1
|
Li Z, Huang L, Guo B, Zhang P, Wang J, Wang X, Yao W. The predictive ability of routinely collected laboratory markers for surgically treated spinal metastases: a retrospective single institution study. BMC Cancer 2022; 22:1231. [PMID: 36447178 PMCID: PMC9706860 DOI: 10.1186/s12885-022-10334-8] [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: 07/12/2022] [Accepted: 11/18/2022] [Indexed: 11/30/2022] Open
Abstract
PURPOSE We aimed to identify effective routinely collected laboratory biomarkers for predicting postoperative outcomes in surgically treated spinal metastases and attempted to establish an effective prediction model. METHODS This study included 268 patients with spinal metastases surgically treated at a single institution. We evaluated patient laboratory biomarkers to determine trends to predict survival. The markers included white blood cell (WBC) count, platelet count, neutrophil count, lymphocyte count, hemoglobin, albumin, alkaline phosphatase, creatinine, total bilirubin, calcium, international normalized ratio (INR), platelet-to-lymphocyte ratio (PLR), and neutrophil-to-lymphocyte ratio (NLR). A nomogram based on laboratory markers was established to predict postoperative 90-day and 1-year survival. The discrimination and calibration were validated using concordance index (C-index), area under curves (AUC) from receiver operating characteristic curves, and calibration curves. Another 47 patients were used as a validation group to test the accuracy of the nomogram. The prediction accuracy of the nomogram was compared to Tomita, revised Tokuhashi, modified Bauer, and Skeletal Oncology Research Group machine-learning (SORG ML). RESULTS WBC, lymphocyte count, albumin, and creatinine were shown to be the independent prognostic factors. The four predictive laboratory markers and primary tumor, were incorporated into the nomogram to predict the 90-day and 1-year survival probability. The nomogram performed good with a C-index of 0.706 (0.702-0.710). For predicting 90-day survival, the AUC in the training group and the validation group was 0.740 (0.660-0.819) and 0.795 (0.568-1.000), respectively. For predicting 1-year survival, the AUC in the training group and the validation group was 0.765 (0.709-0.822) and 0.712 (0.547-0.877), respectively. Our nomogram seems to have better predictive accuracy than Tomita, revised Tokuhashi, and modified Bauer, alongside comparable prediction ability to SORG ML. CONCLUSIONS Our study confirmed that routinely collected laboratory markers are closely associated with the prognosis of spinal metastases. A nomogram based on primary tumor, WBC, lymphocyte count, albumin, and creatinine, could accurately predict postoperative survival for patients with spinal metastases.
Collapse
Affiliation(s)
- Zhehuang Li
- grid.414008.90000 0004 1799 4638Department of Musculoskeletal Oncology, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, 45000 Henan China
| | - Lingling Huang
- grid.414008.90000 0004 1799 4638Department of Musculoskeletal Oncology, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, 45000 Henan China
| | - Bairu Guo
- grid.414008.90000 0004 1799 4638Department of Musculoskeletal Oncology, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, 45000 Henan China
| | - Peng Zhang
- grid.414008.90000 0004 1799 4638Department of Musculoskeletal Oncology, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, 45000 Henan China
| | - Jiaqiang Wang
- grid.414008.90000 0004 1799 4638Department of Musculoskeletal Oncology, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, 45000 Henan China
| | - Xin Wang
- grid.414008.90000 0004 1799 4638Department of Musculoskeletal Oncology, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, 45000 Henan China
| | - Weitao Yao
- grid.414008.90000 0004 1799 4638Department of Musculoskeletal Oncology, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, 45000 Henan China
| |
Collapse
|
2
|
Madeddu C, Sanna E, Nemolato S, Mulas O, Oppi S, Scartozzi M, La Nasa G, Maccio A. Pathogenic and Prognostic Roles of Paraneoplastic Leukocytosis in Cervical Cancer: Can Genomic-Based Targeted Therapies Have a Role? A Literature Review and an Emblematic Case Report. Diagnostics (Basel) 2022; 12:diagnostics12081910. [PMID: 36010260 PMCID: PMC9406983 DOI: 10.3390/diagnostics12081910] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/27/2022] [Accepted: 08/05/2022] [Indexed: 11/16/2022] Open
Abstract
Tumor-associated leukocytosis has been associated with poor prognosis in cervical cancer. Leukemoid reaction (i.e., white blood cell count > 40,000/μL) is defined paraneoplastic (PLR) when it occurs in the presence of a cytokine-secreting tumor (CST) without neoplastic bone marrow infiltration. Cervical cancers displaying PLR represent a peculiar entity characterized by a rapidly progressive behavior typically associated with chemo-radioresistance. The present paper aims to review the literature about the pathogenetic mechanisms of PLR and its prognostic role in cervical cancer. Moreover, it reports the emblematic case of a patient with an advanced cervical cancer associated with PLR that was chemotherapy resistant. The patient underwent a palliative cytoreductive surgery of high complexity, obtaining a temporary regression of PLR. The tumor sample stained positive for G-CSF and IL-6, thus indicating a CST. Notably, the tumor genomic analysis revealed a PI3CKA mutation. Therefore, at the instrumental evidence of a rapidly progressive disease relapse, which was accompanied by reappearance of PLR, we started a targeted treatment with a selective PIK3 inhibitor alpesilib combined with the JAK1-2 inhibitor ruxolitinib. We achieved a relief of symptoms and leukocytosis; however, severe side effects necessitated the treatment suspension. In conclusion, as therapeutic strategies for cancer with PLR are scarcely reported in literature, our study could contribute to expand our understanding of the topic and provide a basis for further research.
