite significant surveillance bias, such as earlier detection in 2nd primary PC, the outcomes of patients with 2nd primary PC were comparable to those of patients with 1st primary PC. Further investigation with a larger sample size and matching for patient age and tumor stage in both groups is needed to elucidate the biological features of 2nd primary PC.
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Affiliation(s)
- Sojun Hoshimoto
- Department of Digestive Surgery, Tochigi Cancer Center, 4-9-13, Yohnan, Utsunomiya, Tochigi, 320-0834, Japan.
| | - Shoichi Hishinuma
- Department of Digestive Surgery, Tochigi Cancer Center, 4-9-13, Yohnan, Utsunomiya, Tochigi, 320-0834, Japan
| | - Hirofumi Shirakawa
- Department of Digestive Surgery, Tochigi Cancer Center, 4-9-13, Yohnan, Utsunomiya, Tochigi, 320-0834, Japan
| | - Moriaki Tomikawa
- Department of Digestive Surgery, Tochigi Cancer Center, 4-9-13, Yohnan, Utsunomiya, Tochigi, 320-0834, Japan
| | - Iwao Ozawa
- Department of Digestive Surgery, Tochigi Cancer Center, 4-9-13, Yohnan, Utsunomiya, Tochigi, 320-0834, Japan
| | - Yoshiro Ogata
- Department of Digestive Surgery, Tochigi Cancer Center, 4-9-13, Yohnan, Utsunomiya, Tochigi, 320-0834, Japan
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Neutrophil-lymphocyte ratio in metastatic breast cancer is not an independent predictor of survival, but depends on other variables. Sci Rep 2019; 9:16979. [PMID: 31740715 PMCID: PMC6861311 DOI: 10.1038/s41598-019-53606-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 10/30/2019] [Indexed: 12/11/2022] Open
Abstract
The prognostic impact of neutrophil-lymphocyte ratio (NLR) in metastatic breast cancer (MBC) has been previously evaluated in early and metastatic mixed breast cancer cohorts or without considering other relevant prognostic factors. Our aim was to determine whether NLR prognostic and predictive value in MBC was dependent on other clinical variables. We studied a consecutive retrospective cohort of patients with MBC from a single centre, with any type of first line systemic treatment. The association of NLR at diagnosis of metastasis with progression free survival (PFS) and overall survival (OS) was evaluated using Cox univariate and multivariate proportional hazard models. In the full cohort, that included 263 MBC patients, a higher than the median (>2.32) NLR was significantly associated with OS in the univariate analysis (HR 1.36, 95% CI 1.00–1.83), but the association was non-significant (HR 1.12, 95% CI 0.80–1.56) when other clinical covariates (performance status, stage at diagnosis, CNS involvement, visceral disease and visceral crisis) were included in the multivariate analysis. No significant association was observed for PFS. In conclusion, MBC patients with higher baseline NLR had worse overall survival, but the prognostic impact of NLR is likely derived from its association with other relevant clinical prognostic factors.
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67
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Tatara T, Suzuki S, Kanaji S, Yamamoto M, Matsuda Y, Hasegawa H, Yamashita K, Matsuda T, Oshikiri T, Nakamura T, Kakeji Y. Lymphopenia predicts poor prognosis in older gastric cancer patients after curative gastrectomy. Geriatr Gerontol Int 2019; 19:1215-1219. [PMID: 31674139 DOI: 10.1111/ggi.13794] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 08/08/2019] [Accepted: 09/19/2019] [Indexed: 01/08/2023]
Abstract
AIM Total lymphocyte count in preoperative peripheral blood is associated with prognosis in various cancers. The predictive value of preoperative total lymphocyte count for survival was assessed in older gastric cancer patients after gastrectomy. METHODS A total of 200 gastric cancer patients aged ≥75 years who underwent curative resection from 2000 to 2014 were included in this retrospective study. The cut-off value of total lymphocyte count in preoperative peripheral blood was determined using receiver operating characteristic curve analysis, and the association with prognosis was examined. RESULTS The cut-off value of total lymphocyte count was 1462/μL, and 94 patients were classified as low total lymphocyte count patients and 106 patients were classified as high total lymphocyte count patients. In univariate analysis, American Society of Anesthesiologists score ≥3, Charlson Comorbidity Index ≥3, total lymphocyte count <1462/μL, stage III, open approach, total gastrectomy, splenectomy and infectious complication were significantly associated with overall survival. In multivariate analysis, total lymphocyte count <1462/μL (P = 0.003), American Society of Anesthesiologists score ≥3 (P = 0.01) and stage III (P = 0.017) were independent prognostic factors. Low total lymphocyte count significantly reduced overall survival in stage I (P = 0.037) and II (P = 0.009) patients, but not stage III patients (P = 0.29). CONCLUSION Total lymphocyte count in preoperative peripheral blood can predict postoperative survival of older patients with relatively early-stage gastric cancer. Geriatr Gerontol Int 2019; 19: 1215-1219.
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Affiliation(s)
- Takashi Tatara
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Satoshi Suzuki
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shingo Kanaji
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masashi Yamamoto
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yoshiko Matsuda
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hiroshi Hasegawa
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kimihiro Yamashita
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takeru Matsuda
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Taro Oshikiri
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tetsu Nakamura
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yoshihiro Kakeji
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
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68
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Arroyo‐Crespo JJ, Armiñán A, Charbonnier D, Deladriere C, Palomino‐Schätzlein M, Lamas‐Domingo R, Forteza J, Pineda‐Lucena A, Vicent MJ. Characterization of triple-negative breast cancer preclinical models provides functional evidence of metastatic progression. Int J Cancer 2019; 145:2267-2281. [PMID: 30860605 PMCID: PMC6767480 DOI: 10.1002/ijc.32270] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 01/25/2019] [Accepted: 02/28/2019] [Indexed: 12/13/2022]
Abstract
Triple-negative breast cancer (TNBC), an aggressive, metastatic and recurrent breast cancer (BC) subtype, currently suffers from a lack of adequately described spontaneously metastatic preclinical models that faithfully reproduce the clinical scenario. We describe two preclinical spontaneously metastatic TNBC orthotopic murine models for the development of advanced therapeutics: an immunodeficient human MDA-MB-231-Luc model and an immunocompetent mouse 4T1 model. Furthermore, we provide a broad range of multifactorial analysis for both models that could provide relevant information for the development of new therapies and diagnostic tools. Our comparisons uncovered differential growth rates, stromal arrangements and metabolic profiles in primary tumors, and the presence of cancer-associated adipocyte infiltration in the MDA-MB-231-Luc model. Histopathological studies highlighted the more rapid metastatic spread to the lungs in the 4T1 model following a lymphatic route, while we observed both homogeneous (MDA-MB-231-Luc) and heterogeneous (4T1) metastatic spread to axillary lymph nodes. We encountered unique metabolomic signatures in each model, including crucial amino acids and cell membrane components. Hematological analysis demonstrated severe leukemoid and lymphoid reactions in the 4T1 model with the partial reestablishment of immune responses in the immunocompromised MDA-MB-231-Luc model. Additionally, we discovered β-immunoglobulinemia and increased basal levels of G-CSF correlating with a metastatic switch, with G-CSF also promoting extramedullary hematopoiesis (both models) and causing hepatosplenomegaly (4T1 model). Overall, we believe that the characterization of these preclinical models will foster the development of advanced therapeutic strategies for TNBC treatment, especially for the treatment of patients presenting both, primary tumors and metastatic spread.
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Affiliation(s)
- Juan J. Arroyo‐Crespo
- Polymer Therapeutics LaboratoryCentro de Investigación Príncipe FelipeAv. Eduardo Primo Yúfera 3Valencia, 46012Spain
| | - Ana Armiñán
- Polymer Therapeutics LaboratoryCentro de Investigación Príncipe FelipeAv. Eduardo Primo Yúfera 3Valencia, 46012Spain
| | - David Charbonnier
- Polymer Therapeutics LaboratoryCentro de Investigación Príncipe FelipeAv. Eduardo Primo Yúfera 3Valencia, 46012Spain
- Screening Platform, Centro de Investigación Príncipe FelipeAv. Eduardo Primo Yúfera 3Valencia, 46012Spain
| | - Coralie Deladriere
- Polymer Therapeutics LaboratoryCentro de Investigación Príncipe FelipeAv. Eduardo Primo Yúfera 3Valencia, 46012Spain
| | - Martina Palomino‐Schätzlein
- Joint Research Unit in Clinical MetabolomicsCentro de Investigación Príncipe FelipeAv. Eduardo Primo Yúfera 3Valencia, 46012Spain
| | - Rubén Lamas‐Domingo
- Joint Research Unit in Clinical MetabolomicsCentro de Investigación Príncipe FelipeAv. Eduardo Primo Yúfera 3Valencia, 46012Spain
| | - Jerónimo Forteza
- Unidad Mixta Centro de Investigación Príncipe Felipe‐Instituto Valenciano de PatologíaCentro de Investigación Príncipe FelipeAv. Eduardo Primo Yúfera 3Valencia, 46012Spain
| | - Antonio Pineda‐Lucena
- Joint Research Unit in Clinical MetabolomicsCentro de Investigación Príncipe FelipeAv. Eduardo Primo Yúfera 3Valencia, 46012Spain
- Drug Discovery UnitInstituto de Investigación Sanitaria La FeAvda. Fernando Abril Martorell, 106, 46026ValenciaSpain
| | - María J. Vicent
- Polymer Therapeutics LaboratoryCentro de Investigación Príncipe FelipeAv. Eduardo Primo Yúfera 3Valencia, 46012Spain
- Screening Platform, Centro de Investigación Príncipe FelipeAv. Eduardo Primo Yúfera 3Valencia, 46012Spain
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DiGiacomo JW, Gilkes DM. Tumor Hypoxia As an Enhancer of Inflammation-Mediated Metastasis: Emerging Therapeutic Strategies. Target Oncol 2019; 13:157-173. [PMID: 29423593 DOI: 10.1007/s11523-018-0555-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Metastasis is the leading cause of cancer-related deaths. Recent research has implicated tumor inflammation as a promoter of metastasis. Myeloid, lymphoid, and mesenchymal cells in the tumor microenvironment promote inflammatory signaling amongst each other and together with cancer cells to modulate sustained inflammation, which may enhance cancer invasiveness. Tumor hypoxia, a state of reduced available oxygen present in the majority of solid tumors, acts as a prognostic factor for a worse outcome and is known to have a role in tumor inflammation through the regulation of inflammatory mediator signals in both cancer and neighboring cells in the microenvironment. Multiple methods to target tumor hypoxia have been developed and tested in clinical trials, and still more are emerging as the impacts of hypoxia become better understood. These strategies include mechanistic inhibition of the hypoxia inducible factor signaling pathway and hypoxia activated pro-drugs, leading to both anti-tumor and anti-inflammatory effects. This prompts a need for further research on the prevention of hypoxia-mediated inflammation in cancer. Hypoxia-targeting strategies seem to have the most potential for therapeutic benefit when combined with traditional chemotherapy agents. This paper will serve to summarize the role of the inflammatory response in metastasis, to discuss how hypoxia can enable or enhance inflammatory signaling, and to review established and emerging strategies to target the hypoxia-inflammation-metastasis axis.
