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Yang C, Chang Z, Dai Y, Mo J, Zhang Q, Zhu M, Luan L, Zhang J, Sun B, Jia J. Trans-ancestry analysis in over 799,000 individuals yields new insights into the genetic etiology of colorectal cancer. PLoS One 2024; 19:e0301811. [PMID: 39024248 PMCID: PMC11257326 DOI: 10.1371/journal.pone.0301811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 03/20/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND Recent studies have demonstrated the relevance of circulating factors in the occurrence and development of colorectal cancer (CRC); however, the causal relationship remains unclear. METHODS Summary-level data for CRC were obtained from the UK Biobank (5,657 cases and 372,016 controls), FinnGen cohort (3,022 cases and 215,770 controls), and BioBank Japan Project (BBJ, 7,062 cases and 195,745 controls). Thirty-two peripheral markers with consistent definitions were collected from the three biobanks. Mendelian randomization (MR) was used to evaluate the causal effect of circulating factors on CRC. The effects from the three consortiums were combined using trans-ancestry meta-analysis methods. RESULTS Our analysis provided compelling evidence for the causal association of higher genetically predicted eosinophil cell count (EOS, odds ratio [OR], 0.8639; 95% confidence interval [CI] 0.7922-0.9421) and red cell distribution width (RDW, OR, 0.9981; 95% CI, 0.9972-0.9989) levels with a decreased risk of CRC. Additionally, we found suggestive evidence indicating that higher levels of total cholesterol (TC, OR, 1.0022; 95% CI, 1.0002-1.0042) may increase the risk of CRC. Conversely, higher levels of platelet count (PLT, OR, 0.9984; 95% CI, 0.9972-0.9996), total protein (TP, OR, 0.9445; 95% CI, 0.9037-0.9872), and C-reactive protein (CRP, OR, 0.9991; 95% CI, 0.9983-0.9999) may confer a protective effect against CRC. Moreover, we identified six ancestry-specific causal factors, indicating the necessity of considering patients' ancestry backgrounds before formulating prevention strategies. CONCLUSIONS MR findings support the independent causal roles of circulating factors in CRC, which might provide a deeper insight into early detection of CRC and supply potential preventative strategies.
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Affiliation(s)
- Changlong Yang
- Department of Gastric and Intestinal Surgery, Yunnan Tumor Hospital, The Third Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Zhenglin Chang
- Department of Clinical Laboratory of the First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China
- Guangzhou Laboratory, Guangzhou International Bio Island, Guangzhou, Guangdong Province, China
| | - Youguo Dai
- Department of Gastric and Intestinal Surgery, Yunnan Tumor Hospital, The Third Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Jinzhao Mo
- Southern Medical University, Guangzhou, Guangdong Province, China
| | - Qitai Zhang
- Department of Clinical Laboratory of the First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China
| | - Mingming Zhu
- Department of Gastric and Intestinal Surgery, Yunnan Tumor Hospital, The Third Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Likun Luan
- Department of Gastric and Intestinal Surgery, Yunnan Tumor Hospital, The Third Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Jinhu Zhang
- Department of Urology, Suizhou Central Hospital, The Fifth Affiliated Hospital of Hubei University of Medicine, Suizhou, Hubei, China
| | - Baoqing Sun
- Department of Clinical Laboratory of the First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China
- Guangzhou Laboratory, Guangzhou International Bio Island, Guangzhou, Guangdong Province, China
| | - Junyi Jia
- Department of Gastric and Intestinal Surgery, Yunnan Tumor Hospital, The Third Affiliated Hospital of Kunming Medical University, Kunming, China
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2
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Orafaie A, Shahabi F, Mehri A, Ansari M, Kasraeifar S, Ghiyasi M, Saberi‐Karimian M, Abdollahi A, Tabatabaei SM. The association of preoperative hematologic parameters with short-term clinical outcomes in rectal cancer: A feature importance analysis. Cancer Med 2024; 13:e7225. [PMID: 38778698 PMCID: PMC11112298 DOI: 10.1002/cam4.7225] [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: 10/28/2023] [Revised: 03/14/2024] [Accepted: 04/18/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Various hematologic parameters have been proposed as prognostic factors in rectal cancer management, but data are conflicting and unclear. This study is designed to investigate the prognostic factor capability of preoperative hematologic parameters with postoperative morbidities and mortality in rectal cancer patients undergoing curative resection. METHODS All 200 consecutive rectal cancer patients diagnosed at Ghaem University Hospital from 2017 to 2022 were retrospectively evaluated. The receiver operating characteristic (ROC) curves and machine learning (ML) algorithms of Random Forest, Recursive Feature Elimination, simulated annealing, Support Vector Machine, Decision Tree, and eXtreme Gradient Boosting were administered to investigate the role of preoperative hematologic parameters accompanied by baseline characteristics on three clinical outcomes including surgical infectious complications, recurrence, and death. RESULTS The frequency of infectious complications was correlated with the surgical procedure, while tumor recurrence was significantly influenced by T stage and N stage. In terms of mortality, alongside T and N stage, the status of resection margin involvement was significantly correlated. Based on the ROC analysis, the NLR >2.69, MPV ≤9 fL, and PDW ≤10.5 fL were more classified patients to mortality status. Likewise, the PLT >220 109/L, MPV ≤9 fL, PDW ≤10.4 fL, and PLR >13.6 were correlated with recurrence. However, all factors examined in this study were not significant classifiers for the outcome of surgical infectious complications. The results of ML algorithms were also in line with ROC analysis. CONCLUSION According to the results of both ROC analysis and ML models, preoperative hematologic parameters are considerable prognostic factors of postoperative outcomes in rectal cancer patients, and are recommended to be monitored by clinicians to prevent unfavorable outcomes.
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Affiliation(s)
- Ala Orafaie
- Endoscopic and Minimally Invasive Surgery Research CenterMashhad University of Medical SciencesMashhadIran
| | - Fatemeh Shahabi
- Endoscopic and Minimally Invasive Surgery Research CenterMashhad University of Medical SciencesMashhadIran
| | - Ali Mehri
- Endoscopic and Minimally Invasive Surgery Research CenterMashhad University of Medical SciencesMashhadIran
| | - Majid Ansari
- Endoscopic and Minimally Invasive Surgery Research CenterMashhad University of Medical SciencesMashhadIran
| | - Sajjad Kasraeifar
- Endoscopic and Minimally Invasive Surgery Research CenterMashhad University of Medical SciencesMashhadIran
| | - Mahdie Ghiyasi
- Endoscopic and Minimally Invasive Surgery Research CenterMashhad University of Medical SciencesMashhadIran
| | - Maryam Saberi‐Karimian
- Endoscopic and Minimally Invasive Surgery Research CenterMashhad University of Medical SciencesMashhadIran
- Lung Diseases Research CenterMashhad University of Medical SciencesMashhadIran
| | - Abbas Abdollahi
- Endoscopic and Minimally Invasive Surgery Research CenterMashhad University of Medical SciencesMashhadIran
| | - Seyyed Mohammad Tabatabaei
- Department of Medical Informatics, School of MedicineMashhad University of Medical SciencesMashhadIran
- Clinical Research Unit, Imam Reza Hospital, School of MedicineMashhad University of Medical SciencesMashhadIran
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3
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Suto H, Matsukawa H, Ando Y, Oshima M, Fuke T, Nagao M, Yamana H, Kamada H, Kumamoto K, Okano K. Predictive role of the prognostic nutritional index in patients with pancreatic ductal adenocarcinoma who underwent neoadjuvant chemoradiotherapy followed by curative pancreatic resection: A retrospective study using prospectively collected data. JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES 2024. [PMID: 38462668 DOI: 10.1002/jhbp.1424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
BACKGROUND Despite a strong association between nutritional indices and disease prognosis, evidence regarding the evaluation of nutritional indices after preoperative treatment for pancreatic ductal adenocarcinoma (PDAC) is insufficient. We evaluated the clinical significance of the prognostic nutritional index (PNI) in patients with resectable (R-) and borderline resectable (BR-) PDAC who received neoadjuvant chemoradiotherapy (NACRT) followed by pancreatic resection. METHODS We assessed 153 patients with R- and BR-PDAC who underwent NACRT followed by curative resection between 2009 and 2022. We evaluated the association between preoperative PNI after NACRT and short- and long-term outcomes. RESULTS The median preoperative PNI value after NACRT was 42.1, and the optimal cutoff value from the time-dependent receiver operating characteristic curve was 38.6. The low PNI group (PNI < 38.6, n = 44) exhibited significantly worse inflammatory parameters, surgical outcomes, and prognoses than the high PNI group (PNI ≥ 38.6, n = 109). Multivariate analysis identified preoperative PNI ≤ 38.6 (hazard ratio [HR]: 2.32, 95% confidence interval [CI]: 1.00-5.38, p = .049), blood loss ≥1642 mL (HR: 3.05, 95% CI: 1.65-5.64, p < .001), node positive pathology (HR: 2.10, 95% CI: 1.32-3.34, p = .002), and lack of postoperative adjuvant chemotherapy (HR: 3.55, 95% CI: 2.05-6.15, p < .001) as significant predictors of overall survival. CONCLUSIONS For patients with R- and BR-PDAC receiving preoperative treatment, it is imperative to closely monitor their nutritional status when determining the optimal surgical procedure timing.
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Affiliation(s)
- Hironobu Suto
- Department of Gastroenterological Surgery, Faculty of Medicine, Kagawa University, Ikenobe, Kagawa, Japan
| | - Hiroyuki Matsukawa
- Department of Gastroenterological Surgery, Faculty of Medicine, Kagawa University, Ikenobe, Kagawa, Japan
| | - Yasuhisa Ando
- Department of Gastroenterological Surgery, Faculty of Medicine, Kagawa University, Ikenobe, Kagawa, Japan
| | - Minoru Oshima
- Department of Gastroenterological Surgery, Faculty of Medicine, Kagawa University, Ikenobe, Kagawa, Japan
| | - Takuro Fuke
- Department of Gastroenterological Surgery, Faculty of Medicine, Kagawa University, Ikenobe, Kagawa, Japan
| | - Mina Nagao
- Department of Gastroenterological Surgery, Faculty of Medicine, Kagawa University, Ikenobe, Kagawa, Japan
- Department of Molecular Oncologic Pathology, Faculty of Medicine, Kagawa University, Ikenobe, Kagawa, Japan
| | - Hiroki Yamana
- Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Ikenobe, Kagawa, Japan
| | - Hideki Kamada
- Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Ikenobe, Kagawa, Japan
| | - Kensuke Kumamoto
- Department of Gastroenterological Surgery, Faculty of Medicine, Kagawa University, Ikenobe, Kagawa, Japan
| | - Keiichi Okano
- Department of Gastroenterological Surgery, Faculty of Medicine, Kagawa University, Ikenobe, Kagawa, Japan
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Liao K, Zhang X, Liu J, Teng F, He Y, Cheng J, Yang Q, Zhang W, Xie Y, Guo D, Cao G, Xu Y, Huang B, Wang X. The role of platelets in the regulation of tumor growth and metastasis: the mechanisms and targeted therapy. MedComm (Beijing) 2023; 4:e350. [PMID: 37719444 PMCID: PMC10501337 DOI: 10.1002/mco2.350] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 07/21/2023] [Accepted: 07/23/2023] [Indexed: 09/19/2023] Open
Abstract
Platelets are a class of pluripotent cells that, in addition to hemostasis and maintaining vascular endothelial integrity, are also involved in tumor growth and distant metastasis. The tumor microenvironment is a complex and comprehensive system composed of tumor cells and their surrounding immune and inflammatory cells, tumor-related fibroblasts, nearby interstitial tissues, microvessels, and various cytokines and chemokines. As an important member of the tumor microenvironment, platelets can promote tumor invasion and metastasis through various mechanisms. Understanding the role of platelets in tumor metastasis is important for diagnosing the risk of metastasis and prolonging survival. In this study, we more fully elucidate the underlying mechanisms by which platelets promote tumor growth and metastasis by modulating processes, such as immune escape, angiogenesis, tumor cell homing, and tumor cell exudation, and further summarize the effects of platelet-tumor cell interactions in the tumor microenvironment and possible tumor treatment strategies based on platelet studies. Our summary will more comprehensively and clearly demonstrate the role of platelets in tumor metastasis, so as to help clinical judgment of the potential risk of metastasis in cancer patients, with a view to improving the prognosis of patients.
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Affiliation(s)
- Kaili Liao
- Jiangxi Province Key Laboratory of Laboratory MedicineJiangxi Provincial Clinical Research Center for Laboratory MedicineDepartment of Clinical LaboratoryThe Second Affiliated Hospital of Nanchang UniversityNanchangChina
| | - Xue Zhang
- Queen Mary College of Nanchang UniversityNanchangChina
| | - Jie Liu
- School of Public HealthNanchang UniversityNanchangChina
| | - Feifei Teng
- School of Public HealthNanchang UniversityNanchangChina
| | - Yingcheng He
- Queen Mary College of Nanchang UniversityNanchangChina
| | - Jinting Cheng
- School of Public HealthNanchang UniversityNanchangChina
| | - Qijun Yang
- Queen Mary College of Nanchang UniversityNanchangChina
| | - Wenyige Zhang
- Queen Mary College of Nanchang UniversityNanchangChina
| | - Yuxuan Xie
- The Second Clinical Medical CollegeNanchang UniversityNanchangChina
| | - Daixin Guo
- School of Public HealthNanchang UniversityNanchangChina
| | - Gaoquan Cao
- The Fourth Clinical Medical CollegeNanchang UniversityNanchangChina
| | - Yanmei Xu
- Jiangxi Province Key Laboratory of Laboratory MedicineJiangxi Provincial Clinical Research Center for Laboratory MedicineDepartment of Clinical LaboratoryThe Second Affiliated Hospital of Nanchang UniversityNanchangChina
| | - Bo Huang
- Jiangxi Province Key Laboratory of Laboratory MedicineJiangxi Provincial Clinical Research Center for Laboratory MedicineDepartment of Clinical LaboratoryThe Second Affiliated Hospital of Nanchang UniversityNanchangChina
| | - Xiaozhong Wang
- Jiangxi Province Key Laboratory of Laboratory MedicineJiangxi Provincial Clinical Research Center for Laboratory MedicineDepartment of Clinical LaboratoryThe Second Affiliated Hospital of Nanchang UniversityNanchangChina
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5
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Giacomelli M, Monti M, Pezzola DC, Lonardi S, Bugatti M, Missale F, Cioncada R, Melocchi L, Giustini V, Villanacci V, Baronchelli C, Manenti S, Imberti L, Giurisato E, Vermi W. Immuno-Contexture and Immune Checkpoint Molecule Expression in Mismatch Repair Proficient Colorectal Carcinoma. Cancers (Basel) 2023; 15:3097. [PMID: 37370706 DOI: 10.3390/cancers15123097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 06/01/2023] [Accepted: 06/01/2023] [Indexed: 06/29/2023] Open
Abstract
Colorectal carcinoma (CRC) represents a lethal disease with heterogeneous outcomes. Only patients with mismatch repair (MMR) deficient CRC showing microsatellite instability and hyper-mutated tumors can obtain clinical benefits from current immune checkpoint blockades; on the other hand, immune- or target-based therapeutic strategies are very limited for subjects with mismatch repair proficient CRC (CRCpMMR). Here, we report a comprehensive typing of immune infiltrating cells in CRCpMMR. We also tested the expression and interferon-γ-modulation of PD-L1/CD274. Relevant findings were subsequently validated by immunohistochemistry on fixed materials. CRCpMMR contain a significantly increased fraction of CD163+ macrophages (TAMs) expressing TREM2 and CD66+ neutrophils (TANs) together with decrease in CD4-CD8-CD3+ double negative T lymphocytes (DNTs); no differences were revealed by the analysis of conventional and plasmacytoid dendritic cell populations. A fraction of tumor-infiltrating T-cells displays an exhausted phenotype, co-expressing PD-1 and TIM-3. Remarkably, expression of PD-L1 on fresh tumor cells and TAMs was undetectable even after in vitro stimulation with interferon-γ. These findings confirm the immune suppressive microenvironment of CRCpMMR characterized by dense infiltration of TAMs, occurrence of TANs, lack of DNTs, T-cell exhaustion, and interferon-γ unresponsiveness by host and tumor cells. Appropriate bypass strategies should consider these combinations of immune escape mechanisms in CRCpMMR.
