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Făgărășan V, Bințințan V, Seicean R, Caziuc A, AIlioaie R, Făgărășan G, Ilie-Ene A, Dindelegan G, Căinap C. Lymphocyte-to-monocyte, platelet-to-albumin and platelet-to-lymphocyte ratios as prognostic biomarkers for neoadjuvant treatment response in rectal cancer patients. Surg Oncol 2024; 56:102126. [PMID: 39213835 DOI: 10.1016/j.suronc.2024.102126] [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: 06/09/2024] [Revised: 08/24/2024] [Accepted: 08/25/2024] [Indexed: 09/04/2024]
Abstract
INTRODUCTION Systemic inflammatory response (SIR) indicators are an emerging category of serum biomarkers with significant potential as prognostic and predictive factors in various types of cancers The primary focus of our study was to determine the prognostic value of the lymphocyte-to-monocyte ratio (LMR), platelet-to-albumin ratio (PLR) and platelet-to-albumin ratio (PAR) in evaluating the response to neoadjuvant treatment for patients with rectal cancer. MATERIALS AND METHODS We included 99 consecutive patients with rectal cancer which were admitted for surgery in our institution after completing a standard neoadjuvant radio-chemotherapy regimen. Several hematologic parameters, including LMR, PAR and PLR, were calculated by collecting and analyzing blood samples preoperatively. Cases were divided into groups using ROC curve analysis to determine optimal cutoff values for each of the investigated parameters. Treatment response was assessed through histopathological analysis of the resected specimens. RESULTS PLR values over 215.2 were correlated with the presence of lymph node metastasis. A similar correlation was observed between PAR values over 41.89 and lymph node positivity. A significant correlation was observed between the presence of tumor budding on histopathological analysis and high-PAR values. A statistically significant correlation between a high PLR and a good response to neoadjuvant treatment was determined. CONCLUSIONS High PLR values may be associated with a more favorable treatment response to neoadjuvant radio-chemotherapy. A high PAR may be associated with unfavorable histopathological characteristics. Further studies on these readily available biomarkers are required in order to validate their clinical utility.
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Affiliation(s)
- V Făgărășan
- 1st Surgical Department, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400012, Cluj Napoca, Romania.
| | - V Bințințan
- 1st Surgical Department, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400012, Cluj Napoca, Romania.
| | - R Seicean
- 1st Surgical Department, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400012, Cluj Napoca, Romania.
| | - A Caziuc
- 1st Surgical Department, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400012, Cluj Napoca, Romania.
| | - R AIlioaie
- 1st Surgical Department, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400012, Cluj Napoca, Romania.
| | - G Făgărășan
- 1st Surgical Department, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400012, Cluj Napoca, Romania.
| | - A Ilie-Ene
- 1st Surgical Department, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400012, Cluj Napoca, Romania.
| | - G Dindelegan
- 1st Surgical Department, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400012, Cluj Napoca, Romania.
| | - C Căinap
- Department of Medical Oncology, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400012, Cluj-Napoca, Romania.
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Tur-Martínez J, Rodríguez-Santiago J, Osorio J, Miró M, Yarnoz C, Jofra M, Ferret G, Salvador-Roses H, Fernández-Ananín S, Clavell A, Luna A, Aldeano A, Olona C, Hermoso J, Güell-Farré M, Dal Cero M, Gimeno M, Pallarès N, Pera M. Prognostic Relevance of Preoperative Immune, Inflammatory, and Nutritional Biomarkers in Patients Undergoing Gastrectomy for Resectable Gastric Adenocarcinoma: An Observational Multicentre Study. Cancers (Basel) 2024; 16:2188. [PMID: 38927894 PMCID: PMC11201927 DOI: 10.3390/cancers16122188] [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: 05/26/2024] [Revised: 06/07/2024] [Accepted: 06/09/2024] [Indexed: 06/28/2024] Open
Abstract
Background: The aim of this study was to evaluate different preoperative immune, inflammatory, and nutritional scores and their best cut-off values as predictors of poorer overall survival (OS) and disease-free survival (DFS) in patients who underwent curative gastric cancer resection. Methods: This was a retrospective observational multicentre study based on data of the Spanish EURECCA Esophagogastric Cancer Registry. Time-dependent Youden index and log-rank test were used to obtain the best cut-offs of 18 preoperative biomarkers for OS and DFS. An adjusted Cox model with variables selected by bootstrapping was used to identify the best preoperative biomarkers, which were also analysed for every TNM stage. Results: High neutrophil-to-lymphocyte ratio (NLR), high monocyte systemic inflammation index (moSII), and low prognostic nutritional index (PNI) were identified as independent predictors of poor outcome: NLR > 5.91 (HR:1.73; 95%CI [1.23-2.43]), moSII >2027.12 (HR:2.26; 95%CI [1.36-3.78]), and PNI >40.31 (HR:0.75; 95%CI [0.58-0.96]) for 5-year OS and NLR > 6.81 (HR:1.75; 95%CI [1.24-2.45]), moSII > 2027.12 (HR:2.46; 95%CI [1.49-4.04]), and PNI > 40.31 (HR:0.77; 95%CI [0.60,0.97]) for 5-year DFS. These outcomes were maintained in the whole cohort for NLR and moSII (p < 0.05) but not in stage II and for PNI in all tumoral stages. The associations of NLR-PNI and moSII-PNI were also a relevant prognostic factor for OS. Conclusions: High NLR, high moSII (for stages I and III), and low PNI (regardless of tumour stage) were the most promising preoperative biomarkers to predict poor OS and DFS in gastric cancer patients treated with curative intent.
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Affiliation(s)
- Jaume Tur-Martínez
- Department of Surgery, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain
- Department of Surgery, Complex Hospitalari Universitari Moisès Broggi, 08970 Sant Joan Despí, Spain
| | | | - Javier Osorio
- Department of Surgery, Hospital Clínic de Barcelona, 08036 Barcelona, Spain
| | - Mònica Miró
- Department of Surgery, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Concepción Yarnoz
- Department of Surgery, Hospital Universitario de Navarra, Universidad Pública de Navarra, 31008 Pamplona, Spain
| | - Mariona Jofra
- Department of Surgery, Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain
| | - Georgina Ferret
- Department of Surgery, Hospital Universitari Josep Trueta, 17007 Girona, Spain
| | | | - Sonia Fernández-Ananín
- Department of Surgery, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, 08025 Barcelona, Spain
| | - Arantxa Clavell
- Department of Surgery, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, 08916 Badalona, Spain
| | - Alexis Luna
- Department of Surgery, Hospital Universitari Parc Taulí de Sabadell, 08208 Sabadell, Spain
| | - Aurora Aldeano
- Department of Surgery, Hospital General de Granollers, 08402 Granollers, Spain
| | - Carles Olona
- Department of Surgery, Hospital Universitari de Tarragona Joan XXIII, 43005 Tarragona, Spain
| | - Judith Hermoso
- Department of Surgery, Hospital Universitari de Vic, 08500 Vic, Spain
| | - Mercè Güell-Farré
- Department of Surgery, Althaia Xarxa Assistencial Universitària de Manresa, 08243 Manresa, Spain
- Faculty of Medicine, Universitat de Vic-Universitat Central de Cataluña (UVIC-UCC), 08500 Vic, Spain
- Institut de Recerca i Innovació en Ciències de la Vida i de la Salut a la Catalunya Central (IRIS-CC), 08500 Vic, Spain
| | - Mariagiulia Dal Cero
- Section of Gastrointestinal Surgery, Hospital del Mar, Department of Surgery, Universitat Autònoma de Barcelona, Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain
| | - Marta Gimeno
- Section of Gastrointestinal Surgery, Hospital del Mar, Department of Surgery, Universitat Autònoma de Barcelona, Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain
| | - Natàlia Pallarès
- Biostatistics Support and Research Unit, Germans Trias i Pujol Research Institute and Hospital (IGTP), 08916 Barcelona, Spain
| | - Manuel Pera
- Section of Gastrointestinal Surgery, Hospital del Mar, Department of Surgery, Universitat Autònoma de Barcelona, Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain
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Wang D, Wang Y, Dong X, Yu M, Cai H. The significance of preoperative neutrophil-to-lymphocyte ratio in predicting short-term complications and survival benefits of pancreaticoduodenectomy: A systematic review and meta-analysis. Am J Surg 2024; 229:76-82. [PMID: 38101977 DOI: 10.1016/j.amjsurg.2023.11.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 11/08/2023] [Accepted: 11/24/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND The established association between the inflammatory marker, neutrophil-lymphocyte ratio (NLR), and both long-term surgical prognosis and short-term postoperative complications is well-recognized. However, its prognostic value in pancreaticoduodenectomy (PD) is yet to be ascertained. This meta-analysis investigates the prognostic relevance of preoperative NLR in PD patients. METHOD We systematically searched electronic databases to identify studies exploring the relationship between pre-treatment blood NLR levels and overall survival (OS), disease-free survival (DFS), and immediate postoperative complications in PD patients. Statistical evaluations, using RevMan 5.4 and Stata 12, focused on hazard ratios (HRs) and risk ratios (RRs). Additionally, subgroup analyses, publication bias tests, and sensitivity analyses were performed. RESULT Our analysis encompassed 18 retrospective studies, with NLR cutoff values ranging from 2 to 3.8. The meta-analysis revealed that PD patients with elevated NLR had diminished OS and DFS, evidenced by an HR of 1.35 (95% CI: 1.11-1.64, p = 0.003) and 1.62 (95% CI: 1.15-2.27, p = 0.005), respectively. Moreover, NLR emerged as an independent determinant of immediate postoperative complications, indicated by an OR of 1.91 (95% CI: 1.01-3.59, p = 0.013) and an HR of 2.15 (95% CI: 1.23-3.73, p < 0.01). CONCLUSION NLR serves as a significant prognostic indicator for both OS and DFS following PD and is a reliable predictor of postoperative complications. Preoperative Neutrophil-to-Lymphocyte Ratio (NLR) is a significant prognostic indicator for overall survival (OS) and disease-free survival (DFS) in patients undergoing pancreaticoduodenectomy (PD).
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Affiliation(s)
- Da Wang
- Jiangsu University, Zhenjiang, 212000, China; Key Laboratory of Molecular Diagnostics and Precision Medicine for Surgical Oncology in Gansu Province, Gansu Provincial Hospital, Lanzhou, 730000, China; General Surgery Clinical Medical Center, Gansu Provincial Hospital, Lanzhou, 730000, China
| | | | - Xiaohua Dong
- Key Laboratory of Molecular Diagnostics and Precision Medicine for Surgical Oncology in Gansu Province, Gansu Provincial Hospital, Lanzhou, 730000, China; General Surgery Clinical Medical Center, Gansu Provincial Hospital, Lanzhou, 730000, China; First Clinical College of Medicine, Lanzhou University, Lanzhou, 730000, China
| | - Miao Yu
- Key Laboratory of Molecular Diagnostics and Precision Medicine for Surgical Oncology in Gansu Province, Gansu Provincial Hospital, Lanzhou, 730000, China; General Surgery Clinical Medical Center, Gansu Provincial Hospital, Lanzhou, 730000, China
| | - Hui Cai
- Jiangsu University, Zhenjiang, 212000, China; Key Laboratory of Molecular Diagnostics and Precision Medicine for Surgical Oncology in Gansu Province, Gansu Provincial Hospital, Lanzhou, 730000, China; General Surgery Clinical Medical Center, Gansu Provincial Hospital, Lanzhou, 730000, China.
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Sumagin R. Phenotypic and Functional Diversity of Neutrophils in Gut Inflammation and Cancer. THE AMERICAN JOURNAL OF PATHOLOGY 2024; 194:2-12. [PMID: 37918801 PMCID: PMC10768535 DOI: 10.1016/j.ajpath.2023.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 10/09/2023] [Accepted: 10/18/2023] [Indexed: 11/04/2023]
Abstract
Neutrophils [polymorphonuclear leukocytes (PMNs)] execute important effector functions protecting the host against invading pathogens. However, their activity in tissue can exacerbate inflammation and inflammation-associated tissue injury and tumorigenesis. Until recently, PMNs were considered to be short-lived, terminally differentiated phagocytes. However, this view is rapidly changing with the emerging evidence of increased PMN lifespan in tissues, PMN plasticity, and phenotypic heterogeneity. Specialized PMN subsets have been identified in inflammation and in developing tumors, consistent with both beneficial and detrimental functions of PMNs in these conditions. Because PMN and tumor-associated neutrophil activity and the resulting beneficial/detrimental impacts primarily occur after homing to inflamed tissue/tumors, studying the underlying mechanisms of PMN/tumor-associated neutrophil trafficking is of high interest and clinical relevance. This review summarizes some of the key findings from over a decade of work from my laboratory and others on the regulation of PMN recruitment and identification of phenotypically and functionally diverse PMN subtypes as they pertain to gut inflammation and colon cancer.
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Affiliation(s)
- Ronen Sumagin
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
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Mosca M, Nigro MC, Pagani R, De Giglio A, Di Federico A. Neutrophil-to-Lymphocyte Ratio (NLR) in NSCLC, Gastrointestinal, and Other Solid Tumors: Immunotherapy and Beyond. Biomolecules 2023; 13:1803. [PMID: 38136673 PMCID: PMC10741961 DOI: 10.3390/biom13121803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 12/14/2023] [Accepted: 12/16/2023] [Indexed: 12/24/2023] Open
Abstract
In the era of immunotherapy, identifying biomarkers of immune system activation has become a high-priority challenge. The blood neutrophil-to-lymphocyte ratio (NLR) has been largely investigated as a biomarker in several cancer types. NLR values have been shown to mirror the tumor-induced inflammatory status and have been demonstrated to be a reliable prognostic tool across stages of disease and therapeutic approaches. When integrated with other biomarkers of response to immunotherapy, such as PD-L1, tumor mutational burden, and tumor-associated immune cells, the NLR may allow to further stratify patients with different likelihoods of deriving a significant clinical benefit. However, despite its accessibility, low cost, and easy interpretation, the NLR is still poorly used as a prognostic tool in daily clinical practice. In this review, we analyze the role of the NLR in defining the relationship between cancer and the immune system, its usefulness in daily clinical practice, and its relationship with other established or emerging biomarkers of immunotherapy outcomes.
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Affiliation(s)
- Mirta Mosca
- Department of Medical and Surgical Sciences, S. Orsola-Malpighi University Hospital, University of Bologna, 40138 Bologna, Italy; (M.M.); (M.C.N.); (R.P.); (A.D.F.)
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Maria Concetta Nigro
- Department of Medical and Surgical Sciences, S. Orsola-Malpighi University Hospital, University of Bologna, 40138 Bologna, Italy; (M.M.); (M.C.N.); (R.P.); (A.D.F.)
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Rachele Pagani
- Department of Medical and Surgical Sciences, S. Orsola-Malpighi University Hospital, University of Bologna, 40138 Bologna, Italy; (M.M.); (M.C.N.); (R.P.); (A.D.F.)
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Andrea De Giglio
- Department of Medical and Surgical Sciences, S. Orsola-Malpighi University Hospital, University of Bologna, 40138 Bologna, Italy; (M.M.); (M.C.N.); (R.P.); (A.D.F.)
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Alessandro Di Federico
- Department of Medical and Surgical Sciences, S. Orsola-Malpighi University Hospital, University of Bologna, 40138 Bologna, Italy; (M.M.); (M.C.N.); (R.P.); (A.D.F.)
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
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Gan X, Gou Q, Zhu J, Zhang T. Dynamic change of the systemic immune inflammation index is a risk factor for patients with oropharyngeal cancer: a case control study and an additional HPV-status subgroup analysis. Eur J Med Res 2023; 28:191. [PMID: 37353817 DOI: 10.1186/s40001-023-01157-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 06/05/2023] [Indexed: 06/25/2023] Open
Abstract
BACKGROUND The study aimed to analyze the relationship between the dynamic systemic immune inflammation index (SII), human papillomavirus (HPV) infection, and the prognosis of oropharyngeal cancer patients. METHOD We retrospectively obtained the data for 131 patients treated with curative treatments and calculated their SII values based on results acquired approximately 9 months after the first treatment. The entire cohort was divided into groups according to dynamic SII and HPV infection, and their prognoses were compared. RESULTS The high SII group, particularly the persistently high SII group, had a poor prognosis, and static SII levels cannot fully reflect the prognosis of patients with oropharyngeal cancer. In HPV- patients, unfavorable dynamic SII and the site of tumor locating at the tongue base were all significantly associated with decreased disease-free survival. In contrast, no characteristic was presented as a poor prognostic factor for disease-free or overall survival in HPV+ patients. CONCLUSION Dynamic SII values are more comprehensive prognostic indicators for oropharyngeal cancer patients, particularly HPV- patients. It could imply that an HPV- oropharyngeal cancer patient who experienced unfavorable dynamic changes in SII should receive more frequent tests or more advanced therapies.