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Affiliation(s)
- Josh W DiGiacomo
- Department of Chemical & Biomolecular Engineering, Johns Hopkins University, Baltimore, MD, 21218, USA.,Breast & Ovarian Cancer Program, Department of Oncology, Johns Hopkins School of Medicine, Baltimore, MD, 21287, USA
| | - Daniele M Gilkes
- Department of Chemical & Biomolecular Engineering, Johns Hopkins University, Baltimore, MD, 21218, USA. .,Breast & Ovarian Cancer Program, Department of Oncology, Johns Hopkins School of Medicine, Baltimore, MD, 21287, USA.
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Rivas M, Acevedo F, Dominguez F, Galindo H, Camus M, Oddo D, Villarroel A, Razmilic D, Peña J, Munoz Medel M, Navarro ME, Perez-Sepulveda A, Medina L, Merino T, Briones J, Kalergis A, Sanchez C. The Neutrophil to Lymphocyte Ratio Predicts the Response to Neoadjuvant Chemotherapy in Luminal B Breast Cancer. Asian Pac J Cancer Prev 2019; 20:2209-2212. [PMID: 31350986 PMCID: PMC6745205 DOI: 10.31557/apjcp.2019.20.7.2209] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Indexed: 12/24/2022] Open
Abstract
Objective: Tumor response to neoadjuvant chemotherapy (NAC) in breast cancer (BC) patients is a predictor for overall survival. The aim of our study was to determine a relationship between the neutrophil to lymphocyte ratio (NLR) prior to NAC, BC subtypes and the probability of a pathologic complete response (pCR). Materials and Methods: Medical records were collected retrospectively from Centro de Cancer at Red Salud UC-Christus. Clinical data collected included peripheral blood cell counts, BC subtype at diagnosis and the pathology report of surgery after chemotherapy. Results: A total of 88 patients were analyzed. Approximately, a 25% had a pCR, and displayed a significant correlation between BC subtype and pCR (p= 0.0138 Chi2); this was more frequent in epidermal growth factor receptor type 2 (HER2) enriched subtype patients (54%). Luminal B BC patients with a pCR had significantly lower NLR levels (t test, p= 0.0181). Conclusions: HER2-enriched tumors had a higher probability of pCR. In Luminal B tumors, NLR had a statistically significant relationship with the probability of pCR. In this subtype, NLR could be a useful biomarker to predict tumor response to NAC. Further studies including other clinical parameters for systemic inflammation such as platelet counts, intratumoral NLR or body mass index could help identify patients that would get the most benefit from NAC.
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Affiliation(s)
- Mauricio Rivas
- Department of Hematology and Oncology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.
| | - Francisco Acevedo
- Department of Hematology and Oncology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.
| | - Francisco Dominguez
- Department of Oncological and Maxillofacial Surgery, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Hector Galindo
- Department of Hematology and Oncology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.
| | - Mauricio Camus
- Department of Oncological and Maxillofacial Surgery, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - David Oddo
- Department of Anatomy and Pathology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Alejandra Villarroel
- Department of Anatomy and Pathology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Dravna Razmilic
- Department of Radiology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Jose Peña
- Department of Hematology and Oncology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.
| | - Matias Munoz Medel
- Department of Hematology and Oncology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.
| | - Maria Elena Navarro
- Department of Radiology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Alejandra Perez-Sepulveda
- Department of Hematology and Oncology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.
| | - Lidia Medina
- Centro de Cancer, Red de Salud UC-CHRISTUS, Santiago, Chile
| | - Tomas Merino
- Department of Hematology and Oncology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.
| | - Juan Briones
- Department of Hematology and Oncology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.
| | - Alexis Kalergis
- Millennium Institute on Immunology and Immunotherapy, Department of Molecular Genetics and Microbiology, Faculty of Biologic Sciences, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Cesar Sanchez
- Department of Hematology and Oncology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.
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Siristatidis C, Christoforaki V, Zafeiriou Z, Mastorakos G, Vrantza T, Daskalakis G. First trimester neutrophil-to-lymphocyte ratio (NLR) and pregnancy outcomes in medically assisted reproduction (MAR): a case control study. Gynecol Endocrinol 2019; 35:434-438. [PMID: 30614314 DOI: 10.1080/09513590.2018.1534949] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
As success rates after medically assisted reproduction (MAR) technologies have remained constantly limited during the last years, there has been a systematic effort to predict clinical outcomes. There is currently weak evidence to name the neutrophil-to-lymphocyte ratio (NLR), as an accurate predictor in MAR. Through a case control study, and by setting strict eligibility criteria, we enrolled 66 women (35 with negative outcome and 31 cycles with live birth), in terms of NLR at the time of oocyte retrieval. Clinical and IVF cycle characteristics were comparable in a normalized population. There was a positive correlation between NLR and the age of the woman (r = 0.310, p=.011 and rs =0.363, p=.033). Higher odds ratios (ORs) of MAR positive outcome were detected only at higher NLR values, when NLR was divided into quartiles, but only in the 4th quartile [OR =4.33 (95%CI: 1.02-10.79)]. ROC curve resulted on an AUC equal to 0.660 (95%CI: 0.529-0.791) and p value .025. The estimated specificity, sensitivity and cutoff point were 0.57, 0.548, and 1.98, respectively, while PPV and NPV values were 70.6% and 59.3%, respectively. In conclusion, NLR was positively correlated with maternal age; in our study cohort, MAR failure was associated with lower NLR values.
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Affiliation(s)
- Charalampos Siristatidis
- a Third Department Department of Obstetrics and Gynaecology, Assisted Reproduction Unit , "Attikon Hospital", Medical School, National and Kapodistrian University of Athens , Athens , Greece
| | - Viktoria Christoforaki
- b Department of Obstetrics and Gynaecology , University Hospital of Heraklion , Heraklion , Greece
| | - Zafeiris Zafeiriou
- c "Theagenio" Anticancer Hospital of Thessaloniki , Thessaloniki , Greece
| | - George Mastorakos
- d Second Department of Obstetrics and Gynaecology , Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens , Athens , Greece
| | - Tereza Vrantza
- a Third Department Department of Obstetrics and Gynaecology, Assisted Reproduction Unit , "Attikon Hospital", Medical School, National and Kapodistrian University of Athens , Athens , Greece
| | - George Daskalakis
- e First Department of Obstetrics and Gynaecology , Alexandra Hospital, Medical School, National and Kapodistrian University of Athens , Athens , Greece
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Jiang DM, Fyles A, Nguyen LT, Neel BG, Sacher A, Rottapel R, Wang BX, Ohashi PS, Sridhar SS. Phase I study of local radiation and tremelimumab in patients with inoperable locally recurrent or metastatic breast cancer. Oncotarget 2019; 10:2947-2958. [PMID: 31105877 PMCID: PMC6508206 DOI: 10.18632/oncotarget.26893] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 04/14/2019] [Indexed: 12/31/2022] Open
Abstract
Immunotherapy has shown modest activity in metastatic breast cancer (MBC). In this phase I dose escalation study, we assessed safety of tremelimumab, a humanized anti-CTLA4 monoclonal antibody, at starting dose 3 mg/kg, on the third day of palliative radiotherapy (2000cGy in 5 daily fractions) in patients with MBC. Primary objective was to determine the maximum tolerated dose (MTD) of tremelimumab combined with RT. Secondary objective was to assess response. Among 6 patients enrolled between July 2010 and October 2011, 5 had hormone receptor-positive MBC, 1 had triple negative MBC. Median age was 45 years. Common toxicities included lymphopenia (83%), fatigue (50%) and rash (33%). One dose-limiting toxicity occurred at 6 mg/kg, however the trial closed before MTD could be determined. One patient discontinued treatment due to a pathological fracture. Best response was stable disease (SD), 1 patient had SD for >6 months. Median follow up was 27.0 months. Median OS was 50.8 months, with 1 patient surviving >8 years. Peripheral blood mononuclear cell (PBMC) profiles showed increasing proliferating (Ki67+) Treg cells 1 week post treatment in 5 patients. Overall, tremelimumab at 3 mg/kg combined with RT appears to be a tolerable treatment strategy. Further studies are needed to optimize this combination approach.