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Affiliation(s)
- Mauro Giacomelli
- Department of Pathology, ASST Spedali Civili di Brescia, 25123 Brescia, Italy
| | - Matilde Monti
- Department of Molecular and Translational Medicine, University of Brescia, 25123 Brescia, Italy
| | - Diego Cesare Pezzola
- Department of Surgery, Surgery Division II, ASST Spedali Civili di Brescia, 25123 Brescia, Italy
| | - Silvia Lonardi
- Department of Molecular and Translational Medicine, University of Brescia, 25123 Brescia, Italy
| | - Mattia Bugatti
- Department of Pathology, ASST Spedali Civili di Brescia, 25123 Brescia, Italy
- Department of Molecular and Translational Medicine, University of Brescia, 25123 Brescia, Italy
| | - Francesco Missale
- Department of Molecular and Translational Medicine, University of Brescia, 25123 Brescia, Italy
- Department of Head & Neck Oncology & Surgery Otorhinolaryngology, Antoni Van Leeuwenhoek-Nederlands Kanker Instituut, 1066 CX Amsterdam, The Netherlands
| | - Rossella Cioncada
- Department of Pathology, ASST Spedali Civili di Brescia, 25123 Brescia, Italy
| | - Laura Melocchi
- Department of Pathology, Fondazione Poliambulanza, 25124 Brescia, Italy
| | - Viviana Giustini
- CREA Laboratory, AIL Center for Hemato-Oncologic Research, Diagnostic Department, ASST Spedali Civili di Brescia, 25123 Brescia, Italy
| | - Vincenzo Villanacci
- Department of Pathology, ASST Spedali Civili di Brescia, 25123 Brescia, Italy
| | - Carla Baronchelli
- Department of Pathology, ASST Spedali Civili di Brescia, 25123 Brescia, Italy
| | - Stefania Manenti
- Department of Pathology, ASST Spedali Civili di Brescia, 25123 Brescia, Italy
| | - Luisa Imberti
- Section of Microbiology, University of Brescia, 25123 Brescia, Italy
| | - Emanuele Giurisato
- Department of Biotechnology Chemistry and Pharmacy, University of Siena, 53100 Siena, Italy
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, UK
| | - William Vermi
- Department of Pathology, ASST Spedali Civili di Brescia, 25123 Brescia, Italy
- Department of Molecular and Translational Medicine, University of Brescia, 25123 Brescia, Italy
- Department of Pathology and Immunology, School of Medicine, Washington University, Saint Louis, MO 63130, USA
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6
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Turri G, Caligola S, Ugel S, Conti C, Zenuni S, Barresi V, Ruzzenente A, Lippi G, Scarpa A, Bronte V, Guglielmi A, Pedrazzani C. Pre-diagnostic prognostic value of leukocytes count and neutrophil-to-lymphocyte ratio in patients who develop colorectal cancer. Front Oncol 2023; 13:1148197. [PMID: 37342188 PMCID: PMC10277676 DOI: 10.3389/fonc.2023.1148197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 05/22/2023] [Indexed: 06/22/2023] Open
Abstract
Introduction Emerging evidence is pointing towards a relevant role of immunity in cancer development. Alterations in leukocytes count and neutrophil-to-lymphocyte ratio (NLR) at diagnosis of colorectal cancer (CRC) seems to predict poor prognosis, but no data is available for the pre-diagnostic values. Methods Retrospective analysis of patients who underwent surgery for CRC at our center (2005 - 2020). 334 patients with a complete blood count dating at least 24 months prior to diagnosis were included. Changes in pre-diagnosis values of leukocytes (Pre-Leu), lymphocytes (Pre-Lymph), neutrophils (Pre-Neut), and NLR (Pre-NLR) and their correlation with overall- (OS) and cancer-related survival (CRS) were analyzed. Results Pre-Leu, Pre-Neut and Pre-NLR showed an increasing trend approaching the date of diagnosis, while Pre-Lymph tended to decrease. The parameters were tested for associations with survival after surgery through multivariable analysis. After adjusting for potential confounding factors, Pre-Leu, Pre-Neut, Pre-Lymph and Pre-NLR resulted independent prognostic factors for OS and CRS. On sub-group analysis considering the interval between blood sampling and surgery, higher Pre-Leu, Pre-Neut, and Pre-NLR and lower Pre-Lymph were associated with worse CRS, and the effect was more evident when blood samples were closer to surgery. Conclusion To our knowledge, this is the first study showing a significant correlation between pre-diagnosis immune profile and prognosis in CRC.
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Affiliation(s)
- Giulia Turri
- Division of General and Hepatobiliary Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | | | - Stefano Ugel
- Immunology Section, University Hospital and Department of Medicine, University of Verona, Verona, Italy
| | - Cristian Conti
- Division of General and Hepatobiliary Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | - Silvia Zenuni
- Division of General and Hepatobiliary Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | - Valeria Barresi
- Department of Diagnostics and Public Health, Section of Pathology, University of Verona, Verona, Italy
| | - Andrea Ruzzenente
- Division of General and Hepatobiliary Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | - Giuseppe Lippi
- Department of Neurological, Biomedical and Movement Sciences, Section of Clinical Biochemistry, University of Verona, Verona, Italy
| | - Aldo Scarpa
- Department of Diagnostics and Public Health, Section of Pathology, University of Verona, Verona, Italy
| | | | - Alfredo Guglielmi
- Division of General and Hepatobiliary Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | - Corrado Pedrazzani
- Division of General and Hepatobiliary Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
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7
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Mitigating Effect of Dietary Dioclea reflexa (Hook F) Seed Inclusion in Experimental Colon Carcinogenesis. J Food Biochem 2023. [DOI: 10.1155/2023/2823143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
Abstract
Rats exposed to 72-hour intrarectal instillations of N-methyl-N-nitrosourea (MNU) were fed with Dioclea reflexa seed-included diets (0, 2.5, 5.0, and 10%). Following sacrifice, organs and blood were collected and analyzed for indices of oxidative stress and carcinogenesis using spectrophotometric, ELISA, histological, and immunohistochemical techniques. Dioclea reflexa seed-included diets significantly (
) prevented MNU-induced elevation of carcinoembryonic antigen (CEA), malondialdehyde, and neutrophil-to-lymphocyte ratio (NLR) and boosted the activities of glutathione s-transferase, superoxide dismutase, and catalase. It also prevented MNU-induced colonic mucosal ulceration/interglandular inflammations and protected the mismatch repair gene, Mutl homolog1, against MNU-induced damage. There was a strong negative relationship between CEA, NLR, and the antioxidant enzyme activities, as well as total polyphenols, total flavonoids, and crude fiber, while CEA correlated positively with malondialdehyde levels. These results suggest that Dioclea reflexa seed is endowed with constituents possessing a potent capacity to mitigate oxidative stress, as well as the initiation and promotion of chemically induced colon carcinogenesis.
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8
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Liu XR, Wang LL, Zhang B, Liu XY, Li ZW, Kang B, Yuan C, Wei ZQ, Peng D. The advanced lung cancer inflammation index is a prognostic factor for gastrointestinal cancer patients undergoing surgery: a systematic review and meta-analysis. World J Surg Oncol 2023; 21:81. [PMID: 36879283 PMCID: PMC9987069 DOI: 10.1186/s12957-023-02972-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 02/27/2023] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND The advanced lung cancer inflammation index (ALI) is a comprehensive assessment indicator that can reflect inflammation and nutrition conditions. However, there are some controversies about whether ALI is an independent prognostic factor for gastrointestinal cancer patients undergoing surgical resection. Thus, we aimed to clarify its prognostic value and explore the potential mechanisms. METHODS Four databases including PubMed, Embase, the Cochrane Library, and CNKI were used for searching eligible studies from inception to June 28, 2022. All gastrointestinal cancers, including colorectal cancer (CRC), gastric cancer (GC), esophageal cancer (EC), liver cancer, cholangiocarcinoma, and pancreatic cancer were enrolled for analysis. We focused on prognosis most in the current meta-analysis. Survival indicators, including overall survival (OS), disease-free survival (DFS), and cancer-special survival (CSS) were compared between the high ALI group and the low ALI group. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist was submitted as a supplementary document. RESULTS We finally included fourteen studies involving 5091 patients in this meta-analysis. After pooling the hazard ratios (HRs) and 95% confidence intervals (CIs), ALI was found to be an independent prognostic factor for both OS (HR = 2.09, I2 = 92%, 95% CI = 1.53 to 2.85, P < 0.01), DFS (HR = 1.48, I2 = 83%, 95% CI = 1.18 to 1.87, P < 0.01), and CSS (HR = 1.28, I2 = 1%, 95% CI = 1.02 to 1.60, P = 0.03) in gastrointestinal cancer. After subgroup analysis, we found that ALI was still closely related to OS for CRC (HR = 2.26, I2 = 93%, 95% CI = 1.53 to 3.32, P < 0.01) and GC (HR = 1.51, I2 = 40%, 95% CI = 1.13 to 2.04, P = 0.006) patients. As for DFS, ALI also has a predictive value on the prognosis of CRC (HR = 1.54, I2 = 85%, 95% CI = 1.14 to 2.07, P = 0.005) and GC (HR = 1.37, I2 = 0%, 95% CI = 1.09 to 1.73, P = 0.007) patients. CONCLUSION ALI affected gastrointestinal cancer patients in terms of OS, DFS, and CSS. Meanwhile, ALI was a prognostic factor both for CRC and GC patients after subgroup analysis. Patients with low ALI had poorer prognoses. We recommended that surgeons should perform aggressive interventions in patients with low ALI before the operation.
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Affiliation(s)
- Xu-Rui Liu
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Lian-Lian Wang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Bin Zhang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Xiao-Yu Liu
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Zi-Wei Li
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Bing Kang
- Department of Clinical Nutrition, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Chao Yuan
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Zheng-Qiang Wei
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Dong Peng
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
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9
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Misiewicz A, Dymicka-Piekarska V. Fashionable, but What is Their Real Clinical Usefulness? NLR, LMR, and PLR as a Promising Indicator in Colorectal Cancer Prognosis: A Systematic Review. J Inflamm Res 2023; 16:69-81. [PMID: 36643953 PMCID: PMC9833126 DOI: 10.2147/jir.s391932] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 12/16/2022] [Indexed: 01/09/2023] Open
Abstract
The link between inflammation and cancer is still an attractive subject of many studies because systemic inflammatory response has been proven to play a pivotal role in cancer progression and metastasis. The strongest relationship between chronic inflammation and cancer development is observed in colorectal cancer (CRC). The evaluation of ratios derived from the routinely performed inflammatory biomarkers shows limited performances and limited clinical utility when individually used as prognostic factors for patients with CRC. In this review, we would like to summarize the latest knowledge about the diagnostic utility of systemic inflammatory ratios: neutrophil/lymphocyte (NLR), lymphocyte/monocyte (LMR), and platelet/lymphocyte (PLR) in CRC. We focused on the papers that assessed the diagnostic utility of blood cell parameters on the basis of the area under the ROC curve published in the recent 6 years. Identification of biomarkers that are significantly associated with prognostic in cancer would help the selection of patients with a high risk of poor outcomes.
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Affiliation(s)
| | - Violetta Dymicka-Piekarska
- Department of Clinical Laboratory Diagnostics, Medical University of Bialystok, Białystok, Poland,Correspondence: Violetta Dymicka-Piekarska, Department of Clinical Laboratory Diagnostics, Medical University of Bialystok, Waszyngtona Str. 15, Bialystok, 15-276, Poland, Tel +48 85 746 85 84, Email
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10
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Development and validation of a [18F]FDG PET/CT-based radiomics nomogram to predict the prognostic risk of pretreatment diffuse large B cell lymphoma patients. Eur Radiol 2022; 33:3354-3365. [PMID: 36547676 PMCID: PMC10121518 DOI: 10.1007/s00330-022-09301-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 09/03/2022] [Accepted: 11/13/2022] [Indexed: 12/24/2022]
Abstract
Abstract
Objective
In this study, based on PET/CT radiomics features, we developed and validated a nomogram to predict progression-free survival (PFS) for cases with diffuse large B cell lymphoma (DLBCL) treated with immunochemotherapy.
Methods
This study retrospectively recruited 129 cases with DLBCL. Among them, PET/CT scans were conducted and baseline images were collected for radiomics features along with their clinicopathological features. Radiomics features related to recurrence were screened for survival analysis using univariate Cox regression analysis with p < 0.05. Next, a weighted Radiomics-score (Rad-score) was generated and independent risk factors were obtained from univariate and multivariate Cox regressions to build the nomogram. Furthermore, the nomogram was tested for their ability to predict PFS using time-dependent receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA).
Results
Blood platelet, Rad-score, and gender were included in the nomogram as independent DLBCL risk factors for PFS. We found that the training cohort areas under the curve (AUCs) were 0.79, 0.84, and 0.88, and validation cohort AUCs were 0.67, 0.83, and 0.72, respectively. Further, the DCA and calibration curves confirmed the predictive nomogram’s clinical relevance.
Conclusion
Using Rad-score, blood platelet, and gender of the DLBCL patients, a PET/CT radiomics-based nomogram was developed to guide cases’ recurrence risk assessment prior to treatment. The developed nomogram can help provide more appropriate treatment plans to the cases.
Key Points
• DLBCL cases can be classified into low- and high-risk groups using PET/CT radiomics based Rad-score.
• When combined with other clinical characteristics (gender and blood platelet count), Rad-score can be used to predict the outcome of the pretreatment of DLBCL cases with a certain degree of accuracy.
• A prognostic nomogram was established in this study in order to aid in assessing prognostic risk and providing more accurate treatment plans for DLBCL cases.
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Urs AB, Augustine J, Khurana N, Uniyal A, Passey JC, Meher R. Preoperative platelet-lymphocyte ratio and neutrophil-lymphocyte ratio as predictors of occult lymph node metastasis detected using Desmoglein 3 and Cytokeratin in Indian population. J Oral Maxillofac Pathol 2022; 26:596. [PMID: 37082044 PMCID: PMC10112119 DOI: 10.4103/jomfp.jomfp_49_21] [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] [Received: 02/09/2021] [Revised: 01/04/2022] [Accepted: 01/24/2022] [Indexed: 04/22/2023] Open
Abstract
Aim This study aims to assess whether preoperative platelet-lymphocyte ratio (PLR) and neutrophil-lymphocyte ratio (NLR) can predict occult metastasis in oral squamous cell carcinoma (OSCC). Materials and Methods Thirty-five OSCC cases were analyzed for clinicopathological and hematological data. Cases without metastasis (pN0) were checked for micrometastasis immunohistochemically using Desmoglein 3 (DSG3) and Cytokeratin (CK). Mean PLR and NLR were compared and analyzed between the study groups. Results Metastatic deposits were detected in 9 out of 26 pN0 cases (34.6%) accounting for 11 out of 62 (17%) lymph nodes subjected to immunohistochemistry. The mean PLR was higher in OSCC cases with or without occult metastasis in comparison to controls (P < 0.001). No significant difference was found in the mean PLR and NLR between OSCC cases with and without occult metastasis. Furthermore, we found DSG3+ sinus histiocytes within the lymph nodes in majority of cases which is least reported in literature. Conclusion A significant percentage of cases showed occult metastasis in this study which led to upstaging of tumor. Although PLR was elevated in OSCC cases, it did not have a positive correlation with the presence of occult metastasis but was able to successfully distinguish OSCC patients from healthy individuals.
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Affiliation(s)
- Aadithya B Urs
- Department of Oral Pathology, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Jeyaseelan Augustine
- Department of Oral Pathology, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Nita Khurana
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Akanksha Uniyal
- Department of Oral Pathology, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - J C Passey
- Department of ENT, Lok Nayak Hospital, New Delhi, India
| | - Ravi Meher
- Department of ENT, Lok Nayak Hospital, New Delhi, India
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12
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Eren T. Prognostic significance of the preoperative lymphocyte to C-reactive protein ratio in patients with stage III colorectal cancer. ANZ J Surg 2022; 92:2585-2594. [PMID: 35779019 DOI: 10.1111/ans.17896] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 06/21/2022] [Accepted: 06/22/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Stage III colorectal cancer (CRC), which accounts for approximately one third of all CRC cases, is associated with worsened prognosis. The aim of this study was to compare the preoperatively measured systemic inflammatory markers and to define the most significant marker in terms of its prognostic value in stage III CRC. METHODS Surgically treated stage III CRC patients were included. Demographics, preoperatively measured Glasgow prognostic score (GPS), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), lymphocyte/C-reactive protein ratio (LCR) and C-reactive protein/albumin ratio (CAR) values, clinicopathological features, surgical, oncological and survival outcomes were recorded and statistically analysed. RESULTS The study group of 102 patients consisted of 65 (63.7%) men and 37 (36.3%) women with a median age of 64 (range: 26-89). The mean follow-up period was 42.8 ± 30.5 (range: 6-107) months. Overall survival (OS) and disease-free survival (DFS) rates were 71.6%, and 67.7%, respectively. Elevated CRP, GPS 2, LCR ≤ 0.530, CAR ≥ 0.080, higher numbers of metastatic lymph nodes and N2b nodal status were detected to impair DFS (P = 0.001, P = 0.015, P = 0.001, P = 0.001, P = 0.001 and P = 0.043, respectively). Variables including GPS 2, PLR≥190.83, CAR≥0.045, LCR≤0.684, surgical site infection and longer hospital stay decreased OS (P = 0.004, P = 0.002, P = 0.005, P = 0.001, P = 0.001 and P = 0.001, respectively). According to multivariate analysis; PLR ≥ 190.83 was associated with three times [HR: 2.892 (95% CI: 1.100-7.602), P = 0.031], and LCR ≤ 0.684 was associated with four times [HR: 3.919 (95% CI: 1.130-13.592), P = 0.031] greater risk of cancer-related mortality. CONCLUSION As an independent prognostic factor, LCR had the highest impact on predicting survival after curative resection for stage III CRC.
