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Huangfu Y, Chang F, Zhang F, Jiao Y, Han L. Monocytes-to-lymphocytes ratio increases the prognostic value of circulating tumor cells in non-small cell lung cancer: a prospective study. Transl Cancer Res 2024; 13:3589-3598. [PMID: 39145074 PMCID: PMC11319958 DOI: 10.21037/tcr-24-10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 05/29/2024] [Indexed: 08/16/2024]
Abstract
Background Circulating tumor cells (CTCs) has shown important prognostic value in non-small cell lung cancer (NSCLC). However, the present low sensitivity of CTC capture technology restricts their clinical application. This study aims to explore the feasibility of combining the peripheral blood cell (PBC)-derived inflammation-based score with CTCs to increase the prognostic value of CTCs in NSCLC. Methods Sixty volunteers diagnosed with NSCLC were recruited. CTC count and six inflammation-based scores were examined and the association with progression-free survival (PFS) and overall survival (OS) was explored. The changes in the CTC counts before and after the immunotherapy were observed. Results Multivariate analysis showed that CTCs >7 [hazard ratio (HR) =9.07; 95% confidence interval (CI): 3.68-22.37, P<0.001] and monocytes-to-lymphocytes ratio (MLR) > 0.2 (HR =3.07; 95% CI: 1.21-7.84; P=0.01) were associated with shorter OS and PFS in patients with NSCLC. Patients with CTCs >7 and MLR >0.2 had 12.30 times increased risk of death (P<0.001) and 6.10 times increased risk of disease progression (P=0.002) compared with those with CTCs ≤7 and MLR ≤0.2. Decreased CTC counts after immunotherapy were closely related to disease control (r=0.535, P=0.01). Conclusions CTCs and MLR are both independent risk factors for prognosis in patients with NSCLC. The combination of CTCs with MLR significantly increased the prognostic value of CTCs, which would contribute to stratification of NSCLC patients and providing precise treatment. Dynamic monitoring of CTCs efficiently shows the immunotherapy response in NSCLC.
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Affiliation(s)
- Yun Huangfu
- Department of Clinical Medicine, Henan Medical College, Zhengzhou, China
| | - Fangfang Chang
- Department of Clinical Medicine, Henan Medical College, Zhengzhou, China
| | - Fengjuan Zhang
- Department of Clinical Medicine, Henan Medical College, Zhengzhou, China
| | - Yanru Jiao
- Department of Clinical Medicine, Henan Medical College, Zhengzhou, China
| | - Lei Han
- Eye Institute, Henan Provincial People’s Hospital, Zhengzhou, China
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Lehrich BM, Zhang J, Monga SP, Dhanasekaran R. Battle of the biopsies: Role of tissue and liquid biopsy in hepatocellular carcinoma. J Hepatol 2024; 80:515-530. [PMID: 38104635 PMCID: PMC10923008 DOI: 10.1016/j.jhep.2023.11.030] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 10/27/2023] [Accepted: 11/27/2023] [Indexed: 12/19/2023]
Abstract
The diagnosis and management of hepatocellular carcinoma (HCC) have improved significantly in recent years. With the introduction of immunotherapy-based combination therapy, there has been a notable expansion in treatment options for patients with unresectable HCC. Simultaneously, innovative molecular tests for early detection and management of HCC are emerging. This progress prompts a key question: as liquid biopsy techniques rise in prominence, will they replace traditional tissue biopsies, or will both techniques remain relevant? Given the ongoing challenges of early HCC detection, including issues with ultrasound sensitivity, accessibility, and patient adherence to surveillance, the evolution of diagnostic techniques is more relevant than ever. Furthermore, the accurate stratification of HCC is limited by the absence of reliable biomarkers which can predict response to therapies. While the advantages of molecular diagnostics are evident, their potential has not yet been fully harnessed, largely because tissue biopsies are not routinely performed for HCC. Liquid biopsies, analysing components such as circulating tumour cells, DNA, and extracellular vesicles, provide a promising alternative, though they are still associated with challenges related to sensitivity, cost, and accessibility. The early results from multi-analyte liquid biopsy panels are promising and suggest they could play a transformative role in HCC detection and management; however, comprehensive clinical validation is still ongoing. In this review, we explore the challenges and potential of both tissue and liquid biopsy, highlighting that these diagnostic methods, while distinct in their approaches, are set to jointly reshape the future of HCC management.
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Affiliation(s)
- Brandon M Lehrich
- Department of Pathology and Pittsburgh Liver Institute, University of Pittsburgh, School of Medicine and University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Josephine Zhang
- Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University, Staford, CA, 94303, USA
| | - Satdarshan P Monga
- Department of Pathology and Pittsburgh Liver Institute, University of Pittsburgh, School of Medicine and University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
| | - Renumathy Dhanasekaran
- Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University, Staford, CA, 94303, USA.
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Zhang H, Sheng S, Qiao W, Han M, Jin R. A novel nomogram to predict the overall survival of early-stage hepatocellular carcinoma patients following ablation therapy. Front Oncol 2024; 14:1340286. [PMID: 38384805 PMCID: PMC10880021 DOI: 10.3389/fonc.2024.1340286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 01/22/2024] [Indexed: 02/23/2024] Open
Abstract
Introduction This study aimed to assess factors affecting the prognosis of early-stage hepatocellular carcinoma (HCC) patients undergoing ablation therapy and create a nomogram for predicting their 3-, 5-, and 8-year overall survival (OS). Methods The research included 881 early-stage HCC patients treated at Beijing You'an Hospital, affiliated with Capital Medical University, from 2014 to 2022. A nomogram was developed using independent prognostic factors identified by Lasso and multivariate Cox regression analyses. Its predictive performance was evaluated with concordance index (C-index), receiver operating characteristic curve (ROC), calibration curve, and decision curve analysis (DCA). Results The study identified age, tumor number, tumor size, gamma-glutamyl transpeptidase (GGT), international normalized ratio (INR), and prealbumin (Palb) as independent prognostic risk factors. The nomogram achieved C-indices of 0.683 (primary cohort) and 0.652 (validation cohort), with Area Under the Curve (AUC) values of 0.776, 0.779, and 0.822 (3-year, 5-year, and 8-year OS, primary cohort) and 0.658, 0.724, and 0.792 (validation cohort), indicating that the nomogram possessed strong discriminative ability. Calibration and DCA curves further confirmed the nomogram's predictive accuracy and clinical utility. The nomogram can effectively stratify patients into low-, intermediate-, and high-risk groups, particularly identifying high-risk patients. Conclusions The established nomogram in our study can provide precise prognostic information for HCC patients following ablation treatment and enable physicians to accurately identify high-risk individuals and facilitate timely intervention.
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Affiliation(s)
- Honghai Zhang
- Interventional Therapy Center for Oncology, Beijing You’an Hospital, Capital Medical University, Beijing, China
| | - Shugui Sheng
- Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Infectious Diseases, Beijing, China
- National Center for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Wenying Qiao
- Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Infectious Diseases, Beijing, China
- National Center for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
- Changping Laboratory, Beijing, China
| | - Ming Han
- Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Infectious Diseases, Beijing, China
- National Center for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Ronghua Jin
- Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Infectious Diseases, Beijing, China
- National Center for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
- Changping Laboratory, Beijing, China
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