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Seretis K, Sfaelos K, Boptsi E, Gaitanis G, Bassukas ID. The Neutrophil-to-Lymphocyte Ratio as a Biomarker in Cutaneous Oncology: A Systematic Review of Evidence beyond Malignant Melanoma. Cancers (Basel) 2024; 16:1044. [PMID: 38473401 PMCID: PMC10931327 DOI: 10.3390/cancers16051044] [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: 02/14/2024] [Revised: 02/29/2024] [Accepted: 03/01/2024] [Indexed: 03/14/2024] Open
Abstract
With the ongoing progress of basic research along with the introduction of new pharmaceutical options spanning almost all therapeutic areas, the need for biomarkers that will be implemented into the personalized medical approach is higher than ever. Their use can be incorporated into clinical practice and can be applied to the classification of disorders and the evaluation of disease severity but also to the monitoring of the progress of therapeutic/pharmaceutical interventions. This systematic review collects the findings of hematologic biomarkers in various cutaneous malignancies, excluding malignant melanoma, to support their potential use in the prognosis but also in the assessment of therapeutic strategies for the specific category of skin disorders.
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Affiliation(s)
- Konstantinos Seretis
- Department of Plastic Surgery, Faculty of Medicine, School of Health Sciences, University of Ioannina, 451 10 Ioannina, Greece; (K.S.); (E.B.)
| | - Konstantinos Sfaelos
- Department of Skin and Venereal Diseases, Faculty of Medicine, School of Health Sciences, University of Ioannina, 451 10 Ioannina, Greece; (K.S.); (G.G.)
| | - Elena Boptsi
- Department of Plastic Surgery, Faculty of Medicine, School of Health Sciences, University of Ioannina, 451 10 Ioannina, Greece; (K.S.); (E.B.)
| | - Georgios Gaitanis
- Department of Skin and Venereal Diseases, Faculty of Medicine, School of Health Sciences, University of Ioannina, 451 10 Ioannina, Greece; (K.S.); (G.G.)
| | - Ioannis D. Bassukas
- Department of Skin and Venereal Diseases, Faculty of Medicine, School of Health Sciences, University of Ioannina, 451 10 Ioannina, Greece; (K.S.); (G.G.)
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Stem J, Yang Q, Carchman E, Striker R, Sanger CB. Do immune inflammatory markers correlate with anal dysplasia and anal cancer risk in patients living with HIV? Int J Colorectal Dis 2022; 37:983-988. [PMID: 35332364 DOI: 10.1007/s00384-022-04123-9] [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] [Accepted: 03/02/2022] [Indexed: 02/04/2023]
Abstract
PURPOSE People living with HIV (PLWH) are at an elevated risk for developing anal cancer. As screening is invasive, markers predicting those at highest risk for anal cancer could guide individualized screening. Neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), and prognostic nutritional index (PNI) are surrogate inflammatory/immune markers known to correlate with cancer outcomes. This study aims to assess whether these markers correlate with anal cancer risk in PLWH. METHODS This is a retrospective single-institution cohort study of PLWH at a single academic medical center who were diagnosed with or screened for anal dysplasia between 2001 and 2019. Aforementioned markers collected within one year of diagnosis were recorded. Regression modeling was used to estimate odds of anal cancer. Receiver operating characteristic analysis was utilized to determine optimal cutoff for screening values. RESULTS Five-hundred-fourteen patients were included. NLR and PNI were significantly associated with cancer risk on univariate (p = 0.03, p = 0.001) and multivariate analyses (p = 0.03, p = 0.01). NLR increased across all grades of dysplasia. PLR was not associated with cancer risk. A NLR of ≥ 1.64 can be utilized to capture 76% of cancer patients in our cohort. CONCLUSIONS NLR values in patients living with HIV correlate with risk of anal cancer and increasing grades of dysplasia. A cutoff NLR of ≥ 1.64 can be used to help capture those at risk. NLR is a promising marker of risk of anal cancer and progression of anal dysplasia in patients with HIV infection and could be used to risk-stratify screening and surveillance intervals.