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Affiliation(s)
- XiaoChuan Gan
- Department of Oncology, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuzhong, Chongqing, 400016, China
| | - QiTao Gou
- Department of Oncology, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuzhong, Chongqing, 400016, China
| | - Jing Zhu
- Department of Oncology, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuzhong, Chongqing, 400016, China.
| | - Tao Zhang
- Department of Oncology, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuzhong, Chongqing, 400016, China.
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Deng L, Li L, Qiu Y, Cao Y, Lian S, Si Y. Preoperative Platelet-Lymphocyte Ratio (PLR) as a prognostic inflammation biomarker in Asian HIV-infected patients with gastric cancer: a single-center study. BMC Gastroenterol 2023; 23:187. [PMID: 37237259 DOI: 10.1186/s12876-023-02828-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 05/20/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND The serum systemic inflammation biomarkers have been established as predictors of prognosis in gastric cancer (GC) patients, but their prognostic value in human immunodeficiency virus (HIV)-infected patients with GC has not been well studied. This retrospective study aimed to evaluate the prognostic value of preoperative systemic inflammation biomarkers in Asian HIV-infected patients with GC. METHODS We retrospectively analyzed 41 HIV-infected GC patients who underwent surgery between January 2015 and December 2021 at the Shanghai Public Health Clinical Center. Preoperative systemic inflammation biomarkers were measured and patients were divided into two groups based on the optimal cut-off value. Overall survival (OS) and progression-free survival (PFS) were measured using the Kaplan-Meier method and the log-rank test. Multivariate analysis of variables was performed using the Cox proportional regression model. As a comparison, 127 GC patients without HIV infection were also recruited. RESULTS The median age of the 41 patients included in the study was 59 years, with 39 males and two females. The follow-up period for OS and PFS ranged from 3 to 94 months. The cumulative three-year OS rate was 46.0%, and the cumulative three-year PFS rate was 44%. HIV-infected GC patients had worse clinical outcomes compared to the normal GC population. The optimal cut-off value for preoperative platelet to lymphocyte ratio (PLR) was 199 in HIV-infected GC patients. Multivariate Cox regression analysis revealed that a low PLR was an independent predictor of better OS and PFS (OS: HR = 0.038, 95% CI: 0.006-0.258, P < 0.001; PFS: HR = 0.027, 95% CI: 0.004-0.201, P < 0.001). Furthermore, higher preoperative PLR in HIV-infected GC was significantly associated with lower BMI, hemoglobin, albumin, CD4 + T, CD8 + T, and CD3 + T cell counts. CONCLUSION The preoperative PLR is an easily measurable immune biomarker that may provide useful prognostic information in HIV-infected GC patients. Our findings suggest that PLR could be a valuable clinical tool for guiding treatment decisions in this population.
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Affiliation(s)
- Li Deng
- Department of General Surgery, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.
| | - Lei Li
- Department of General Surgery, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Yiling Qiu
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, China
| | - Ye Cao
- Department of General Surgery, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Shixian Lian
- Department of General Surgery, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Yanhui Si
- Department of General Surgery, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.
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BAŞÇEKEN Sİ, TİKİCİ D. Predictive value of inflammatory markers in gastric cancer. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2023. [DOI: 10.32322/jhsm.1230078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023] Open
Abstract
Aim: Many recent studies are increasingly shedding light on the nature of the relationship between cancer and inflammation. Neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) platelet/neutrophil ratio (PNR), and Mean Platelet Volume (MPV) are proinflammatory markers, and their prognostic importance has been investigated in many solid cancers. In this study, we discussed the association of these derivative inflammatory markers, obtained from a cheap and simple peripheral blood test, with clinicopathologic variables in patients undergoing gastrectomy for gastric cancer.
Material and Method: The retrospective database of a total of 148 patients who were operated for gastric cancer in the Diyarbakır Gazi Yaşargil Training and Research Hospital Department of Surgery was analyzed. All blood results and pathology reports of the patients were reviewed retrospectively. Demographic characteristics of the patients and pathological features of the tumor were extracted from the database. NLR, PLR, PNR and MPV values were calculated from peripheral blood cell counts. Data were analyzed using SPSS version 24.0.
Results: PNR and MPV values were statistically significant according to N and T stage of the tumor, respectively (p=0.035, p=0.011). In MPV, this difference was statistically observed between T1 and T2 tumors (p=0.029). PLR and NLR values did not show a significant difference according to the size of the tumor (p>.05).
Conclusion: MPV values are significantly associated with tumor T stage. PNR values are significantly associated with tumor N stage. However, the clinical implications and the added value to clinical practice require further research.
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Affiliation(s)
- Salim İlksen BAŞÇEKEN
- Health Sciences University, Gazi Yaşargil Training and Research Hospital, Department of Surgical Oncology
| | - Deniz TİKİCİ
- Health Sciences University, Gazi Yaşargil Training and Research Hospital, Department of Gastroenterologic Surgery
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Shi Y, Ju M, Di X, Sun X, Chen X, He C, Liang L. Prognostic value of modified-Gustave-Roussy Immunity Score in resectable proximal gastric cancer. Medicine (Baltimore) 2023; 102:e33334. [PMID: 36961166 PMCID: PMC10036012 DOI: 10.1097/md.0000000000033334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 03/01/2023] [Indexed: 03/25/2023] Open
Abstract
The prognostic evaluation of GRIm score has been confirmed in many tumor species. The purpose of this study is to clarify the value of GRIm score in the prognostic evaluation of patients with resectable proximal gastric cancer. A single center retrospective study was conducted in 174 patients with proximal gastric cancer who underwent radical total gastrectomy. An in-depth analysis was carried out to explore the prognostic differences between high and low GRIm, and the influencing factors of disease-free survival rates and overall survival rates were analyzed by Cox regression model and Kaplan-Meier method. A total of 174 patients were divided into two groups: 135 patients were marked in L-mGRIm and 39 patients in H-mGRIm groups respectively. The median OS of the H-mGRIm and L-mGRIm groups were 23.2 and 38.6 months, respectively. The median DFS of the H-mGRIm and L-mGRIm groups was 16.9 and 31.7 months, respectively. Both DFS and OS were significantly different between groups (P = .000, P = .000). In multivariate analysis, ZPS (2 vs 0-1: HR 1.99 95% CI 1.05-3.76 P = .035), LDH (≥193 vs <193:HR 0.6; 95% CI 0.38-0.95 P = .028), mGRIm score (2-3 vs 0-1: HR 2.4; 95% CI 1.09-5.23 P = .029) was independent risk factors of OS. The age (>65 vs ≤65 years HR 0.63; 95% CI 0.4-0.95 P = .003), LDH (>193 U/L vs ≤193 U/L: HR 0.55; 95% CI 0.37-0.82 P = .004) and mGRIm score (2-3 vs 0-1: HR 4.74; 95% CI 2.24-9.9 P = .000) as an independent risk factor for DFS. mGRIm score is a novel, simple and effective index for prognosis evaluation of resectable cardiac cancer and can be used as a part of the risk stratification process.
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Affiliation(s)
- Yujing Shi
- Department of Oncology, Jurong People’s Hospital, Zhenjiang, China
- Department of Oncology, Jurong Hospital Affiliated to Jiangsu University, Zhenjiang, China
| | - Mengyang Ju
- Department of Radiation Oncology, Osaka University, Suita, Japan
| | - Xiaoke Di
- Department of Radiotherapy, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xinchen Sun
- Department of Radiotherapy, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiaojiao Chen
- Department of Oncology, Jurong People’s Hospital, Zhenjiang, China
- Department of Oncology, Jurong Hospital Affiliated to Jiangsu University, Zhenjiang, China
| | - Chenhong He
- Department of Oncology, Jurong People’s Hospital, Zhenjiang, China
- Department of Oncology, Jurong Hospital Affiliated to Jiangsu University, Zhenjiang, China
| | - Liang Liang
- Department of Oncology, Jurong People’s Hospital, Zhenjiang, China
- Department of Oncology, Jurong Hospital Affiliated to Jiangsu University, Zhenjiang, China
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Chan KM, Lai Y, Hung HC, Lee JC, Cheng CH, Wang YC, Wu TH, Lee CF, Wu TJ, Chou HS, Wang CT, Chai PM, Lien HY, Lee WC. Significance of Physical Status and Liver Function Reserve for Outcome of Patients with Advanced Hepatocellular Carcinoma Receiving Lenvatinib Treatment. J Hepatocell Carcinoma 2023; 10:281-290. [PMID: 36845025 PMCID: PMC9946007 DOI: 10.2147/jhc.s393964] [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: 10/18/2022] [Accepted: 02/11/2023] [Indexed: 02/19/2023] Open
Abstract
Background Tyrosine kinase inhibitors (TKIs) remain the primary therapeutic option for patients with advanced-stage hepatocellular carcinoma (HCC). However, the selection of a suitable TKI is an issue in real-world clinical practice. Thus, this study aimed to identify patients most likely to benefit from lenvatinib treatment. Methods A retrospective review of 143 patients with unresectable advanced-stage HCC treated with lenvatinib between January 2020 and December 2021 was performed. Outcomes related to lenvatinib treatment were measured, and the clinical parameters affecting prognosis were analyzed. Results Overall, the median time of progression-free survival (PFS) and overall survival (OS) were 7.1 months and 17.7 months, respectively. Prognostic analyses found that Child-Pugh score > 5 (hazard ratio [HR] = 2.43, 95% confidence interval [CI] = 1.55-3.80, p = 0.001) was a significant factor affecting the PFS of HCC after lenvatinib treatment. Child-Pugh score > 5 (HR = 2.12, 95% CI = 1.20-3.74, p = 0.009), body weight ≥ 60 kg (HR = 0.54, 95% CI = 0.32-0.90, p = 0.020), and additional trans-arterial chemoembolization (TACE) treatment (HR = 0.38, 95% CI = 0.21-0.70, p = 0.003) were significant prognostic factors for OS. However, early α-fetoprotein reduction was not significantly correlated with patient outcomes. Additionally, patients with pre-treatment neutrophil-lymphocyte ratio > 4.07 showed a significant worse PFS and OS than other patients. Conclusion The outcome of patients with advanced-stage HCC remains poor. However, the host condition, including good physical status and better functional liver preservation, largely affected the outcome of patients receiving lenvatinib treatment. Moreover, additional locoregional therapy for intrahepatic HCC, other than TKI treatment, can be considered in certain patients to achieve a favorable outcome.
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Affiliation(s)
- Kun-Ming Chan
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan,Correspondence: Kun-Ming Chan, Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, No. 5 Fu-Hsing Street, Gui-Shan District, Taoyuan City, 33305, Taiwan, Tel +886-3-3281200 Ext 3366, Fax +886-3-3285818, Email
| | - Yin Lai
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Hao-Chien Hung
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Jin-Chiao Lee
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Chih-Hsien Cheng
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Yu-Chao Wang
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Tsung-Han Wu
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Chen-Fang Lee
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Ting-Jung Wu
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Hong-Shiue Chou
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Ching-Ting Wang
- Department of Nursing, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Pei-Mei Chai
- Department of Nursing, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Hsin-Yi Lien
- Graduate School of Education, Ming Chuan University, Taoyuan, Taiwan
| | - Wei-Chen Lee
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
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Takahara K, Tamura R, Kuranari Y, Karatsu K, Akiyama T, Toda M. Prognostic significance of preoperative neutrophil-to-lymphocyte ratio in surgically resected schwannomas. Front Oncol 2023; 13:1099384. [PMID: 36845735 PMCID: PMC9950385 DOI: 10.3389/fonc.2023.1099384] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 01/30/2023] [Indexed: 02/12/2023] Open
Abstract
Objective The goal of schwannoma resection is to control the tumor while preserving neurological function. Schwannomas have a variable postoperative growth pattern, therefore preoperative prediction of a schwannoma's growth pattern is favorable. This study aimed to examine the relationship between preoperative neutrophil-to-lymphocyte ratio (NLR) and postoperative recurrence and retreatment in patients with schwannoma. Methods We retrospectively examined 124 patients who underwent schwannoma resection in our institution. Associations between preoperative NLR, other patient and tumor characteristics, and tumor recurrence and retreatment were analyzed. Results Median follow-up was 2569.5 days. Postoperative recurrence occurred in 37 patients. Recurrence that required retreatment occurred in 22. Treatment-free survival (TFS) was significantly shorter in patients with NLR ≥2.21 (P = 0.0010). Multivariate Cox proportional hazards regression showed that NLR and neurofibromatosis type 2 were independent predictors of retreatment (P = 0.0423 and 0.0043, respectively). TFS was significantly shorter in patients with NLR ≥2.21 in the following subgroups: sporadic schwannoma, primary schwannoma, schwannoma ≥30 mm in size, subtotal resection, vestibular schwannoma, and postoperative recurrence. Conclusions Preoperative NLR ≥2.21 before surgery was significantly associated with retreatment after schwannoma resection. NLR may be a novel predictor of retreatment and assist surgeons in preoperative surgical decision making.
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Affiliation(s)
- Kento Takahara
- Department of Neurosurgery, Keio University School of Medicine, Tokyo, Japan
| | - Ryota Tamura
- Department of Neurosurgery, Keio University School of Medicine, Tokyo, Japan,*Correspondence: Ryota Tamura,
| | - Yuki Kuranari
- Department of Neurosurgery, Kawasaki Municipal Hospital, Kawasaki-ku, Kanagawa, Japan
| | - Kosuke Karatsu
- Department of Neurosurgery, Keio University School of Medicine, Tokyo, Japan
| | - Takenori Akiyama
- Department of Neurosurgery, Keio University School of Medicine, Tokyo, Japan
| | - Masahiro Toda
- Department of Neurosurgery, Keio University School of Medicine, Tokyo, Japan
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12
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Shimura M, Mizuma M, Motoi F, Kusaka A, Aoki S, Iseki M, Inoue K, Douchi D, Nakayama S, Miura T, Ishida M, Ohtsuka H, Nakagawa K, Morikawa T, Kamei T, Unno M. Negative prognostic impact of sarcopenia before and after neoadjuvant chemotherapy for pancreatic cancer. Pancreatology 2023; 23:65-72. [PMID: 36473785 DOI: 10.1016/j.pan.2022.11.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 11/12/2022] [Accepted: 11/24/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To elucidate the prognostic impact of sarcopenia before and after neoadjuvant chemotherapy (NAC) for pancreatic cancer (PC). METHODS We retrospectively studied 75 consecutive PC patients who underwent neoadjuvant gemcitabine plus S-1 combination therapy followed by pancreatectomy between 2008 and 2016. According to the skeletal muscle volume index (SMI), the patients were divided into the muscle attenuation group (MAG) and normal group (NG) before or after NAC. Prognostic factors for overall survival (OS) were analyzed by Cox proportional hazards models. RESULTS The MAG showed significantly poorer OS than the NG before and after NAC. Pre-NAC, median OS was 20.0 months in the MAG versus 49.0 months in the NG (p = 0.006). Post-NAC, median OS was 21.3 months in the MAG versus 48.8 months in the NG (p = 0.014). Multivariate analysis, excluding muscle attenuation after NAC because of confounding factors and lower hazard ratio (2.08, 95% confidence interval: 1.14-3.78, p = 0.016) than that before NAC (2.14, 1.23-3.70, p = 0.007) by univariate analysis, revealed the following independent prognostic factors: muscle attenuation pre-NAC (2.25, 1.26-4.05, p = 0.007); borderline resectability (1.96, 1.04-3.69, p = 0.038); operative blood loss (2.60, 1.38-4.88, p = 0.003); and distant metastasis (3.31, 1.40-7.82, p = 0.006). CONCLUSIONS Sarcopenia before and after NAC for PC is suggested to be a poor prognostic factor, with a stronger impact before than after NAC.