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Affiliation(s)
- Di Maria Jiang
- Department of Medical Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Canada
| | - Anthony Fyles
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Canada
| | - Linh T Nguyen
- Ontario Cancer Institute, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Benjamin G Neel
- Ontario Cancer Institute, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.,Laura and Isaac Perlmutter Cancer Center, NYU Langone Health, New York, NY, USA
| | - Adrian Sacher
- Department of Medical Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Canada
| | - Robert Rottapel
- Ontario Cancer Institute, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Ben X Wang
- Ontario Cancer Institute, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Pamela S Ohashi
- Ontario Cancer Institute, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.,Department of Immunology, Faculty University of Toronto, Toronto, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, Canada
| | - Srikala S Sridhar
- Department of Medical Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Canada
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Gorphe P, Bouhir S, Garcia GCTE, Alali A, Even C, Breuskin I, Tao Y, Janot F, Bidault F, Temam S. Anemia and neutrophil-to-lymphocyte ratio in laryngeal cancer treated with induction chemotherapy. Laryngoscope 2019; 130:E144-E150. [PMID: 31006874 DOI: 10.1002/lary.28021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 03/21/2019] [Accepted: 04/03/2019] [Indexed: 01/17/2023]
Abstract
OBJECTIVES/HYPOTHESIS We studied the influence of the neutrophil-to-lymphocyte ratio (NLR) and anemia on the response to induction chemotherapy (IC) and survival outcomes in laryngeal cancer patients treated with a preservation protocol. STUDY DESIGN Retrospective single-center case series. METHODS We analyzed patients with T3 laryngeal cancer treated with IC using a preservation protocol. The NLR and hemoglobin levels were assessed before treatment and after IC. The response to chemotherapy was assessed using Response Evaluation Criteria in Solid Tumours 1.1 and World Heath Organization standards. The oncological endpoints were overall survival (OS) and disease-free survival (DFS). RESULTS Sixty-eight patients were analyzed. The median NLR and hemoglobin levels before and after IC were 2.76 and 14.5 g/dL, and 2.01 and 11.6 g/dL, respectively. The NLR and anemia before treatment were not correlated, and they were not associated with the response to chemotherapy. However, an NLR > 5 and anemia before treatment were both associated with shorter OS and DFS. Notably, they were the only factors found to be significantly associated with survival outcomes. CONCLUSIONS In laryngeal cancer, patients treated with a preservation protocol, a high NLR ratio, and anemia before IC were associated with shorter survival, independently of the response to chemotherapy. LEVEL OF EVIDENCE 4 Laryngoscope, 130:E144-E150, 2020.
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Affiliation(s)
- Philippe Gorphe
- Department of Head and Neck Oncology, Gustave Roussy Institute, University of Paris-Saclay, Villejuif, France
| | - Samia Bouhir
- Department of Head and Neck Oncology, Gustave Roussy Institute, University of Paris-Saclay, Villejuif, France
| | - Gabriel C T E Garcia
- Department of Radiology, Gustave Roussy Institute, University of Paris-Saclay, Villejuif, France
| | - Abeer Alali
- Department of Head and Neck Oncology, Gustave Roussy Institute, University of Paris-Saclay, Villejuif, France
| | - Caroline Even
- Department of Head and Neck Oncology, Gustave Roussy Institute, University of Paris-Saclay, Villejuif, France
| | - Ingrid Breuskin
- Department of Head and Neck Oncology, Gustave Roussy Institute, University of Paris-Saclay, Villejuif, France
| | - Yungan Tao
- Department of Radiotherapy, Gustave Roussy Institute, University of Paris-Saclay, Villejuif, France
| | - François Janot
- Department of Head and Neck Oncology, Gustave Roussy Institute, University of Paris-Saclay, Villejuif, France
| | - François Bidault
- Department of Radiology, Gustave Roussy Institute, University of Paris-Saclay, Villejuif, France
| | - Stéphane Temam
- Department of Head and Neck Oncology, Gustave Roussy Institute, University of Paris-Saclay, Villejuif, France
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Association of white blood cell count with breast cancer burden varies according to menopausal status, body mass index, and hormone receptor status: a case-control study. Sci Rep 2019; 9:5762. [PMID: 30962496 PMCID: PMC6453890 DOI: 10.1038/s41598-019-42234-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 03/22/2019] [Indexed: 12/24/2022] Open
Abstract
Breast cancer is a heterogeneous disease that among Korean women has a peak incidence in the perimenopausal period. The full epidemiological characteristics of breast cancer in Korean women are not yet properly understood. We investigated whether white blood cell (WBC) is related to breast cancer burden according to estrogen receptor (ER) and progesterone receptor (PR) status in the context of body mass index and menopausal status. We conducted a large case-control study and compared WBC counts between patients with breast cancer (N = 4,402) and propensity score-matched controls (N = 4,402) selected from the Korean National Health and Nutrition Examination Survey (KNHANES). We stratified the study sample by ER/PR status, menopausal status, and body mass index and assessed the association between WBC count and breast cancer burden using multinomial logistic regression. Compared with controls, non-obese patients with ER+/PR+ breast cancer had significantly higher WBC counts regardless of menopausal status (OR 1.293 95% CI 1.139–1.363, p < 0.001 in premenopausal and OR 1.049 95% CI 1.019–1.295, p = 0.023 in postmenopausal). There was no relationship between WBC count and ER+/PR+ breast cancer among premenopausal obese women. Furthermore, premenopausal non-obese women and postmenopausal obese women with ER+/PR+ breast cancer had higher WBC counts than those with ER−/PR− breast cancer. Further larger-scale prospective cohort studies are warranted to determine these associations in the future.
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Shao GL, Wang MC, Fan XL, Zhong L, Ji SF, Sang G, Wang S. Correlation Between Raf/MEK/ERK Signaling Pathway and Clinicopathological Features and Prognosis for Patients With Breast Cancer Having Axillary Lymph Node Metastasis. Technol Cancer Res Treat 2019. [PMID: 29529946 PMCID: PMC5858680 DOI: 10.1177/1533034617754024] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Objective: This study aims to investigate the correlations between rapidly accelerated fibrosarcoma/mitogen-activated protein kinase kinase (MEK)/extracellular signal-regulated kinase signaling pathway and clinicopathological features and prognosis for patients with breast cancer having axillary lymph node metastasis. Methods: A total of 118 breast cancer tissues with axillary lymph node metastasis (axillary lymph node metastasis group), 150 breast cancer tissues with non-axillary lymph node metastasis (non-axillary lymph node metastasis group), and 216 normal breast tissues (normal group) were enrolled in this study. The messenger RNA and protein expressions of rapidly accelerated fibrosarcoma, MEK, extracellular signal-regulated kinase, and their phosphorylated (p-) proteins were examined by reverse transcriptase quantitative polymerase chain reaction and immunohistochemistry, respectively. All patients received a 1-year follow-up, and the clinical follow-up data were collected. The multiple factors on the prognosis of patients with breast cancer having axillary lymph node metastasis were tested by Cox regression analysis. Results: The messenger RNA expressions of rapidly accelerated fibrosarcoma, MEK, and extracellular signal-regulated kinase and positive rates of rapidly accelerated fibrosarcoma, MEK, phosphorylated MEK, extracellular signal-regulated kinase, and p-extracellular signal-regulated kinase in the axillary lymph node metastasis group were higher than in the non-axillary lymph node metastasis and normal groups (all P < .05). The protein expressions of rapidly accelerated fibrosarcoma, MEK, phosphorylated MEK, extracellular signal-regulated kinase, and p-extracellular signal-regulated kinase were associated with tumor size, clinical stage, and axillary lymph node metastasis number (all P < .05). Rapidly accelerated fibrosarcoma, MEK, and extracellular signal-regulated kinase expressions were significantly correlated with the prognosis of patients with breast cancer (all P < .05). Patients with BC having positive rapidly accelerated fibrosarcoma, MEK, phosphorylated MEK, extracellular signal-regulated kinase, and phosphorylated ERK expressions had a higher survival rate than patients with BC having the negative ones (all P < .05). Rapidly accelerated fibrosarcoma and extracellular signal-regulated kinase protein expressions, clinical stage, pathological grade, and axillary lymph node metastasis number were independent prognostic factors in patients with breast cancer having axillary lymph node metastasis (all P < .05). Conclusion: Our study proved that rapidly accelerated fibrosarcoma/MEK/extracellular signal-regulated kinase signaling pathway is significantly correlated with the clinicopathological features and prognosis for patients with BC having axillary lymph node metastasis. Rapidly accelerated fibrosarcoma and extracellular signal-regulated kinase protein expressions are independent prognostic factors for patients with breast cancer having axillary lymph node metastasis.
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Affiliation(s)
- Guo-Li Shao
- 1 Special Medical Service Center, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Meng-Chuan Wang
- 2 Department of General Surgery, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Xu-Long Fan
- 3 Department of Breast Surgery, Foshan Women and Children Hospital, Foshan, China
| | - Lin Zhong
- 1 Special Medical Service Center, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Shu-Feng Ji
- 1 Special Medical Service Center, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Guo Sang
- 1 Special Medical Service Center, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Shui Wang
- 1 Special Medical Service Center, Zhujiang Hospital of Southern Medical University, Guangzhou, China
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Xiu DH, Liu GF, Yu SN, Li LY, Zhao GQ, Liu L, Li XF. Long non-coding RNA LINC00968 attenuates drug resistance of breast cancer cells through inhibiting the Wnt2/β-catenin signaling pathway by regulating WNT2. JOURNAL OF EXPERIMENTAL & CLINICAL CANCER RESEARCH : CR 2019; 38:94. [PMID: 30791958 PMCID: PMC6385430 DOI: 10.1186/s13046-019-1100-8] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 02/11/2019] [Indexed: 01/17/2023]
Abstract
Background Breast cancer is one the most common cancers, making it the second leading cause of cancer-related death among women. Long non-coding RNAs (lncRNAs), with tightly regulated expression patterns, also serve as tumor suppressor during tumorigenesis. The present study aimed to elucidate the role of LINC00968 in breast cancer via WNT2-mediated Wnt2/β-catenin signaling pathway. Methods Breast cancer chip GSE26910 was utilized to identify differential expression in LINC00968 and WNT2. The possible relationship among LINC00968, transcriptional repressor HEY and WNT2 was analyzed and then verified. Effects of LINC00968 on activation of the Wnt2/β-catenin signaling pathway was also tested. Drug resistance, colony formation, cell migration, invasion ability and cell apoptosis after transfection were also determined. Furthermore, tumor xenograft in nude mice was performed to test tumor growth and weight in vivo. Results WNT2 expression exhibited at a high level, whereas LINC00968 at a low expression in breast cancer which was also associated with poor prognosis in patients. LINC00968 targeted and negatively regulated WNT2 potentially via HEY1. Either overexpressed LINC00968 or silenced inhibited activation of the Wnt2/β-catenin signaling pathway, thereby reducing drug resistance, decreasing colony formation ability, as well as suppressing migration and invasion abilities of breast cancer cells in addition to inducing apoptosis. Lastly, in vivo experiment suggested that LINC00968 overexpression also suppressed transplanted tumor growth in nude mice. Conclusion Collectively, overexpressed LINC00968 contributes to reduced drug resistance in breast cancer cells by inhibiting the activation of the Wnt2/β-catenin signaling pathway through silencing WNT2. This study offers a new target for the development of breast cancer treatment.