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Affiliation(s)
- Jonathan Stem
- Department of Surgery, University of North Carolina at Chapel Hill School of Medicine, Campus Box 7081, Chapel Hill, NC, 27599-7211, USA.
| | - Qiuyu Yang
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Evie Carchman
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- William S. Middleton Memorial Veteran's Hospital, Madison, WI, USA
| | - Robert Striker
- William S. Middleton Memorial Veteran's Hospital, Madison, WI, USA
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Cristina B Sanger
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- William S. Middleton Memorial Veteran's Hospital, Madison, WI, USA
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Rimini M, Franco P, De Bari B, Zampino MG, Vagge S, Frassinetti GL, Arcadipane F, Bacigalupo A, Valgiusti M, Aloi D, Gervaso L, Corvò R, Bartolini G, Gerardi MA, Cascinu S, Casadei-Gardini A. The Prognostic Value of the New Combined Hemo-Eosinophil Inflammation Index (HEI Index): A Multicenter Analysis of Anal Cancer Patients Treated with Concurrent Chemo-Radiation. Cancers (Basel) 2021; 13:671. [PMID: 33562397 PMCID: PMC7914854 DOI: 10.3390/cancers13040671] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 02/01/2021] [Accepted: 02/03/2021] [Indexed: 12/27/2022] Open
Abstract
Anal squamous cell carcinoma (SCC) is a rare tumor, and bio-humoral predictors of response to chemo-radiation (CT-RT) are lacking. We developed a prognostic score system based on laboratory inflammation parameters. We investigated the correlation between baseline clinical and laboratory variables and disease-free (DFS) and overall (OS) survival in anal SCC patients treated with CT-RT in five institutions. The bio-humoral parameters of significance were included in a new scoring system, which was tested with other significant variables in a Cox's proportional hazard model. A total of 308 patients was included. We devised a prognostic model by combining baseline hemoglobin level, SII, and eosinophil count: the Hemo-Eosinophils Inflammation (HEI) Index. We stratified patients according to the HEI index into low- and high-risk groups. Median DFS for low-risk patients was not reached, and it was found to be 79.5 months for high-risk cases (Hazard Ratio 3.22; 95% CI: 2.04-5.10; p < 0.0001). Following adjustment for clinical covariates found significant at univariate analysis, multivariate analysis confirmed the HEI index as an independent prognostic factor for DFS and OS. The HEI index was shown to be a prognostic parameter for DFS and OS in anal cancer patients treated with CT-RT. An external validation of the HEI index is mandatory for its use in clinical practice.
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Affiliation(s)
- Margherita Rimini
- Department of Oncology and Hematology, Division of Oncology, University Hospital Modena, 41000 Modena, Italy;
| | - Pierfrancesco Franco
- Department of Oncology, Radiation Oncology, University of Turin, 10126 Turin, Italy;
| | - Berardino De Bari
- Department of Radiation Oncology, University Hospital of Besançon, 25000 Besançon, France; (B.D.B.); (D.A.)
- Department of Radiation Oncology, Réseau Hospitalier Neuchâtelois, 2300 La Chaux-de-Fonds, Switzerland
| | - Maria Giulia Zampino
- Division of Gastrointestinal Oncology and Neuroendocrine Tumors, European Institute of Oncology, IRCCS, 20019 Milan, Italy; (M.G.Z.); (L.G.)
| | - Stefano Vagge
- Department of Radiation Oncology, IRCCS Ospedale Policlinico San Martino, 16121 Genova, Italy; (S.V.); (A.B.)
| | - Giovanni Luca Frassinetti
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori ‘Dino Amadori’–IRST, 47014 Meldola, Italy; (G.L.F.); (M.V.); (G.B.)
| | - Francesca Arcadipane
- Department of Oncology, Radiation Oncology, University of Turin, 10126 Turin, Italy;
| | - Almalina Bacigalupo
- Department of Radiation Oncology, IRCCS Ospedale Policlinico San Martino, 16121 Genova, Italy; (S.V.); (A.B.)
| | - Martina Valgiusti
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori ‘Dino Amadori’–IRST, 47014 Meldola, Italy; (G.L.F.); (M.V.); (G.B.)
| | - Deborah Aloi
- Department of Radiation Oncology, University Hospital of Besançon, 25000 Besançon, France; (B.D.B.); (D.A.)
| | - Lorenzo Gervaso
- Division of Gastrointestinal Oncology and Neuroendocrine Tumors, European Institute of Oncology, IRCCS, 20019 Milan, Italy; (M.G.Z.); (L.G.)
| | - Renzo Corvò
- Department of Radiation Oncology, IRCCS Ospedale Policlinico San Martino and Health Science Department (DISSAL), University of Genova, 16121 Genova, Italy;
| | - Giulia Bartolini
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori ‘Dino Amadori’–IRST, 47014 Meldola, Italy; (G.L.F.); (M.V.); (G.B.)
| | | | - Stefano Cascinu
- Department of Oncology, IRCCS San Raffaele Scientific Institute Hospital, 20019 Milan, Italy; (S.C.); (A.C.-G.)
| | - Andrea Casadei-Gardini
- Department of Oncology, IRCCS San Raffaele Scientific Institute Hospital, 20019 Milan, Italy; (S.C.); (A.C.-G.)
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