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Affiliation(s)
- Mitsuhiro Shimura
- Department of Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryomachi, Aobaku, Sendai, 980-8574, Japan
| | - Masamichi Mizuma
- Department of Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryomachi, Aobaku, Sendai, 980-8574, Japan.
| | - Fuyuhiko Motoi
- Department of Gastroenterological, General, Breast and Thyroid Surgery, Yamagata University Graduate School of Medical Science, 2-2-2 Iidanishi, Yamagata, 990-9585, Japan
| | - Akiko Kusaka
- Department of Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryomachi, Aobaku, Sendai, 980-8574, Japan
| | - Shuichi Aoki
- Department of Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryomachi, Aobaku, Sendai, 980-8574, Japan
| | - Masahiro Iseki
- Department of Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryomachi, Aobaku, Sendai, 980-8574, Japan
| | - Koetsu Inoue
- Department of Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryomachi, Aobaku, Sendai, 980-8574, Japan
| | - Daisuke Douchi
- Department of Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryomachi, Aobaku, Sendai, 980-8574, Japan
| | - Shun Nakayama
- Department of Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryomachi, Aobaku, Sendai, 980-8574, Japan
| | - Takayuki Miura
- Department of Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryomachi, Aobaku, Sendai, 980-8574, Japan
| | - Masaharu Ishida
- Department of Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryomachi, Aobaku, Sendai, 980-8574, Japan
| | - Hideo Ohtsuka
- Department of Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryomachi, Aobaku, Sendai, 980-8574, Japan
| | - Kei Nakagawa
- Department of Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryomachi, Aobaku, Sendai, 980-8574, Japan
| | - Takanori Morikawa
- Department of Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryomachi, Aobaku, Sendai, 980-8574, Japan
| | - Takashi Kamei
- Department of Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryomachi, Aobaku, Sendai, 980-8574, Japan
| | - Michiaki Unno
- Department of Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryomachi, Aobaku, Sendai, 980-8574, Japan
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13
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Liu Y, Wang C, Wang H, Yang C, Cheng X, Li W. Prognostic Nomogram Combining Preoperative Neutrophil to Lymphocyte Ratio and Clinicopathologic Features for Gastric Cancer Patients after Distal Radical Gastrectomy: Based on Propensity Score Matching. J Pers Med 2022; 13:jpm13010086. [PMID: 36675747 PMCID: PMC9862479 DOI: 10.3390/jpm13010086] [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: 12/02/2022] [Revised: 12/26/2022] [Accepted: 12/27/2022] [Indexed: 12/31/2022] Open
Abstract
Background: Preoperative inflammatory status has been widely used in assessing the prognosis of malignant tumor. This study aimed to establish a novel nomogram combining preoperative inflammatory factors and clinicopathologic features to predict the prognosis of gastric cancer (GC) patients after distal radical gastrectomy. Methods: A total of 522 GC patients from Fujian Provincial Hospital were retrospectively reviewed. Propensity score matching was performed and Cox regression models were used to analyze the clinical and pathological factors to determine their impact on survival. A prognostic nomogram was established and validated based on these factors. Results: The multivariate analysis indicated that tumor stage, pathological type, and neutrophil to lymphocyte ratio (NLR) were independent risk factors for the prognosis of GC patients. The nomogram was established based on these factors. In the primary cohort, the concordance index (C-index) of the nomogram was 0.753 (95% CI 0.647-0.840), which was higher than that of the American Joint Committee on Cancer (AJCC) tumor-node-metastasis (TNM) stage. The calibration curve showed the actual overall survival (OS) probabilities were in good keeping with those predicted by the nomogram. Furthermore, we divided the patients into two distinct risk groups for OS according to the nomogram points: low and high risk. The OS rates were significantly different among the subgroups (p ˂ 0.001). Conclusions: We proposed a novel nomogram combining preoperative NLR and clinicopathologic features that is economical, routinely available, and highly predictive of OS in GC patients after distal radical gastrectomy. Compared with the current AJCC TNM staging, this model was more accurate in prognostic prediction.
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Affiliation(s)
- Yi Liu
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou 350000, China
| | - Chuandong Wang
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou 350000, China
| | - Huan Wang
- Department of Gastrointestinal Surgery, People’s Hospital of Macheng City, Huanggang 438300, China
| | - Changshun Yang
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou 350000, China
- Department of Surgical Oncology, Fujian Provincial Hospital, Fuzhou 350000, China
| | - Xuefei Cheng
- Cardiac Center, Guangdong Women and Children’s Hospital, Guangzhou 510000, China
- Correspondence: (X.C.); (W.L.); Tel.: +86-18506009193 (X.C.); +86-18106061193 (W.L.); Fax: +86-20-39151608 (X.C.); +86-591-88217150 (W.L.)
| | - Weihua Li
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou 350000, China
- Department of Surgical Oncology, Fujian Provincial Hospital, Fuzhou 350000, China
- Correspondence: (X.C.); (W.L.); Tel.: +86-18506009193 (X.C.); +86-18106061193 (W.L.); Fax: +86-20-39151608 (X.C.); +86-591-88217150 (W.L.)
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14
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Zhou L, Ren L, Yu W, Qi M, Yuan J, Wang W, Su X, Yin F, Deng M, Wang H, Long H, Zeng J, Yu J, Fan H, Wang Z. Construction and validation of a prediction model of extrahepatic metastasis for hepatocellular carcinoma based on common clinically available data. Front Oncol 2022; 12:961194. [PMID: 36465396 PMCID: PMC9709221 DOI: 10.3389/fonc.2022.961194] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 10/25/2022] [Indexed: 08/09/2023] Open
Abstract
OBJECTIVE This study aimed to investigate the clinical characteristics and risk factors of patients with hepatocellular carcinoma (HCC) with extrahepatic metastases (EHM) and to establish an effective predictive nomogram. METHODS Clinical and pathological data from 607 patients with hepatocellular carcinoma admitted to the Affiliated Hospital of Qinghai University between 1 January 2015 and 31 May 2018 were documented, as well as demographics, clinical pathological characteristics, and tumor-related parameters to clarify clinical risk factors for HCC EHM. These risks were selected to build an R-based clinical prediction model. The predictive accuracy and discriminating ability of the model were determined by the concordance index (C-index) and the calibration curve. The results were validated with a bootstrap resample and 151 patients from 1 June 2018 to 31 December 2019 at the same facility. RESULTS In multivariate analysis, independent factors for EHM were neutrophils, prothrombin time, tumor number, and size, all of which were selected in the model. The C-index in the EHM prediction model was 0.672 and in the validation cohort was 0.694. In the training cohort and the validation cohort, the calibration curve for the probability of EHM showed good agreement between the nomogram prediction and the actual observation. CONCLUSION The extrahepatic metastasis prediction model of hepatocellular carcinoma constructed in this study has some evaluation capability.
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Affiliation(s)
- Liuxin Zhou
- Department of Hepatopancreatobiliary Surgery, The Affiliated Hospital of Qinghai University, Xining, Qinghai, China
- Department of Hepatopancreatobiliary Surgery, The Chongqing University Fuling Hospital, Fuling, Chongqing, China
| | - Li Ren
- Department of Hepatopancreatobiliary Surgery, The Affiliated Hospital of Qinghai University, Xining, Qinghai, China
| | - Wenhao Yu
- Department of Hepatopancreatobiliary Surgery, The Affiliated Hospital of Qinghai University, Xining, Qinghai, China
| | - Mengjian Qi
- Department of Hepatopancreatobiliary Surgery, The Affiliated Hospital of Qinghai University, Xining, Qinghai, China
| | - Jiaqi Yuan
- Department of Hepatopancreatobiliary Surgery, The Affiliated Hospital of Qinghai University, Xining, Qinghai, China
| | - Wen Wang
- Department of Hepatopancreatobiliary Surgery, The Affiliated Hospital of Qinghai University, Xining, Qinghai, China
| | - Xiaoxia Su
- Department of Hepatopancreatobiliary Surgery, The Affiliated Hospital of Qinghai University, Xining, Qinghai, China
| | - Fengjiao Yin
- Department of Hepatopancreatobiliary Surgery, The Affiliated Hospital of Qinghai University, Xining, Qinghai, China
| | - Manjun Deng
- Department of Hepatopancreatobiliary Surgery, The Affiliated Hospital of Qinghai University, Xining, Qinghai, China
| | - Haijiu Wang
- Department of Hepatopancreatobiliary Surgery, The Affiliated Hospital of Qinghai University, Xining, Qinghai, China
| | - Hongmu Long
- Department of Hepatopancreatobiliary Surgery, The Chongqing University Fuling Hospital, Fuling, Chongqing, China
| | - Jiangchao Zeng
- Department of Hepatopancreatobiliary Surgery, The Chongqing University Fuling Hospital, Fuling, Chongqing, China
| | - Jiajian Yu
- Department of Hepatopancreatobiliary Surgery, The Chongqing University Fuling Hospital, Fuling, Chongqing, China
| | - Haining Fan
- Department of Hepatopancreatobiliary Surgery, The Affiliated Hospital of Qinghai University, Xining, Qinghai, China
| | - Zhixin Wang
- Department of Hepatopancreatobiliary Surgery, The Affiliated Hospital of Qinghai University, Xining, Qinghai, China
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Yu W, Yang Z. Clinical significance of circulating neutrophils and lymphocyte subsets in newly diagnosed patients with diffuse large B-cell lymphoma. Clin Exp Med 2022:10.1007/s10238-022-00867-4. [PMID: 35939174 DOI: 10.1007/s10238-022-00867-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 07/18/2022] [Indexed: 11/24/2022]
Abstract
Lymphocytes play crucial roles in tumor surveillance in diffuse large B-cell lymphoma (DLBCL). Neutrophil-to-lymphocyte ratio (NLR), a biomarker for systematic inflammation, has been confirmed to be a prognostic factor for many malignant diseases. Herein, we conducted a systemic in-depth study of circulating neutrophils and lymphocyte subsets in DLBCL patients and their dynamics along with chemoimmunotherapy. A total of 61 patients with DLBCL were enrolled. Detection of lymphocyte subsets by flow cytometry was conducted at diagnosis and after 2/4/6/8 cycles' treatment of R-CHOP. Clinical significance, including incidence of infection, curative effect and disease-free survival (DFS), was analyzed based on the patients' clinical data and the quantity of lymphocyte subsets. The absolute numbers of neutrophils in stage III-IV DLBCL patients were obviously increased (p = 0.012), while the absolute numbers of lymphocytes were decreased (p = 0.025). Consequently, DLBCL patients had significantly higher NLR than healthy controls (p < 0.001). Further analysis of lymphocyte subsets showed a significantly reduced CD4 + T cells in DLBCL patients (p = 0.001). Patients with a lower lymphocyte counts (< 1.26*10E9/L) were more susceptible to infection (p < 0.001). NK cells were much higher in patients achieving complete remission than those of non-complete remission (p = 0.032). Higher neutrophils and NLR were closely associated with poorer DFS (p = 0.001 and p = 0.045, respectively). Circulating cells in DLBCL patients were dysregulated, featured with increased neutrophils and reduced lymphocytes. Higher NK cells before treatment predicted better therapeutic outcome. Higher neutrophils and NLR can be regarded as inferior prognostic predictors for DLBCL patients at diagnosis.
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Affiliation(s)
- Wei Yu
- Department of International Medicine, The Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao, 266555, Shandong, People's Republic of China.
| | - Zhiluo Yang
- Department of Hematology, Qingdao Municipal Hospital, 1 Jiaozhou Road, Qingdao, 266000, Shandong, People's Republic of China
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16
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Schietroma M, Romano L, Schiavi D, Pessia B, Mattei A, Fiasca F, Carlei F, Giuliani A. Systemic inflammation response index (SIRI) as predictor of anastomotic leakage after total gastrectomy for gastric cancer. Surg Oncol 2022; 43:101791. [DOI: 10.1016/j.suronc.2022.101791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 04/20/2022] [Accepted: 06/06/2022] [Indexed: 02/07/2023]
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17
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Living-Donor Liver Transplantation for Hepatocellular Carcinoma: Impact of the MELD Score and Predictive Value of NLR on Survival. Curr Oncol 2022; 29:3881-3893. [PMID: 35735419 PMCID: PMC9221955 DOI: 10.3390/curroncol29060310] [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: 04/26/2022] [Revised: 05/18/2022] [Accepted: 05/24/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Patients with hepatocellular carcinoma (HCC) tend to be referred for liver transplantation (LT) at an early stage of cirrhosis, with lower pre-LT Model of End-Stage Liver Disease (MELD) scores. We investigated the impact of high MELD scores on post-LT outcomes in patients with HCC and validated the prognostic significance of the neutrophil-to-lymphocyte ratio (NLR). Patients and Method: This retrospective single-center cohort study enrolled 230 patients with HCC who underwent LDLT from 2004−2019 in our institute. We defined a high MELD score as ≥20. Results: The MELD < 20 and MELD ≥ 20 groups comprised 205 and 25 cases, respectively. Although there was no significant difference in disease-free survival between the two groups (p = 0.629), the incidence of septic shock (p = 0.019) was significantly higher in the high MELD group. The one-, three-, and five-year overall survival rates were not significantly different between the two groups (p = 0.056). In univariate analysis, a high pre-LT NLR was associated with poorer survival in the high MELD group (p = 0.029, hazard ratio [HR]: 1.07, 90% confidence interval [CI]: 1.02−1.13). NLR cut-off values of ≥10.7 and <10.7 were predictive of mortality, with an AUC of 0.705 (90% CI: 0.532−0.879). The one-, three-, and five-year post-LT survival rates were significantly higher among the recipients with an NLR < 10.7 than those with an NLR ≥ 10.7 (p = 0.005). Conclusions: Pre-LT MELD score ≥ 20 was associated with a higher risk of developing post-LT septic shock and mortality. The pre-LT serum NLR is a useful predictive factor for clinical outcomes in patients with HCC with high MELD scores.
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Russu E, Mureșan AV, Arbănași EM, Kaller R, Hosu I, Voidăzan S, Arbănași EM, Coșarcă CM. The Predictive Role of NLR and PLR in Outcome and Patency of Lower Limb Revascularization in Patients with Femoropopliteal Disease. J Clin Med 2022; 11:2620. [PMID: 35566745 PMCID: PMC9103104 DOI: 10.3390/jcm11092620] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 04/27/2022] [Accepted: 05/04/2022] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Peripheral arterial disease (PAD) changes the arterial structure and function, and is the most common manifestation of the atherosclerotic process, except for the coronary and cerebral arterial systems. Inflammation is well known to have a role in the progression of atherosclerosis and, by extension, in PAD. Among the recently studied markers in the literature, we list the neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR). This study aims to analyze the preoperative role of NLR and PLR in the medium-term outcome of patients surgically revascularized for femoropopliteal disease. METHODS A retrospective study included patients admitted to the Vascular Surgery Clinic of the County Emergency Clinical Hospital of Târgu-Mureș, Romania, between January 2017 and December 2019, diagnosed with femoropopliteal disease and having presented an indication for surgical revascularization. The patients included in the study were classified according to the 12 months primary patency in two groups: "patency" and "nonpatency". RESULTS Depending on the Rutherford classification (RC), there was a higher incidence of stages II and III in the patency group and a higher incidence of stage V in the nonpatency group. Depending on the optimal cut-off value according to ROC for the 12 months primary patency, obtained from Youden's index (3.95 for NLR (82.6% sensitivity and 89.9% specificity), and 142.13 for PLR (79.1% sensitivity and 82.6% specificity)), in all high-NLR and high-PLR groups, there was a higher incidence of all adverse outcomes. Moreover, a multivariate analysis showed that a high baseline value for NLR and PLR was an independent predictor of all outcomes for all recruited patients. Furthermore, for all hospitalized patients, RC 5 was an independent predictor of poor prognosis. CONCLUSIONS Our findings establish that a high value of preoperative NLR and PLR determined at hospital admission is strongly predictive of primary patency failure (12 months after revascularization). Additionally, elevated ratio values are an independent predictor for a higher amputation rate and death for all patients enrolled in the study, except for mortality in RC 2, and both amputation and mortality in RC 5.
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Affiliation(s)
- Eliza Russu
- Clinic of Vascular Surgery, Mureș County Emergency Hospital, 540136 Targu Mures, Romania; (E.R.); (A.V.M.); (C.M.C.)
- Department of Surgery, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540139 Targu Mures, Romania
| | - Adrian Vasile Mureșan
- Clinic of Vascular Surgery, Mureș County Emergency Hospital, 540136 Targu Mures, Romania; (E.R.); (A.V.M.); (C.M.C.)
- Department of Surgery, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540139 Targu Mures, Romania
| | - Emil Marian Arbănași
- Clinic of Vascular Surgery, Mureș County Emergency Hospital, 540136 Targu Mures, Romania; (E.R.); (A.V.M.); (C.M.C.)
| | - Réka Kaller
- Clinic of Vascular Surgery, Mureș County Emergency Hospital, 540136 Targu Mures, Romania; (E.R.); (A.V.M.); (C.M.C.)
| | - Ioan Hosu
- Department of Nephrology, Mureș County Emergency Hospital, 540136 Targu Mures, Romania;
| | - Septimiu Voidăzan
- Department of Epidemiology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540139 Targu Mures, Romania; (S.V.); (E.M.A.)
| | - Eliza Mihaela Arbănași
- Department of Epidemiology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540139 Targu Mures, Romania; (S.V.); (E.M.A.)
| | - Cătălin Mircea Coșarcă
- Clinic of Vascular Surgery, Mureș County Emergency Hospital, 540136 Targu Mures, Romania; (E.R.); (A.V.M.); (C.M.C.)