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Affiliation(s)
- Tunc Eren
- Department of General Surgery, Faculty of Medicine, Istanbul Medeniyet University, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkey
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Hernandez-Ainsa M, Velamazan R, Lanas A, Carrera-Lasfuentes P, Piazuelo E. Blood-Cell-Based Inflammatory Markers as a Useful Tool for Early Diagnosis in Colorectal Cancer. Front Med (Lausanne) 2022; 9:843074. [PMID: 35795635 PMCID: PMC9252519 DOI: 10.3389/fmed.2022.843074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 05/30/2022] [Indexed: 12/24/2022] Open
Abstract
Background Systemic inflammation seems to be involved in the pathogenetic pathways of colorectal cancer (CRC). Analytical markers that reflect the inflammatory status, such as neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) or systemic immune-inflammation index (SII), have been proposed as tools for the prognosis of CRC. Nevertheless, their use for diagnosis has been scarcely investigated. Aims To analyze the ability of these markers and of a new marker combining SII and hemoglobin concentration, named NP/LHb = [neutrophils x platelets]/[lymphocytes x hemoglobin], as tools for CRC diagnosis. Furthermore, we studied their association with CRC-related variables. Methods Case-control study including 214 CRC patients and 214 controls without CRC, matched by age (±5 years) and sex. We collected demographic, CRC-related and laboratory variables to calculate NLR, PLR, SII, and NP/LHb. In the case group, the laboratory variables were collected at two different period times, 6 months (IQR 4–8) before the CRC diagnosis and at the time of the diagnosis. ROC analysis was performed to evaluate the discriminatory accuracy of each index and we calculated Se, Sp, PPV, NPV, and OR to identify the diagnostic performance of each positive marker. Results NP/LHb showed high Sp (92.06%) and PPV (87.50%) to diagnose patients with CRC. This index exhibited an OR of 14.52 (8.26–25.52) and the best area under the curve (AUC: 0.78) for a positive CRC diagnosis. We found significant differences in all indices according to the presence of CRC, observing the highest values in CRC patients at time of diagnosis, in comparison with the analysis performed in the previous months to diagnosis or with control patients. There were significant differences in all ratios according to TNM stages (p < 0.05). PLR, SII and NP/LHb (but not NLR) showed significant differences according to tumor location (p < 0.05). Right-sided colon cancers presented the highest values, in comparison with left-sided and rectal cancers. Conclusions Systemic inflammatory cell ratios (especially NP/LHb) change over time with the development of CRC, so they could be useful in its early diagnosis. We suggest that they could be routinely measured in patients with suspicion of CRC, to identify those ones with a higher risk of cancer, considering the high positive predictive value they have shown in our study.
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Affiliation(s)
- Maria Hernandez-Ainsa
- Service of Digestive Diseases, University Clinic Hospital, Zaragoza, Spain
- Aragón Health Research Institute (IIS Aragón), Zaragoza, Spain
- *Correspondence: Maria Hernandez-Ainsa
| | - Raul Velamazan
- Service of Digestive Diseases, University Clinic Hospital, Zaragoza, Spain
- Aragón Health Research Institute (IIS Aragón), Zaragoza, Spain
| | - Angel Lanas
- Service of Digestive Diseases, University Clinic Hospital, Zaragoza, Spain
- Aragón Health Research Institute (IIS Aragón), Zaragoza, Spain
- Department of Medicine, Psychiatry and Dermatology, University of Zaragoza, Zaragoza, Spain
- Biomedical Research Networking Center in Hepatic and Digestive Diseases (CIBERehd), Madrid, Spain
| | - Patricia Carrera-Lasfuentes
- Aragón Health Research Institute (IIS Aragón), Zaragoza, Spain
- Biomedical Research Networking Center in Hepatic and Digestive Diseases (CIBERehd), Madrid, Spain
| | - Elena Piazuelo
- Aragón Health Research Institute (IIS Aragón), Zaragoza, Spain
- Biomedical Research Networking Center in Hepatic and Digestive Diseases (CIBERehd), Madrid, Spain
- Aragón Health Sciences Institute (IACS), Zaragoza, Spain
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Detection of Specific Immune Cell Subpopulation Changes Associated with Systemic Immune Inflammation–Index Level in Germ Cell Tumors. Life (Basel) 2022; 12:life12050678. [PMID: 35629346 PMCID: PMC9147028 DOI: 10.3390/life12050678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 04/27/2022] [Accepted: 04/29/2022] [Indexed: 11/21/2022] Open
Abstract
The tumor microenvironment (TME) and the host inflammatory response are closely interconnected. The interplay between systemic inflammation and the local immune response may influence tumor development and progression in various types of cancer. The systemic immune–inflammation index (SII) represents a prognostic marker for germ cell tumors (GCTs). The aim of the present study was to detect specific immune cell subpopulation changes which were associated with the SII level in chemotherapy-naïve GCT patients. In total, 51 GCT patients, prior to cisplatin-based chemotherapy, were included in the present study. Immunophenotyping of peripheral blood leukocyte subpopulations was performed using flow cytometry. The SII level was correlated with the percentage of various leukocyte subpopulations. The obtained results demonstrated that SII levels above the cut-off value of SII ≥ 1003 were associated with higher neutrophil percentages. An inverse correlation was found between the SII and the peripheral lymphocyte percentage that logically reflects the calculations of the SII index. Furthermore, the presented data also showed that in the lymphocyte subpopulation, the association with the SII was driven by T-cell subpopulations. In innate immunity–cell subpopulations, we observed a correlation between SII level and neutrophils as well as associations with eosinophil, basophil, natural killer cell and dendritic cell percentages. We suppose that the described interactions represent a manifestation of cancer-induced immune suppression. The results of the present study contribute to the elucidation of the interrelationship between tumor cells and the innate/adaptive immune system of the host.
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A novel inflammation-related prognostic biomarker for predicting the disease-free survival of patients with colorectal cancer. World J Surg Oncol 2022; 20:79. [PMID: 35277188 PMCID: PMC8917685 DOI: 10.1186/s12957-022-02550-0] [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] [Received: 01/17/2022] [Accepted: 03/03/2022] [Indexed: 12/24/2022] Open
Abstract
Background To develop and evaluate the prognostic value of a comprehensive inflammatory biomarker for postoperative colorectal cancer (CRC) patients. Methods A total of 646 CRC patients were recruited between August 2017 and December 2019 from Fujian Medical University Union Hospital, with follow-up data up to 2021. The least absolute shrinkage and selection operator method (LASSO) was used to select inflammation indicators in order to construct a comprehensive biomarker (named NSAP). The Cox regression model was utilized to analyze the association between the NSAP and the disease-free survival (DFS) of CRC. Predictive performance and clinical utility of prognostic models were evaluated by area under the curve (AUC) and decision curve analyses (DCAs). Results During a median follow-up of 23 months, 95 clinical outcomes were observed, with a 1-year survival rate is 89.47%. A comprehensive inflammatory biomarker (NSAP) was established based on four blood indicators (including neutrophil-to-lymphocyte ratio (NLR), neutrophil×monocyte-to-lymphocyte ratio (SIRI), albumin-to-globulin ratio (AGR), and platelet-to-lymphocytes ratio (PLR)). Patients with a lower NSAP had significantly associated with better DFS of CRC (HR=0.53, 95%CI 0.32–0.89). Moreover, compared to a previously established model, the traditional TNM staging system or/and tumor markers, the nomogram based on NSAP displayed more excellent predictive ability (0.752 vs 0.597, 0.711 and 0.735, P < 0.05). DCAs also demonstrated that the established nomogram had better utility for decision making. Conclusions Our study suggests that NSAP may be a useful comprehensive prognostic biomarker for predicting the DFS of CRC patients. The nomogram based on NSAP can be considered a valuable tool to estimate the prognosis of patients with CRC. Supplementary Information The online version contains supplementary material available at 10.1186/s12957-022-02550-0.
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Zou W, Huang R, Zheng Y, Liu C, Sun J, Sun Y, Yue J. Investigation of the systemic inflammatory index as a predictor of downstaging in locally advanced rectal cancer patients with preoperative chemoradiation. PRECISION RADIATION ONCOLOGY 2022. [DOI: 10.1002/pro6.1145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022] Open
Affiliation(s)
- Wenxue Zou
- Department of Graduate Shandong Cancer Hospital and Institute Shandong First Medical University and Shandong Academy of Medical Sciences Jinan Shandong China
| | - Rui Huang
- Department of Graduate Shandong Cancer Hospital and Institute Shandong First Medical University and Shandong Academy of Medical Sciences Jinan Shandong China
| | - Yanfen Zheng
- Department of Graduate Shandong Cancer Hospital and Institute Shandong First Medical University and Shandong Academy of Medical Sciences Jinan Shandong China
| | - Chao Liu
- Department of Radiation Oncology Shandong Cancer Hospital and Institute Shandong First Medical University and Shandong Academy of Medical Sciences Jinan Shandong China
| | - Jujie Sun
- Department of Radiation Oncology Shandong Cancer Hospital and Institute Shandong First Medical University and Shandong Academy of Medical Sciences Jinan Shandong China
| | - Yanlai Sun
- Department of Gastrointestinal Cancer Surgery Shandong Cancer Hospital and Institute Shandong First Medical University and Shandong Academy of Medical Sciences Jinan China
| | - Jinbo Yue
- Department of Radiation Oncology Shandong Cancer Hospital and Institute Shandong First Medical University and Shandong Academy of Medical Sciences Jinan Shandong China
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Mahmoud HA, El Amin HA, Ahmed ESM, Kenawy AG, El-Ebidi AM, ElNakeeb I, Kholef EFM, Elsewify WAE. Role of MicroRNA-223 and MicroRNA-182 as Novel Biomarkers in Early Detection of Colorectal Cancer. Int J Gen Med 2022; 15:3281-3291. [PMID: 35368799 PMCID: PMC8964337 DOI: 10.2147/ijgm.s353244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 03/10/2022] [Indexed: 12/18/2022] Open
Abstract
Background Colorectal cancer is a common and lethal disease. It is estimated that approximately 145,600 new cases of large bowel cancer are diagnosed annually in the USA. MiRNA-223 and miRNA-182 have been reported in various cancers, such as lung, gastric, breast and colorectal cancer and proposed to be valid and reliable for diagnosis as well as prognosis. Aim This study aimed to determine the role of miR-223 and miR-182 as novel biomarkers for early detection and prognosis of CRC. Patient and Methods This case–control study was conducted at the department of Internal Medicine, Aswan University Hospital, in the period from the 1st of February 2020 to the 20th of April 2021. Thirty-five cases and thirty age- and sex-matched controls were included in the study. All patients were subject to complete clinical evaluation, routine investigations, occult blood in stool, serum levels of CEA and CA 19–9, serum levels of miR-223 and miR-182 by quantitative PCR. Results Significant difference between the two studied groups regarding biomarker changes was found. ROC curve analysis showed that the new markers had excellent diagnostic as well as prognostic criteria. Micro-RNA-223 diagnostic accuracy, sensitivity, specificity, PPV, NPV, FDR and FOR were 97%, 97.1%, 96.7%, 97%, 97%, 3.3% and 2.9%, respectively. Also, micro-RNA-182 diagnostic accuracy, sensitivity, specificity, PPV, NPV, FDR and FOR were 97%, 98%, 96%, 96%, 98%, 3.9% and 2%, respectively. Conclusion MiR-223 and miR-182 have been discovered to be relevant and reliable biomarkers for the early identification and prognosis of CRC. Increased levels of miR-223 and miR-182 were associated with increased risk of disease progression, and the more accurate the value of miR-223 and miR-182, the earlier the diagnosis of colorectal cancer.
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Affiliation(s)
- Hala A Mahmoud
- Department of Internal Medicine, Faculty of Medicine, Aswan University, Aswan, Egypt
| | - Hussein Ahmed El Amin
- Department of Internal Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt
| | | | - Ahmed Gaber Kenawy
- Department of Internal Medicine, Faculty of Medicine, Aswan University, Aswan, Egypt
| | - Abdallah M El-Ebidi
- Department of Biochemistry, Faculty of Medicine, Aswan University, Aswan, Egypt
| | - Islam ElNakeeb
- Department of Clinical Pathology, Faculty of Medicine, Aswan University, Aswan, Egypt
| | | | - Wael Abd Elgwad Elsewify
- Department of Internal Medicine, Faculty of Medicine, Aswan University, Aswan, Egypt
- Correspondence: Wael Abd Elgwad Elsewify, Department of Internal Medicine, Faculty of Medicine, Aswan University, Aswan, 81528, Egypt, Tel +201001657295, Fax +20973480449, Email
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Mbanu P, Osorio EV, Mistry H, Malcomson L, Yousif S, Aznar M, Kochhar R, Van Herk M, Renehan AG, Saunders MP. Clinico-pathological predictors of clinical complete response in rectal cancer. Cancer Treat Res Commun 2022; 31:100540. [PMID: 35231874 DOI: 10.1016/j.ctarc.2022.100540] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 02/17/2022] [Accepted: 02/19/2022] [Indexed: 06/14/2023]
Abstract
PURPOSE Prediction of clinical complete response in rectal cancer before neoadjuvant chemo-radiotherapy treatment enables treatment selection. Patients predicted to have complete response could have chemo-radiotherapy, and others could have additional doublet chemotherapy at this stage of their treatment to improve their overall outcome. This work investigates the role of clinical variables in predicting clinical complete response. METHOD Using the UK-based OnCoRe database (2008 to 2019), we performed a propensity-score matched study of 322 patients who received neoadjuvant chemoradiotherapy. We collected pre-treatment clinic-pathological, inflammatory and radiotherapy-related characteristics. We determined the odds for the occurrence of cCR using conditional logistic regression models. We derived the post-model Area under the Curve (AUC) as an indicator of discrimination performance and stated a priori that an AUC of 0.75 or greater was required for potential clinical utility. RESULTS Pre-treatment tumour diameter, mrT-stage, haemoglobin, alkaline phosphate and total radiotherapy depths were associated with cCR on univariable and multivariable analysis. Additionally, neutrophil to lymphocyte ratio (NLR), neutrophil-monocyte to lymphocyte ratio (NMLR), lymphocyte count and albumin were all significantly associated with cCR on multivariable analysis. A nomogram using the above parameters was developed with a resulting ROC AUC of 0.75. CONCLUSION We identified routine clinic-pathological, inflammatory and radiotherapy-related variables which are independently associated with cCR. A nomogram was developed to predict cCR. The performance characteristics from this model were on the prior clinical utility threshold. Additional research is required to develop more associated variables to better select patients with rectal cancer undergoing chemoradiotherapy who may benefit from pursuing a W&W strategy.
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Affiliation(s)
- P Mbanu
- Department of Clinical Oncology, Christie NHS Foundation Trust, Manchester, United Kingdom.
| | - E Vasquez Osorio
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
| | - H Mistry
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom; Division of Pharmacy, University of Manchester, Manchester, United Kingdom
| | - L Malcomson
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom; Colorectal and Peritoneal Oncology Centre, Christie NHS Foundation Trust, Manchester, United Kingdom
| | - S Yousif
- Department of Clinical Oncology, Lancashire Teaching Hospital, Preston, United Kingdom
| | - M Aznar
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
| | - R Kochhar
- Department of Radiological Oncology, Christie NHS Foundation Trust, Manchester, United Kingdom
| | - M Van Herk
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
| | - A G Renehan
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom; Colorectal and Peritoneal Oncology Centre, Christie NHS Foundation Trust, Manchester, United Kingdom
| | - M P Saunders
- Department of Clinical Oncology, Christie NHS Foundation Trust, Manchester, United Kingdom
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Hamid HKS, Emile SH, Davis GN. Prognostic Significance of Lymphocyte-to-Monocyte and Platelet-to-Lymphocyte Ratio in Rectal Cancer: A Systematic Review, Meta-analysis, and Meta-regression. Dis Colon Rectum 2022; 65:178-187. [PMID: 34775400 DOI: 10.1097/dcr.0000000000002291] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND The low lymphocyte-to-monocyte ratio and high platelet-to-lymphocyte ratio have been reported to be poor prognostic indicators in various solid tumors, but the prognostic significance in rectal cancer remains controversial. OBJECTIVES We sought to determine the prognostic value of the lymphocyte-to-monocyte ratio and the platelet-to-lymphocyte ratio following curative-intent surgery for rectal cancer. DATA SOURCES Following PRISMA guidelines (PROSPERO, ID: CRD42020190880), PubMed and Embase databases were searched through January 2021 including 3 other registered medical databases. STUDY SELECTION Studies evaluating the impact of pretreatment lymphocyte-to-monocyte ratio and platelet-to-lymphocyte ratio on overall or disease-free survival in patients undergoing curative rectal cancer resection were selected. MAIN OUTCOMES MEASURES The main outcome measures were overall and disease-free survival. RESULTS A total of 23 studies (6683 patients) were included; lymphocyte-to-monocyte ratio and platelet-to-lymphocyte ratio were evaluated in 14 and 16 studies. A low lymphocyte-to-monocyte ratio was associated with poorer overall survival (HR, 1.57; 95% CI, 1.29-1.90; p < 0.001) and disease-free survival (HR, 1.29; 95% CI, 1.13-1.46; p < 0.001). However, when the analysis was limited to patients treated with surgery alone or to those with stage I to III tumors, lymphocyte-to-monocyte ratio was not a predictor of overall survival and disease-free survival. The platelet-to-lymphocyte ratio did not predict for overall or disease-free survival, regardless of the treatment modality, studied population, tumor stage, or cutoff value. Finally, a low lymphocyte-to-monocyte ratio, but not a high platelet-to-lymphocyte ratio, was inversely correlated with complete pathologic response rate. LIMITATIONS The retrospective nature of most included studies was a limitation. CONCLUSIONS Pretreatment lymphocyte-to-monocyte ratio, but not platelet-to-lymphocyte ratio, correlates with tumor response to neoadjuvant chemoradiotherapy and poorer prognosis after curative-intent surgery for rectal cancer, and it potentially represents a simple and reliable biomarker that could help optimize individualized clinical decision-making in high-risk patients. REGISTRATION https://www.crd.york.ac.uk/prospero/; ID: CRD42020190880.