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Affiliation(s)
- Dian-Hui Xiu
- Department of Radiology, China-Japan Union Hospital of Jilin University, Changchun, 130033, People's Republic of China
| | - Gui-Feng Liu
- Department of Radiology, China-Japan Union Hospital of Jilin University, Changchun, 130033, People's Republic of China
| | - Shao-Nan Yu
- Department of Radiology, China-Japan Union Hospital of Jilin University, Changchun, 130033, People's Republic of China
| | - Long-Yun Li
- Department of Anesthesiology, China-Japan Union Hospital of Jilin University, No. 126, Xiantai Street, Changchun, 130033, Jilin Province, People's Republic of China
| | - Guo-Qing Zhao
- Department of Anesthesiology, China-Japan Union Hospital of Jilin University, No. 126, Xiantai Street, Changchun, 130033, Jilin Province, People's Republic of China
| | - Lin Liu
- Department of Radiology, China-Japan Union Hospital of Jilin University, Changchun, 130033, People's Republic of China
| | - Xue-Feng Li
- Department of Anesthesiology, China-Japan Union Hospital of Jilin University, No. 126, Xiantai Street, Changchun, 130033, Jilin Province, People's Republic of China.
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Significance of baseline neutrophil-to-lymphocyte ratio for progression-free survival of patients with HER2-positive breast cancer treated with trastuzumab emtansine. Sci Rep 2019; 9:1811. [PMID: 30755651 PMCID: PMC6372578 DOI: 10.1038/s41598-018-37633-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 12/10/2018] [Indexed: 01/13/2023] Open
Abstract
The efficacy of trastuzumab emtansine (T-DM1) is prolonged for some patients; however, the predictive factors remain unknown. We focused on a peripheral blood biomarker, the neutrophil-to-lymphocyte ratio (NLR), regarding T-DM1 treatment efficacy. Fifty-three advanced or metastatic breast cancers treated with T-DM1 were retrospectively recruited from three institutes. The NLR in the peripheral blood was measured at baseline and after one cycle. The cutoff value of the NLR was set at median value 2.56. The progression-free survival (PFS) of patients with NLR-low at baseline (n = 26; median, not reached) was significantly better than that of patients with NLR-high (n = 27; median, 4.13 months; hazard ratio [HR], 0.226; 95% confidence interval [CI], 0.112–0.493; p = 0.0001). Longer overall survival was significantly associated with a low NLR (HR, 0.384; 95% CI, 0.170–0.910; p = 0.0296). In the subgroup analysis, patients with NLR-low consistently had longer PFS compared to those with NLR-high irrespective of the number of prior chemotherapy regimens, prior trastuzumab, visceral metastasis, estrogen receptor status, and human epidermal growth factor receptor 2 (HER2) score. Although detailed mechanisms remain unknown, treatment efficacy of T-DM1 may be partly mediated by activation of the immune system. Low baseline NLR appears to be beneficial for treatment with T-DM1 in HER2-positive breast cancers.
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Melo MCA, Garcia RF, de Araújo CFC, Abreu RLC, de Bruin PFC, de Bruin VMS. Clinical significance of neutrophil-lymphocyte and platelet-lymphocyte ratios in bipolar patients: An 18-month prospective study. Psychiatry Res 2019; 271:8-14. [PMID: 30448449 DOI: 10.1016/j.psychres.2018.10.077] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 10/15/2018] [Accepted: 10/30/2018] [Indexed: 12/18/2022]
Abstract
Neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) have recently been investigated as inexpensive and reproducible markers of systemic inflammation in many diseases. However, few studies evaluate clinical and prognostic value of NLR and PLR in psychiatric patients. The objective of this study is to investigate the clinical repercussions of NLR and PLR in patients with bipolar disorder (BD). An 18-month prospective study followed up eighty euthymic BD outpatients. Baseline data included an interviewer-administered questionnaire, behavioral scales and a blood count to calculate NLR and PLR. The occurrence of mood episodes and hospitalizations was assessed monthly for 18 months. Higher NLR and PRL were associated with more anxious symptoms and poorer functioning. BD patients with Night Eating Syndrome (NES) had higher PLR and tended to higher NLR. No association with other sleep parameters was evidenced. Higher NLR and PRL were also associated with more episodes and hospitalizations after 18 months. However, only higher baseline NLR was related to more (hypo)mania episodes. NLR and PLR are important prognostic factor for BD. This study suggested the importance of a simple blood count, an inexpensive and reproducible exam, in evaluating the course of the BD. Further studies must be performed to confirm these results.
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Affiliation(s)
- Matias Carvalho Aguiar Melo
- Department of Medical Sciences, Federal University of Ceará, Fortaleza, Brazil; Professor Frota Pinto Mental Health Hospital, Fortaleza, Brazil; Fortaleza University, Fortaleza, Brazil.
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Canbolat N, Buget MI, Sivrikoz N, Altun D, Kucukay S. The relationship between neutrophil to lymphocyte ratio and postoperative pain in total knee and hip arthroplasty. BRAZILIAN JOURNAL OF ANESTHESIOLOGY (ENGLISH EDITION) 2019. [PMID: 30401474 PMCID: PMC9391744 DOI: 10.1016/j.bjane.2018.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background and objectives Neutrophil to lymphocyte ratio is a simple, cost-effective and easily applicable inflammation indicator that is being used frequently in mortality, morbidity and prognosis studies in the recent years. We evaluated the relationship between neutrophil to lymphocyte ratio and postoperative pain in patients undergoing total hip arthroplasty and total knee arthroplasty. Material and methods We included 101 patients who preferred spinal anesthesia and intravenous patient-controlled analgesia in accordance and divided them into two groups, total hip arthroplasty and total knee arthroplasty. We recorded demographic information, duration of operation, length of hospital stay, analgesics consumption, neutrophil to lymphocyte ratio results and postoperative pain using Visual Analog Scale. Results The morphine consumption of the patients was as follows in group total hip arthroplasty and total knee arthroplasty: at the 4th hour: 7.38 mg, 7.80 mg; 8th hour: 12.19 mg, 13.29 mg; 12th hour: 16.94 mg, 19.18 mg; 24th hour: 25.97 mg, 27.98 mg; 48th hour: 36.38 mg, 39.59 mg. The Visual Analog Scale scores of the patients was as follows in group total hip arthroplasty and total knee arthroplasty: at the 4th hour: 4.10, 4.51; 8th hour: 3.02, 3.43; 12th hour: 2.29, 2.55; 24th hour: 1.90, 1.87; 48th hour: 1.08, 1.13. In group total hip arthroplasty, we found a statistically significant association between postoperative neutrophil to lymphocyte ratio and the Visual Analog Scale values on the 48th hour in a positive direction (r = 0.311; P = 0.031; P < 0.05). Conclusion Neutrophil to lymphocyte ratio can be accepted as a relatively objective method for the diagnosis of postoperative pain.
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Affiliation(s)
- Nur Canbolat
- Istanbul University, Istanbul Medical Faculty, Department of Anesthesiology, Istanbul, Turquia.
| | - Mehmet Ilke Buget
- Istanbul University, Istanbul Medical Faculty, Department of Anesthesiology, Istanbul, Turquia
| | - Nukhet Sivrikoz
- Istanbul University, Istanbul Medical Faculty, Department of Anesthesiology, Istanbul, Turquia
| | - Demet Altun
- Istanbul University, Istanbul Medical Faculty, Department of Anesthesiology, Istanbul, Turquia
| | - Suleyman Kucukay
- Istanbul University, Istanbul Medical Faculty, Department of Anesthesiology, Istanbul, Turquia
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80
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Duan J, Pan L, Yang M. Preoperative elevated neutrophil-to-lymphocyte ratio (NLR) and derived NLR are associated with poor prognosis in patients with breast cancer: A meta-analysis. Medicine (Baltimore) 2018; 97:e13340. [PMID: 30544398 PMCID: PMC6310509 DOI: 10.1097/md.0000000000013340] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Preoperative neutrophil-lymphocyte ratio (NLR) and derived NLR (dNLR) have been suggested to be correlated with the prognosis of patients with breast cancer (BC). However, the results still remain controversial. Therefore, this study was to further evaluate the prognostic potential of preoperative NLR and dNLR for BC patients using a meta-analysis. METHODS Relevant articles were sought in PubMed and Cochrane Library databases up to September 2018. The associations between preoperative NLR/dNLR and overall survival (OS), disease-free survival (DFS) and recurrence-free survival (RFS) were assessed by the STATA software with the results presented as pooled hazard ratio (HR) with 95% confidence interval (CI). RESULTS Twenty-one studies were enrolled. Pooled results showed that elevated NLR was significantly associated with poorer OS (HR = 2.45, 95% CI: 1.69-3.54), DFS (HR = 1.54, 95% CI: 1.28-1.87) and RFS (HR = 4.05, 95% CI: 1.94-8.47) in BC patients undergoing surgery. High-preoperative dNLR was also significantly associated with worse OS (HR = 1.75, 95% CI: 1.39-2.19) and DFS (HR = 1.62, 95% CI: 1.09-2.41). Moreover, subgroup analysis showed significant associations between preoperative elevated NLR and poor prognosis were not changed by the stratification of ethnicity, cutoff of NLR, pathological stage, neoadjuvant, and adjuvant therapy. CONCLUSION Preoperative NLR and dNLR may be effective predictive biomarkers for prognosis in patients with BC. Detection of NLR and dNLR may be helpful to identify the patients who may benefit from the surgery.
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81
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Hasselbalch IC, Søndergaard HB, Koch-Henriksen N, Olsson A, Ullum H, Sellebjerg F, Oturai AB. The neutrophil-to-lymphocyte ratio is associated with multiple sclerosis. Mult Scler J Exp Transl Clin 2018; 4:2055217318813183. [PMID: 30515298 PMCID: PMC6262498 DOI: 10.1177/2055217318813183] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 10/12/2018] [Accepted: 10/14/2018] [Indexed: 12/20/2022] Open
Abstract
Background Subtypes of white blood cell counts are known biomarkers of systemic inflammation and a high neutrophil-to-lymphocyte ratio (NLR) has been associated with several autoimmune diseases. Few studies have investigated the NLR in multiple sclerosis (MS). Objective To examine the association between NLR, MS and disability measured by the MS severity score (MSSS). Methods Patients were included from the Danish Multiple Sclerosis Biobank. Information on patient NLR was obtained just before their first treatment and clinical information was provided by the Danish Multiple Sclerosis Treatment Register. Information on NLR from controls was collected from the Danish Blood Donor Study. Patients and controls were 1:2 propensity score matched by baseline confounders. Results Propensity score matching left 740 of 743 MS patients and 1420 of 4691 controls for further analyses. Odds-ratio (OR) was 3.64 (95% confidence interval 2.87–4.60, p < 0.001) for MS disease per unit increase of logarithmically transformed NLR (ln-NLR), corresponding to an OR of 2.68 for each doubling of NLR. Mean NLR was 2.12 for patients and 1.72 for controls (p < 0.001). Ln-NLR correlated weakly with patient MSSS (R2 = 0.019, p = 0.008). Conclusion Patients with early MS had increased levels of NLR compared to healthy controls and NLR was weakly correlated with MSSS.