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Tur-Martínez J, Osorio J, Pérez-Romero N, Puértolas-Rico N, Pera M, Delgado S, Rodríguez-Santiago J. Preoperative neutrophil-to-lymphocyte ratio behaves as an independent prognostic factor even in patients with postoperative complications after curative resection for gastric cancer. Langenbecks Arch Surg 2022; 407:1017-1026. [PMID: 34999967 PMCID: PMC9151531 DOI: 10.1007/s00423-022-02432-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 01/03/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE The aim of this study was to determine if the prognostic value of the preoperative neutrophil-to-lymphocyte ratio (NLR) could be modified by the presence of postoperative complications (POC) and their severity in patients with gastric adenocarcinoma resected with curative intent. METHODS A retrospective study based on a prospective database of patients with resectable gastric adenocarcinoma treated with radical intention (R0) between January 1998 and February 2012. The primary endpoint was overall survival according to preoperative peripheral blood NLR and postoperative complications. Clinicopathological variables, preoperative blood tests, POC and its severity (Clavien-Dindo classification), type of POC (infectious or not infectious) and mortality were registered. A univariate and multivariate analysis (step forward Cox regression) was performed. The Kaplan-Meier method was used to assess overall survival. RESULTS The 147 patients with gastric cancer who had undergone radical resection were included from an initial cohort of 209 patients. Univariant analysis: type of surgery, pT, pN, postoperative complications (Clavien-Dindo ≥ 3) and preoperative NLR ≥ 2.4 were significantly associated with survival (p < 0.05). Patients with POC showed worse long-term survival (p = 0.000), with no difference (p = 0.867) between infectious or non-infectious POC. NLR ≥ 2.4 was associated with infectious POC (p < 0.001). Patients with preoperative NLR ≥ 2.4 (p = 0.02) had a worse prognosis. Multivariate analysis: pN (p < 0.001), postoperative complications (p < 0.001) (HR 3.04; 95% CI: 1.97-4.70) and NLR ≥ 2.4 (p = 0.04) (HR = 1.55; 95% CI: 1.02-2.3) were independent prognostic factors. CONCLUSION The preoperative inflammatory state of patients with gastric cancer measured by NLR behaves as an independent prognostic factor, even in patients with POC.
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Affiliation(s)
- Jaume Tur-Martínez
- Service of General Surgery, University Hospital Mútua Terrassa, Terrassa, Barcelona, Spain.
- Department of Surgery, Universitat Autònoma de Barcelona, Bellaterra, Spain.
| | - Javier Osorio
- Service of General Surgery, University Hospital Mútua Terrassa, Terrassa, Barcelona, Spain
| | - Noelia Pérez-Romero
- Service of General Surgery, University Hospital Mútua Terrassa, Terrassa, Barcelona, Spain
| | - Noelia Puértolas-Rico
- Service of General Surgery, University Hospital Mútua Terrassa, Terrassa, Barcelona, Spain
| | - Manuel Pera
- Section of Gastrointestinal Surgery. Hospital del Mar, Universitat Autónoma de Barcelona, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Bellaterra, Spain
| | - Salvadora Delgado
- Service of General Surgery, University Hospital Mútua Terrassa, Terrassa, Barcelona, Spain
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Neutrophil to lymphocyte ratio based perioperative prediction of prognosis model on early mortality after cytoreductive surgery with hyperthermic intraperitoneal chemotherapy. Asian J Surg 2022; 45:2676-2685. [PMID: 35260332 DOI: 10.1016/j.asjsur.2022.01.104] [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: 05/22/2021] [Revised: 07/23/2021] [Accepted: 01/04/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Combined cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) to treat peritoneal surface malignancy (PSM) has gained a positive result compared with palliative chemotherapy alone in several cancer types. However, its postoperative care could be challenging. We aimed to develop a predicting model on early mortality. METHODS We retrospectively reviewed 132 PSM patients who had received CRS-HIPEC. The optimal cut-off value of the neutrophil-to-lymphocyte ratio (NLR) was determined as 4.4 by using the receiver operating characteristic curve analysis with an area under the curve (AUC) of 0.75. The impact of NLR on survival was elucidated by comparing the pre-operative low (NLR≤ 4.4, n = 101) and high (NLR> 4.4, n = 31) groups using the Kaplan-Meier method. The significant variables selected in multivariate analysis on early mortality were used in prediction model development. RESULTS Multivariate analysis showed that incomplete CRS, major postoperative complications, higher pre-operative NLR, and dynamic NLR changes were significant predictors of early mortality. Our perioperative prediction of prognosis (triple P) model contained four independent risks, and the AUC after classification was 0.860 (95% confidence interval [CI]: 0.773-0.947). External validation confirmed positive discrimination ability (AUC: 0.808, 95% CI: 0.666-0.950). CONCLUSION In conclusion, our triple P model provides great determination in outcomes prediction and it is easily obtained, reliable, and applicable in routine practice.
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The monocyte to lymphocyte ratio not only at baseline but also at relapse predicts poor outcomes in patients with hepatocellular carcinoma receiving locoregional therapy. BMC Gastroenterol 2022; 22:98. [PMID: 35246045 PMCID: PMC8896362 DOI: 10.1186/s12876-022-02180-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 02/22/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Monocyte to lymphocyte ratio (MLR) represents a pro-inflammatory immune microenvironment. The aim of this study was to elucidate the effect of MLR and subsequent MLR when relapse occurred (R-MLR) on prognosis for hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE) combined with ablation. METHODS A prospective analysis was conducted on 606 patients with HCC who were treated with TACE combined with local ablation in Beijing You'an Hospital affiliated to Capital Medical University from January 1, 2012 to December 31, 2016. MLR or R-MLR were stratified according to the optimal cut-off values. The cumulative recurrence-free survival (RFS), overall survival (OS) , and recurrence-death survival (RDS) rates were calculated by Kaplan-Meier method. The Cox proportion hazard model and logistic regression analysis was conducted to screen for independent predictive factors for indicating early relapse and long-term prognosis. RESULTS High MLR was significantly associated with relapse, early recurrence, and overall survival. After a median follow-up of 59.4 months, The cumulative 1-, 3-, 5-year RFS rates of low MLR were 74.6%, 43.8%, and 34.0%; while 66.1%, 32.2%, and 22.6% for high group (P < 0.001). There were also significant differences in corresponding OS rates of the two groups (P = 0.003). The cumulative 1-, 3-, 5-year OS rates of low R-MLR were 99.5%, 87.2%, 75.5%; while 98.3%, 78.3%, 61.7% for high group (P < 0.001). There were also significant differences in corresponding RDS rates in the two groups (P = 0.008). 436 patients were divided into four groups on the base of cut-off values of MLR and R-MLR (low-low, low-high, high-low, and high-high). The low-low group has shown better outcomes including the cumulative 1-, 3-, 5-year OS, and RDS rates(P < 0.001). CONCLUSIONS High MLR was related to unfavorable outcome. Subsequent change of MLR between baseline and HCC relapse could indicate poor long-term survival after relapse.
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Karakaya S, Karadağ İ, Yılmaz ME, Çakmak Öksüzoğlu ÖB. High Neutrophil-Lymphocyte Ratio, Platelet-Lymphocyte Ratio and Low Lymphocyte Levels Are Correlated With Worse Pathological Complete Response Rates. Cureus 2022; 14:e22972. [PMID: 35415045 PMCID: PMC8990043 DOI: 10.7759/cureus.22972] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2022] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE To investigate the effect of hemogram parameters on predicting pathological complete response (pCR) in locally advanced rectal cancer. METHODOLOGY A total of 227 patients with rectal cancer treated with neoadjuvant concurrent chemoradiotherapy (CRT) were retrospectively analyzed. All patients were divided into two subgroups as high or low hemogram parameters according to the cut-off value obtained using the receiver operating characteristic (ROC) curve. RESULTS In patients with low neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) levels, pCR rate was statistically significantly higher than the group with high NLR and PLR levels (for NLR: 39.77% vs. 5.34%; p<0.001, for PLR: 32.38% vs 7.01%; p<0.001 respectively). In addition, the pCR rate was significantly better in patients with high lymphocyte levels compared to the group with low lymphocyte levels (33.33% vs. 7.5%; p<0.001, respectively). According to the multivariate logistic regression analysis result, NLR and PLR levels were considered as independent predictors to predict pathological complete response [p<0.001, HR: 0.128 (95% CI=0.051 - 0.322) for NLR; p=0.017, HR: 0.332 (95% CI=0.134 - 0.821) for PLR, respectively]. CONCLUSION Our study showed that high NLR, PLR, and low lymphocyte levels were correlated with worse pCR rates. In addition to that, NLR and PLR emerged as independent predictive markers.
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Affiliation(s)
- Serdar Karakaya
- Medical Oncology, Health Science University, Atatürk Chest Diseases and Chest Surgery Training and Research Hospital, Ankara, TUR
| | - İbrahim Karadağ
- Department of Medical Oncology, Çorum Hittite University Erol Olçok Training and Research Hospital, Çorum, TUR
| | - Mehmet Emin Yılmaz
- Department of Internal Medicine, Health Sciences University, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, TUR
| | - Ömür Berna Çakmak Öksüzoğlu
- Department of Medical Oncology, Health Sciences University, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, TUR
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Yang S, Li S. Development of prognostic predictive model with neutrophil-lymphocyte ratio (NLR) in patients with gastric signet ring carcinoma. Medicine (Baltimore) 2022; 101:e28043. [PMID: 35029873 PMCID: PMC8735796 DOI: 10.1097/md.0000000000028043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 11/11/2021] [Indexed: 11/25/2022] Open
Abstract
The risk factors have not been well-defined for prognosis in gastric signet ring cell carcinoma (GSRC) patients. This study is designed to prognosticate survival in GSRC patients by establishing and verifying a predictive model with neutrophil-lymphocyte ratio (NLR).A total of 147 GSRC patients from Department of Surgical Oncology, Neimenggu Baogang Hospital, Inner Mongolia Medical University were retrospectively reviewed. A predictive model was established using Cox proportional hazards. The performance of the model was evaluated by ROC curves.In present study, we found that overall survival (OS) (P < .001, Fig. 1A) and tumor recurrence rate (P = .036, Fig. 1B) in the NLR ≤ 2.8 group were significantly better than those in the NLR > 2.8 group. These results showed that NLR ≤ 2.8 was significant prognostic factor related with both OS and tumor recurrence in patients with GSRC. After adjusting for competing risk factors, NLR ≤ 2.8 (hazard ratio [HR]: 2.625, 95% confidence interval [CI]: 1.505-5.3166, P = .003), tumor size (HR: 3.024, 95% CI: 1.521-4.186, P = .005), and tumor metastasis (HR: 3.303, 95% CI: 1.25-4.525, P = .012) remained independent predictors of tumor recurrence rate and OS. Our results showed that comparing with the model without NLR (area under ROC curve: 0.798), the model with NLR (area under ROC curve: 0.826) had significant better predictive power than the model without NLR, which further confirmed the value of NLR in predicting prognosis of patients with GSRC.In conclusion, a high NLR value independently predicts poor survival in patients with GSRC after surgery. The NLR may help oncologists evaluate outcomes of patients received surgical resection and chemotherapy in order to choose alternative therapies for patients with high NLR value.
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Qiu Y, Zhang X, Deng X, Zhang R, Cai Z, Zhang Z, Liu H. Circulating tumor cell-associated white blood cell cluster is associated with poor survival of patients with gastric cancer following radical gastrectomy. Eur J Surg Oncol 2021; 48:1039-1045. [PMID: 34836729 DOI: 10.1016/j.ejso.2021.11.115] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 09/29/2021] [Accepted: 11/16/2021] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION The prognostic implication of circulating tumor cell (CTC) -associated white blood cell clusters (CTC-WBC clusters) in patients with gastric cancer (GC) after radical gastrectomy is not well defined. METHODS The prognostic value of the CTC-WBC clusters was evaluated retrospectively in an independent cohort of GC patients with radical gastrectomy from Nanfang Hospital, Southern Medical University, China, between March 1, 2018, and September 31, 2019. The cohort was grouped into two groups: CTC-WBC group and CTC group. The CTC-WBC clusters and CTCs in blood were detected by technology of Canapatrol™ CTC filtration system. The Kaplan-Meier method was used to generate survival curve and compare the disease-free survival and OS. Cox regression model was used for multivariate analyses. RESULTS Two hundred and seventeen patients were included for analyses, 29 patients presenting CTC-WBC clusters positive (CTC-WBC group) and 188 patients presenting exclusively CTCs (CTC group). Depth of tumor invasion was statistically different between two groups (P = 0.043), and the other clinicopathological features between the two groups were similar. Kaplan-Meier analysis showed that positive CTC-WBC cluster patients had significantly shorter OS than patients with exclusively CTC (P = 0.037). Cox regression analysis revealed that CTC-WBC cluster was an independent factor (Hazard Ratio = 2.553, 95% Confidence Interval: 1.008-6.465, P = 0.048) for OS after adjustment of age, gender, number of CTCs, type of CTCs, and tumor stage. CONCLUSION The presence of CTC-WBC clusters is associated with poor OS in the GC patients after radical surgery regardless of tumor stage. Our data suggest alternative prognostic model needs to be further investigated.
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Affiliation(s)
- Yaopeng Qiu
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Xinxin Zhang
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiangqian Deng
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Renyi Zhang
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Zhen Cai
- Laboratory Medicine Center, Nanfang Hospital, Southern Medical University, Guangzhou, China.
| | - Zhenzhan Zhang
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
| | - Hao Liu
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
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Chang YH, Lin PH, Chen CC, Weng WH, Yu KJ, Liu CY, Hsieh CH, Chang TH, Shao IH, Kan HC, Chuang CK, Pang ST. Gain of TPPP as a predictor of progression in patients with bladder cancer. Exp Ther Med 2021; 22:1204. [PMID: 34584549 DOI: 10.3892/etm.2021.10638] [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: 09/05/2019] [Accepted: 06/17/2020] [Indexed: 11/05/2022] Open
Abstract
The present study investigated the role of tubulin polymerization promoting protein (TPPP) in the regulation of bladder cancer (BC) cell proliferation and migration, in addition to the association between TPPP gene copy number amplification and clinicopathological characteristics of BC. TPPP gene amplification was measured in human BC epithelial cells and samples obtained from 52 patients with BC via fluorescence in situ hybridization. TPPP gain was defined as mean TPPP copy number >2.2 per nucleus (cutoff). The neutrophil-to-lymphocyte ratio (NLR) was also obtained from the preoperative data of the patients. For in vitro assays, BC cell lines were transfected with either TPPP small interfering RNAs or scrambled control, following which cell proliferation and migration were determined using Cell Counting Kit-8 and Transwell migration assays, respectively. The percentage of cells with TPPP copy number amplification in the four BC epithelial cell lines (MGH-U1, -U1R, -U3, -U4) examined (86.0-100.0%) was found to be higher compared with that in the normal human uroepithelial cell lines (3.0 and 9.0%). Patients were divided into one- (1.9%), two- (55.8%), three- (7.7%), four- (26.9%) and five-copy (7.7%) types. Results calculated using Fisher's exact test indicated that the gain of TPPP in patients with BC associated significantly with age (P<0.05), advanced histological grade (P<0.001), tumor stage (P<0.05), histological type (P<0.001) and NLR (P<0.05). In MGH-U1R and MGH-U4 cells, cell proliferation and migration were revealed to be significantly lower following TPPP knockdown compared with those in cells transfected with the scrambled control. In conclusion, findings from the present study suggest that TPPP is important for cell proliferation, cell migration and BC progression, such that TPPP copy number assessment would be advised for preoperative urine cytology for urothelial neoplasia diagnosis.