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Affiliation(s)
- Hytham K S Hamid
- Department of Surgery, East Kent Hospitals University NHS Foundation Trust, Ashford, United Kingdom
| | - Sameh H Emile
- Colorectal Surgery Unit, Department of General Surgery, Mansoura University Hospitals, Mansoura University, Mansoura, Egypt
| | - George N Davis
- Department of Surgery, Dorset County Hospital NHS Foundation Trust, Dorchester, United Kingdom
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20
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Kuo YH, You JF, Hung HY, Chin CC, Chiang JM, Chang CH. Number of negative lymph nodes with a positive impact on survival of stage III colon cancer; a retrospective observation study for right side and left side colon. BMC Cancer 2022; 22:126. [PMID: 35100975 PMCID: PMC8802462 DOI: 10.1186/s12885-021-09154-z] [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: 11/05/2020] [Accepted: 12/24/2021] [Indexed: 12/24/2022] Open
Abstract
Background The purpose was to examine the effect of negative lymph nodes (NLN) number on survival in stage III colon cancer. To reduce the interference of acute inflammation, we included patients with stage III colon cancer who had undergone elective surgery and excluded those who had tumor perforation, obstruction, ischemia, or massive tumor bleeding. Methods This retrospective cohort study included 2244 patients with stage III colon cancer between 1995 and 2016 at a single center. The effect of NLN on 5-year relapse-free survival (RFS), 5-year overall survival (OS), and comparison of multivariate factors was assessed according to tumor locations. Results The two optimal cutoff values of NLN for proximal and distal colon, namely 27 and 12, were determined by plotting the time-dependent receiver operating characteristic curve. Overall, 499 of 891 and 1020 of 1353 patients with right-side and left-side colon cancer, respectively, had high NLN. In right-side colon cancer, patients with high NLN (≥ 27) had superior OS (74.9% vs. 62.7%, P < 0.001) and RFS (75.0% vs. 61.9%, P < 0.001) than did those with low NLN. Moreover, in left-side colon cancer, patients with high NLN (≥12) experienced significantly superior OS (80.8% vs. 68.6%, P < 0.001) and RFS (77.3% vs. 66.2%, P < 0.001) than did those with low NLN. Among the different subgroups of stage III colon cancer, the high NLN group showed significantly superior RFS and OS in stage IIIB (RFS: 77.0% vs. 68.0%, P = 0.001; OS: 78.6% vs. 67.9%, P < 0.001) and IIIC (RFS: 58.2% vs. 44.1%, P = 0.001; OS: 65.7% vs. 51.1%, P < 0.001) colon cancer. However, in stage IIIA colon cancer, high NLN only showed survival benefit in OS (91.5% vs. 89.8%, P = 0.041). Multivariate analyses confirmed that high NLN, high carcinoembryonic antigen (≥ 5 ng/mL) level, and stage IIIC status are three independent prognostic factors in both the proximal and distal colon. Conclusions NLN is a crucial prognostic factor for stage III colon cancer in various tumor locations or in the subgroups of stage III disease. In advanced stage III colon cancer, the importance of NLN and its role in anti-cancer immune response could be highlighted.
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Affiliation(s)
- Yi-Hung Kuo
- Division of Colon and Rectal Surgery, Department of Surgery, Chang Gung Medical Foundation, Chiayi Branch, No. 6, Sec. West, Chia-Pu Road, Putz City, Chiayi Hsien, 613, Taiwan.,Graduate Institute of Clinical Medicine, Chang Gung University, Linkuo, Taiwan
| | - Jeng-Fu You
- Division of Colon and Rectal Surgery, Department of Surgery, Chang Gung Medical Foundation, Linkuo, Taiwan
| | - Hsin-Yuan Hung
- Division of Colon and Rectal Surgery, Department of Surgery, Chang Gung Medical Foundation, Linkuo, Taiwan
| | - Chih-Chien Chin
- Division of Colon and Rectal Surgery, Department of Surgery, Chang Gung Medical Foundation, Chiayi Branch, No. 6, Sec. West, Chia-Pu Road, Putz City, Chiayi Hsien, 613, Taiwan. .,Graduate Institute of Clinical Medicine, Chang Gung University, Linkuo, Taiwan.
| | - Jy-Ming Chiang
- Division of Colon and Rectal Surgery, Department of Surgery, Chang Gung Medical Foundation, Linkuo, Taiwan
| | - Chia-Hao Chang
- Chang Gung University of Science and Technology, Chiayi, Taiwan
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21
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Hosseini SV, Maleknejad A, Salem SA, Pourahmad S, Zabangirfard Z, Zamani M. The pre- and postoperative neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios: The comparison of laparoscopy and laparotomy in colorectal cancer patients. Asian J Endosc Surg 2022; 15:44-50. [PMID: 34159727 DOI: 10.1111/ases.12962] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/27/2021] [Accepted: 06/05/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The management of inflammation after colorectal surgery is important to decrease the susceptibility to postoperative complications. Platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) in the peripheral blood are known as two important inflammatory markers. In this study we evaluated and compared colorectal laparoscopy and laparotomy based on the PLR and NLR. METHODS Totally, 76 patients were divided into two groups including patients who underwent laparoscopy (45 cases) or laparotomy (31 cases). The PLR and NLR were calculated based on cell blood count analysis of preoperative and postoperative day (POD) one and three in both groups. Statistical analysis was performed using SPSS software version 22. RESULTS The PLR and NLR have no significant association with age, gender and tumor site (p > 0.05). However, both ratios were significantly increased in laparotomy patients at POD1 compared with the laparoscopy patients (p < 0.05). According to the two by two comparisons, the preoperative and postoperative PLR were significantly different in the laparotomy group (p < 0.05) but not in the laparoscopy group (p > 0.05). However, the preoperative and postoperative NLR were significantly different in both laparoscopy and laparotomy groups (p < 0.05). CONCLUSION The NLR and PLR markers indicated that laparoscopy can be a better choice for colorectal surgery due to lower induction of inflammation compared with laparotomy.
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Affiliation(s)
- Seyed V Hosseini
- Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | | | - Saeedeh Pourahmad
- Department of Biostatistics, Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Zabangirfard
- Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mozhdeh Zamani
- Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Autophagy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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22
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De B, Ludmir EB, Messick CA, Cagley MC, Morris VK, Das P, Minsky BD, Taniguchi CM, Smith GL, Koay EJ, Koong AC, Mohan R, Holliday EB. Prognostic impact of lymphopenia and neutrophil-lymphocyte ratio for patients with anal squamous cell carcinoma. J Gastrointest Oncol 2021; 12:2412-2422. [PMID: 34790402 DOI: 10.21037/jgo-21-323] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 08/23/2021] [Indexed: 12/31/2022] Open
Abstract
Background Outcomes after definitive chemoradiation for squamous cell carcinoma are generally favorable. However, biomarkers to further yield prognostic information are desired. Treatment-related lymphopenia as well as an elevated baseline neutrophil-lymphocyte ratio have been associated with worse survival in several cancer types. We evaluated absolute lymphocyte count and neutrophil-lymphocyte ratio at baseline and at treatment-related nadir in patients with anal cancer for associations with oncologic endpoints. Methods We conducted a retrospective analysis of 428 consecutive patients with non-metastatic anal cancer treated with definitive, intensity-modulated radiation therapy-based chemoradiation. We analyzed absolute neutrophil and lymphocyte counts at several timepoints: pretreatment, weekly during treatment, and in the six weeks following treatment completion. Neutrophil-lymphocyte ratio was calculated at baseline and treatment-related nadir. We estimated oncologic endpoints using life tables and compared them using the log-rank test. We conducted univariate and multivariable time-to-event analyses using Cox proportional hazards. Results Median absolute lymphocyte count at baseline and nadir were 1.80 [interquartile range (IQR), 1.45-2.32] k/µL and 0.26 (IQR, 0.18-0.36) k/µL, respectively, and 31% developed treatment-related grade 4 lymphopenia. Median neutrophil-lymphocyte ratio at baseline and nadir were 2.34 (IQR, 1.68-3.30) and 8.80 (IQR, 5.86-12.68), respectively. Estimates of overall survival, local failure-free survival, distant metastasis-free survival (DMFS), and freedom from colostomy at 5 years were 87%, 86%, 82%, and 88%, respectively. Baseline and nadir absolute lymphocyte count were not associated with selected outcomes on univariate analysis. On multivariable analysis, factors independently associated with death included T3-T4 disease, HIV-positive status, treatment break, and baseline neutrophil-lymphocyte ratio >3. Baseline neutrophil-lymphocyte ratio showed a trend toward association with distant progression or death (P=0.07). The 5-year overall survival estimates for patients with baseline neutrophil-lymphocyte ratios ≤3 and >3 were 92.3% and 80.6%, respectively. Conclusions Lymphopenia during and after chemoradiation for anal cancer is common but does not appear to be associated with worse survival, recurrence, or metastases. However, elevated baseline neutrophil-lymphocyte ratio was independently associated with overall survival, local recurrence-free survival, and DMFS. Further studies are needed to determine the clinical utility of baseline neutrophil-lymphocyte ratio to guide treatment and follow-up.
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Affiliation(s)
- Brian De
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ethan B Ludmir
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Craig A Messick
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Matthew C Cagley
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Van K Morris
- Department of Gastrointestinal Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Prajnan Das
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Bruce D Minsky
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Cullen M Taniguchi
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Grace L Smith
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Eugene J Koay
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Albert C Koong
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Radhe Mohan
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Emma B Holliday
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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23
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Yamamoto T, Kawada K, Obama K. Inflammation-Related Biomarkers for the Prediction of Prognosis in Colorectal Cancer Patients. Int J Mol Sci 2021; 22:ijms22158002. [PMID: 34360768 PMCID: PMC8348168 DOI: 10.3390/ijms22158002] [Citation(s) in RCA: 149] [Impact Index Per Article: 49.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 07/21/2021] [Accepted: 07/23/2021] [Indexed: 12/13/2022] Open
Abstract
Colorectal cancer (CRC) is the leading cause of cancer deaths around the world. It is necessary to identify patients with poor prognosis or with high risk for recurrence so that we can selectively perform intensive treatments such as preoperative and/or postoperative chemotherapy and extended surgery. The clinical usefulness of inflammation-related prognostic biomarkers available from routine blood examination has been reported in many types of cancer, e.g., neutrophil–lymphocyte ratio (NLR), lymphocyte–C-reactive protein ratio (LCR), platelet–lymphocyte ratio (PLR), lymphocyte–monocyte ratio (LMR), and so on. Moreover, some scoring systems based on circulating blood cell counts and albumin concentration have been also reported to predict cancer patients’ prognosis, such as the Glasgow prognostic score (GPS), systemic inflammation score (SIS), and prognostic nutritional index (PNI). The optimal biomarker and optimal cutoff value of the markers can be different depending on the cancer type. In this review, we summarize the prognostic impact of each inflammation-related marker in CRC.
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Affiliation(s)
- Takehito Yamamoto
- Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, Japan; (T.Y.); (K.O.)
- Department of Gastroenterological Surgery, Kitano Hospital, The Tazuke Kofukai Medical Research Institute, Osaka 530-8480, Japan
| | - Kenji Kawada
- Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, Japan; (T.Y.); (K.O.)
- Correspondence: ; Tel.: +81-75-366-7595
| | - Kazutaka Obama
- Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, Japan; (T.Y.); (K.O.)
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24
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Hayama T, Ozawa T, Asako K, Kondo R, Ono K, Okada Y, Tsukamoto M, Fukushima Y, Shimada R, Nozawa K, Matsuda K, Fujii S, Fukagawa T, Hashiguchi Y. Impact of Colon Cancer Location on the Prognostic Significance of Nutritional Indexes and Inflammatory Markers. In Vivo 2021; 35:1261-1269. [PMID: 33622929 DOI: 10.21873/invivo.12377] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 01/26/2021] [Accepted: 01/29/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND/AIM The prognosis of colorectal cancer is reported to differ depending on the tumor site, and clinical differences depending on the site of occurrence have gained attention. The aim was to compare nutrition index and inflammatory markers according to the site of colon cancer. PATIENTS AND METHODS We retrospectively analyzed 272 cases of stage I-III colon cancer (55% males, 45% females). The clinical characteristics, nutrition index and inflammatory markers were compared between patients with right colon cancer (RCC, n=119) and those with left colon cancer (LCC, n=153), and the relapse-free survival was then compared. RESULTS RCC was associated with older age (p=0.03), female gender (p=0.003), higher T stage (p=0.01), elevated platelet/lymphocyte ratio (PLR) (p=0.009), and elevated CONUT score (p=0.028). The prognostic values differed between RCC and LCC (RCC: CONUT score, p=0.04, LCC: PLR, p=0.02). CONCLUSION RCC was associated with an elevated CONUT score and PLR. In RCC, the CONUT score was an independent recurrence factor, and in LCC, the PLR was an independent recurrence factor.
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Affiliation(s)
- Tamuro Hayama
- Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan;
| | - Tsuyoshi Ozawa
- Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Kentaro Asako
- Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Rie Kondo
- Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Kohei Ono
- Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Yuka Okada
- Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Mitsuo Tsukamoto
- Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan
| | | | - Ryu Shimada
- Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Keijiro Nozawa
- Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Keiji Matsuda
- Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan
| | | | - Takeo Fukagawa
- Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Yojiro Hashiguchi
- Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan
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25
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Hamid HKS, Davis GN, Trejo-Avila M, Igwe PO, Garcia-Marín A. Prognostic and predictive value of neutrophil-to-lymphocyte ratio after curative rectal cancer resection: A systematic review and meta-analysis. Surg Oncol 2021; 37:101556. [PMID: 33819850 DOI: 10.1016/j.suronc.2021.101556] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/23/2021] [Accepted: 03/26/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Neutrophil-to-lymphocyte ratio (NLR) has been shown to be associated with poor prognosis in numerous solid malignancies. Here, we quantify the prognostic value of NLR in rectal cancer patients undergoing curative-intent surgery, and compare it with platelet-to-lymphocyte ratio (PLR) and lymphocyte-to-monocyte ratio (LMR). METHODS A comprehensive search of several electronic databases was performed through January 2021, to identify studies evaluating the prognostic impact of pretreatment NLR in patients undergoing curative rectal cancer resection. The endpoints were overall survival (OS), disease-free survival (DFS), and clinicopathologic parameters. The pooled hazard ratio (HR) or odds ratio with 95% confidence interval (CI) were calculated. RESULTS Thirty-one studies comprising 7553 patients were assessed. All studies evaluated NLR; thirteen and six evaluated PLR and LMR, respectively. High NLR was associated with worse OS (HR 1.92, 95% CI 1.60-2.30, P < 0.001) and DFS (HR 1.83, 95% CI 1.51-2.22, P < 0.001), and the results were consistent in all subgroup analyses by treatment modality, tumor stage, study location, and NLR cut-off value, except for the subgroups limited to cohorts with cut-off value ≥ 4. The size of effect of NLR on OS and DFS was greater than that of PLR, and similar to that of LMR. Finally, high NLR was associated with lower rate of pathologic complete response. CONCLUSIONS In the setting of curative rectal cancer resection, pretreatment NLR correlates with tumor response to neoadjuvant therapy, and along with LMR, is a robust predictor of poorer prognosis. These biomarkers may thus help risk-stratify patients for individualized treatments and enhanced surveillance.