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Affiliation(s)
- I C Hasselbalch
- Danish Multiple Sclerosis Center, University of Copenhagen, Denmark
| | - H B Søndergaard
- Danish Multiple Sclerosis Center, University of Copenhagen, Denmark
| | - N Koch-Henriksen
- The Danish Multiple Sclerosis Registry, University of Copenhagen, Denmark.,Department of Clinical Epidemiology, University of Aarhus, Denmark
| | - A Olsson
- Danish Multiple Sclerosis Center, University of Copenhagen, Denmark
| | - H Ullum
- Department of Clinical Immunology, University of Copenhagen, Copenhagen, Denmark
| | - F Sellebjerg
- Danish Multiple Sclerosis Center, University of Copenhagen, Denmark
| | - A B Oturai
- Danish Multiple Sclerosis Center, University of Copenhagen, Denmark
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Hogan SA, Courtier A, Cheng PF, Jaberg-Bentele NF, Goldinger SM, Manuel M, Perez S, Plantier N, Mouret JF, Nguyen-Kim TDL, Raaijmakers MIG, Kvistborg P, Pasqual N, Haanen JBAG, Dummer R, Levesque MP. Peripheral Blood TCR Repertoire Profiling May Facilitate Patient Stratification for Immunotherapy against Melanoma. Cancer Immunol Res 2018; 7:77-85. [PMID: 30425105 DOI: 10.1158/2326-6066.cir-18-0136] [Citation(s) in RCA: 95] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 06/29/2018] [Accepted: 11/06/2018] [Indexed: 11/16/2022]
Abstract
Many metastatic melanoma patients experience durable responses to anti-PD1 and/or anti-CTLA4; however, a significant proportion (over 50%) do not benefit from the therapies. In this study, we sought to assess pretreatment liquid biopsies for biomarkers that may correlate with response to checkpoint blockade. We measured the combinatorial diversity evenness of the T-cell receptor (TCR) repertoire (the DE50, with low values corresponding to more clonality and lack of TCR diversity) in pretreatment peripheral blood mononuclear cells from melanoma patients treated with anti-CTLA4 (n = 42) or anti-PD1 (n = 38) using a multi-N-plex PCR assay on genomic DNA (gDNA). A receiver operating characteristic curve determined the optimal threshold for a dichotomized analysis according to objective responses as defined by RECIST1.1. Correlations between treatment outcome, clinical variables, and DE50 were assessed in multivariate regression models and confirmed with Fisher exact tests. In samples obtained prior to treatment initiation, we showed that low DE50 values were predictive of a longer progression-free survival and good responses to PD-1 blockade, but, on the other hand, predicted a poor response to CTLA4 inhibition. Multivariate logistic regression models identified DE50 as the only independent predictive factor for response to anti-CTLA4 therapy (P = 0.03) and anti-PD1 therapy (P = 0.001). Fisher exact tests confirmed the association of low DE50 with response in the anti-CTLA4 (P = 0.041) and the anti-PD1 cohort (P = 0.0016). Thus, the evaluation of basal TCR repertoire diversity in peripheral blood, using a PCR-based method, could help predict responses to anti-PD1 and anti-CTLA4 therapies.
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Affiliation(s)
- Sabrina A Hogan
- University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | | | - Phil F Cheng
- University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | | | | | | | | | | | | | | | | | - Pia Kvistborg
- Netherlands Cancer Institute, Amsterdam, the Netherlands
| | | | | | - Reinhard Dummer
- University Hospital Zurich, University of Zurich, Zurich, Switzerland
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Canbolat N, Buget MI, Sivrikoz N, Altun D, Kucukay S. [The relationship between neutrophil to lymphocyte ratio and postoperative pain in total knee and hip arthroplasty]. Rev Bras Anestesiol 2018; 69:42-47. [PMID: 30401474 DOI: 10.1016/j.bjan.2018.07.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 07/15/2018] [Accepted: 07/18/2018] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Neutrophil to lymphocyte ratio is a simple, cost-effective and easily applicable inflammation indicator that is being used frequently in mortality, morbidity and prognosis studies in the recent years. We evaluated the relationship between neutrophil to lymphocyte ratio and postoperative pain in patients undergoing total hip arthroplasty and total knee arthroplasty. MATERIAL AND METHODS We included 101 patients who preferred spinal anesthesia and intravenous patient-controlled analgesia in accordance and divided them into two groups, total hip arthroplasty and total knee arthroplasty. We recorded demographic information, duration of operation, length of hospital stay, analgesics consumption, neutrophil to lymphocyte ratio results and postoperative pain using Visual Analog Scale. RESULTS The morphine consumption of the patients was as follows in group total hip arthroplasty and total knee arthroplasty: at the 4th hour: 7.38mg, 7.80mg; 8th hour: 12.19mg, 13.29mg; 12th hour: 16.94mg, 19.18mg; 24th hour: 25.97mg, 27.98mg; 48th hour: 36.38mg, 39.59mg. The Visual Analog Scale scores of the patients was as follows in group total hip arthroplasty and total knee arthroplasty: at the 4th hour: 4.10, 4.51; 8th hour: 3.02, 3.43; 12th hour: 2.29, 2.55; 24th hour: 1.90, 1.87; 48th hour: 1.08, 1.13. In group total hip arthroplasty, we found a statistically significant association between postoperative neutrophil to lymphocyte ratio and the Visual Analog Scale values on the 48th hour in a positive direction (r=0.311; P=0.031; P<0.05). CONCLUSION Neutrophil to lymphocyte ratio can be accepted as a relatively objective method for the diagnosis of postoperative pain.
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Affiliation(s)
- Nur Canbolat
- Istanbul University, Istanbul Medical Faculty, Department of Anesthesiology, Istanbul, Turquia.
| | - Mehmet Ilke Buget
- Istanbul University, Istanbul Medical Faculty, Department of Anesthesiology, Istanbul, Turquia
| | - Nukhet Sivrikoz
- Istanbul University, Istanbul Medical Faculty, Department of Anesthesiology, Istanbul, Turquia
| | - Demet Altun
- Istanbul University, Istanbul Medical Faculty, Department of Anesthesiology, Istanbul, Turquia
| | - Suleyman Kucukay
- Istanbul University, Istanbul Medical Faculty, Department of Anesthesiology, Istanbul, Turquia
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84
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Khadge S, Thiele GM, Sharp JG, McGuire TR, Klassen LW, Black PN, DiRusso CC, Cook L, Talmadge JE. Long-chain omega-3 polyunsaturated fatty acids decrease mammary tumor growth, multiorgan metastasis and enhance survival. Clin Exp Metastasis 2018; 35:797-818. [PMID: 30327985 DOI: 10.1007/s10585-018-9941-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 10/04/2018] [Indexed: 02/07/2023]
Abstract
Epidemiological studies show a reduced risk of breast cancer (BC) in women consuming high levels of long-chain (LC) omega-3 (ω-3) fatty acids (FAs) compared with women who consumed low levels. However, the regulatory and mechanistic roles of dietary ω-6 and LC-ω-3 FAs on tumor progression, metastasis and survival are poorly understood. Female BALB/c mice (10-week old) were pair-fed with a diet containing ω-3 or an isocaloric, isolipidic ω-6 diet for 16 weeks prior to the orthotopic implantation of 4T1 mammary tumor cells. Major outcomes studied included: mammary tumor growth, survival analysis, and metastases analyses in multiple organs including pulmonary, hepatic, bone, cardiac, renal, ovarian, and contralateral MG (CMG). The dietary regulation of the tumor microenvironment was evaluated in mice autopsied on day-35 post tumor injection. In mice fed the ω-3 containing diet, there was a significant delay in tumor initiation and prolonged survival relative to the ω-6 diet-fed group. The tumor size on day 35 post tumor injection in the ω-3 group was 50% smaller and the frequencies of pulmonary and bone metastases were significantly lower relative to the ω-6 group. Similarly, the incidence/frequencies and/or size of cardiac, renal, ovarian metastases were significantly lower in mice fed the ω-3 diet. The analyses of the tumor microenvironment showed that tumors in the ω-3 group had significantly lower numbers of proliferating tumor cells (Ki67+)/high power field (HPF), and higher numbers of apoptotic tumor cells (TUNEL+)/HPF, lower neo-vascularization (CD31+ vessels/HPF), infiltration by neutrophil elastase+ cells, and macrophages (F4/80+) relative to the tumors from the ω-6 group. Further, in tumors from the ω-3 diet-fed mice, T-cell infiltration was 102% higher resulting in a neutrophil to T-lymphocyte ratio (NLR) that was 76% lower (p < 0.05). Direct correlations were observed between NLR with tumor size and T-cell infiltration with the number of apoptotic tumor cells. qRT-PCR analysis revealed that tumor IL10 mRNA levels were significantly higher (six-fold) in the tumors from mice fed the ω-3 diet and inversely correlated with the tumor size. Our data suggest that dietary LC-ω-3FAs modulates the mammary tumor microenvironment slowing tumor growth, and reducing metastases to both common and less preferential organs resulting in prolonged survival. The surrogate analyses undertaken support a mechanism of action by dietary LC-ω-3FAs that includes, but is not limited to decreased infiltration by myeloid cells (neutrophils and macrophages), an increase in CD3+ lymphocyte infiltration and IL10 associated anti-inflammatory activity.