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Affiliation(s)
- Ying-Hsu Chang
- Department of Urology, New Taipei Municipal Tucheng Hospital, Chang Gung Memorial Hospital, New Taipei City 236017, Taiwan, R.O.C.,Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan 33305, Taiwan, R.O.C.,Department of Medicine, College of Medicine, Chang Gung University, Taoyuan 33305, Taiwan, R.O.C
| | - Po-Hung Lin
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan 33305, Taiwan, R.O.C.,Department of Medicine, College of Medicine, Chang Gung University, Taoyuan 33305, Taiwan, R.O.C.,Graduate Institute of Clinical Medical Science, College of Medicine, Chang Gung University, Taoyuan 33305, Taiwan, R.O.C
| | - Chin-Chang Chen
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan 33305, Taiwan, R.O.C
| | - Wen-Hui Weng
- Department of Chemical Engineering and Biotechnology and Graduate Institute of Biochemical and Biomedical Engineering, National Taipei University of Technology, Taipei 10608, Taiwan, R.O.C
| | - Kai-Jie Yu
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan 33305, Taiwan, R.O.C.,Department of Medicine, College of Medicine, Chang Gung University, Taoyuan 33305, Taiwan, R.O.C.,Department of Chemical Engineering and Biotechnology and Graduate Institute of Biochemical and Biomedical Engineering, National Taipei University of Technology, Taipei 10608, Taiwan, R.O.C
| | - Chung-Yi Liu
- Department of Urology, New Taipei Municipal Tucheng Hospital, Chang Gung Memorial Hospital, New Taipei City 236017, Taiwan, R.O.C.,Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan 33305, Taiwan, R.O.C.,Department of Medicine, College of Medicine, Chang Gung University, Taoyuan 33305, Taiwan, R.O.C
| | - Chin-Hsuan Hsieh
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan 33305, Taiwan, R.O.C
| | - Tzu-Hsuan Chang
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan 33305, Taiwan, R.O.C
| | - I-Hung Shao
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan 33305, Taiwan, R.O.C.,Department of Medicine, College of Medicine, Chang Gung University, Taoyuan 33305, Taiwan, R.O.C.,Graduate Institute of Clinical Medical Science, College of Medicine, Chang Gung University, Taoyuan 33305, Taiwan, R.O.C
| | - Hung-Cheng Kan
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan 33305, Taiwan, R.O.C.,Department of Medicine, College of Medicine, Chang Gung University, Taoyuan 33305, Taiwan, R.O.C
| | - Cheng-Keng Chuang
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan 33305, Taiwan, R.O.C.,Department of Medicine, College of Medicine, Chang Gung University, Taoyuan 33305, Taiwan, R.O.C.,Graduate Institute of Clinical Medical Science, College of Medicine, Chang Gung University, Taoyuan 33305, Taiwan, R.O.C
| | - See-Tong Pang
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan 33305, Taiwan, R.O.C.,Department of Medicine, College of Medicine, Chang Gung University, Taoyuan 33305, Taiwan, R.O.C
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Xu Z, Zhang J, Zhong Y, Mai Y, Huang D, Wei W, Huang J, Zhao P, Lin F, Jin J. Predictive value of the monocyte-to-lymphocyte ratio in the diagnosis of prostate cancer. Medicine (Baltimore) 2021; 100:e27244. [PMID: 34559125 PMCID: PMC8462614 DOI: 10.1097/md.0000000000027244] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 08/25/2021] [Indexed: 01/05/2023] Open
Abstract
It has been reported that inflammation and immune system are related to prostate cancer. The neutrophil-to-lymphocyte ratio (NLR), as well as the platelet-to-lymphocyte ratio (PLR), have already been proposed as new indices to help diagnose prostate cancer (PCa). However, the monocyte-to-lymphocyte ratio (MLR) with regard to PCa has rarely been mentioned.To investigate the capability of the MLR to predict PCa.Patients who were pathologically diagnosed with PCa in our hospital and healthy control subjects who conformed to the inclusion criteria were enrolled. Patient data were recorded, including age, complete blood counts, blood biochemistry, and serum prostate-specific antigen (PSA) levels. The differences in these data between the groups were analyzed and the diagnostic value of the MLR was compared with PSA.Our study included a total of 100 patients with PCa and 103 healthy control subjects. Patients with PCa presented with a significantly higher NLR, MLR, and PLR compared to control subjects. However, the hemoglobin and lymphocyte levels were lower (P < .05) in PCa patients. The area under the curve (AUC) of PSA and ratio of free/total serum prostate-specific antigen were 0.899 (95% confidence interval [CI]: 0.857-0.942) and 0.872 (95% CI: 0.818-0.926), respectively, while the AUC of the MLR was 0.852 (95% CI: 0.798-0.906), which was higher than that of the NLR, PLR, and any other blood parameters. Additionally, the optimal cut-off value of the MLR for PCa was 0.264, with a specificity of 87.4% and a sensitivity of 72.0%. An evaluation of the diagnostic value of MLR + PSA gave an AUC of 0.936 (95% CI: 0.902-0.970). However, the AUC of MLR + PSA + f/tPSA was 0.996 (95% CI: 0.991-1.000). The diagnostic value of MLR + NLR + PSA gave an AUC of 0.945 (95% CI: 0.913-0.977), and the specificity is 0.971.PSA remains the most important diagnostic indicator. MLR combined with PSA and f/tPSA has the higher predictive value than PSA. It suggests that MLR may be another good predictive indicator of PCa. It can help reduce the clinical false positive rate.
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Affiliation(s)
- Zhanping Xu
- Department of Urology, Foshan Hospital of Traditional Chinese Medicine, Foshan, Guangdong, PR China
| | - Jing Zhang
- Department of Gynecology, Family Planning Research Institute of Guangdong Province, Guangzhou, Guangdong, PR China
| | - Yuxiang Zhong
- Department of Urology, Foshan Hospital of Traditional Chinese Medicine, Foshan, Guangdong, PR China
| | - Yuan Mai
- Department of Urology, Foshan Hospital of Traditional Chinese Medicine, Foshan, Guangdong, PR China
| | - Danxuan Huang
- Health Management Center, Foshan Hospital of Traditional Chinese Medicine, Foshan, Guangdong, PR China
| | - Wei Wei
- Department of Urology, Foshan Hospital of Traditional Chinese Medicine, Foshan, Guangdong, PR China
| | - Jianhua Huang
- Department of Urology, Foshan Hospital of Traditional Chinese Medicine, Foshan, Guangdong, PR China
| | - Pengpeng Zhao
- Department of Urology, Foshan Hospital of Traditional Chinese Medicine, Foshan, Guangdong, PR China
| | - Fuxiang Lin
- Department of Urology, Foshan Hospital of Traditional Chinese Medicine, Foshan, Guangdong, PR China
| | - Jingmiao Jin
- Department of Urology, Foshan Hospital of Traditional Chinese Medicine, Foshan, Guangdong, PR China
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Sim JH, Lee JS, Jang DM, Kim HJ, Lee SW, Cho HS, Choi WJ. Effects of Perioperative Inflammatory Response in Cervical Cancer: Laparoscopic versus Open Surgery. J Clin Med 2021; 10:jcm10184198. [PMID: 34575308 PMCID: PMC8467117 DOI: 10.3390/jcm10184198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 08/31/2021] [Accepted: 09/14/2021] [Indexed: 12/31/2022] Open
Abstract
There are few studies between postoperative neutrophil to lymphocyte ratio (NLR) and survival in cervical cancer. We compared postoperative changes in NLR according to surgical methods and analyzed the effect of these changes on 5-year mortality of cervical cancer patients. A total of 929 patients were assigned to either the laparoscopic radical hysterectomy (LRH) (n = 721) or open radical hysterectomy (ORH) (n = 208) group. Propensity score matching analysis compared the postoperative NLR changes between the two groups, and multivariate logistic regression analysis evaluated the association between NLR changes and 5-year mortality. Surgical outcomes between the two groups were also compared. In the LRH group, NLR changes at postoperative day (POD) 0 and POD 1 were significantly lower than in the ORH group after matching (NLR change at POD 0, 10.4 vs. 14.3, p < 0.001; NLR change at POD 1, 3.5 vs. 5.4, p < 0.001). In multivariate logistic regression analysis, postoperative NLR change was not associated with 5-year mortality (2nd quartile: OR 1.55, 95% CI 0.56–4.29, p = 0.401; 3rd quartile: OR 0.90, 95% CI 0.29–2.82, p = 0.869; 4th quartile: OR 1.40, 95% CI 0.48–3.61, p = 0.598), whereas preoperative NLR was associated with 5-year mortality (OR 1.23, 95% CI 1.06–1.43, p = 0.005). After matching, there were no significant differences in surgical outcomes between the two groups. There were significantly fewer postoperative changes of NLR in the LRH group. However, the extent of these NLR changes was not associated with 5-year mortality. By contrast, preoperative NLR was associated with 5-year mortality.
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Affiliation(s)
- Ji-Hoon Sim
- Asan Medical Center, Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.-H.S.); (J.-S.L.); (D.-M.J.); (W.-J.C.)
| | - Ju-Seung Lee
- Asan Medical Center, Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.-H.S.); (J.-S.L.); (D.-M.J.); (W.-J.C.)
| | - Dong-Min Jang
- Asan Medical Center, Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.-H.S.); (J.-S.L.); (D.-M.J.); (W.-J.C.)
| | - Hwa Jung Kim
- Asan Medical Center, Department of Clinical Epidemiology and Biostatistics, University of Ulsan College of Medicine, Seoul 05505, Korea;
| | - Shin-Wha Lee
- Asan Medical Center, Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Seoul 05505, Korea;
| | - Hyun-Seok Cho
- Asan Medical Center, Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.-H.S.); (J.-S.L.); (D.-M.J.); (W.-J.C.)
- Correspondence: ; Tel.: +82-2-3010-0807; Fax: +82-2-3010-6790
| | - Woo-Jong Choi
- Asan Medical Center, Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.-H.S.); (J.-S.L.); (D.-M.J.); (W.-J.C.)
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Konopka K, Micek A, Ochenduszko S, Streb J, Potocki P, Kwinta Ł, Wysocki PJ. Combined Neutrophil-to-Lymphocyte and Platelet-Volume-to-Platelet Ratio (NLR and PVPR Score) Represents a Novel Prognostic Factor in Advanced Gastric Cancer Patients. J Clin Med 2021; 10:3902. [PMID: 34501353 PMCID: PMC8432226 DOI: 10.3390/jcm10173902] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 08/20/2021] [Accepted: 08/27/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Chemotherapy is a cornerstone of treatment in advanced gastric cancer (GC) with a proven impact on overall survival, however, reliable predictive markers are missing. The role of various inflammatory markers has been tested in gastric cancer patients, but there is still no general consensus on their true clinical applicability. High neutrophil-to-lymphocyte (NLR) and low (medium)-platelets-volume-to-platelet ratio (PVPR) are known markers of unspecific immune system activation, correlating significantly with outcomes in advanced GC patients. METHODS Metastatic GC patients (N:155) treated with chemotherapy +/- trastuzumab were enrolled in this retrospective study. Pre-treatment NLR and PVPR, as well as other inflammatory markers were measured in peripheral blood. Univariate Cox regression was conducted to find markers with a significant impact on overall survival (OS) and progression-free survival (PFS). Spearman correlation and Cohen's kappa was used to analyze multicollinearity. Multiple multivariable Cox regression models were built to study the combined impact of NLR and PVPR, as well as other known prognostic factors on OS. RESULTS Elevated NLR was significantly associated with increased risk of death (HR = 1.95; 95% CI: 1.17-3.24), and lower PVPR was significantly associated with improved outcomes (HR = 0.53; 95% CI: 0.32-0.90). A novel inflammatory marker, based on a combination of NLR and PVPR, allows for the classification of GC patients into three prognostic groups, characterized by median OS of 8.4 months (95% CI 5.8-11.1), 10.5 months (95% CI 8.8-12.1), and 15.9 months (95% CI 13.5-18.3). CONCLUSION The NLR and PVPR score (elevated NLR and decreased PVPR) is a marker of detrimental outcome of advanced GC patients treated with chemotherapy.
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Affiliation(s)
- Kamil Konopka
- Department of Oncology, Jagiellonian University Medical College, 31-007 Cracow, Poland; (J.S.); (P.P.); (Ł.K.); (P.J.W.)
| | - Agnieszka Micek
- Department of Nursing Management and Epidemiology Nursing, Jagiellonian University Medical College, 31-007 Cracow, Poland;
| | | | - Joanna Streb
- Department of Oncology, Jagiellonian University Medical College, 31-007 Cracow, Poland; (J.S.); (P.P.); (Ł.K.); (P.J.W.)
| | - Paweł Potocki
- Department of Oncology, Jagiellonian University Medical College, 31-007 Cracow, Poland; (J.S.); (P.P.); (Ł.K.); (P.J.W.)
| | - Łukasz Kwinta
- Department of Oncology, Jagiellonian University Medical College, 31-007 Cracow, Poland; (J.S.); (P.P.); (Ł.K.); (P.J.W.)
| | - Piotr J. Wysocki
- Department of Oncology, Jagiellonian University Medical College, 31-007 Cracow, Poland; (J.S.); (P.P.); (Ł.K.); (P.J.W.)
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Lusho S, Durando X, Mouret-Reynier MA, Kossai M, Lacrampe N, Molnar I, Penault-Llorca F, Radosevic-Robin N, Abrial C. Platelet-to-Lymphocyte Ratio Is Associated With Favorable Response to Neoadjuvant Chemotherapy in Triple Negative Breast Cancer: A Study on 120 Patients. Front Oncol 2021; 11:678315. [PMID: 34367964 PMCID: PMC8331686 DOI: 10.3389/fonc.2021.678315] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 06/29/2021] [Indexed: 12/31/2022] Open
Abstract
Introduction Triple negative breast cancer (TNBC) is highly heterogeneous, but still most of the patients are treated by the anthracycline/taxane-based neoadjuvant therapy (NACT). Tumor-infiltrating lymphocytes (TILs) are a strong predictive and prognostic biomarker in TNBC, however are not always available. Peripheral blood counts, which reflect the systemic inflammatory/immune status, are easier to obtain than TILs. We investigated whether baseline white cell or platelet counts, as well as, Neutrophil-to-Lymphocyte Ratio (NLR) or Platelet-to-Lymphocyte Ratio (PLR) could replace baseline TILs as predictive or prognostic biomarkers in a series of TNBC treated by standard NACT. Patients and Methods One hundred twenty patients uniformly treated by FEC/taxane NACT in a tertiary cancer care center were retrospectively analyzed. The presence of pathological complete response (pCR: ypT0/Tis, ypN0) or the presence of pCR and/small residual disease (ypT0/Tis/T1ab, ypN0) were considered as good responses in data analysis. Baseline/pre-NACT blood count, NLR, PLR and TILs were evaluated as predictors of response, distant recurrence rate and distant recurrence-free survival (DRFS). Results TILs ≥30% and ≥1.5% were best predictors of pCR and distant recurrence risk, respectively (p = 0.007, p = 0.012). However, in this cohort, pCR status was not significantly associated with recurrence. Only the ensemble of patients with pCR and small residual disease had lower recurrence risk and longer survival DRFS (p = 0.042, p = 0.024, respectively) than the rest of the cohort (larger residual disease). The only parameter which could predict the pCR/small residual disease status was PLR: patients with values lower than 133.25 had significantly higher chance of reaching that status after NACT (p = 0.045). However, no direct correlation could be established between baseline PLR and metastatic recurrence. No correlation either was found between TIL and individual blood counts, or between TILs and NLR or PLR. Conclusion In this cohort, TILs retained their pCR predictive value; however PLR was a better predictor of the ensemble of responses which had good outcome in terms of less distant recurrences or longer DRFS (pCR or small residual disease). Thus, baseline PLR is worth further, prospective investigation together with baseline TILs, as it might indicate a good TNBC response to NACT when TILs are unavailable.