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Affiliation(s)
- Hytham K S Hamid
- Department of Surgery, East Kent Hospitals NHS Foundation Trust, Ashford, UK.
| | - George N Davis
- Department of Surgery, Dorset County Hospital NHS Foundation Trust, Dorchester, UK
| | - Mario Trejo-Avila
- Department of Surgery, General Hospital Dr. Manuel Gea Gonzalez, Mexico City, Mexico
| | - Patrick O Igwe
- Department of Surgery, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
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26
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Papila Kundaktepe B, Papila C. The clinical significance of preoperative plasma fibrinogen levels and platelet counts in resectable colon cancer. World J Surg Oncol 2021; 19:69. [PMID: 33706789 PMCID: PMC7953657 DOI: 10.1186/s12957-021-02180-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 03/02/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND AND AIM Several aspects of the correlation between colon cancer and hemostatic markers are still unknown to many researchers in the field. In this study, we evaluated the association, if any, of preoperative platelet (PLT) counts and plasma fibrinogen levels with postoperative lymph node involvement and venous invasion in colon cancer patients. METHODS This study retrospectively included eighty patients with colon cancer (mean age 58.09 years; 37% female 63% male). RESULTS Patients with negative lymph nodes and venous invasion showed a significantly lower PLT count and higher fibrinogen level than their counterparts, i.e., patients with positive lymph nodes (p<0.001, all of them) and venous invasion (p<0.001, all of them). The results also showed a positive association of PLT counts and fibrinogen levels with lymphatic invasion (r=0.670, p<0.001 and r=0.639, p<0.001, respectively) and a positive association of PLT counts and fibrinogen levels with venous invasion (r=0.3988, p<0.001 and r=0.5268, p<0.001, respectively). According to the results of the ROC curve analysis, when the PLT count cutoff was 290/mm3, the sensitivity and specificity were 82% and 86.67%, respectively (AUC = 0.8840, p<0.0001, 95% CI 0.8084-0.9596). When the fibrinogen level cutoff was 310.0 mg/dL, the sensitivity and specificity were 72% and 96.67%, respectively (AUC 0.8790, p <0.0001, 95% CI 0.8067-0.9513). CONCLUSION The preoperative PLT count and plasma fibrinogen level may be considered key markers to monitor postoperative lymph node involvement and venous invasion in colon cancer patients.
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Affiliation(s)
- Berrin Papila Kundaktepe
- Department of General Surgery, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey.
| | - Cigdem Papila
- Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
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27
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Ferro M, Musi G, Matei DV, Mistretta AF, Luzzago S, Cozzi G, Bianchi R, Di Trapani E, Cioffi A, Lucarelli G, Busetto GM, Del Giudice F, Russo GI, Di Mauro M, Porreca A, Renne G, Catellani M, Bottero D, Brescia A, Cordima G, de Cobelli O. Assessment of PSIM (Prostatic Systemic Inflammatory Markers) Score in Predicting Pathologic Features at Robotic Radical Prostatectomy in Patients with Low-Risk Prostate Cancer Who Met the Inclusion Criteria for Active Surveillance. Diagnostics (Basel) 2021; 11:diagnostics11020355. [PMID: 33672650 PMCID: PMC7924196 DOI: 10.3390/diagnostics11020355] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 02/18/2021] [Accepted: 02/19/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND circulating levels of lymphocytes, platelets and neutrophils have been identified as factors related to unfavorable clinical outcome for many solid tumors. The aim of this cohort study is to evaluate and validate the use of the Prostatic Systemic Inflammatory Markers (PSIM) score in predicting and improving the detection of clinically significant prostate cancer (csPCa) in men undergoing robotic radical prostatectomy for low-risk prostate cancer who met the inclusion criteria for active surveillance. METHODS we reviewed the medical records of 260 patients who fulfilled the inclusion criteria for active surveillance. We performed a head-to-head comparison between the histological findings of specimens after radical prostatectomy (RP) and prostate biopsies. The PSIM score was calculated on the basis of positivity according to cutoffs (neutrophil-to-lymphocyte ratio (NLR) 2.0, platelets-to-lymphocyte ratio (PLR) 118 and monocyte-to-lymphocyte-ratio (MLR) 5.0), with 1 point assigned for each value exceeding the specified threshold and then summed, yielding a final score ranging from 0 to 3. RESULTS median NLR was 2.07, median PLR was 114.83, median MLR was 3.69. CONCLUSION we found a significantly increase in the rate of pathological International Society of Urological Pathology (ISUP) ≥ 2 with the increase of PSIM. At the multivariate logistic regression analysis adjusted for age, prostate specific antigen (PSA), PSA density, prostate volume and PSIM, the latter was found the sole independent prognostic variable influencing probability of adverse pathology.
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Affiliation(s)
- Matteo Ferro
- Department of Urology, European Institute of Oncology, IRCCS, 20141 Milan, Italy; (G.M.); (D.V.M.); (A.F.M.); (S.L.); (G.C.); (R.B.); (E.D.T.); (A.C.); (M.C.); (D.B.); (A.B.); (G.C.); (O.d.C.)
- Correspondence: ; Tel.: +39-3286238819
| | - Gennaro Musi
- Department of Urology, European Institute of Oncology, IRCCS, 20141 Milan, Italy; (G.M.); (D.V.M.); (A.F.M.); (S.L.); (G.C.); (R.B.); (E.D.T.); (A.C.); (M.C.); (D.B.); (A.B.); (G.C.); (O.d.C.)
| | - Deliu Victor Matei
- Department of Urology, European Institute of Oncology, IRCCS, 20141 Milan, Italy; (G.M.); (D.V.M.); (A.F.M.); (S.L.); (G.C.); (R.B.); (E.D.T.); (A.C.); (M.C.); (D.B.); (A.B.); (G.C.); (O.d.C.)
| | - Alessandro Francesco Mistretta
- Department of Urology, European Institute of Oncology, IRCCS, 20141 Milan, Italy; (G.M.); (D.V.M.); (A.F.M.); (S.L.); (G.C.); (R.B.); (E.D.T.); (A.C.); (M.C.); (D.B.); (A.B.); (G.C.); (O.d.C.)
| | - Stefano Luzzago
- Department of Urology, European Institute of Oncology, IRCCS, 20141 Milan, Italy; (G.M.); (D.V.M.); (A.F.M.); (S.L.); (G.C.); (R.B.); (E.D.T.); (A.C.); (M.C.); (D.B.); (A.B.); (G.C.); (O.d.C.)
| | - Gabriele Cozzi
- Department of Urology, European Institute of Oncology, IRCCS, 20141 Milan, Italy; (G.M.); (D.V.M.); (A.F.M.); (S.L.); (G.C.); (R.B.); (E.D.T.); (A.C.); (M.C.); (D.B.); (A.B.); (G.C.); (O.d.C.)
| | - Roberto Bianchi
- Department of Urology, European Institute of Oncology, IRCCS, 20141 Milan, Italy; (G.M.); (D.V.M.); (A.F.M.); (S.L.); (G.C.); (R.B.); (E.D.T.); (A.C.); (M.C.); (D.B.); (A.B.); (G.C.); (O.d.C.)
| | - Ettore Di Trapani
- Department of Urology, European Institute of Oncology, IRCCS, 20141 Milan, Italy; (G.M.); (D.V.M.); (A.F.M.); (S.L.); (G.C.); (R.B.); (E.D.T.); (A.C.); (M.C.); (D.B.); (A.B.); (G.C.); (O.d.C.)
| | - Antonio Cioffi
- Department of Urology, European Institute of Oncology, IRCCS, 20141 Milan, Italy; (G.M.); (D.V.M.); (A.F.M.); (S.L.); (G.C.); (R.B.); (E.D.T.); (A.C.); (M.C.); (D.B.); (A.B.); (G.C.); (O.d.C.)
| | - Giuseppe Lucarelli
- Department of Emergency and Organ Transplantation, Urology, Andrology and Kidney Transplantation Unit, University of Bari, 70124 Bari, Italy;
| | - Gian Maria Busetto
- Department of Urology and Renal Transplantation, University of Foggia Policlinico Riuniti, 71122 Foggia, Italy;
| | - Francesco Del Giudice
- Department of Urology, Sapienza Rome University Policlinico Umberto I, 00185 Rome, Italy;
| | - Giorgio Ivan Russo
- Department of Urology, University of Catania, 95123 Catania, Italy; (G.I.R.); (M.D.M.)
| | - Marina Di Mauro
- Department of Urology, University of Catania, 95123 Catania, Italy; (G.I.R.); (M.D.M.)
| | - Angelo Porreca
- Department of Urology, Veneto Institute of Oncology, 31033 Padua, Italy;
| | - Giuseppe Renne
- Department of Pathology, European Institute of Oncology, IRCCS, 20141 Milan, Italy;
| | - Michele Catellani
- Department of Urology, European Institute of Oncology, IRCCS, 20141 Milan, Italy; (G.M.); (D.V.M.); (A.F.M.); (S.L.); (G.C.); (R.B.); (E.D.T.); (A.C.); (M.C.); (D.B.); (A.B.); (G.C.); (O.d.C.)
| | - Danilo Bottero
- Department of Urology, European Institute of Oncology, IRCCS, 20141 Milan, Italy; (G.M.); (D.V.M.); (A.F.M.); (S.L.); (G.C.); (R.B.); (E.D.T.); (A.C.); (M.C.); (D.B.); (A.B.); (G.C.); (O.d.C.)
| | - Antonio Brescia
- Department of Urology, European Institute of Oncology, IRCCS, 20141 Milan, Italy; (G.M.); (D.V.M.); (A.F.M.); (S.L.); (G.C.); (R.B.); (E.D.T.); (A.C.); (M.C.); (D.B.); (A.B.); (G.C.); (O.d.C.)
| | - Giovanni Cordima
- Department of Urology, European Institute of Oncology, IRCCS, 20141 Milan, Italy; (G.M.); (D.V.M.); (A.F.M.); (S.L.); (G.C.); (R.B.); (E.D.T.); (A.C.); (M.C.); (D.B.); (A.B.); (G.C.); (O.d.C.)
| | - Ottavio de Cobelli
- Department of Urology, European Institute of Oncology, IRCCS, 20141 Milan, Italy; (G.M.); (D.V.M.); (A.F.M.); (S.L.); (G.C.); (R.B.); (E.D.T.); (A.C.); (M.C.); (D.B.); (A.B.); (G.C.); (O.d.C.)
- Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy
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Ferro D, Matias M, Neto J, Dias R, Moreira G, Petersen N, Azevedo E, Castro P. Neutrophil-to-Lymphocyte Ratio Predicts Cerebral Edema and Clinical Worsening Early After Reperfusion Therapy in Stroke. Stroke 2021; 52:859-867. [PMID: 33517702 DOI: 10.1161/strokeaha.120.032130] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND PURPOSE The mechanisms linking systemic inflammation to poor outcome in ischemic stroke are not fully understood. The authors investigated if peripheral inflammation following reperfusion therapy leads to an increase in cerebral edema (CED), thus hindering the clinical recovery. METHODS We designed a single-center study conducted at Centro Hospitalar Universitário São João between 2017 and 2019. Inclusion criteria were being adult, having an anterior circulation acute ischemic stroke, and receiving reperfusion therapy. Neutrophil-to-lymphocyte, platelet-to-lymphocyte ratios, and the systemic inflammatory response syndrome criteria were determined. The presence and grade of CED were evaluated on the computed tomography performed 24 hours following event. The clinical outcomes included early neurological deterioration and functional dependence at 90 days. Adjusted odds ratio and 95% CI were obtained by ordinal and logistic regression models. Optimal cutoff values were defined using receiver operating characteristic analysis in the training cohort and validated in an independent data set. RESULTS Five hundred fifty-three patients were included. Neutrophil-to-lymphocyte increased with higher degrees of CED at 24 hours (adjusted odds ratio, 1.34 [1.09-1.68], P<0.01) and was associated with early neurological deterioration (adjusted odds ratio, 1.30 [1.04-1.63], P<0.05) and poor functional status at 90 days (adjusted odds ratio, 1.79 [1.28-2.48], P<0.01). Platelet-to-lymphocyte was not associated with the outcomes. Systemic inflammatory response syndrome was related to CED due to altered white blood cell counts. Neutrophil-to-lymphocyte was the best predictor with an area under the curve around 0.7. Neutrophil-to-lymphocyte ≥7 had and accuracy, sensitivity, and specificity around 60%. CONCLUSIONS Increased systemic inflammation is linked to the severity of CED early after reperfusion therapy in stroke. Easily obtained inflammatory markers convey early warning alerts for patients at risk of severe neurological complications with an impact on long-term functional outcome. CED quantification should be included as an end point in proof-of-concept trials in immunomodulation in stroke.
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Affiliation(s)
- Daniela Ferro
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, Portugal (D.F., J.N., R.D.)
- Department of Neurology (D.F., M.M., R.D., E.A., P.C.), Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Margarida Matias
- Department of Neurology (D.F., M.M., R.D., E.A., P.C.), Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Joana Neto
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, Portugal (D.F., J.N., R.D.)
| | - Rafael Dias
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, Portugal (D.F., J.N., R.D.)
- Department of Neurology (D.F., M.M., R.D., E.A., P.C.), Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Goreti Moreira
- Department of Internal Medicine (G.M.), Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Nils Petersen
- Neurocritical Care and Emergency Neurology, Yale School of Medicine, Yale-New Haven Hospital, CT (N.P.)
| | - Elsa Azevedo
- Department of Neurology (D.F., M.M., R.D., E.A., P.C.), Centro Hospitalar Universitário de São João, Porto, Portugal
- Department of Clinical Neurosciences and Mental Health, Cardiovascular Research and Development Unit, Faculty of Medicine, University of Porto, Portugal (E.A., P.C.)
| | - Pedro Castro
- Department of Neurology (D.F., M.M., R.D., E.A., P.C.), Centro Hospitalar Universitário de São João, Porto, Portugal
- Department of Clinical Neurosciences and Mental Health, Cardiovascular Research and Development Unit, Faculty of Medicine, University of Porto, Portugal (E.A., P.C.)
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Solak M, Kraljević I, Zibar Tomšić K, Kaštelan M, Kakarigi L, Kaštelan D. Neutrophil-Lymphocyte Ratio as a Prognostic Marker in Adrenocortical Carcinoma. Endocr Res 2021; 46:74-79. [PMID: 33416409 DOI: 10.1080/07435800.2020.1870234] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
PURPOSE The purpose of the present study was to analyze the impact of the neutrophil-lymphocyte ratio (NLR) on the long-term outcomes of patients with adrenocortical carcinoma (ACC). METHODS This retrospective, single-institution study included 48 patients with the diagnosis of ACC. The primary outcomes of the study were differences in overall survival (OS) and disease-specific survival (DSS) with respect to the NLR level. RESULTS Patients with ENSAT stage IV had higher levels of NLR compared to those with ENSAT stage I-III (5.7 (1.6-12.5) vs 3.3 (1.3-11); p = .01). A higher NLR was also observed among patients with cortisol-secreting tumors (4.6 (1.7-12.5) vs 2.8 (1.3-10.3); p = .003) and those with Ki-67 index >10% (4.3 (1.3-12.5) vs 2.6 (1.6-11.0); p = .005). With respect to survival, the univariate analysis revealed worse ACC-related survival (p = .02) and OS (p = .004) in patients with NLR >3.9 than in those with NLR ≤3.9. In addition, patients with NLR >3.9 had a higher Weiss score (p = .046), a higher Ki-67 index (p = .006) and a higher disease stage (p = .01) compared to patients with NLR ≤3.9. No differences between the groups were observed regarding excess glucocorticoid secretion. CONCLUSION The study demonstrated that a higher NLR level in ACC patients was associated with unfavorable outcomes in terms of DSS and OS. These results indicate that NLR might be used as an additional marker in ACC risk stratification and identification of patients with the most adverse prognosis.
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Affiliation(s)
- Mirsala Solak
- Department of Endocrinology, University Hospital Center Zagreb, Zagreb, Croatia
| | - Ivana Kraljević
- Department of Endocrinology, University Hospital Center Zagreb, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Karin Zibar Tomšić
- Department of Endocrinology, University Hospital Center Zagreb, Zagreb, Croatia
| | - Marko Kaštelan
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Luka Kakarigi
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Darko Kaštelan
- Department of Endocrinology, University Hospital Center Zagreb, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
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Turri G, Barresi V, Valdegamberi A, Gecchele G, Conti C, Ammendola S, Guglielmi A, Scarpa A, Pedrazzani C. Clinical Significance of Preoperative Inflammatory Markers in Prediction of Prognosis in Node-Negative Colon Cancer: Correlation between Neutrophil-to-Lymphocyte Ratio and Poorly Differentiated Clusters. Biomedicines 2021; 9:biomedicines9010094. [PMID: 33478082 PMCID: PMC7835814 DOI: 10.3390/biomedicines9010094] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/14/2021] [Accepted: 01/16/2021] [Indexed: 02/06/2023] Open
Abstract
Although stage I and II colon cancers (CC) generally show a very good prognosis, a small proportion of these patients dies from recurrent disease. The identification of high-risk patients, who may benefit from adjuvant chemotherapy, becomes therefore essential. We retrospectively evaluated 107 cases of stage I (n = 28, 26.2%) and II (n = 79, 73.8%) CC for correlations among preoperative inflammatory markers, histopathological factors and long-term prognosis. A neutrophil-to-lymphocyte ratio greater than 3 (H-NLR) and a platelet-to-lymphocyte ratio greater than 150 (H-PLR) were significantly associated with the presence of poorly differentiated clusters (PDC) (p = 0.007 and p = 0.039, respectively). In addition, H-NLR and PDC proved to be significant and independent survival prognosticators for overall survival (OS; p = 0.007 and p < 0.001, respectively), while PDC was the only significant prognostic factor for cancer-specific survival (CSS; p < 0.001,). Finally, the combination of H-NLR and PDC allowed an optimal stratification of OS and CSS in our cohort, suggesting a potential role in clinical practice for the identification of high-risk patients with stage I and II CC.