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Affiliation(s)
- Saraswoti Khadge
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, 68198-6495, USA
| | - Geoffrey M Thiele
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, 68198-6495, USA.,Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, 68198-6495, USA.,Veteran Affairs Nebraska-Western Iowa Health Care System, Omaha, NE, USA
| | - John Graham Sharp
- Department of Genetics, Cell Biology and Anatomy, University of Nebraska Medical Center, Omaha, NE, USA
| | - Timothy R McGuire
- Department of Pharmacy Practice, University of Nebraska Medical Center, Omaha, NE, USA
| | - Lynell W Klassen
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, 68198-6495, USA.,Veteran Affairs Nebraska-Western Iowa Health Care System, Omaha, NE, USA
| | - Paul N Black
- Department of Biochemistry, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Concetta C DiRusso
- Department of Biochemistry, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Leah Cook
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, 68198-6495, USA
| | - James E Talmadge
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, 68198-6495, USA. .,Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, 68198-6495, USA.
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85
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Ranasinghe SL, Boyle GM, Fischer K, Potriquet J, Mulvenna JP, McManus DP. Kunitz type protease inhibitor EgKI-1 from the canine tapeworm Echinococcus granulosus as a promising therapeutic against breast cancer. PLoS One 2018; 13:e0200433. [PMID: 30169534 PMCID: PMC6118354 DOI: 10.1371/journal.pone.0200433] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 08/06/2018] [Indexed: 12/21/2022] Open
Abstract
EgKI-1, a member of the Kunitz type protease inhibitor family, is highly expressed by the oncosphere of the canine tapeworm Echinococcus granulosus, the stage that is infectious to humans and ungulates, giving rise to a hydatid cyst localized to the liver and other organs. Larval protoscoleces, which develop within the hydatid cyst, have been shown to possess anti-cancer properties, although the precise molecules involved have not been identified. We show that recombinant EgKI-1 inhibits the growth and migration of a range of human cancers including breast, melanoma and cervical cancer cell lines in a dose-dependent manner in vitro without affecting normal cell growth. Furthermore, EgKI-1 treatment arrested the cancer cell growth by disrupting the cell cycle and induced apoptosis of cancer cells in vitro. An in vivo model of triple negative breast cancer (MDA-MB-231) in BALB/c nude mice showed significant tumor growth reduction in EgKI-1-treated mice compared with controls. These findings indicate that EgKI-1 shows promise for future development as an anti-cancer therapeutic.
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Affiliation(s)
- Shiwanthi L. Ranasinghe
- Molecular Parasitology Laboratory, Immunology Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
- * E-mail:
| | - Glen M. Boyle
- Cancer Drug Mechanisms Group, Cell & Molecular Biology Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Katja Fischer
- Scabies Group, Cell & Molecular Biology Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Jeremy Potriquet
- Australian Institute of Tropical Health & Medicine, James Cook University, Cairns, Australia
| | - Jason P. Mulvenna
- Biomarkers and Biology of Infection Related Cancers Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Donald P. McManus
- Molecular Parasitology Laboratory, Immunology Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
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86
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Fang Q, Tong YW, Wang G, Zhang N, Chen WG, Li YF, Shen KW, Wu BW, Chen XS. Neutrophil-to-lymphocyte ratio, obesity, and breast cancer risk in Chinese population. Medicine (Baltimore) 2018; 97:e11692. [PMID: 30045325 PMCID: PMC6078664 DOI: 10.1097/md.0000000000011692] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Breast cancer (BC), obesity, and metabolic syndrome (MetS) shared a common mechanism of dysregulated metabolism and inflammatory response in disease initiation. Neutrophil-to-lymphocyte ratio (NLR) is associated with adverse survival of BC patients. The aim of this study is to identify risk effect between NLR and BC in Chinese population with or without obesity and MetS. BC and age-matched breast benign disease (BBD) patients were retrospectively analyzed from Comprehensive Breast Health Center, Shanghai Ruijin Hospital. MetS was defined using AHA/NHLBI criteria. Individuals were classified into very low (0-1.30), low (1.31-1.67), intermediate (1.68-2.20), and high (>2.20) NLR subsets by each NLR quartile. In all, 1540 BC and 1540 BBD patients were included. Univariate and multivariate analysis found that NLR (OR: 1.27, 95% CI: 1.16-1.39, P < .001) and obesity (OR: 1.19, 95% CI: 1.00-1.42, P = .046) but not MetS (P = .060) were significantly associated with increased BC risk. Intermediate or high NLR substantially increased BC risk compared to very low NLR group (OR: 1.57, 95% CI: 1.29-1.92, P < .001; OR: 1.84, 95% CI: 1.50-2.25, P < .001; respectively) in whole population. Subgroup analysis found that the impact of higher NLR on BC risk was more obvious in patients without obesity (intermediate NLR, OR: 1.72, 95% CI: 1.37-2.16, P < .001; high NLR, OR: 1.92, 95% CI: 1.53-2.41, P < .001) or without MetS (intermediate NLR, OR: 1.70, 95% CI: 1.35-2.14, P < .001; high NLR, OR: 1.98, 95% CI: 1.57-2.51, P < .001). Higher preoperative NLR was found in BC patients compared with BBD patients. Intermediate to high NLR level substantially increased BC risk, which was more relevant for those without obesity or MetS.
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Affiliation(s)
- Qiong Fang
- School of Nursing, Shanghai Jiao Tong University
- Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
| | - Yi-Wei Tong
- Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
| | - Gen Wang
- Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
| | - Nan Zhang
- Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei-Guo Chen
- Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
| | - Ya-Fen Li
- Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
| | - Kun-Wei Shen
- Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
| | - Bei-Wen Wu
- Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiao-Song Chen
- Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
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87
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Ding Y, Zhang S, Qiao J. Prognostic value of neutrophil-to-lymphocyte ratio in melanoma: Evidence from a PRISMA-compliant meta-analysis. Medicine (Baltimore) 2018; 97:e11446. [PMID: 30045267 PMCID: PMC6078713 DOI: 10.1097/md.0000000000011446] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND A number of studies have investigated the prognostic impact of the neutrophil-to-lymphocyte ratio (NLR) in patients with melanoma but the results were controversial. Therefore, we conducted a meta-analysis to explore the prognostic value of NLR in melanoma. METHODS The databases of PubMed, Embase, and Web of Science were thoroughly searched. Associations between NLR and overall survival (OS) and progression-free survival (PFS) were investigated by pooling hazard ratio (HR) and 95% confidence interval (CI). RESULTS A total of 12 studies comprising 3207 patients were finally included in the meta-analysis. The results showed that a high NLR was associated with poor OS (HR = 2.23, 95% CI = 1.64-3.04, P < .001, random-effects model) and PFS (HR = 2.19, 95% CI = 1.78-2.69, P < .001, fixed-effects model). Subgroup analyses demonstrated that NLR was still associated with poor OS and PFS for patients in Western countries who were treated with ipilimumab. No significant publication bias was found in this meta-analysis. CONCLUSION This meta-analysis demonstrated that a high NLR was predictive of poor OS and PFS in patients with melanoma.
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88
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Zhao Y, Xu P, Kang H, Lin S, Wang M, Yang P, Dai C, Liu X, Liu K, Zheng Y, Dai Z. Prognostic nutritional index as a prognostic biomarker for survival in digestive system carcinomas. Oncotarget 2018; 7:86573-86583. [PMID: 27888808 PMCID: PMC5349936 DOI: 10.18632/oncotarget.13472] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 11/08/2016] [Indexed: 12/17/2022] Open
Abstract
The prognostic nutritional index (PNI) has been reported to correlate with the prognosis in patients with various malignancies. We performed a meta-analysis to determine the predictive potential of PNI in digestive system cancers. Twenty-three studies with a total of 7,384 patients suffering from digestive system carcinomas were involved in this meta-analysis. A lower PNI was significantly associated with the shorter overall survival (OS) [Hazard Ratio (HR) 1.83, 95% Confidence Interval (CI) 1.62–2.07], the poorer disease-free survival (DFS) (HR 1.85, 95% CI 1.19–2.89), and the higher rate of post-operative complications (HR 2.31, 95% CI 1.63–3.28). In conclusion, PNI was allowed to function as an efficient indicator for the prognosis of patients with digestive system carcinomas.
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Affiliation(s)
- Yang Zhao
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, PR China
| | - Peng Xu
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, PR China
| | - Huafeng Kang
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, PR China
| | - Shuai Lin
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, PR China
| | - Meng Wang
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, PR China
| | - Pengtao Yang
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, PR China
| | - Cong Dai
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, PR China
| | - Xinghan Liu
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, PR China
| | - Kang Liu
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, PR China
| | - Yi Zheng
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, PR China
| | - Zhijun Dai
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, PR China
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89
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Mittal S, Brown NJ, Holen I. The breast tumor microenvironment: role in cancer development, progression and response to therapy. Expert Rev Mol Diagn 2018; 18:227-243. [DOI: 10.1080/14737159.2018.1439382] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Suruchi Mittal
- Department of Oncology and Metabolism, University of Sheffield, UK
| | - Nicola J. Brown
- Department of Oncology and Metabolism, University of Sheffield, UK
| | - Ingunn Holen
- Department of Oncology and Metabolism, University of Sheffield, UK
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90
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Abstract
Cancer-associated cachexia is a disorder characterized by loss of body weight with specific losses of skeletal muscle and adipose tissue. Cachexia is driven by a variable combination of reduced food intake and metabolic changes, including elevated energy expenditure, excess catabolism and inflammation. Cachexia is highly associated with cancers of the pancreas, oesophagus, stomach, lung, liver and bowel; this group of malignancies is responsible for half of all cancer deaths worldwide. Cachexia involves diverse mediators derived from the cancer cells and cells within the tumour microenvironment, including inflammatory and immune cells. In addition, endocrine, metabolic and central nervous system perturbations combine with these mediators to elicit catabolic changes in skeletal and cardiac muscle and adipose tissue. At the tissue level, mechanisms include activation of inflammation, proteolysis, autophagy and lipolysis. Cachexia associates with a multitude of morbidities encompassing functional, metabolic and immune disorders as well as aggravated toxicity and complications of cancer therapy. Patients experience impaired quality of life, reduced physical, emotional and social well-being and increased use of healthcare resources. To date, no effective medical intervention completely reverses cachexia and there are no approved drug therapies. Adequate nutritional support remains a mainstay of cachexia therapy, whereas drugs that target overactivation of catabolic processes, cell injury and inflammation are currently under investigation.