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Affiliation(s)
- Sejdi Lusho
- Clermont Auvergne University, INSERM U1240 "Molecular Imaging and Theranostic Strategies", Centre Jean Perrin, Clermont-Ferrand, France.,Delegation for Clinical Research and Innovation, Centre Jean Perrin, Clermont-Ferrand, France.,Centre for Clinical Investigation, INSERM U501, Clermont-Ferrand, France
| | - Xavier Durando
- Clermont Auvergne University, INSERM U1240 "Molecular Imaging and Theranostic Strategies", Centre Jean Perrin, Clermont-Ferrand, France.,Delegation for Clinical Research and Innovation, Centre Jean Perrin, Clermont-Ferrand, France.,Centre for Clinical Investigation, INSERM U501, Clermont-Ferrand, France.,Department of Medical Oncology, Centre Jean Perrin, Clermont-Ferrand, France
| | - Marie-Ange Mouret-Reynier
- Clermont Auvergne University, INSERM U1240 "Molecular Imaging and Theranostic Strategies", Centre Jean Perrin, Clermont-Ferrand, France.,Delegation for Clinical Research and Innovation, Centre Jean Perrin, Clermont-Ferrand, France.,Centre for Clinical Investigation, INSERM U501, Clermont-Ferrand, France.,Department of Medical Oncology, Centre Jean Perrin, Clermont-Ferrand, France
| | - Myriam Kossai
- Clermont Auvergne University, INSERM U1240 "Molecular Imaging and Theranostic Strategies", Centre Jean Perrin, Clermont-Ferrand, France.,Department of Pathology, Centre Jean Perrin, Clermont-Ferrand, France
| | - Nathalie Lacrampe
- Clermont Auvergne University, INSERM U1240 "Molecular Imaging and Theranostic Strategies", Centre Jean Perrin, Clermont-Ferrand, France.,Department of Pathology, Centre Jean Perrin, Clermont-Ferrand, France
| | - Ioana Molnar
- Clermont Auvergne University, INSERM U1240 "Molecular Imaging and Theranostic Strategies", Centre Jean Perrin, Clermont-Ferrand, France.,Delegation for Clinical Research and Innovation, Centre Jean Perrin, Clermont-Ferrand, France.,Centre for Clinical Investigation, INSERM U501, Clermont-Ferrand, France
| | - Frederique Penault-Llorca
- Clermont Auvergne University, INSERM U1240 "Molecular Imaging and Theranostic Strategies", Centre Jean Perrin, Clermont-Ferrand, France
| | - Nina Radosevic-Robin
- Clermont Auvergne University, INSERM U1240 "Molecular Imaging and Theranostic Strategies", Centre Jean Perrin, Clermont-Ferrand, France.,Department of Pathology, Centre Jean Perrin, Clermont-Ferrand, France
| | - Catherine Abrial
- Clermont Auvergne University, INSERM U1240 "Molecular Imaging and Theranostic Strategies", Centre Jean Perrin, Clermont-Ferrand, France.,Delegation for Clinical Research and Innovation, Centre Jean Perrin, Clermont-Ferrand, France.,Centre for Clinical Investigation, INSERM U501, Clermont-Ferrand, France
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Xu L, Song J. Elevated neutrophil-lymphocyte ratio can be a biomarker for predicting the development of cervical intraepithelial neoplasia. Medicine (Baltimore) 2021; 100:e26335. [PMID: 34260524 PMCID: PMC8284729 DOI: 10.1097/md.0000000000026335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 05/26/2021] [Indexed: 01/04/2023] Open
Abstract
Cervical intraepithelial neoplasia (CIN) is the abnormal growth of cells on the surface of the cervix that could potentially lead to cervical cancer. In the present study, we investigated whether measuring the neutrophil-lymphocyte ratio (NLR) can be useful for predicting the risks of developing cervical lesions.This is a retrospective analysis of 212 women who were enrolled in this study. Among them, 106 patients with histologically confirmed CIN1-3 who were treated with loop electrosurgical excision procedure or cold knife cone in the Department of Gynecology, The Affiliated Hospital of Inner Mongolia Medical University between July 30th 2016 and January 30th 2019.Among the 106 patients in the CIN group, cytology showed minor abnormality which included atypical squamous cells of undetermined significance or low-grade squamous intraepithelial lesion in 42, high-grade squamous intraepithelial lesion in 62, and squamous cell carcinoma in 2 patients. We found that the NLR has no significant difference between the control group and the CIN1 group, while there were significant differences between CIN1 and CIN2, and CIN2 and CIN3 group. The median of the NLR was higher in the HPV16-persistent groups than in the HPV-negative group.In conclusion, a high NLR value independently predicts CIN and the stage of CIN. The NLR may help doctors evaluate outcomes of patients received conization and choose alternative therapies for patients with high NLR value.
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Neutrophil-to-Lymphocyte Ratio as a Biomarker Predicting Overall Survival after Chemoembolization for Intermediate-Stage Hepatocellular Carcinoma. Cancers (Basel) 2021; 13:cancers13112830. [PMID: 34204125 PMCID: PMC8201147 DOI: 10.3390/cancers13112830] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 05/31/2021] [Accepted: 06/03/2021] [Indexed: 12/23/2022] Open
Abstract
Simple Summary Baseline neutrophil-to-lymphocyte ratio ≥3 was a robust independent predictor of overall survival after chemoembolization for intermediate-stage hepatocellular carcinoma, with the predictive value verified by cross-validation. Abstract The clinical impact of neutrophil-to-lymphocyte ratio (NLR) in predicting outcomes in hepatocellular carcinoma (HCC) patients treated with transarterial chemoembolization (TACE) remain unclear, and additional large-scale studies are required. This retrospective study evaluated outcomes in treatment-naïve patients who received TACE as first-line treatment for intermediate-stage HCC between 2008 and 2017. Patients who underwent TACE before and after 2013 were assigned to the development (n = 495) and validation (n = 436) cohorts, respectively. Multivariable Cox analysis identified six factors predictive of outcome, including NLR, which were used to create models predictive of overall survival (OS) in the development cohort. Risk scores of 0–3, 4–7, and 8–12 were defined as low, intermediate, and high risk, respectively. Median OS times in the low-, medium-, and high-risk groups in the validation cohort were 48.1, 24.3, and 9.7 months, respectively (p < 0.001). Application to the validation cohort of time-dependent ROC curves for models predictive of OS showed AUC values of 0.72 and 0.70 at 3 and 5 years, respectively. Multivariable logistic regression analysis found that NLR ≥ 3 was a significant predictor (odds ratio, 3.4; p < 0.001) of disease progression 6 months after TACE. Higher baseline NLR was predictive of poor prognosis in patients who underwent TACE for intermediate-stage HCC.
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Is Sarcopenic Obesity an Indicator of Poor Prognosis in Gastric Cancer Surgery? A Cohort Study in a Western Population. J Gastrointest Surg 2021; 25:1388-1403. [PMID: 32661833 DOI: 10.1007/s11605-020-04716-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 06/23/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND The prognostic value of sarcopenic obesity in gastric cancer surgery remains debated. We aimed to evaluate the impact on outcomes of body composition and sarcopenic obesity after gastrectomy for gastric cancer. METHODS A retrospective review of prospectively maintained database of patients undergoing gastrectomy for gastric cancer from 2010 to 2017 was performed. Skeletal muscle mass and visceral adipose tissue were evaluated by preoperative computed tomography to define sarcopenia and obesity. Patients were classified in body composition groups according to the presence or absence of sarcopenia and obesity. Prognostic factors for survival were assessed by multivariate Cox analysis. RESULTS Of the 198 patients undergoing gastrectomy for gastric cancer, 90 (45.4%) patients were sarcopenic, 130 (67.7%) obese, and in the subclassification for body composition categories: 33 (17%) nonsarcopenic nonobesity, 75 (38%) non sarcopenic obesity, 35 (17%) sarcopenic nonobesity, and 55 (28%) sarcopenic obesity. No category of body composition was a predictor of postoperative complications and worse overall and disease-free survival outcomes. Multivariable analysis identified ASA III classification, preoperative weight loss > 10%, postoperative surgical re-intervention, and advanced tumor stage as independent prognostic factors for overall survival, and patients aged 75 years or older, preoperative weight loss > 10%, elevated netrophil-lymphocyte ratio, and advanced tumor stage as independent prognostic factors for disease-free survival. CONCLUSIONS Sarcopenia, obesity, and sarcopenic obesity were not associated with worse outcomes after gastric cancer surgery.
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Kunisaki C, Sato S, Tsuchiya N, Kubo H, Watanabe J, Sato T, Takeda K, Tamura Y, Kasahara K, Kosaka T, Akiyama H, Endo I. Real-World Therapeutic Outcomes of S-1 Adjuvant Chemotherapy for pStage II/III Gastric Cancer in the Elderly. Eur Surg Res 2021; 62:40-52. [PMID: 33794520 DOI: 10.1159/000515175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 02/08/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND The predictive factors for discontinuation of S-1 administration and prognostic factors in elderly patients with pStage II/III gastric cancer receiving S-1 adjuvant chemotherapy remain unclear. METHODS Between January 2004 and December 2016, 80 elderly gastric cancer patients (≥70 years) undergoing curative D2 gastrectomy were enrolled in this study. Predictive factors for completion of S-1 administration over 1 year, adverse events due to S-1 administration, and prognostic factors for overall survival (OS) and relapse-free survival (RFS) were evaluated. RESULTS Twenty-eight patients (35%) completed 8 courses of S-1. The median relative dose intensity was 82.1% (IQR 31.1-100%). The incidence rates of hematological and nonhematological adverse events were acceptable. Distal gastrectomy was an independent predictive factor for completion of S-1 administration (odds ratio [OR] 0.364; 95% confidence interval [CI] 0.141-0.939; p = 0.037). Higher postoperative neutrophil count/lymphocyte count (N/L) ratio and more advanced stage adversely influenced OS. Multivariate analysis revealed that a higher postoperative N/L ratio and more advanced stage adversely affected RFS. CONCLUSION To complete adjuvant S-1 administration to elderly patients with pStage II/III gastric cancer, total gastrectomy should be avoided if possible. A new regimen for elderly gastric cancer patients with higher postoperative N/L ratios and more advanced stage should be established.
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Affiliation(s)
- Chikara Kunisaki
- Department of Surgery, Gastroenterological Center, Yokohama City University, Yokohama, Japan
| | - Sho Sato
- Department of Surgery, Gastroenterological Center, Yokohama City University, Yokohama, Japan
| | - Nobuhiro Tsuchiya
- Department of Surgery, Gastroenterological Center, Yokohama City University, Yokohama, Japan
| | - Hirokazu Kubo
- Department of Surgery, Gastroenterological Center, Yokohama City University, Yokohama, Japan
| | - Jun Watanabe
- Department of Surgery, Gastroenterological Center, Yokohama City University, Yokohama, Japan
| | - Tsutomu Sato
- Department of Surgery, Gastroenterological Center, Yokohama City University, Yokohama, Japan
| | - Kazuhisa Takeda
- Department of Surgery, Gastroenterological Center, Yokohama City University, Yokohama, Japan
| | - Yuko Tamura
- Department of Gastroenterological Surgery, Yokohama City University, School of Medicine, Yokohama, Japan
| | - Kohei Kasahara
- Department of Gastroenterological Surgery, Yokohama City University, School of Medicine, Yokohama, Japan
| | - Takashi Kosaka
- Department of Gastroenterological Surgery, Yokohama City University, School of Medicine, Yokohama, Japan
| | - Hirotoshi Akiyama
- Department of Gastroenterological Surgery, Yokohama City University, School of Medicine, Yokohama, Japan
| | - Itaru Endo
- Department of Gastroenterological Surgery, Yokohama City University, School of Medicine, Yokohama, Japan
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Response Prediction in Immune Checkpoint Inhibitor Immunotherapy for Advanced Hepatocellular Carcinoma. Cancers (Basel) 2021; 13:cancers13071607. [PMID: 33807219 PMCID: PMC8036568 DOI: 10.3390/cancers13071607] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 03/20/2021] [Accepted: 03/24/2021] [Indexed: 12/17/2022] Open
Abstract
Simple Summary Hepatocellular carcinoma is the most common liver malignancy. In the population with an advanced stage of the disease, outcomes could be disappointed by treating with molecular targeting agents because of low treatment response rates. It has gained improving effects of immune checkpoint inhibitor as an emerging treatment for advanced HCC (Hepatocellular carcinoma). However, this novel treatment regimen is quite expensive; to select suitable patients prior to treatment is crucial in daily practice. Here, we intend to present the effect of immunotherapy in treating advanced hepatocellular carcinoma in the real world and to assess potential factors predicting treatment responses for patient selection. Abstract Immune checkpoint inhibitors (ICI) have been applied to treat advanced stage hepatocellular carcinoma (HCC) and obtain promising effects. However, tumor response to treatment was unpredictable. A predicting biomarker of objective response or disease-control is an unmet need for patient selection. In this study, 45 advanced HCC patients who failed to sorafenib treatment and received nivolumab, 3 mg/kg bi-weekly, were included. Tumor responses to nivolumab treatment were assessed by the modified response evaluation criteria in solid tumors (mRECIST) criteria. Tumor responses were correlated to clinical characteristics to find out response predictors. In this small series, the prevalence of extrahepatic nodal metastasis, distant metastasis, and portal vein thrombus among the patients were 22.2% (n = 10), 48.9% (n = 22), and 42.2% (n = 19), respectively. The pre-treatment tumor size was 7.2 ± 4.2 cm in maximal diameter, and the calculated total tumor volume was 619.0 ± 831.1 cm3. Among 45 patients, 3 patients had partial response (PR), 11 had stable disease (SD), and the other 31 had progression of disease. By correlating clinical data to the patients with PR and SD, serum neutrophil-to-lymphocyte ratio (NLR) (hazard ratio (HR) = 2.04) and patient-generated subjective global assessment (PG-SGA) score (HR = 2.30) were the independent factors in multivariate analysis. By receiver operating characteristic curve analysis, pre-treatment NLR ≤ 2.5 and PG-SGA score < 4 were the cutoff points to predict tumor response to ICI treatment. In conclusion, biomarkers to predict tumor response for HCC are still lacking in this costly ICI therapy. In this study, NLR ≤ 2.5 and PG-SGA score < 4 indicated disease-control, and can be applied as biomarkers to select the right patients to receive this costly therapy.
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Neutrophil-lymphocyte ratio (NLR) was associated with prognosis and immunomodulatory in patients with pancreatic ductal adenocarcinoma (PDAC). Biosci Rep 2021; 40:225197. [PMID: 32510138 PMCID: PMC7300287 DOI: 10.1042/bsr20201190] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 05/27/2020] [Accepted: 06/01/2020] [Indexed: 02/07/2023] Open
Abstract
Although the oncological outcomes in patients with pancreatic ductal adenocarcinoma (PDAC) have markedly improved over the past decade, the survival prediction is still challenging. The aim of this study was to investigate the prognostic value of neutrophil–lymphocyte ratio (NLR) and analyze the relationship of between the NLR and immune cells phenotypes in patients with PDAC. Sixty-seven consecutive patients with PDAC were recruited in this study. Life-table estimates of survival time were calculated according to the Kaplan and Meier methodology. The phenotypic T cells subclasses were evaluated by flow cytometry. All the 67 patients in this study were treated with surgical resection and among them, 46 patients received adjuvant chemotherapy. Receiver operating characteristic (ROC) curves analysis was performed to compare prognostic value of NLR with CA199. We found that the Harrell's area under ROC (AUROC) for the NLR to predict overall survival (OS) (0.840; 95% CI, 0.766–0.898) was significantly higher than that of the CA199 levels. After that we stratified all patients into NLR > 2.5 (n = 42) and NLR ≤ 2.5 (n = 25) groups according to the OS of patients with PDAC. Survival analysis showed that patients with NLR ≤ 2.5 had significantly favorable OS and progressive free survival (PFS) compared with patients with NLR > 2.5. The CD3+ and CD8+/CD28+ T cell subsets were significantly increased in patients with NLR ≤ 2.5 (P<0.05), while the CD8+/CD28- and CD4+/CD25+ cell subsets were significantly decreased in patients with NLR ≤ 2.5 (P<0.05). In conclusion, a high NLR value independently predicts poor survival in patients with PDAC after surgical resection. The NLR was closely related with immune cells phenotypes The NLR may help oncologists evaluate outcomes of patients received surgical resection and chemotherapy to choose alternative therapies for patients with high NLR value.
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Hoshino S, Takeuchi M, Kawakubo H, Matsuda S, Mayanagi S, Irino T, Fukuda K, Nakamura R, Wada N, Kitagawa Y. Usefulness of Neutrophil to Lymphocyte Ratio at Recurrence for Predicting Long-Term Outcomes in Patients with Recurrent Esophageal Squamous Cell Carcinoma. Ann Surg Oncol 2021; 28:3001-3008. [PMID: 33689078 DOI: 10.1245/s10434-021-09637-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 12/11/2020] [Indexed: 01/11/2023]
Abstract
BACKGROUND Although radical esophagectomy with multifield lymph node dissection is a promising treatment to achieve long-term survival for resectable esophageal cancer, survival after postoperative recurrence remains poor. To select the optimal treatment for patients with recurrent esophageal cancer, simple, objective indicators for predicting of long-term outcomes are needed. PATIENTS AND METHODS We conducted a single-institution, retrospective cohort study between 2004 and 2019, wherein 586 patients underwent transthoracic esophagectomy for primary esophageal squamous cell carcinoma. Of these, 133 patients with postoperative recurrence were included in this analysis. Several predictors of survival after recurrence were investigated. RESULTS Among all patients, the 1- and 3-year survival rates after recurrence were 48.0% and 23.1%, respectively. On multivariate analysis, the neutrophil to lymphocyte ratio (NLR) at recurrence was identified as a significant predictor of death after recurrence (hazard ratio 1.061; 95% confidence interval 1.002-1.125; p = 0.043). Time-dependent receiver operating characteristics curves showed that the area under the curve value of the NLR at recurrence was superior to the modified Glasgow Prognostic Score at recurrence in all terms. To simulate the clinical decision process, we set the cut-off NLR at recurrence for survival using survival classification and regression tree (CART) and defined the optimal cut-off value as 3.374. CONCLUSIONS NLR at recurrence was a significant indicator of survival after recurrence in patients with recurrent esophageal cancer. CART analysis was used to determine the optimal cut-off value for the prediction of survival, allowing the NLR to be used clinically to facilitate decision making.