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Affiliation(s)
- Giulia Turri
- Unit of General and Hepatobiliary Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37134 Verona, Italy; (G.T.); (A.V.); (G.G.); (C.C.); (A.G.)
| | - Valeria Barresi
- Department of Diagnostics and Public Health, Section of Pathology, University of Verona, 37134 Verona, Italy; (V.B.); (S.A.); (A.S.)
| | - Alessandro Valdegamberi
- Unit of General and Hepatobiliary Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37134 Verona, Italy; (G.T.); (A.V.); (G.G.); (C.C.); (A.G.)
| | - Gabriele Gecchele
- Unit of General and Hepatobiliary Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37134 Verona, Italy; (G.T.); (A.V.); (G.G.); (C.C.); (A.G.)
| | - Cristian Conti
- Unit of General and Hepatobiliary Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37134 Verona, Italy; (G.T.); (A.V.); (G.G.); (C.C.); (A.G.)
| | - Serena Ammendola
- Department of Diagnostics and Public Health, Section of Pathology, University of Verona, 37134 Verona, Italy; (V.B.); (S.A.); (A.S.)
| | - Alfredo Guglielmi
- Unit of General and Hepatobiliary Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37134 Verona, Italy; (G.T.); (A.V.); (G.G.); (C.C.); (A.G.)
| | - Aldo Scarpa
- Department of Diagnostics and Public Health, Section of Pathology, University of Verona, 37134 Verona, Italy; (V.B.); (S.A.); (A.S.)
| | - Corrado Pedrazzani
- Unit of General and Hepatobiliary Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37134 Verona, Italy; (G.T.); (A.V.); (G.G.); (C.C.); (A.G.)
- Correspondence: ; Tel.: +39-(0)45-8124464-6719; Fax: +39-(0)45-8027426
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ARICI S, ÇEKİN R. Neutrophil-to-Lymphocyte Ratio May Guide the Choice of Treatment in Metastatic Cancer Patients: Chemotherapy or Best Supportive Care. ARCHIVES OF CLINICAL AND EXPERIMENTAL MEDICINE 2020. [DOI: 10.25000/acem.803359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Zhao C, Li LQ, Yang FD, Wei RL, Wang MK, Song DX, Guo XY, Du W, Wei XT. A Hematological-Related Prognostic Scoring System for Patients With Newly Diagnosed Glioblastoma. Front Oncol 2020; 10:591352. [PMID: 33363021 PMCID: PMC7758450 DOI: 10.3389/fonc.2020.591352] [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: 08/04/2020] [Accepted: 11/11/2020] [Indexed: 12/17/2022] Open
Abstract
Background Glioblastoma is the most common primary malignant brain tumor. Recent studies have shown that hematological biomarkers have become a powerful tool for predicting the prognosis of patients with cancer. However, most studies have only investigated the prognostic value of unilateral hematological markers. Therefore, we aimed to establish a comprehensive prognostic scoring system containing hematological markers to improve the prognostic prediction in patients with glioblastoma. Patients and Methods A total of 326 patients with glioblastoma were randomly divided into a training set and external validation set to develop and validate a hematological-related prognostic scoring system (HRPSS). The least absolute shrinkage and selection operator Cox proportional hazards regression analysis was used to determine the optimal covariates that constructed the scoring system. Furthermore, a quantitative survival-predicting nomogram was constructed based on the hematological risk score (HRS) derived from the HRPSS. The results of the nomogram were validated using bootstrap resampling and the external validation set. Finally, we further explored the relationship between the HRS and clinical prognostic factors. Results The optimal cutoff value for the HRS was 0.839. The patients were successfully classified into different prognostic groups based on their HRSs (P < 0.001). The areas under the curve (AUCs) of the HRS were 0.67, 0.73, and 0.78 at 0.5, 1, and 2 years, respectively. Additionally, the 0.5-, 1-y, and 2-y AUCs of the HRS were 0.51, 0.70, and 0.79, respectively, which validated the robust prognostic performance of the HRS in the external validation set. Based on both univariate and multivariate analyses, the HRS possessed a strong ability to predict overall survival in both the training set and validation set. The nomogram based on the HRS displayed good discrimination with a C-index of 0.81 and good calibration. In the validation cohort, a high C-index value of 0.82 could still be achieved. In all the data, the HRS showed specific correlations with age, first presenting symptoms, isocitrate dehydrogenase mutation status and tumor location, and successfully stratified them into different risk subgroups. Conclusions The HRPSS is a powerful tool for accurate prognostic prediction in patients with newly diagnosed glioblastoma.
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Affiliation(s)
- Chao Zhao
- Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Long-Qing Li
- Department of Orthopedic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Feng-Dong Yang
- Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ruo-Lun Wei
- Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Min-Kai Wang
- Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Di-Xiang Song
- Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiao-Yue Guo
- Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Wei Du
- Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xin-Ting Wei
- Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Tse G, Zhou J, Lee S, Liu Y, Leung KSK, Lai RWC, Burtman A, Wilson C, Liu T, Li KHC, Lakhani I, Zhang Q. Multi-parametric system for risk stratification in mitral regurgitation: A multi-task Gaussian prediction approach. Eur J Clin Invest 2020; 50:e13321. [PMID: 32535888 DOI: 10.1111/eci.13321] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 05/31/2020] [Accepted: 06/07/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND We hypothesized that a multi-parametric approach incorporating medical comorbidity information, electrocardiographic P-wave indices, echocardiographic assessment, neutrophil-to-lymphocyte ratio (NLR) and prognostic nutritional index (PNI) calculated from laboratory data can improve risk stratification in mitral regurgitation (MR). METHODS Patients diagnosed with mitral regurgitation between 1 March 2005 and 30 October 2018 from a single centre were retrospectively analysed. Outcomes analysed were incident atrial fibrillation (AF), transient ischemic attack (TIA)/stroke and mortality. RESULTS This study cohort included 706 patients, of whom 171 had normal inter-atrial conduction, 257 had inter-atrial block (IAB) and 266 had AF at baseline. Logistic regression analysis showed that age, hypertension and mean P-wave duration (PWD) were significant predictors of new-onset AF. Low left ventricular ejection fraction (LVEF), abnormal P-wave terminal force in V1 (PTFV1) predicted TIA/stroke. Age, smoking, hypertension, diabetes mellitus, hypercholesterolaemia, ischemic heart disease, secondary mitral regurgitation, urea, creatinine, NLR, PNI, left atrial diameter (LAD), left ventricular end-diastolic dimension, LVEF, pulmonary arterial systolic pressure, IAB, baseline AF and heart failure predicted all-cause mortality. A multi-task Gaussian process learning model demonstrated significant improvement in risk stratification compared to logistic regression and a decision tree method. CONCLUSIONS A multi-parametric approach incorporating multi-modality clinical data improves risk stratification in mitral regurgitation. Multi-task machine learning can significantly improve overall risk stratification performance.
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Affiliation(s)
- Gary Tse
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China
| | - Jiandong Zhou
- School of Data Science, City University of Hong Kong, Kowloon, Hong Kong SAR, China
| | - Sharen Lee
- Laboratory of Cardiovascular Physiology, Li Ka Shing Institute of Health Sciences, Hong Kong S.A.R., China
| | - Yingzhi Liu
- Department of Anaesthesia and Intensive Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong S.A.R., China
| | | | - Rachel Wing Chuen Lai
- Laboratory of Cardiovascular Physiology, Li Ka Shing Institute of Health Sciences, Hong Kong S.A.R., China
| | - Anthony Burtman
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, AZ, USA
| | - Carly Wilson
- Department of Biology, University of Calgary, Calgary, Canada
| | - Tong Liu
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China
| | | | - Ishan Lakhani
- Department of Anaesthesia and Intensive Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong S.A.R., China
| | - Qingpeng Zhang
- School of Data Science, City University of Hong Kong, Kowloon, Hong Kong SAR, China
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Tse G, Zhou J, Woo SWD, Ko CH, Lai RWC, Liu T, Liu Y, Leung KSK, Li A, Lee S, Li KHC, Lakhani I, Zhang Q. Multi-modality machine learning approach for risk stratification in heart failure with left ventricular ejection fraction ≤ 45. ESC Heart Fail 2020; 7:3716-3725. [PMID: 33094925 PMCID: PMC7754744 DOI: 10.1002/ehf2.12929] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 06/13/2020] [Accepted: 07/19/2020] [Indexed: 12/14/2022] Open
Abstract
AIMS Heart failure (HF) involves complex remodelling leading to electrical and mechanical dysfunction. We hypothesized that machine learning approaches incorporating data obtained from different investigative modalities including atrial and ventricular measurements from electrocardiography and echocardiography, blood inflammatory marker [neutrophil-to-lymphocyte ratio (NLR)], and prognostic nutritional index (PNI) will improve risk stratification for adverse outcomes in HF compared to logistic regression. METHODS AND RESULTS Consecutive Chinese patients referred to our centre for transthoracic echocardiography and subsequently diagnosed with HF, between 1 January 2010 and 31 December 2016, were included in this study. Two machine learning techniques, multilayer perceptron and multi-task learning, were compared with logistic regression for their ability to predict incident atrial fibrillation (AF), transient ischaemic attack (TIA)/stroke, and all-cause mortality. This study included 312 HF patients [mean age: 64 (55-73) years, 75% male]. There were 76 cases of new-onset AF, 62 cases of incident TIA/stroke, and 117 deaths during follow-up. Univariate analysis revealed that age, left atrial reservoir strain (LARS) and contractile strain (LACS) were significant predictors of new-onset AF. Age and smoking predicted incident stroke. Age, hypertension, type 2 diabetes mellitus, chronic kidney disease, mitral or aortic regurgitation, P-wave terminal force in V1, the presence of partial inter-atrial block, left atrial diameter, ejection fraction, global longitudinal strain, serum creatinine and albumin, high NLR, low PNI, and LARS and LACS predicted all-cause mortality. Machine learning techniques achieved better prediction performance than logistic regression. CONCLUSIONS Multi-modality assessment is important for risk stratification in HF. A machine learning approach provides additional value for improving outcome prediction.
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Affiliation(s)
- Gary Tse
- Xiamen Cardiovascular Hospital, Xiamen University, Xiamen, China.,Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, 300211, China
| | - Jiandong Zhou
- School of Data Science, City University of Hong Kong, Hong Kong, SAR, China
| | - Samuel Won Dong Woo
- Laboratory of Cardiovascular Physiology, Li Ka Shing Institute of Health Sciences, Hong Kong, China
| | - Ching Ho Ko
- Laboratory of Cardiovascular Physiology, Li Ka Shing Institute of Health Sciences, Hong Kong, China
| | - Rachel Wing Chuen Lai
- Laboratory of Cardiovascular Physiology, Li Ka Shing Institute of Health Sciences, Hong Kong, China
| | - Tong Liu
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, 300211, China
| | - Yingzhi Liu
- Department of Anaesthesia and Intensive Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, SAR, China
| | | | - Andrew Li
- Faculty of Science, University of Calgary, Calgary, AB, Canada
| | - Sharen Lee
- Laboratory of Cardiovascular Physiology, Li Ka Shing Institute of Health Sciences, Hong Kong, China
| | | | - Ishan Lakhani
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, 300211, China
| | - Qingpeng Zhang
- School of Data Science, City University of Hong Kong, Hong Kong, SAR, China
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Advanced Lung Cancer Inflammation Index Predicts Outcomes of Patients With Colorectal Cancer After Surgical Resection. Dis Colon Rectum 2020; 63:1242-1250. [PMID: 33216495 DOI: 10.1097/dcr.0000000000001658] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The advanced lung cancer inflammation index is considered a useful prognostic biomarker of clinical outcomes in patients with malignancies. However, the prognostic value of the advanced lung cancer index in patients with colorectal cancer who underwent surgical resection remains unclear. OBJECTIVE In this study, we evaluated the prognostic value of the advanced lung cancer index in patients with colorectal cancer. DESIGN Prospectively obtained data of patients with colorectal cancer were retrospectively evaluated to clarify the clinical relevance of the advanced lung cancer index. SETTINGS We conducted this study at a single expert center. PATIENTS We enrolled 298 patients with colorectal cancer who underwent surgical resection in this retrospective study. MAIN OUTCOME MEASURES The primary outcome was the clinical relevance of the advanced lung cancer index in patients with rectal cancer. RESULTS Low status of advanced lung cancer index was significantly correlated with undifferentiated histology (p = 0.004), T stage progression (p < 0.001), R1/R2 resection for primary surgery (p = 0.004), and distant metastasis (p < 0.001). Multivariate analysis showed that low advanced lung cancer index status was an independent prognostic factor for both overall survival (HR = 3.21 (95% CI, 1.97-5.19); p < 0.001) and disease-free survival (HR = 2.13 (95% CI, 1.23-3.63); p = 0.008) in patients with colorectal cancer. Furthermore, the clinical burden of the advanced lung cancer index was consistent between sexes, and its prognostic value was verified in patients with clinically relevant stage III colorectal cancer. LIMITATIONS The present study had several limitations, including retrospective observation and a small sample size of Japanese patients from a single institution. CONCLUSIONS The advanced lung cancer index could be a useful prognostic indicator of clinical outcomes in patients who underwent surgical resection for colorectal cancer. See Video Abstract at http://links.lww.com/DCR/B267. EL ÍNDICE AVANZADO DE INFLAMACIÓN DEL CÁNCER DE PULMÓN, PREDICE LOS RESULTADOS DE LOS PACIENTES CON CÁNCER COLORRECTAL DESPUÉS DE LA RESECCIÓN QUIRÚRGICA: El índice avanzado de inflamación del cáncer de pulmón, es considerado como un útil biomarcador pronóstico, en los resultados clínicos de pacientes con neoplasias malignas. Sin embargo, aún no está claro el valor pronóstico del índice avanzado de cáncer de pulmón, en pacientes con cáncer colorrectal sometidos a resección quirúrgica.Evaluar el valor pronóstico del índice avanzado del cáncer de pulmón, en pacientes con cáncer colorrectal.Los datos obtenidos prospectivamente de pacientes con cáncer colorrectal, fueron evaluados retrospectivamente, para aclarar la relevancia clínica del índice avanzado del cáncer de pulmónEstudio realizado en un solo centro experto.Estudio retrospectivo, incluyendo 298 pacientes con cáncer colorrectal, sometidos a resección quirúrgica.El resultado primario fue la relevancia clínica del índice avanzado de cáncer de pulmón, en pacientes con cáncer rectal.Un índice avanzado de cáncer de pulmón bajo, se correlacionó significativamente con la histología indiferenciada (p = 0.004), la progresión de la etapa T (p <0.001), la resección R1 / R2 para cirugía primaria (p = 0.004) y la metástasis a distancia (p <0.001). El análisis multivariante mostró que el índice avanzado de cáncer de pulmón bajo, era un factor pronóstico independiente, tanto para la supervivencia general (HR = 3.21 IC 95% 1.97-5.19 p <0.001) como para la supervivencia libre de enfermedad (HR = 2.13, IC 95% 1.23-3.63, p = 0,008), en pacientes con cáncer colorrectal. Además, la carga clínica del índice avanzado de cáncer de pulmón, fue consistente entre los sexos y su valor pronóstico se verificó clínicamente relevante, en pacientes con cáncer colorrectal en estadio III.El presente estudio tuvo varias limitaciones, incluyendo la observación retrospectiva y la pequeña muestra de pacientes japoneses, en una sola institución.El índice avanzado de cáncer de pulmón, podría ser un indicador pronóstico útil, en los resultados clínicos de pacientes sometidos a resección quirúrgica por cáncer colorrectal. Consulte Video Resumen http://links.lww.com/DCR/B267.
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Jakubowska K, Koda M, Kisielewski W, Kańczuga-Koda L, Grudzińska M, Famulski W. Pre- and postoperative neutrophil and lymphocyte count and neutrophil-to-lymphocyte ratio in patients with colorectal cancer. Mol Clin Oncol 2020; 13:56. [PMID: 32905328 DOI: 10.3892/mco.2020.2126] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 06/05/2020] [Indexed: 12/14/2022] Open
Abstract
Colorectal cancer (CRC) is one of the most common malignant cancers worldwide. Patients with CRC are diagnosed based on various predictors, including performance status, clinicopathological factors and TNM classification. The aim of the present study was to analyze the neutrophil and lymphocyte counts, as well as the neutrophil-to-lymphocyte ratio (NLR) in pre- and postoperative blood samples of patients with CRC in correlation with specific anatomical variables and disease- free survival (DFS). The variables pre- and postoperative neutrophil count (preNEU and postNEU, respectively), lymphocyte count and NLR were significantly higher in cancer patients than those noted in healthy subjects (all P<0.001). PreNEU count correlated with tumor size, necrosis and tumor budding (R=0.204, P=0.014; R=0.189, P=0.023; R=-0.174, P=0.036, respectively). Moreover, postNEU was associated only with the histological type (R=0.174; P=0.047). The PreLYMPH count was correlated with distant metastasis (R=-0.153, P=0.046). PreNLR and postNLR were associated with the expression of various histological markers of disease progression. Analysis of DFS indicated that the postNEU count in the low group exhibited a tendency to lower DFS duration, although the results were not significant (P=0.055). In conclusion, the present study indicated a significant correlation between the factors analyzed in blood samples of CRC patients and the disease progression markers.