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Affiliation(s)
- Vickie E Baracos
- Division of Palliative Care Medicine, Department of Oncology, University of Alberta, Cross Cancer Institute 11560 University Avenue, Edmonton, T6G 1Z2 Alberta, Canada
| | - Lisa Martin
- Department of Agricultural, Food & Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Murray Korc
- Section of Endocrinology, Departments of Medicine and Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Denis C Guttridge
- Department of Cancer Biology and Genetics, The Ohio State University, Columbus, Ohio, USA
| | - Kenneth C H Fearon
- Clinical and Surgical Sciences, School of Clinical Sciences and Community Health, Royal Infirmary, University of Edinburgh, Edinburgh, UK
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91
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Simpson G, Saunders R, Wilson J, Magee C. The role of the neutrophil:lymphocyte ratio (NLR) and the CRP:albumin ratio (CAR) in predicting mortality following emergency laparotomy in the over 80 age group. Eur J Trauma Emerg Surg 2017; 44:877-882. [PMID: 29134253 DOI: 10.1007/s00068-017-0869-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 10/30/2017] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Emergency laparotomy in the elderly is an increasingly common procedure which carries high morbidity and mortality. Risk prediction tools, although imperfect, can help guide management decisions. Novel markers of surgical outcomes may contribute to these scoring systems. The neutrophil:lymphocyte ratio (NLR) and CRP:albumin ratio (CAR) have been associated with outcomes in malignancy and sepsis. We assessed the use of ratio NLR and CAR as prognostic indicators in patients over the age of 80 undergoing emergency laparotomy. METHODS A retrospective analysis of all patients over the age of 80 who underwent emergency laparotomy during a 3 year period was conducted. Pre and post-operative NLR and CAR were assessed in relation to outcome measures including inpatient, 30-day and 90-day mortality. Statistical analysis was conducted with Mann-Whitney U, receiver operating characteristics, Spearmans rank correlation coefficient and chi-squared tests. RESULTS One hundred and thirty-six patients over the age of 80 underwent emergency laparotomy. Median age was 84 years (range 80-96 years). Overall inpatient mortality was 19.2%. Pre-operative and post-operative NLR and CAR were significantly raised in patients with sepsis v no sepsis (p < 0.05). Pre-operative NLR was significantly associated with inpatient (p = 0.046), 30-day (p = 0.02) and 90-day mortality (p = 0.01) in patients with visceral perforation. A pre-operative NLR value of greater than 8 was associated with significantly increased mortality (p = 0.016, AUC:0.78). CAR was not associated with mortality. CONCLUSION Pre-operative NLR is associated with mortality in patients with visceral perforation undergoing emergency laparotomy. NLR > 8 is associated with a poorer outcome in this group of patients. CAR was not associated with mortality in over-80s undergoing emergency laparotomy.
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Affiliation(s)
- G Simpson
- Division of GI Surgery, Wirral University Teaching Hospitals, Wirral, UK
| | - R Saunders
- University of Liverpool Division of Oncology and Surgery, Liverpool, UK
| | - J Wilson
- Division of GI Surgery, Wirral University Teaching Hospitals, Wirral, UK
| | - C Magee
- Division of GI Surgery, Wirral University Teaching Hospitals, Wirral, UK.
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92
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Komura N, Mabuchi S, Yokoi E, Kozasa K, Kuroda H, Sasano T, Matsumoto Y, Kimura T. Comparison of clinical utility between neutrophil count and neutrophil–lymphocyte ratio in patients with ovarian cancer: a single institutional experience and a literature review. Int J Clin Oncol 2017; 23:104-113. [DOI: 10.1007/s10147-017-1180-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 08/08/2017] [Indexed: 12/15/2022]
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93
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Hwang KT, Chung JK, Roh EY, Kim J, Oh S, Kim YA, Rhu J, Kim S. Prognostic Influence of Preoperative Fibrinogen to Albumin Ratio for Breast Cancer. J Breast Cancer 2017; 20:254-263. [PMID: 28970851 PMCID: PMC5620440 DOI: 10.4048/jbc.2017.20.3.254] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 06/14/2017] [Indexed: 12/20/2022] Open
Abstract
PURPOSE Elevated serum concentration of fibrinogen and decreased serum concentration of albumin have been reported to be markers of elevated systemic inflammation. We attempted to investigate the prognostic influence of preoperative fibrinogen to albumin ratio (FAR) for breast cancer. METHODS Data from 793 consecutive primary breast cancer patients were retrospectively analyzed. Serum levels of fibrinogen and albumin were tested before curative surgery. Subjects were grouped into two groups according to the cutoff value determined by performing the receiver operating characteristic curve analysis: the high FAR group (FAR>7.1) and the low FAR group (FAR≤7.1). Overall survival was assessed using the Kaplan-Meier estimator. Independent prognostic significance was analyzed using the Cox proportional hazards model. RESULTS The high FAR group had a worse prognosis compared to the low FAR group (log-rank test, p<0.001). The prognostic effect of FAR was more significant than that of single markers such as fibrinogen (log-rank test, p=0.001) or albumin (log-rank test, p=0.001). The prognostic effect of FAR was prominent in the stage II/III subgroup (log-rank test, p<0.001) and luminal A-like subtype (log-rank test, p<0.001). FAR was identified as a significant independent factor on both univariate (hazard ratio [HR], 2.722; 95% confidence interval [CI], 1.659-4.468; p<0.001) and multivariate analysis (HR, 2.622; 95% CI, 1.455-4.724; p=0.001). CONCLUSION Preoperative FAR was a strong independent prognostic factor in breast cancer. Its prognostic effect was more prominent in the stage II/III subgroup and in the luminal A-like subtype. Therefore, preoperative FAR can be utilized as a useful prognosticator for breast cancer patients. Further studies are needed to validate its applications in clinical settings.
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Affiliation(s)
- Ki-Tae Hwang
- Department of Surgery, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Jung Kee Chung
- Department of Surgery, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Eun Youn Roh
- Department of Laboratory Medicine, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Jongjin Kim
- Department of Surgery, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Sohee Oh
- Department of Biostatistics, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Young A Kim
- Department of Pathology, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Jiyoung Rhu
- Department of Surgery, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Suzy Kim
- Department of Radiation Oncology, Seoul National University Boramae Medical Center, Seoul, Korea
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94
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Mouchemore KA, Anderson RL, Hamilton JA. Neutrophils, G-CSF and their contribution to breast cancer metastasis. FEBS J 2017; 285:665-679. [PMID: 28834401 DOI: 10.1111/febs.14206] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 08/03/2017] [Accepted: 08/18/2017] [Indexed: 12/15/2022]
Abstract
Evidence is mounting for a role for neutrophils in breast cancer progression to metastasis. However, the role of G-CSF in neutrophil biology in a cancer setting remains to be defined. Herein we discuss the most recent clinical and experimental evidence for neutrophils and G-CSF in the promotion of metastasis, demonstrating a potential mechanistic link between them. Understanding this link is imperative both for the development of diagnostic tests and for therapies targeting neutrophils to improve the treatment of breast cancer patients with or at risk of developing metastatic disease. As a high neutrophil-to-lymphocyte ratio in patients predicts poor outcome, while mild neutropenia predicts an improved outcome, we urge caution in the use of G-CSF in neutrophil recovery following chemotherapy as there is increasing evidence in preclinical models that G-CSF can promote metastasis.
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Affiliation(s)
- Kellie A Mouchemore
- Department of Biochemistry and Molecular Biology, Monash University, Clayton, Victoria, Australia.,Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
| | - Robin L Anderson
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia.,Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria, Australia.,La Trobe University School of Cancer Medicine, Bundoora, Victoria, Australia
| | - John A Hamilton
- Arthritis and Inflammation Research Centre, Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
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Saraiva DP, Guadalupe Cabral M, Jacinto A, Braga S. How many diseases is triple negative breast cancer: the protagonism of the immune microenvironment. ESMO Open 2017; 2:e000208. [PMID: 29018573 PMCID: PMC5604720 DOI: 10.1136/esmoopen-2017-000208] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 07/21/2017] [Accepted: 07/24/2017] [Indexed: 12/22/2022] Open
Abstract
Triple negative breast cancer (TNBC) is a type of breast cancer (BC) that does not express the oestrogen and the progesterone receptors and the human epidermal growth factor receptor type 2 (HER2). Since there are no positive markers to reliably classify TNBC, these tumours are not yet treated with targeted therapies. Perhaps for this reason they are the most aggressive form of breast carcinomas. However, the clinical observation that these patients do not carry a uniformly dismal prognosis, coupled with data coming from pathology and epidemiology, suggests that this negative definition is not capturing a single clinical entity, but several. We critically evaluate this evidence in this paper, reviewing clinical and epidemiological data and new studies that aim to subclassify TNBC. Moreover, evidence on the role of tumour infiltrating lymphocytes (TILs) on TNBC progression, response to chemotherapy and patient outcome have been published. The heterogeneity, observed even at TILs level, highlights the idea that TNBC is much more than a single disease with a unique treatment. The exploration of the immune environment present at the tumour site could indeed help in answering the question 'How many diseases is TNBC' and will help to define prognosis and eventually develop new therapies, by stimulating the immune effector cells or by inhibiting immunological repressor molecules. In this review, we focus on the prospect of the patient's diverse immune signatures within the tumour as potential biomarkers and how they could be modulated to fight the disease.