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Affiliation(s)
- Shota Hoshino
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Masashi Takeuchi
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Hirofumi Kawakubo
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan.
| | - Satoru Matsuda
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Shuhei Mayanagi
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Tomoyuki Irino
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Kazumasa Fukuda
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Rieko Nakamura
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Norihito Wada
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Yuko Kitagawa
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
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Liu Z, Ge H, Miao Z, Shao S, Shi H, Dong C. Dynamic Changes in the Systemic Inflammation Response Index Predict the Outcome of Resectable Gastric Cancer Patients. Front Oncol 2021; 11:577043. [PMID: 33718137 PMCID: PMC7947713 DOI: 10.3389/fonc.2021.577043] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 01/19/2021] [Indexed: 12/24/2022] Open
Abstract
The systemic inflammation response index (SIRI) has been revealed to be closely related to the prognosis of a variety of tumors. Whether the dynamic change in SIRI before and after surgery can be used to judge the prognosis of patients after radical gastrectomy has not yet been studied. In this study, the predictive ability of preoperative SIRI and changes in SIRI before and after surgery for the survival rate of gastric cancer patients was evaluated in two independent cohorts. It was found that SIRI was closely related to TNM staging. The higher the TNM stage, the higher the proportion of patients with a high SIRI. However, SIRI was not related to any other clinicopathological parameters. Kaplan-Meier survival analysis showed that a high SIRI was associated with poor prognosis in gastric cancer patients in the original cohort and in the validation cohort. SIRI, NLR, PLR, and MLR could be used to judge the prognosis of patients with operable gastric cancer. However, multivariate analysis suggested that only SIRI was an independent prognostic factor for patients with operable gastric cancer. In addition, the change in SIRI at 4 to 6 weeks after surgery compared with SIRI before surgery was closely related to the survival of gastric cancer patients. Compared with the unchanged group (absolute variation <50%), gastric cancer patients with a SIRI increase >50% had a worse OS, while patients with a SIRI decrease >50% had a better prognosis. In conclusion, SIRI can be used as a reliable index to evaluate the prognosis of patients with operable gastric cancer, and the dynamic change in SIRI before and after surgery is significantly related to the prognosis of patients with gastric cancer.
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Affiliation(s)
- Zhenhua Liu
- Department of Radiotherapy, The First People's Hospital of Yancheng, Yancheng, China
| | - Haijue Ge
- Department of Gastroenterology, The Third People's Hospital of Yancheng, Yancheng, China
| | - Zhilong Miao
- Department of General Surgery, The Third People's Hospital of Yancheng, Yancheng, China
| | - Shoupeng Shao
- Department of Oncology, The Third People's Hospital of Yancheng, Yancheng, China
| | - Hongtai Shi
- Department of Radiotherapy, The Third People's Hospital of Yancheng, Yancheng, China
| | - Congsong Dong
- Department of Radiology, The Third People's Hospital of Yancheng, Yancheng, China
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Iuchi H, Kyutoku T, Ito K, Matsumoto H, Ohori J, Yamashita M. Impacts of Inflammation-Based Prognostic Scores on Survival in Patients With Hypopharyngeal Squamous Cell Carcinoma. OTO Open 2020; 4:2473974X20978137. [PMID: 33447693 PMCID: PMC7780318 DOI: 10.1177/2473974x20978137] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 11/03/2020] [Indexed: 12/18/2022] Open
Abstract
Objective To investigate the predictive accuracies of the modified Glasgow Prognostic Score (mGPS), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) as prognostic factors for patients with hypopharyngeal squamous cell carcinoma (HSCC). Study Design Retrospective study. Setting University hospital. Methods The records of 106 patients who were histologically diagnosed with HSCC between January 2007 and December 2017 were reviewed. mGPS, NLR, and PLR were analyzed; univariate and multivariate analyses were performed to evaluate the prognosis of overall survival (OS). Results The overall 5-year survival rates of patients with mGPS0, mGPS1, and mGPS2 were 82.0%, 41.9%, and 13.5%, respectively. The overall 5-year survival rates of patients with low and high NLRs and with low and high PLRs were 83.8%, 46.2%, 57.0%, and 59.1%, respectively. mGPS (P < .001) and NLR (P < .05) were independently associated with OS, whereas PLR was not. For stage IV HSCC, only mGPS was independently associated with OS (P = .004). Conclusion mGPS is an excellent prognostic factor for patients with HSCC.
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Affiliation(s)
- Hiroyuki Iuchi
- Department of Otolaryngology, Head and Neck Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Kagoshima, Japan
| | - Takayuki Kyutoku
- Department of Otolaryngology, Head and Neck Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Kagoshima, Japan
| | - Kotoko Ito
- Department of Otolaryngology, Head and Neck Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Kagoshima, Japan
| | - Hayato Matsumoto
- Department of Otolaryngology, Head and Neck Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Kagoshima, Japan
| | - Junichiro Ohori
- Department of Otolaryngology, Head and Neck Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Kagoshima, Japan
| | - Masaru Yamashita
- Department of Otolaryngology, Head and Neck Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Kagoshima, Japan
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Kim HD, Ryu MH, Yoon S, Na YS, Moon M, Lee H, Song HG, Kang YK. Clinical implications of neutrophil-to-lymphocyte ratio and MDSC kinetics in gastric cancer patients treated with ramucirumab plus paclitaxel. Chin J Cancer Res 2020; 32:621-630. [PMID: 33223757 PMCID: PMC7666782 DOI: 10.21147/j.issn.1000-9604.2020.05.07] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objective We aimed to investigate the prognostic value of neutrophil-to-lymphocyte ratio (NLR) and myeloid-derived suppressor cells (MDSCs) in gastric cancer patients treated with second-line ramucirumab plus paclitaxel. Methods A total of 116 patients with advanced or metastatic gastric cancer who receive ramucirumab plus paclitaxel were prospectively enrolled. Fresh blood samples were collected before and after treatment, and flow cytometry was performed to assess the proportions of monocytic (mMDSCs) and granulocytic MDSCs (gMDSCs). Results Median age was 58 years and 71 (61.2%) patients were male. A baseline NLR≥2.94 was associated with significantly poorer progression-free survival (PFS) and overall survival (OS) vs. an NLR<2.94 (P=0.011 and P=0.002, respectively). In multivariate analysis, an NLR≥2.94 was independently associated with poorer PFS [hazard ratio (HR)=1.58; 95% confidence interval (95% CI): 1.01-2.49, P=0.046] and OS (HR=1.77; 95% CI: 1.04-3.04, P=0.036). While mMDSC counts did not significantly change following two cycles of therapy (P=0.530), gMDSC counts decreased significantly after two treatment cycles (P=0.025) but tended to increase in patients with progressive disease after two treatment cycles (P=0.098). A progressive increase in gMDSC counts (≥44%) was associated with a significantly shorter PFS and OSvs. a gMDSC count increase <44% (P=0.001 and P=0.003, respectively). Conclusions The baseline NLR may help guide clinical decisions during ramucirumab plus paclitaxel therapy for gastric cancer. Our gMDSC kinetics data warrant further clinical validation and mechanistic investigation.
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Affiliation(s)
- Hyung-Don Kim
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - Min-Hee Ryu
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | | | - Young-Soon Na
- Asan Institute for Life Science, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - Meesun Moon
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - Hyungeun Lee
- Asan Institute for Life Science, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | | | - Yoon-Koo Kang
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
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40
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Chen QY, Liu ZY, Zhong Q, Jiang W, Zhao YJ, Li P, Wang JB, Lin JX, Lu J, Cao LL, Lin M, Tu RH, Huang ZN, Lin JL, Zheng HL, Que SJ, Zheng CH, Huang CM, Xie JW. An Intraoperative Model for Predicting Survival and Deciding Therapeutic Schedules: A Comprehensive Analysis of Peritoneal Metastasis in Patients With Advanced Gastric Cancer. Front Oncol 2020; 10:550526. [PMID: 33102217 PMCID: PMC7546781 DOI: 10.3389/fonc.2020.550526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 08/14/2020] [Indexed: 12/24/2022] Open
Abstract
Background and Objective: No specialized prognostic model for patients with gastric cancer with peritoneal metastasis (GCPM) exists for intraoperative clinical decision making. This study aims to establish a new prognostic model to provide individual treatment decisions for patients with GCPM. Method: This retrospective analysis included 324 patients with GCPM diagnosed pathologically by laparoscopy from January 2007 to January 2018 who were randomly assigned to different sets (227 in the training set and 97 in the internal validation set). A nomogram was established from preoperative and intraoperative variables determined by a Cox model. The predictive ability and clinical applicability of the PM nomogram (PMN) were compared with the 15th Japanese Classification of Gastric Carcinoma (JCGC) Staging Guidelines for PM (P1abc). Additional external validation was performed using a dataset (n = 39) from the First Affiliated Hospital of University of Science and Technology of China. Results: The median survival time was 8 (range, 1–90) months. In the training set, each PMN substage had significantly different survival curves (P < 0.001), and the PMN was superior to the P1abc based on the results of time-dependent receiver operating characteristic curve, C-index, Akaike information criterion and likelihood ratio chi-square analyses. In the internal and external validation sets, the PMN was also better than the P1abc in terms of its predictive ability. Of the PMN1 patients, those undergoing palliative resection had better overall survival (OS) than those undergoing exploratory surgery (P < 0.05). Among the patients undergoing exploratory surgery, those who received chemotherapy exhibited better OS than those who did not (P < 0.05). Among the patients who received palliative resection, only PMN1 patients exhibited better OS following chemotherapy (P < 0.05). Conclusion: We developed and validated a simple, specific PM model for patients with GCPM that can predict prognosis well and guide treatment decisions.
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Affiliation(s)
- Qi-Yue Chen
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China.,Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China
| | - Zhi-Yu Liu
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China.,Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China
| | - Qing Zhong
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China.,Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China
| | - Wen Jiang
- Division of Life Sciences and Medicine, Department of Gastrointestinal Surgery, The First Affiliated Hospital of University of Science and Technology of China, University of Science and Technology of China, Hefei, China.,Anhui Provincial Hospital Affiliated With Anhui Medical University, Hefei, China
| | - Ya-Jun Zhao
- Division of Life Sciences and Medicine, Department of Gastrointestinal Surgery, The First Affiliated Hospital of University of Science and Technology of China, University of Science and Technology of China, Hefei, China.,Anhui Provincial Hospital Affiliated With Anhui Medical University, Hefei, China
| | - Ping Li
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China.,Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China.,Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China
| | - Jia-Bin Wang
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China.,Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China.,Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China
| | - Jian-Xian Lin
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China.,Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China.,Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China
| | - Jun Lu
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China.,Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China.,Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China
| | - Long-Long Cao
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China.,Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China
| | - Mi Lin
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China.,Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China
| | - Ru-Hong Tu
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China.,Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China
| | - Ze-Ning Huang
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China.,Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China
| | - Ju-Li Lin
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China.,Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China
| | - Hua-Long Zheng
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China.,Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China
| | - Si-Jin Que
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China.,Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China
| | - Chao-Hui Zheng
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China.,Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China.,Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China
| | - Chang-Ming Huang
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China.,Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China.,Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China
| | - Jian-Wei Xie
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China.,Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China
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Li Q, Huang LY, Xue HP. Comparison of prognostic factors in different age groups and prognostic significance of neutrophil-lymphocyte ratio in patients with gastric cancer. World J Gastrointest Oncol 2020; 12:1146-1166. [PMID: 33133383 PMCID: PMC7579735 DOI: 10.4251/wjgo.v12.i10.1146] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 08/04/2020] [Accepted: 09/02/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Gastric cancer (GC) is one of the most common malignant tumors in the world. Although in recent years tremendous progress has been made in its early detection, the postoperative overall survival (OS) of GC patients remains extremely low. A number of studies have shown that age, to varying degrees, affects the prognosis of patients with GC. Therefore, this study retrospectively analyzed the clinical and pathologic data of patients with GC to explore the differences in the clinical characteristics and prognostic factors in different age groups.
AIM To explore the difference in clinicopathological characteristics and prognostic factors in GC patients in different age groups.
METHODS In this retrospective study, we analyzed 1037 GC patients admitted to Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from May 2010 to January 2013. The patients were divided into two groups based on age: Younger group (less than 70 years old) and older group (no less than 70 years old). In the younger group, we subdivided the patients in two subgroups by a cut-off value of 45 years. The clinical features and prognostic factors were analyzed in both groups. Subsequently, we retrieved studies that evaluated the predictive role of neutrophil-lymphocyte ratio (NLR) by searching two medical databases, PubMed and EMBASE, to conduct a meta-analysis. Random-effects model was used to pool the data.
RESULTS In the retrospective study, the mean OS time of the younger group (64.7 mo) was significantly longer than that of the older group (48.1 mo) (P < 0.001). Among patients under 70 years of age, hospitalization time, tumor–node–metastasis (TNM) stage, vascular invasion, and preoperative low pre-albumin were independently associated with OS (P < 0.005). In patients aged 70 years and above, TNM stage, esophageal invasion, histological type, and preoperative NLR were independent factors for OS (P < 0.05). The OS of these older patients was also significantly shorter (P < 0.05). In the meta-analysis, 19 retrieved studies included a total of 8312 patients, among whom 3558 had elevated NLR values. The results showed that high NLR value was a risk factor for the prognosis of GC (P < 0.01).
CONCLUSION The OS of elderly patients is significantly worse than that of younger patients. There are significant differences in clinicopathological characteristics and prognostic factors between younger and older patients. NLR is a convenient, inexpensive, and reproducible marker that can be used as an important predictor of the prognosis of GC.
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Affiliation(s)
- Qiong Li
- Department ofGastroenterology and Hepatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200001, China
| | - Lin-Yi Huang
- Department ofGastroenterology and Hepatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200001, China
| | - Hui-Ping Xue
- Department ofGastroenterology and Hepatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200001, China
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Transarterial chemoembolization combined with radiofrequency ablation for solitary large hepatocellular carcinoma ranging from 5 to 7 cm: an 8-year prospective study. Abdom Radiol (NY) 2020; 45:2736-2747. [PMID: 32533245 DOI: 10.1007/s00261-020-02612-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE This prospective study was performed to investigate long-term (8-year) survival in patients with solitary large hepatocellular carcinoma (HCC) ranging from 5 to 7 cm who underwent transarterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) and identify factors that significantly affected outcomes. METHODS Forty-eight patients with large HCC (36 men, 12 women; mean age, 57.0 ± 11.2 [range, 37-82] years) without fever or signs of infection were enrolled. All patients were treated with TACE + RFA. Overall survival (OS) and disease-free survival (DFS) were calculated using the Kaplan-Meier method. Prognostic factors were assessed using the Cox hazards regression method. RESULTS The median OS duration was 47.0 months, and the 1-, 3-, 5-, and 8-year OS rates were 73%, 57%, 53%, and 27%, respectively. The median DFS duration was 9.05 (3.99-12.01) months, and the 1-, 3-, and 5-year DFS rates were 35%, 9%, and 0%, respectively. Cox hazards regression analysis revealed that the Child-Pugh class, platelet count, lymphocyte-to-monocyte ratio (LMR), and DFS were independent predictive factors of OS (p = 0.000, 0.003, 0.020, and 0.000, respectively). The LMR and platelet-to-lymphocyte ratio (PLR) were independent predictive factors of recurrence (p = 0.046 and 0.016, respectively). CONCLUSION TACE + RFA may be a safe and effective treatment for selected solitary large HCC ranging from 5 to 7 cm. Measurement of the LMR (> 4) and PLR (≤ 100) in peripheral blood before the intervention might help to identify which patients with solitary large HCC are suitable for TACE + RFA. Registration number: ChiCTR-TRC-12002768 ( https://www.chictr.org.cn ).
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Yin C, Toiyama Y, Okugawa Y, Omura Y, Kusunoki Y, Kusunoki K, Imaoka Y, Yasuda H, Ohi M, Kusunoki M. Clinical significance of advanced lung cancer inflammation index, a nutritional and inflammation index, in gastric cancer patients after surgical resection: A propensity score matching analysis. Clin Nutr 2020; 40:1130-1136. [PMID: 32773141 DOI: 10.1016/j.clnu.2020.07.018] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 03/02/2020] [Accepted: 07/15/2020] [Indexed: 01/04/2023]
Abstract
BACKGROUND The advanced lung cancer inflammation index (ALI) has recently been shown as a prognostic marker for several cancers. However, its predictive value for surgical and oncological outcomes in gastric cancer (GC) remains unclear. METHODS We retrospectively reviewed the preoperative ALI in 620 GC patients receiving gastrectomy to elucidate the prognostic value for overall survival (OS) and disease-free survival (DFS) and to clarify its predictive value for perioperative risk of surgical site infection (SSI) in GC patients. Propensity score matching (PSM) analysis was also conducted to certify these potentials of preoperative ALI. RESULTS Preoperative low ALI was significantly correlated with advanced tumor-node-metastasis stage classification. Patients with low ALI showed poorer OS (p < 0.0001) and DFS (p < 0.0001) compared to those with high ALI, and multivariate analysis showed that decreased ALI was an independent prognostic factor for OS [hazard ratios of 1.59; 95% confidence interval (CI) of 1.15-2.19, p = 0.006]. Meanwhile, preoperative low ALI was also an independent risk factor for overall SSI [odds ratio (OR) of 2.04, 95% CI of 1.24-3.35, p = 0.005] or organ-space SSI (OR of 2.69, 95% CI of 1.40-5.23, p = 0.003). We further conducted PSM analysis and verified all of these findings in the PSM cohort. CONCLUSION Quantification of preoperative ALI can identify patients with high risk of adverse perioperative and oncological outcomes in GC patients.