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Affiliation(s)
- Katarzyna Jakubowska
- Department of Pathomorphology, Comprehensive Cancer Center, Medical University of Bialystok, 15-027 Bialystok, Poland
| | - Mariusz Koda
- Department of General Pathomorphology, Medical University of Bialystok, 15-296 Bialystok, Poland
| | - Wojciech Kisielewski
- Department of Medical Pathomorphology, Medical University of Bialystok, 15-296 Bialystok, Poland
| | - Luiza Kańczuga-Koda
- Department of Pathomorphology, Comprehensive Cancer Center, Medical University of Bialystok, 15-027 Bialystok, Poland
| | - Małgorzata Grudzińska
- Department of General Pathomorphology, Medical University of Bialystok, 15-296 Bialystok, Poland
| | - Waldemar Famulski
- Department of Pathomorphology, Comprehensive Cancer Center, Medical University of Bialystok, 15-027 Bialystok, Poland.,Department of Medical Pathomorphology, Medical University of Bialystok, 15-296 Bialystok, Poland
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Wang L, Xiao J, Li MZ, Teng WH, Jia J, Lin L, Liu S, Ye XM, Zang WD, Chen Y. Performance of a Nomogram Based on the Integration of Inflammation Markers with Tumor Staging in Prognosis Prediction of Stage III Colorectal Cancer. Cancer Manag Res 2020; 12:7077-7085. [PMID: 32821170 PMCID: PMC7423355 DOI: 10.2147/cmar.s263577] [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: 05/28/2020] [Accepted: 07/24/2020] [Indexed: 12/24/2022] Open
Abstract
Introduction The aim of the present study was to evaluate a nomogram model for predicting the 5-year overall survival (OS) in lymph node-metastatic colorectal cancer (CRC) patients by combining inflammation markers with some traditional prognostic factors. Methods A total of 399 patients with stage III (pTXN1-3M0) CRC operated from January 2007 to December 2012 were enrolled in this retrospective study. All patients underwent D2 lymphadenectomy in the hospital. A prognostic nomogram based on the integration of traditional prognostic factors and NLR (neutrophil-to-lymphocyte ratio) and PLR (platelet-to-lymphocyte ratio) was established and compared with the nomogram based on the traditional prognostic factors alone. ROC curves were further applied to verify the predictive accuracy of the established model. Results Both NLR (P=0.00) and PLR (P=0.01) predicted the 5-year OS. In multivariate analysis, age, T3 category, T4 category, N2 category, N3 category, Pgp (P-glycoprotein), NLR and PLR are proven to be independent (all P≤0.05). The established nomogram showed better predictive power than that of traditional profile (c-index: 0.66 versus 0.63) in both training and validation cohorts. External assessment by ROC curve analysis demonstrated that the established model had a good prediction accuracy of 5-year OS in stage III CRC patients, with area under curve values of 0.657 and 0.629 in training and validating sets, respectively. Conclusion A nomogram based on the integration of traditional prognostic factors and inflammatory markers (NLR and PLR) could provide more precise long-term prognosis information for lymph node-metastatic CRC patients than the model based on traditional profile alone. This model might be useful for clinical application in personalized evaluation.
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Affiliation(s)
- Lin Wang
- Central Laboratory, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou 350000, People's Republic of China
| | - Jun Xiao
- Department of Gastrointestinal Surgery, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou 350000, People's Republic of China
| | - Min-Zhe Li
- General Surgery Department, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100000, People's Republic of China
| | - Wen-Hao Teng
- Department of Gastrointestinal Surgery, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou 350000, People's Republic of China
| | - Jing Jia
- Central Laboratory, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou 350000, People's Republic of China
| | - Lu Lin
- Central Laboratory, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou 350000, People's Republic of China
| | - Sheng Liu
- Department of Gastrointestinal Surgery, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou 350000, People's Republic of China
| | - Xing-Ming Ye
- Central Laboratory, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou 350000, People's Republic of China
| | - Wei-Dong Zang
- Department of Gastrointestinal Surgery, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou 350000, People's Republic of China
| | - Ying Chen
- Central Laboratory, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou 350000, People's Republic of China
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Wang L, Yang J, Huang J, Wen ZQ, Xu N, Liu X, Zhang JH, Li WL. miRNA Expression Profile in the N2 Phenotype Neutrophils of Colorectal Cancer and Screen of Putative Key miRNAs. Cancer Manag Res 2020; 12:5491-5503. [PMID: 32765063 PMCID: PMC7368334 DOI: 10.2147/cmar.s251427] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 05/26/2020] [Indexed: 12/14/2022] Open
Abstract
Objective Colorectal cancer (CRC) is one of the most common malignant tumors in the digestive tract, which accounts for 10% of all the malignant tumors in the world. The aim of this study was to identify key genes and miRNAs in CRC diagnosis, prognosis, and therapy and to further explore the potential molecular mechanisms of CRC. Methods The infiltration and metastasis of neutrophils in primary colorectal cancer tissue and paracancerous tissue were observed by immunohistochemical staining. After inducing N2 neutrophils with TGF-β1 in vitro, exosomes were extracted and sequenced, and then the expression differences of miRNAs were screened by using Agilent miRNA microarrays. The data were imported to the Web CARMA for differential expression analysis. The GO and KEGG enrichment analysis were performed using DIANA-MirPath v3.0 using TargetScan database. And the corresponding targets were imported into Gephi for network analysis. The expression level of differentially expressed miRNA using quantitative real-time polymerase chain reaction (RT-PCR) was validated. Results A total of 2 miRNAs were found to be associated with N2 neutrophils, in which the expression of hsa-miR-4780 was upregulated and the expression of hsa-miR-3938 was downregulated in N2 neutrophils, compared with the neutrophils. In addition, the results of miRNA-targets networks showed that the hsa-mir-3938 and hsa-mir-4780 could regulate TUSC1 and ZNF197. The expression level of hsa-miR-4780 and hsa-miR-3938 wase validated in accordance with the results of RT-PCR. Conclusion The hsa-mir-3938 and hsa-mir-4780 were differentially expressed between N2 neutrophils and neutrophils. Moreover, the regulation of TUSC1 and ZNF197 by these DEmiRNA established the theoretical basis for the mechanism of N2 type neutrophils regulating the invasion and metastasis of CRC cells and provided the potential biomarker for prognosis for clinical treatment of CRC.
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Affiliation(s)
- Liang Wang
- Department of Oncology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province 650032, People's Republic of China
| | - Jun Yang
- Department of Oncology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province 650032, People's Republic of China
| | - Jian Huang
- Department of Oncology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province 650032, People's Republic of China
| | - Zheng-Qi Wen
- Department of Oncology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province 650032, People's Republic of China
| | - Ning Xu
- Department of Oncology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province 650032, People's Republic of China
| | - Xuan Liu
- Department of Oncology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province 650032, People's Republic of China
| | - Jian-Hua Zhang
- Department of General Surgery, Hong He Prefecture Third People's Hospital, Gejiu City 661100, People's Republic of China
| | - Wen-Liang Li
- Department of Oncology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province 650032, People's Republic of China
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Chen H, Wu Q, Zhang Y, Li Q, Ma J, Kong F, Ma X. Nomograms based on the novel platelet index score predict postoperative prognosis in endometrial cancer. Gynecol Oncol 2020; 158:689-697. [PMID: 32507649 DOI: 10.1016/j.ygyno.2020.05.040] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 05/23/2020] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To identify preoperative platelet indexes with prognostic value and to develop and validate nomograms for predicting the survival of endometrial cancer (EC) patients. METHODS A total of 1198 women who received primary surgical treatment between January 2008 and January 2017 were included in the study. Data were randomly divided into a training set (70%, N = 840) and an external validation set (30%, n = 358). Cox regression analysis was performed in the training cohort to identify independent prognostic factors and develop nomograms for survival rate prediction. RESULTS High platelet count (PLT ≥350), high mean platelet volume (MPV ≥8.8) and low platelet distribution width (PDW <12.1) were independently associated with poor RFS and OS. PLT, MPV and PDW were thus incorporated in an innovative score called the platelet index score (PIS). The PIS was also an independent indicator, which was related to histology, lymph-vascular space invasion, lymph node involvement and FIGO stage (P = 0.007, P = 0.042, P < 0.001 and P < 0.001, respectively). Furthermore, we developed and validated two nomograms based on Cox regression models. The discriminative ability and calibration of the nomograms revealed good predictive ability, as indicated by the C-indexes and calibration plots. Moreover, both the IDI and NRI were improved. CONCLUSIONS Nomograms based on the PIS and clinicopathological features accurately predict recurrence-free survival and overall survival for EC patients.
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Affiliation(s)
- Hao Chen
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China
| | - Qijun Wu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China
| | - Yunzheng Zhang
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China
| | - Qing Li
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China
| | - Jian Ma
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China
| | - Fanfei Kong
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China
| | - Xiaoxin Ma
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China.
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Guo D, Li X, Xie A, Cao Q, Zhang J, Zhang F, Li W, Chen J. Differences in oncological outcomes and inflammatory biomarkers between right-sided and left-sided stage I-III colorectal adenocarcinoma. J Clin Lab Anal 2020; 34:e23132. [PMID: 31755593 PMCID: PMC7171299 DOI: 10.1002/jcla.23132] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Revised: 10/16/2019] [Accepted: 11/10/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The aim of this study was to investigate the differences in oncological outcome and inflammatory biomarkers between right-sided colon cancer (RCC) and left-sided colorectal cancer (LCRC). METHODS We retrospectively analyzed 339 patients with stage I-III colorectal cancer, including 125 RCC patients and 214 LCRC patients, who underwent radical resection from January 2012 to January 2014. Comparison of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) between RCC and LCRC was evaluated using the Mann-Whitney U test. Overall survival (OS) and disease-free survival (DFS) were analyzed using Kaplan-Meier analysis and compared using the log-rank test. Univariate and multivariate Cox regression analyses were used to identify the prognostic value of inflammatory markers. RESULTS Patients with RCC had higher NLR (P = .002) and PLR (P < .001) but lower LMR (P = .002) compared to LCRC. In stage I-III, RCC showed poorer OS and DFS than LCRC (61.6% vs 71.5%, P = .018; 64.8% vs 76.2%, P = .006). Univariate and multivariate analyses indicated that NLR, PLR, and LMR were independent predictors for both OS and DFS in RCC, whereas only PLR was found to be an independent prognostic predictor in LCRC. CONCLUSION The prognosis and prognostic value of inflammatory biomarkers were significantly different between RCC and LCRC. Novel therapeutic strategies are needed, and proper prognostic predictors should be selected according to colorectal tumor location.
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Affiliation(s)
- Dongming Guo
- Department of Gastrointestinal SurgeryThe First Affiliated Hospital of Shantou University Medical CollegeShantouChina
| | - Xinxin Li
- Department of Gastrointestinal SurgeryThe First Affiliated Hospital of Shantou University Medical CollegeShantouChina
| | - Aosi Xie
- Department of Gastrointestinal SurgeryThe First Affiliated Hospital of Shantou University Medical CollegeShantouChina
| | - Qiangjian Cao
- Department of Gastrointestinal SurgeryThe First Affiliated Hospital of Shantou University Medical CollegeShantouChina
| | - Jinhai Zhang
- Department of Gastrointestinal SurgeryThe First Affiliated Hospital of Shantou University Medical CollegeShantouChina
| | - Feiran Zhang
- Department of Gastrointestinal SurgeryThe First Affiliated Hospital of Shantou University Medical CollegeShantouChina
| | - Wei Li
- Department of Gastrointestinal SurgeryThe First Affiliated Hospital of Shantou University Medical CollegeShantouChina
| | - Juntian Chen
- Department of Gastrointestinal SurgeryThe First Affiliated Hospital of Shantou University Medical CollegeShantouChina
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Xia LJ, Li W, Zhai JC, Yan CW, Chen JB, Yang H. Significance of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, lymphocyte-to-monocyte ratio and prognostic nutritional index for predicting clinical outcomes in T1-2 rectal cancer. BMC Cancer 2020; 20:208. [PMID: 32164623 PMCID: PMC7066735 DOI: 10.1186/s12885-020-6698-6] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 02/28/2020] [Indexed: 12/24/2022] Open
Abstract
Background Inflammation-related parameters have been revealed to have prognostic value in multiple caners. However, the significance of some inflammation-related parameters, including the peripheral blood neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR) and prognostic nutritional index (PNI), remains controversial in T1–2 rectal cancer (RC). Methods Clinical data of 154 T1–2 RC patients were retrospectively reviewed. The cut-off values for NLR, PLR, LMR, and PNI were determined by receiver operating characteristic curves. The relationships of these parameters with postoperative morbidities and prognosis were statistically analysed. Results The optimal cut-off values for preoperative NLR, PLR, LMR and PNI were 2.8, 140.0, 3.9, and 47.1, respectively. Significant but heterogeneous associations were found between NLR, PLR, LMR and PNI and clinicopathological factors. In addition, high NLR, high PLR, and low PNI were correlated with an increased postoperative morbidity rate. Patients with high NLR/PLR or low LMR/PNI had lower OS and DFS rates. On multivariate analysis, only high NLR was identified as an independent risk factor for poor DFS. Conclusions NLR, PLR, and PNI are valuable factors for predicting postoperative complications in T1–2 RC patients. A preoperative NLR of more than 2.8 is an independent prognostic factor for poor DFS in T1–2 RC patients.
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Affiliation(s)
- Li-Jian Xia
- Department of Colorectal and Anal Surgery, the First Affiliated Hospital of Shandong First Medical University, Jinan, 250012, Shandong Province, China
| | - Wen Li
- Department of Colorectal and Anal Surgery, the First Affiliated Hospital of Shandong First Medical University, Jinan, 250012, Shandong Province, China
| | - Jian-Cheng Zhai
- Department of Colorectal and Anal Surgery, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, Jinan, 250012, Shandong Province, China
| | - Chuan-Wang Yan
- Department of Colorectal and Anal Surgery, Shandong Provincial Qianfoshan Hospital, Weifang Medical College, Jinan, 250012, Shandong Province, China
| | - Jing-Bo Chen
- Department of Colorectal and Anal Surgery, the First Affiliated Hospital of Shandong First Medical University, Jinan, 250012, Shandong Province, China
| | - Hui Yang
- Department of Colorectal and Anal Surgery, the First Affiliated Hospital of Shandong First Medical University, Jinan, 250012, Shandong Province, China.
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Nakano E, Takahashi A, Namikawa K, Muto Y, Jinnai S, Kage Y, Mizuta H, Tsutsumida A, Yamazaki N. Correlation between cutaneous adverse events and prognosis in patients with melanoma treated with nivolumab: A single institutional retrospective study. J Dermatol 2020; 47:622-628. [PMID: 32162349 DOI: 10.1111/1346-8138.15309] [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] [Received: 11/04/2019] [Accepted: 02/17/2020] [Indexed: 01/19/2023]
Abstract
Treatment for patients with unresectable melanoma has been dramatically changed by the use of immunocheckpoint inhibitors (ICI). In this study, we reviewed patients with unresectable stage III/IV melanoma, who were treated with nivolumab between July 2014 and March 2017 at the Department of Dermatologic Oncology, National Cancer Center Hospital, Tokyo, and retrospectively recorded cutaneous adverse events (cAE), development of vitiligo, clinical characteristics and clinical responses. We identified 128 patients, 61 (47.7%) of whom showed cAE, including 30 (23.4%) with development or exacerbation of vitiligo. The prognosis of patients with melanoma treated with ICI correlated with cAE, including development of vitiligo. Patients with cAE showed better objective responses (41.0% vs 6.0%, P < 0.001), progression-free survival (PFS) (377 vs 61 days, P < 0.001) and overall survival (OS) (763 vs 209 days, P < 0.001) than did patients without cAE. Patients who developed vitiligo showed better objective responses (53.3% vs 29.0% vs 6.0%, P < 0.001), PFS (median, not reached vs 317 vs 65 days, P < 0.001) and OS (not reached vs 689 vs 209 days, P < 0.001) than did patients with other cAE and patients without cAE. Landmark analysis showed development of vitiligo starting 20 weeks after starting nivolumab correlated with better OS. In multivariate analysis, OS correlated with performance status, number of metastasized organs, cAE other than vitiligo and development of vitiligo. Despite the fact that the correlation between other cAE and OS was less than that of vitiligo, cAE may be a simple marker of favorable prognosis.