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Affiliation(s)
- Diana P Saraiva
- CEDOC, Nova Medical School, Faculdade de Ciências Médicas da Universidade Nova de Lisboa, Lisbon, Portugal
| | - M Guadalupe Cabral
- CEDOC, Nova Medical School, Faculdade de Ciências Médicas da Universidade Nova de Lisboa, Lisbon, Portugal
| | - António Jacinto
- CEDOC, Nova Medical School, Faculdade de Ciências Médicas da Universidade Nova de Lisboa, Lisbon, Portugal
| | - Sofia Braga
- CEDOC, Nova Medical School, Faculdade de Ciências Médicas da Universidade Nova de Lisboa, Lisbon, Portugal
- Instituto CUF de Oncologia, Lisbon, Portugal
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96
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Prognostic significance of neutrophil to lymphocyte ratio in ovarian cancer: evidence from 4,910 patients. Oncotarget 2017; 8:68938-68949. [PMID: 28978169 PMCID: PMC5620309 DOI: 10.18632/oncotarget.20196] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 07/12/2017] [Indexed: 12/12/2022] Open
Abstract
Increasing evidence indicates that elevated neutrophil to lymphocyte ratio (NLR) are related with poor prognosis in various types of tumors. However, the prognostic role of NLR in patients with ovarian cancer (OC) remains controversial. Thus, the current meta-analysis aimed to investigate the prognostic role of NLR in patients with OC. A total of 16 studies with 4,910 patients were included. By pooling hazard ratios (HRs) with 95% confidence intervals (CIs) and odds ratios (ORs) with 95% CIs from each study. The results demonstrated that elevated pretreatment NLR was significantly related to poor OS (HR: 1.50, 95% CI: 1.27-1.77) and PFS (HR: 1.53, 95% CI: 1.28-1.84) in patients with OC. Subgroup analyses was divided by ethnicity, sample size, histologic types, cut-off value of NLR, analysis method and NOS score, but the results did not showed any significant change the main results. This meta-analysis revealed that elevated pretreatment NLR might be a predicative factor of poor prognosis in OC patients.
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97
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Neutrophil-to-Lymphocyte Ratio Is a Potential Prognostic Biomarker in Patients with Ovarian Cancer: A Meta-Analysis. BIOMED RESEARCH INTERNATIONAL 2017; 2017:7943467. [PMID: 28815182 PMCID: PMC5549495 DOI: 10.1155/2017/7943467] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 05/22/2017] [Accepted: 06/08/2017] [Indexed: 02/06/2023]
Abstract
Background and Aims Plenty of studies were conducted to explore the prognostic significance of neutrophil-to-lymphocyte ratio (NLR) in ovarian cancer with contradictory results. This study aims to summarize the prognostic significance of NLR in patients with ovarian cancer. Methods A literature search in PubMed, Cochrane Library, and Embase was conducted. The endpoints were progression-free survival (PFS) and overall survival (OS). Results Eleven studies involving a total of 2,892 patients were identified. The results indicated that patients with high NLR had shorter PFS compared to patients with low NLR in ovarian cancer (HR = 1.55, 95% CI = 1.15–2.08, p = 0.004, and I2 = 61%). Similarly, high NLR was related to shorter OS (HR = 1.51, 95% CI = 1.03–2.23, p = 0.04, and I2 = 85%). Moreover, high NLR was significantly associated with shorter PFS when the NLR cut-off was less than 3.3 (p = 0.03) or when treatment is operation (p = 0.002). In addition, high NLR was distinctly related to worse OS in Asian people (p = 0.04) or operation (p = 0.04). Conclusion High NLR was associated with shorter PFS and shorter OS in ovarian cancer. NLR is potentially a promising prognostic biomarker in patients with ovarian cancer.
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98
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Yu Y, Qian L, Cui J. Value of neutrophil-to-lymphocyte ratio for predicting lung cancer prognosis: A meta-analysis of 7,219 patients. Mol Clin Oncol 2017; 7:498-506. [PMID: 28811903 DOI: 10.3892/mco.2017.1342] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 07/18/2017] [Indexed: 12/15/2022] Open
Abstract
Current evidence suggests that the neutrophil-to-lymphocyte ratio (NLR) may be a biomarker for poor prognosis in lung cancer, although this association remains controversial. Therefore, a meta-analysis was performed to evaluate the association between NLR and lung cancer outcome. A systematic literature search was performed through the PubMed, Embase and Cochrane Library databases (until July 30, 2016), to identify studies evaluating the association between NLR and overall survival (OS) and/or progression-free survival (PFS) among patients with lung cancer. Based on the results of this search, data from 18 studies involving 7,219 patients with lung cancer were evaluated. The pooled hazard ratio (HR) suggested that elevated pretreatment NLR predicted poor OS [HR=1.46, 95% confidence interval (CI): 1.30-1.64] and poor PFS (HR=1.42, 95% CI: 1.15-1.75) among patients with lung cancer. Subgroup analysis revealed that the prognostic value of NLR for predicting poor OS increased among patients who underwent surgery (HR=1.50, 95% CI: 1.21-1.84) or patients with early-stage disease (HR=1.64, 95% CI: 1.37-1.97). An NLR cut-off value of ≥4 significantly predicted poor OS (HR=1.56, 95% CI: 1.31-1.85) and PFS (HR=1.54, 95% CI: 1.13-1.82), particularly in the cases of small-cell lung cancer. Thus, the results of the present meta-analysis suggested that an elevated pretreatment NLR (e.g., ≥4) may be considered as a biomarker for poor prognosis in patients with lung cancer.
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Affiliation(s)
- Yu Yu
- Cancer Center, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Lei Qian
- Cancer Center, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Jiuwei Cui
- Cancer Center, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
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99
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Ljungström L, Pernestig AK, Jacobsson G, Andersson R, Usener B, Tilevik D. Diagnostic accuracy of procalcitonin, neutrophil-lymphocyte count ratio, C-reactive protein, and lactate in patients with suspected bacterial sepsis. PLoS One 2017; 12:e0181704. [PMID: 28727802 PMCID: PMC5519182 DOI: 10.1371/journal.pone.0181704] [Citation(s) in RCA: 108] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 07/04/2017] [Indexed: 02/07/2023] Open
Abstract
Background Early recognition is a key factor to achieve improved outcomes for septic patients. Combinations of biomarkers, as opposed to single ones, may improve timely diagnosis and survival. We investigated the performance characteristics of sepsis biomarkers, alone and in combination, for diagnosis of verified bacterial sepsis using Sepsis-2 and Sepsis-3 criteria, respectively. Methods Procalcitonin (PCT), neutrophil-lymphocyte count ratio (NLCR), C-reactive protein (CRP), and lactate were determined in a total of 1,572 episodes of adult patients admitted to the emergency department on suspicion of sepsis. All sampling were performed prior to antibiotic administration. Discriminant analysis was used to construct two composite biomarkers consisting of linear combinations of the investigated biomarkers, one including three selected biomarkers (i.e., NLCR, CRP, and lactate), and another including all four (i.e., PCT, NLCR, CRP, and lactate). The diagnostic performances of the composite biomarkers as well as the individual biomarkers were compared using the area under the receiver operating characteristic curve (AUC). Results For diagnosis of bacterial sepsis based on Sepsis-3 criteria, the AUC for PCT (0.68; 95% CI 0.65–0.71) was comparable to the AUCs for the both composite biomarkers. Using the Sepsis-2 criteria for bacterial sepsis diagnosis, the AUC for the NLCR (0.68; 95% CI 0.65–0.71) but not for the other single biomarkers, was equal to the AUCs for the both composite biomarkers. For diagnosis of severe bacterial sepsis or septic shock based on the Sepsis-2 criteria, the AUCs for both composite biomarkers were significantly greater than those of the single biomarkers (0.85; 95% CI 0.82–0.88 for the composite three-biomarker, and 0.86; 95% CI 0.83–0.89 for the composite four-biomarker). Conclusions Combinations of biomarkers can improve the diagnosis of verified bacterial sepsis in the most critically ill patients, but in less severe septic conditions either the NLCR or PCT alone exhibit equivalent performance.
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Affiliation(s)
- Lars Ljungström
- Department of Infectious Diseases, Skaraborg Hospital, Skövde, Sweden
| | - Anna-Karin Pernestig
- Systems Biology Research Centre, School of Bioscience, University of Skövde, Skövde, Sweden
| | - Gunnar Jacobsson
- Department of Infectious Diseases, Skaraborg Hospital, Skövde, Sweden
- CARe–Center for Antibiotic Resistance Research, Gothenburg University, Gothenburg, Sweden
| | - Rune Andersson
- CARe–Center for Antibiotic Resistance Research, Gothenburg University, Gothenburg, Sweden
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, Gothenburg University and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Barbara Usener
- Department of Clinical Chemistry, Unilabs AB, Skövde, Sweden
| | - Diana Tilevik
- Systems Biology Research Centre, School of Bioscience, University of Skövde, Skövde, Sweden
- * E-mail:
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100
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Wariss BR, de Souza Abrahão K, de Aguiar SS, Bergmann A, Thuler LCS. Effectiveness of four inflammatory markers in predicting prognosis in 2374 women with breast cancer. Maturitas 2017; 101:51-56. [PMID: 28539169 DOI: 10.1016/j.maturitas.2017.04.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 04/18/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To analyze the association between four biomarkers and overall survival in patients with breast cancer (BC). METHODOLOGY This cohort study had a sample of 2374 women over the age of 18, diagnosed and treated in a single reference center for BC in Brazil, during the year 2008-2009. The following pretreatment indices were analyzed: neutrophil-lymphocyte ratio (NLR), a derived neutrophil-lymphocyte ratio (dNLR), absolute neutrophil count (ANC) and platelet-lymphocyte ratio (PLR). A descriptive analysis was performed using median (range) and absolute and relative frequency as categorical variables. Exploratory survival evaluation was performed using the Kaplan-Meier method and the log-rank test for comparison between survival curves, with a statistical significance level of 5%. The variables with p<0.20 were selected for inclusion in a multivariate Cox regression model, considering as statistically significant p<0.05. RESULTS After adjusting for clinical variables, the biomarkers associated with worse overall survival were NLR >5 (HR=1.66 95%CI 1.08-2.55; p=0.021) and PLR >300 (HR=1.82 95%CI 1.10-2.99; p=0.019). When stratified by molecular subtype, the independent markers related to death were PLR >300 for triple negative (HR 3.27 95%CI 1.38-7.76; p=0.007); NLR >5 (HR 2.47 95%CI 1.16-5.28; p=0.019), ANC >7500 (HR 1.84 95%CI 1.17-2.90; p=0.008) and dNLR >3 (HR 2.45 95%CI 1.29-4.66; p=0.006) for luminal. CONCLUSION NLR and PLR are independent markers of prognosis in BC. Further studies are needed in patients with overexpression of HER 2.
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Affiliation(s)
| | | | | | - Anke Bergmann
- Brazilian National Cancer Institute (INCA), Rio de Janeiro, Brazil
| | - Luiz Claudio Santos Thuler
- Brazilian National Cancer Institute (INCA), Rio de Janeiro, Brazil; Federal University of Rio de Janeiro State (UNIRIO), Rio de Janeiro, Brazil.
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