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Affiliation(s)
- Chengzeng Yin
- Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, Mie, Japan
| | - Yuji Toiyama
- Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, Mie, Japan.
| | - Yoshinaga Okugawa
- Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, Mie, Japan.
| | - Yusuke Omura
- Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, Mie, Japan
| | - Yukina Kusunoki
- Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, Mie, Japan
| | - Kurando Kusunoki
- Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, Mie, Japan
| | - Yuki Imaoka
- Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, Mie, Japan
| | - Hiromi Yasuda
- Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, Mie, Japan
| | - Masaki Ohi
- Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, Mie, Japan
| | - Masato Kusunoki
- Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, Mie, Japan
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Shelat VG. Role of inflammatory indices in management of hepatocellular carcinoma-neutrophil to lymphocyte ratio. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:912. [PMID: 32953712 PMCID: PMC7475436 DOI: 10.21037/atm-2020-90] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Vishal G Shelat
- Department of General Surgery, Tan Tock Seng Hospital, Singapore
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45
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Kim MR, Kim AS, Choi HI, Jung JH, Park JY, Ko HJ. Inflammatory markers for predicting overall survival in gastric cancer patients: A systematic review and meta-analysis. PLoS One 2020; 15:e0236445. [PMID: 32716955 PMCID: PMC7384660 DOI: 10.1371/journal.pone.0236445] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 07/05/2020] [Indexed: 12/18/2022] Open
Abstract
Systemic inflammatory biomarkers have begun to be used in clinical practice to predict prognosis and survival of cancer patients, but the approach remains controversial. We conducted a meta-analysis to determine the predictive value of the c-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), and Glasgow prognostic score (GPS)/modified Glasgow prognostic score (mGPS) in the clinical outcome of gastric cancer (GC) patients. We searched literature databases to identify relevant studies. All articles identified in the search were independently reviewed based on predetermined selection criteria. Meta-analysis was conducted to calculate the hazard ratio (HR) and 95% confidence intervals (CI) of overall survival of the included studies. A total of 41 eligible cohort studies, involving a total of 18,348 patients meeting the inclusion criteria, were considered for meta-analysis. Increases in CRP (HR = 1.654, 95% CI: 1.272–2.151), NLR (HR = 1.605, 95% CI: 1.449–1.779), and GPS/mGPS (HR = 1.648, 95% CI: 1.351–2.011) were significantly associated with poorer survival in patients with GC. Substantial heterogeneities were noted in all three markers (I2 = 86.479%, 50.799%, 69.774%, in CRP, NLR, and GPS/mGPS, respectively). Subgroup analysis revealed a significant positive correlation between each marker and poor survival, regardless of country, study quality, cancer stage, study design, or the inclusion of patients undergoing chemotherapy. This meta-analysis demonstrates that CRP, NLR, and GPS/mGPS are associated with poor survival in patients with GC. Further prospective studies using standardized measurements are warranted to conclude the prognostic value of various inflammatory markers.
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Affiliation(s)
- Mi-Rae Kim
- Department of Family Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - A-Sol Kim
- Department of Family Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
- Department of Family Medicine, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea
| | - Hye-In Choi
- Department of Family Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Jae-Hun Jung
- Department of Family Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Ji Yeon Park
- Department of Surgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
- Gastric Cancer Center, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea
| | - Hae-Jin Ko
- Department of Family Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
- Department of Family Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
- * E-mail:
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46
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Qiao S, Gao W, Guo S. Neutrophil-Lymphocyte Ratio (NLR) for Predicting Clinical Outcomes in Patients with Coronary Artery Disease and Type 2 Diabetes Mellitus: A Propensity Score Matching Analysis. Ther Clin Risk Manag 2020; 16:437-443. [PMID: 32547040 PMCID: PMC7245465 DOI: 10.2147/tcrm.s244623] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 04/03/2020] [Indexed: 12/13/2022] Open
Abstract
Background Cardiovascular diseases (CVD) combined with Type 2 diabetes mellitus (T2DM) frequently occurred. In this study, we aimed at exploring the prognostic significance of blood neutrophil–lymphocyte ratio (NLR) in these types of patients. Patients and Methods Between June 30, 2010 and August 30, 2017, 1454 patients with CVD were enrolled in this study. Kaplan and Meier methodology was used for survival analysis. We also used propensity score matching (PSM) to further compare survival in patients with or without T2DM. Results Among all patients, we applied ROC curve analysis to stratify all patients into two different groups including NLR >2.5 (n=432) and NLR≤ 2.5 (n=1022) groups. After that, we further performed survival analysis between different groups. We found that patients with NLR ≤2.5 had significantly favorable OS compared with the overall survival in patients with NLR >2.5. We further built the PSM using 242 pairs of patients who have CVD and with or without T2DM. After adjusting for competing risk factors, we performed Cox proportional hazards models to identify the independent prognostic factors in multivariable adjustment. We found that NLR ≤2.5 (HR: 2.576, 95% CI: 1.241–4.583, P =0.001) and extent of coronary artery disease (HR: 2.432, 95% CI: 1.189–4.392, P =0.005) remained independent predictors of OS. Conclusion In conclusion, we have established an PSM model and found that a high NLR value was an independent prognostic factor for survival, predicting in patients with both CAD and T2DM. The NLR value would be a valuable biomarker to evaluate the outcomes of patients and give them opportunities for choosing alternative therapies.
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Affiliation(s)
- Shang Qiao
- Department of Cardiology, Bayan Nur Hospital of the Nei Monggol Autonomous Region, Bayan Nur City 015000, People's Republic of China
| | - Wen Gao
- Department of Cardiology, Bayan Nur Hospital of the Nei Monggol Autonomous Region, Bayan Nur City 015000, People's Republic of China
| | - Shujun Guo
- Department of Cardiology, Bayan Nur Hospital of the Nei Monggol Autonomous Region, Bayan Nur City 015000, People's Republic of China
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Toraman A, Neşe N, Özyurt BC, Kürşat S. Association between neutrophil-lymphocyte & platelet lymphocyte ratios with prognosis & mortality in rapidly progressive glomerulonephritis. Indian J Med Res 2020; 150:399-406. [PMID: 31823922 PMCID: PMC6902366 DOI: 10.4103/ijmr.ijmr_1234_17] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background & objectives: Rapidly progressive glomerulonephritis (RPGN) is a clinical syndrome manifested by features of nephritic syndrome and progressive loss of renal function over a short time. The objective of this study was to investigate the relationship between neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and prognostic factors and pathological findings of renal biopsy in RPGN. Methods: Consecutive newly diagnosed RPGN patients who had follow up for at least six months were retrospectively analyzed. The estimated glomerular filtration rate (eGFR) was calculated. Albumin, C-reactive protein (CRP) levels and CRP/albumin ratio were also calculated. Results: Fifty four patients were included in the study. The mean age was 48.92±20.12 years. Clinicopathological diagnosis was pauci-immune glomerulonephritis (GN) in 40 while two had postinfectious GN, six systemic lupus erythematosus, three IgA nephropathy, two Henoch-Schönlein purpura and one membranoproliferative GN. The mean NLR was 7.02±6.34 and mean PLR was 273.90±39.15. Positive correlations between NLR and CRP levels (P=0.009, r=0.511) and CRP/albumin ratios (P=0.005, r=0.542) were observed. PLR and CRP/albumin ratios (P=0.041, r=0.412) were correlated positively. The per cent of fibrocellular crescents was negatively correlated with NLR (P=0.019, r=−0.291), and positively correlated with the lymphocyte count (P=0.05, r=0.256). In secondary crescentic subgroup, the per cent of fibrinoid necrosis had a positive correlation with PLR (P=0.013, r=0.642). Both NLR (P=0.036) and PLR (P=0.051) detected at the first month of the treatment period, were observed to be significantly correlated with mortality. Interpretation & conclusions: This study showed that NLR could predict mortality in patients with RPGN; correlated with systemic inflammation; showed a negative correlation with the per cent of fibrocellular crescents and could be regarded as a measure of glomerular inflammatory state. Moreover, PLR may be considered to be an indicator of disease severity in acute phase of crescentic GN.
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Affiliation(s)
- Aysun Toraman
- Division of Nephrology, Department of Medicine, University of Celal Bayar, Manisa, Turkey
| | - Nalan Neşe
- Division of Pathology, Department of Medicine, University of Celal Bayar, Manisa, Turkey
| | - Beyhan Cengiz Özyurt
- Division of Public Health, Department of Medicine, University of Celal Bayar, Manisa, Turkey
| | - Seyhun Kürşat
- Division of Nephrology, Department of Medicine, University of Celal Bayar, Manisa, Turkey
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Pre-treatment Peripheral Neutrophil-Lymphocyte Ratio as a Prognostic Marker in Gastric Cancer. J Gastrointest Cancer 2020; 50:763-768. [PMID: 30058031 DOI: 10.1007/s12029-018-0144-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Gastric cancer is the fifth cancer worldwide. Inflammatory response increases metastasis through apoptosis inhibition and angiogenesis augmentation. The neutrophil-lymphocyte ratio (NLR), which is a balance between pro-cancer inflammatory and anti-cancer immune responses, was proved as prognostic marker. Peripheral NLR is a good reflection of tumor microenvironment. METHODS We retrospectively collected data of gastric and gastro-esophageal cancer patients treated from January 2015 till December 2016. Sixty-one patients were included. Pre-treatment NLR was calculated. We extracted the different clinic-epidemiological and pathological data. Event-free and overall survivals were plotted using Kaplan-Meier curves. RESULTS The median age was 55. Male to female ratio was 1:1. Forty-seven patients were smokers. Most of the patients (93.4%) had good performance status (ECOG 0-2). Forty-six patients had gastric and 15 had gastro-esophageal cancer. 50.8% had diffuse gastric type. Grade III represented 49.2% and grade II 46%. Twelve patients had ascites at diagnosis. Stage at presentation was 1.6%, 4.9%, 27.9%, 50.8%, and 14.8% for stage I, II, III, IV, and unknown respectively. The median NLR was 2.4. The NLR showed no significant correlation with different clinic-epidemiologic and pathological variables except presence of ascites; p = 0.046. Median event-free survival (EFS) and overall survival (OS) were 6 and 8 months respectively. High NLR was significantly associated with worse survival; EFS, 5 months vs 8 months (95% CI, p = 0.001). OS, 6 months vs 9 months (95% CI, p = 0.013). CONCLUSION Gastric cancer is an aggressive and fatal disease. NLR can be used as a prognostic marker.
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Sharma R, Katiyar V, Gurjar H, Sharma M, Goda R, Vora Z. Is medulloblastoma associated with systemic immunomodulation? - A comparative analysis of preoperative inflammatory markers. Surg Neurol Int 2020; 11:86. [PMID: 32494368 PMCID: PMC7265425 DOI: 10.25259/sni_336_2019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 04/02/2020] [Indexed: 01/05/2023] Open
Abstract
Background: We attempt to compare preoperative inflammatory markers among children with medulloblastoma and pilocytic astrocytoma and establish their diagnostic efficacy to distinguish these tumors. Methods: Children (<18 years) with biopsy-proven medulloblastoma and pilocytic astrocytoma operated at our institute from January 2012 to January 2018 were enrolled in this study. The hematological parameters were compared between the two groups and with healthy controls. Children with a history of disease or medications that may confound these parameters were excluded from the study. Receiver operator characteristic curves were made to assess the diagnostic accuracy of markers found to be significant. Results: Patients with medulloblastoma were found to have higher neutrophil-lymphocyte ratio (NLR), derived neutrophil-lymphocyte ratio (dNLR), platelet-lymphocyte ratio (PLR), and platelet counts compared with pilocytic astrocytoma. Absolute lymphocyte count (ALC) was significantly lower in medulloblastoma group as compared to healthy controls but not with pilocytic astrocytoma. NLR and dNLR demonstrated maximum diagnostic accuracy in distinguishing patients with medulloblastoma from healthy controls and pilocytic astrocytoma. Using a cutoff of 2.45 for NLR distinguishes medulloblastoma from healthy controls as well as pilocytic astrocytoma with a sensitivity of 75.5% and specificity of 66.7%. Similarly, dNLR cutoff of 1.47 distinguishes medulloblastoma from healthy controls with a sensitivity of 83% and specificity of 76% and a cutoff of 1.53 distinguishes medulloblastoma from pilocytic astrocytoma with a sensitivity of 81.1% and specificity of 81.8%. Combination of NLR and dNLR performed only marginally better than individual variables with area under the curve being 0.856 for medulloblastoma versus healthy controls and 0.86 for medulloblastoma versus pilocytic astrocytoma. Conclusion: NLR and dNLR can be used as a preoperative predictive marker in medulloblastoma. There is decreased ALC in patients with medulloblastoma contributing to raised NLR and dNLR suggestive of systemic immunosuppression.
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Affiliation(s)
- Ravi Sharma
- Departments of Neurosurgery, All India Institute of Medical sciences, CNC, AIIMS, New Delhi, India
| | - Varidh Katiyar
- Departments of Neurosurgery, All India Institute of Medical sciences, CNC, AIIMS, New Delhi, India
| | - Hitesh Gurjar
- Departments of Neurosurgery, All India Institute of Medical sciences, CNC, AIIMS, New Delhi, India
| | - Mehar Sharma
- Departments of Pathology, All India Institute of Medical sciences, CNC, AIIMS, New Delhi, India
| | - Revanth Goda
- Departments of Neurosurgery, All India Institute of Medical sciences, CNC, AIIMS, New Delhi, India
| | - Zainab Vora
- Departments of Radio diagnosis, All India Institute of Medical sciences, CNC, AIIMS, New Delhi, India
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Ke TM, Lin LC, Huang CC, Chien YW, Ting WC, Yang CC. High neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio predict poor survival in rectal cancer patients receiving neoadjuvant concurrent chemoradiotherapy. Medicine (Baltimore) 2020; 99:e19877. [PMID: 32332656 PMCID: PMC7220521 DOI: 10.1097/md.0000000000019877] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
This study explored the prognostic value of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in rectal cancer patients receiving neoadjuvant concurrent chemoradiotherapy (CCRT).Between January 2006 and December 2016, 184 patients with newly-diagnosed rectal cancer receiving neoadjuvant CCRT were enrolled. Risk of overall survival (OS) and disease-free survival (DFS) were calculated using the Kaplan-Meier method and Cox proportional hazard models. Stratified survival analyses were also performed between post-neoadjuvant pathological (yp) stage.The mean follow-up time was 72.73 ± 36.82 months. High- and low-NLR patients differed significantly in both 5-year DFS (P = .026) and OS (P = .016). High- and low-PLR patients differed significantly in 5-year DFS (P = .011) but not OS (P = .185). Multivariate analyses revealed worse 5-year DFS (adjusted HR [aHR] = 2.8; 95% CI: 1.473-5.41; P = .002) and 5-year OS (aHR = 1.871; 95%CI: 1.029-3.4; P = .04) in the high-NLR group after adjusting for covariates. After adjustments, the high-PLR group had inferior 5-year DFS (aHR = 2.274; 95%CI: 1.473-5.419; P = .038) but not 5-year OS (aHR = 1.156; 95%CI: 0.650-2.056; P = .622). Further stratified analysis indicated that yp stage II and III patients with high NLR had worse 5-year DFS (aHR = 2.334; 95% CI: 1.158-4.725; P = .018) and OS (aHR = 2.226; 95% CI: 1.165-4.251; P = .015). Additionally, yp stage II and III patients with high PLR had inferior 5-year DFS (aHR = 2.012; 95% CI: 1.049-3.861; P = .036).Pre-CCRT NLR and PLR are independent prognostic factors for rectal cancer patients and could be used as a potential biomarker to identify high-risk patients for more intense treatment and care.
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Affiliation(s)
- Te-Min Ke
- Dali District public health center, Taichung
- Department of Public Health College of Medicine, National Cheng Kung University
| | - Li-Ching Lin
- Department of Radiation Oncology, Chi Mei Medical Center
- Department of Optometry, Chung Hwa University of Medical Technology, Tainan
- School of Medicine, Taipei Medical University, Taipei
| | - Chun-Che Huang
- Department of Healthcare Administration, I-Shou University, Kaohsiung
| | - Yu-Wen Chien
- Department of Public Health College of Medicine, National Cheng Kung University
| | - Wei-Chen Ting
- Department of radiation oncology, Antai Medical Care Corporation Antai Tian-Sheng Memorial Hospital, Pingtung
| | - Ching-Chieh Yang
- Department of Radiation Oncology, Chi Mei Medical Center
- Department of Pharmacy, Chia Nan University of Pharmacy and Science, Tainan Taiwan
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