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Affiliation(s)
- Eiji Nakano
- Department of Dermatologic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Akira Takahashi
- Department of Dermatologic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Kenjiro Namikawa
- Department of Dermatologic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yusuke Muto
- Department of Dermatologic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Shunichi Jinnai
- Department of Dermatologic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yuta Kage
- Department of Dermatologic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Haruki Mizuta
- Department of Dermatologic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Arata Tsutsumida
- Department of Dermatologic Oncology, National Cancer Center Hospital, Tokyo, Japan.,Department of Dermatology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Naoya Yamazaki
- Department of Dermatologic Oncology, National Cancer Center Hospital, Tokyo, Japan
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Prognostic value of red cell distribution width (RDW) in colorectal cancer. Results from a single-center cohort on 591 patients. Sci Rep 2020; 10:1072. [PMID: 31974409 PMCID: PMC6978334 DOI: 10.1038/s41598-020-57721-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 12/31/2019] [Indexed: 02/06/2023] Open
Abstract
Increasing evidence advocates the prognostic role of RDW in various tumours. We analysed 591 patients to assess whether RDW is a prognostic factor for overall (OS) and cancer-related survival (CRS) for patients with colorectal cancer (CRC). The data were retrieved from a retrospective database. The optimal cut-off value for RDW was set at 14.1%; accordingly, two groups were considered: those with a value equal or lower than 14.1% (L-RDW), and those with a value higher than 14.1% (H-RDW). The mean value of RDW rose from pT1 to pT4 tumours. H-RDW correlated with age above the mean, colonic location of the lesion, pT and TNM stage. Finally, H-RDW was significantly associated with the intent of surgery: almost 50% of patients who underwent a non-curative resection presented H-RDW, compared to 19.3% in R0 resections. OS was significantly lower in patients with H-RDW. CRS was similar in the two groups. Stratifying patients according to TNM stage worse OS was associated with H-RDW only in early stages, whereas there was no difference for stages II-IV. Multivariate analysis confirmed that H-RDW was not an independent prognostic factor. Although H-RDW correlated with some negative clinical-pathological factors, it did not seem to independently influence OS and CRS.
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Wang Z, Zhong L, Li G, Huang R, Wang Q, Wang Z, Zhang C, Chen B, Jiang T, Zhang W. Pre-treatment neutrophils count as a prognostic marker to predict chemotherapeutic response and survival outcomes in glioma: a single-center analysis of 288 cases. Am J Transl Res 2020; 12:90-104. [PMID: 32051739 PMCID: PMC7013209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 12/07/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Glioma is the most common and deadliest malignant primary intracranial brain tumor in adults. It remains unclear whether the pre-treatment peripheral blood test parameters might serve as biomarkers for treatment outcome. The purpose of the current study was to investigate the predictive and prognostic value of pre-treatment peripheral blood test parameters in glioma. METHODS In total, 288 glioma patients with complete results of pre-operation peripheral blood test, clinical information and tumor transcriptome data from Chinese Glioma Genome Atlas (CGGA project) were enrolled in our study. Receiver operating characteristic (ROC) curve, Kaplan-Meier analysis and Cox proportional hazards models were performed to evaluate the diagnostic and prognostic value of pre-treatment peripheral blood test parameters in glioma patients. RESULTS The white blood cells (WBC) and neutrophils (NEU) counts and neutrophil to lymphocyte ratio (NLR) were positively correlated with tumor grade. IDH mutation and 1p/19q codeletion occurred frequently in patients with higher NEU counts and NLR. We also found that glioma patients with higher NEU or NLR were more likely to have a significantly decreased overall survival. Meanwhile, NEU count was a prognostic marker for TMZ standard treatment GBM patients or IDH wild-type GBM patients. Further biological and functional analysis revealed that NEU count was positively associated with cell cycle and DNA duplication. CONCLUSION Our study was first to highlight the clinical significance of NEU count in GBM clinical treatment, which should be fully valued for clinical prediction and precise management.
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Affiliation(s)
- Zhiliang Wang
- Beijing Neurosurgical Institute, Capital Medical UniversityBeijing, China
| | - Liyun Zhong
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical UniversityBeijing, China
| | - Guanzhang Li
- Beijing Neurosurgical Institute, Capital Medical UniversityBeijing, China
| | - Ruoyu Huang
- Beijing Neurosurgical Institute, Capital Medical UniversityBeijing, China
| | - Qiangwei Wang
- Beijing Neurosurgical Institute, Capital Medical UniversityBeijing, China
| | - Zheng Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical UniversityBeijing, China
| | - Chuanbao Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical UniversityBeijing, China
| | - Baoshi Chen
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical UniversityBeijing, China
| | - Tao Jiang
- Beijing Neurosurgical Institute, Capital Medical UniversityBeijing, China
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical UniversityBeijing, China
- China National Clinical Research Center for Neurological DiseasesBeijing, China
- Center of Brain Tumor, Beijing Institute for Brain DisordersBeijing, China
| | - Wei Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical UniversityBeijing, China
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Meng XZ, Yan B. Prognostic implications of pre-operative platelet count to maximum tumor diameter ratio for colorectal cancer. Shijie Huaren Xiaohua Zazhi 2020; 28:26-32. [DOI: 10.11569/wcjd.v28.i1.26] [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] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Pre-operative platelet count and maximum tumor diameter are useful in predicting the prognosis of colorectal cancer patients, however, it is still largely unknown whether the combination of these two parameters, e.g., the pre-operative platelet count to maximum tumor diameter ratio (PTR), could contribute to prognostic prediction for these patients.
AIM To explore the prognostic role of pre-operative PTR in predicting the 3-year progression free survival (PFS) in colorectal cancer patients.
METHODS A total of 127 patients who were pathologically confirmed with adenocarcinoma and underwent surgery were collected from December 2012 to June 2019 at Hainan Hospital of PLA General Hospital. The PTR was calculated and its prognostic significance for PFS were analyzed.
RESULTS PTR displayed appreciated prediction value for the patients (AUC = 0.66, 95%CI: 0.56-0.76, P < 0.01), and when the cut-off value point was set at 57.27, it had a sensitivity and specificity of 73.30% and 56.10%, respectively. Patients with a high PTR had a better prognosis (log rank = 9.70, P < 0.01) and much longer PFS (50.02 mo ± 22.33 mo vs 38.46 mo ± 24.39 mo, t = -2.76, P < 0.01) than those with a low PTR. Univariate analysis showed that pre-operative carcinoembryonic antigen (CEA), carbohydrate antigen 199, TNM stage, and PTR could influence the PFS (P < 0.01), but only pre-operative CEA, N stage, and M stage were identified to be independent prognostic factors by multivariate analysis.
CONCLUSION PTR is helpful in predicating the 3-year PFS for colorectal cancer patients. An elevated PTR correlates with a good survival, but it is not an independent prognostic factor.
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Affiliation(s)
- Xian-Ze Meng
- Department of Traditional Chinese Medicine, No. 971 Hospital of PLA, Qingdao 266071, Shandong Province, China
| | - Bing Yan
- Department of Oncology, Hainan Hospital of PLA General Hospital, Sanya 572000, Hainan Province, China
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Song J, Lai X, Zhang Y, Zheng X, Su J. Preoperative platelet morphology parameters as prognostic predictors for endometrial malignant carcinoma stage and progesterone receptor. Medicine (Baltimore) 2019; 98:e17818. [PMID: 31764773 PMCID: PMC6882632 DOI: 10.1097/md.0000000000017818] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
To investigate preoperative platelet morphology parameters and other whole blood cells in patients of malignant endometrial carcinoma compared with benign disease.Retrospective analysis was performed through collecting patients' hematological parameters before performing total abdominal/vaginal hysterectomy and standard radical surgery due to benign and malignant endometrial disease between 2006 and 2017. Parameters required included white blood cell (WBC), hemoglobin, platelet count (PLT), platelet distribution width (PDW), mean platelet volume (MPV), and platelet thrombocytocrit (PCT). And neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were calculated. For malignant carcinoma, Ki-67 percentage and progesterone receptor (PR) status were further collected.A total of 288 patients were included with 145 benign cases and 143 malignant cases. Patients of confirmed endometrial carcinoma showed a significant lower value of PDW (55.21 ± 4.72 vs 49.54 ± 5.89, P < .001), meanwhile significant higher values of MPV (7.12 ± 1.56 vs 8.89 ± 1.67, P < .001) and PCT (24.18 ± 6.89 vs 27.93 ± 8.93, P = .003). Further analysis of endometrial carcinoma patients showed that no significant difference in platelet parameters was found between patients with stage I to II and stage III to IV (P > .05), while increased value in PDW and reduced value in MPV was found in PR negative compared with positive patients.Preoperative platelet morphology parameters seemed to be used as one kind of predictive factors to discriminate malignant and benign endometrial disease. Limited by present study design, further prospective studies are required to support this finding.
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Utility of platelet-to-lymphocyte ratio to support the diagnosis of acute deep vein thrombosis. TURK GOGUS KALP DAMAR CERRAHISI DERGISI-TURKISH JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2019; 27:493-498. [PMID: 32082915 DOI: 10.5606/tgkdc.dergisi.2019.17974] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 08/25/2019] [Indexed: 12/30/2022]
Abstract
Background The aim of this study was to investigate whether routine complete blood count parameters such as the mean platelet volume, red cell distribution width, white blood cell and platelet counts, and novel inflammatory biomarkers such as platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio could be used as the predictors of acute deep vein thrombosis. Methods This retrospective study included a total of 68 patients (29 males, 39 females; mean age 55.2±1.6 years; range, 22 to 80 years) with acute lower extremity deep vein thrombosis and 34 healthy controls (15 males, 19 females; mean age 52.8±2.5 years; range, 21 to 77 years) without acute lower extremity deep vein thrombosis between March 2016 and August 2018. Demographic and clinical characteristics of the participant and laboratory data including complete blood count parameters were recorded. Univariate and multivariate analyses were used to identify significant predictors of deep vein thrombosis. Results Demographic and clinical characteristics were similar between the groups. According to the univariate analysis, platelet count and red cell distribution width were found to be significantly higher in the patient group compared to the control group. However, the red cell distribution width was not considered a significant predictor of acute deep vein thrombosis. According to the multivariate logistic regression analysis, the platelet-to-lymphocyte ratio and platelet count were significant predictors of acute deep vein thrombosis. Conclusion Our study results show that the platelet-tolymphocyte ratio may be a useful biomarker to support the diagnosis of acute deep vein thrombosis.
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Turcato G, Sanchis-Gomar F, Cervellin G, Zorzi E, Sivero V, Salvagno GL, Tenci A, Lippi G. Evaluation of Neutrophil-lymphocyte and Platelet-lymphocyte Ratios as Predictors of 30-day Mortality in Patients Hospitalized for an Episode of Acute Decompensated Heart Failure. J Med Biochem 2019; 38:452-460. [PMID: 31496909 PMCID: PMC6708303 DOI: 10.2478/jomb-2018-0044] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 11/21/2018] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND To investigate the association between both neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) and 30-day mortality in patients hospitalized for an episode of acute decompensated heart failure (ADHF). METHODS 439 patients admitted to emergency department (ED) for an episode of ADHF. Clinical history, demographic, clinical and laboratory data recorded at ED admission and then correlated with 30-day mortality. RESULTS 45/439 (10.3%) patients died within 30 days from ED admission. The median values of NLR (4.1 vs 11.7) and PLR (159.1 vs 285.9) were significantly lower in survivors than in patients who died. The area under the ROC curve of NLR was significantly higher than that of the neutrophil count (0.76 vs 0.59; p<0.001), whilst the AUC of PLR was significantly better than that of the platelet count (0.71 vs 0.51; p<0.001). In univariate analysis, both NLR and PLR were significantly associated with 30-day. In the fully-adjusted multivariate model, NLR (odds ratio, 3.63) and PLR (odds ratio, 3.22) remained independently associated with 30-day mortality after ED admission. CONCLUSIONS Routine assessment of NLR and PLR at ED admission may be a valuable aid to complement other conventional measures for assessing the medium-short risk of ADHF patients.
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Affiliation(s)
- Gianni Turcato
- Department of Emergency Medicine, G. Fracastoro Hospital of San Bonifacio, Azienda Ospedaliera Scaligera, San Bonifacio, Verona, Italy
| | - Fabian Sanchis-Gomar
- Leon H. Charney Division of Cardiology, New York University School of Medicine, New York, USA
- Department of Physiology, Faculty of Medicine, University of Valencia and INCLIVA Biomedical Research Institute, Valencia, Spain
| | | | - Elisabetta Zorzi
- Department of Cardiology and Intensive Care Cardiology, G. Fracastoro Hospital of San Bonifacio, Azienda Ospedaliera Scaligera, San Bonifacio, Verona, Italy
| | - Valentina Sivero
- Department of Emergency Medicine, G. Fracastoro Hospital of San Bonifacio, Azienda Ospedaliera Scaligera, San Bonifacio, Verona, Italy
| | | | - Andrea Tenci
- Department of Emergency Medicine, G. Fracastoro Hospital of San Bonifacio, Azienda Ospedaliera Scaligera, San Bonifacio, Verona, Italy
| | - Giuseppe Lippi
- Section of Clinical Biochemistry, University of Verona, Verona, Italy
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Zhou QP, Li XJ. C-Reactive Protein to Albumin Ratio in Colorectal Cancer: A Meta-Analysis of Prognostic Value. Dose Response 2019; 17:1559325819889814. [PMID: 31798355 PMCID: PMC6868585 DOI: 10.1177/1559325819889814] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 10/11/2019] [Accepted: 10/22/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The relationship between pretreatment C-reactive protein to albumin ratio (CAR) and colorectal cancer (CRC) prognosis has been extensively studied in various tumors. However, little is known on CAR and its association with prognosis in CRC. This study aims to investigate the prognostic value of pretreatment CAR in CRC. METHODS We conducted a systematic search of MEDLINE, EMBASE, and Cochrane Library databases for eligible studies evaluating the associations of CAR with survival and/or clinicopathology of CRC. Overall survival (OS), disease-free survival (DFS), relapse-free survival (RFS), and clinicopathological features were synthesized and compared. RESULTS Nine studies including 3431 patients were analyzed in this meta-analysis. Pooled results showed that elevated pretreatment CAR was associated with poor OS (pooled hazards ratio [HR]: 2.18, 95% confidence interval [CI]: 1.70-2.78, P < .001) and DFS/RFS (pooled HR: 2.36, 95% CI: 1.40-3.98, P < .001). Moreover, elevated pretreatment CARs were correlated with male patients, large tumor diameter, late III-IV tumor node metastasis stage tumors, high serum carcinoembryonic antigen and carbohydrate antigen 19-9, and presence of lymphatic invasion and venous invasion. CONCLUSION Elevated pretreatment CAR could be an adverse prognostic indicator in patients with CRC.
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Affiliation(s)
- Qiang-ping Zhou
- Department of Emergency Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, People’s Republic of China
| | - Xiu-jiang Li
- Department of Emergency Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, People’s Republic of China
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Zhang YY, Li WQ, Li ZF, Guo XH, Zhou SK, Lin A, Yan WH. Higher Levels of Pre-operative Peripheral Lymphocyte Count Is a Favorable Prognostic Factor for Patients With Stage I and II Rectal Cancer. Front Oncol 2019; 9:960. [PMID: 31612109 PMCID: PMC6769073 DOI: 10.3389/fonc.2019.00960] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 09/10/2019] [Indexed: 12/13/2022] Open
Abstract
The clinical significance of peripheral blood parameters has been considered to be a potential prognostic indicator for malignancies. In this study, 224 colorectal cancer (CRC; ncolon = 103; nrectal = 121) patients who underwent resection were enrolled, and the pre- and post-operative clinical laboratory data within 1 week, before and after surgery, were collected. The prognostic value of the counts of white blood cell (WBC), neutrophil, lymphocyte and platelet, the neutrophil to lymphocyte ratio (NLR), and systemic immune-inflammation index (SII) were analyzed. Data revealed that pre-operative lymphocyte count (pre-LC) was much higher than that of post-LC (p < 0.001), and only rectal cancer patients with pre-LChigh (>median: 1.61 × 109/L) had a significantly better overall survival (OS) and 5-year survival rate (SR) than those with pre-LClow (OS: 62.3 vs. 49.5 months; SR: 74.0 vs. 43.0%; p = 0.006). Cox's proportional hazard models revealed that pre-LChigh was an independent, favorable prognostic factor for rectal cancer patients (hazard ratio = 0.348; p = 0.003). Moreover, when the disease stages were stratified, the pre-LChigh was significantly associated with better prognosis of rectal cancer patients with stage I + II rectal cancer (n = 65; OS: 67.5 vs. 54.3 months; p = 0.011). Taken together, our study revealed that pre-operative lymphocyte count is an independent prognostic factor for patients with stage I and II rectal cancer.
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Affiliation(s)
- Ying-Ying Zhang
- School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou, China
| | - Wan-Qing Li
- School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou, China
| | - Zhen-Fa Li
- School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou, China
| | - Xiao-Hua Guo
- School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou, China
| | - Shen-Kang Zhou
- Department of Gastrointestinal Surgery, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai, China
| | - Aifen Lin
- School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou, China
| | - Wei-Hua Yan
- School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou, China
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