Collapse
Affiliation(s)
- Clelia Madeddu
- Department of Medical Sciences and Public Health, University of Cagliari, 09100 Cagliari, Italy
| | - Elisabetta Sanna
- Department of Gynecologic Oncology, A. Businco Hospital, ARNAS G. Brotzu, 09100 Cagliari, Italy
| | - Sonia Nemolato
- Department of Pathology, ARNAS G. Brotzu, 09100 Cagliari, Italy
| | - Olga Mulas
- Hematology and Transplant Center, A. Businco Hospital, ARNAS G. Brotzu, 09100 Cagliari, Italy
| | - Sara Oppi
- Hematology and Transplant Center, A. Businco Hospital, ARNAS G. Brotzu, 09100 Cagliari, Italy
| | - Mario Scartozzi
- Department of Medical Sciences and Public Health, University of Cagliari, 09100 Cagliari, Italy
| | - Giorgio La Nasa
- Hematology and Transplant Center, A. Businco Hospital, ARNAS G. Brotzu, 09100 Cagliari, Italy
| | - Antonio Maccio
- Department of Gynecologic Oncology, A. Businco Hospital, ARNAS G. Brotzu, 09100 Cagliari, Italy
- Department of Surgical Sciences, University of Cagliari, 09100 Cagliari, Italy
- Correspondence: ; Tel.: +39-070-675-4228
| |
Collapse
|
3
|
Combined PLT and NE to predict the prognosis of patients with locally advanced cervical cancer. Sci Rep 2020; 10:11210. [PMID: 32641736 PMCID: PMC7343858 DOI: 10.1038/s41598-020-66387-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 03/11/2020] [Indexed: 12/26/2022] Open
Abstract
Cervical cancer is one of the most common tumors in women. Neutrophils (NEs) and platelets (PLTs) are components of cells in circulating blood. NEs are one of the components of white blood cells (WBCs), accounting for the vast majority of WBCs, recognized as one of the indicators of inflammation. PLTs are associated with thrombosis and inflammation. Both of them play an important role in tumor growth and metastasis. According to pre-radiotherapy PLT and NE media levels, we divided the patients into three groups: PLT and NE both high levels group, single high level group and both low group. By using COX regression models and nomogram, a prognostic model for patients was established. Both high levels of pre-radiotherapy PLT and NE group or high levels of post-radiotherapy PLT and NE group were correlated with worst overall survival (OS) compared with the other two groups. PLT and NE were correlated with outcomes of the patients with locally advanced cervical cancer.
Collapse
|
4
|
Clinical Outcomes of Patients With Gastrointestinal Malignancies Participating in Phase I Clinical Trials. Am J Clin Oncol 2019; 41:133-139. [PMID: 26523441 DOI: 10.1097/coc.0000000000000242] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVES Early-phase clinical trials play a pivotal role in drug development. However, limited data are available on outcomes of gastrointestinal (GI) cancer patients enrolled in phase I clinical trials. Here, we evaluated the characteristics associated with survival in GI cancer patients participating in phase I clinical trials and attempted to validate previously established prognostic models. MATERIALS AND METHODS All consecutive patients with advanced GI tumors who participated in phase I clinical trials at our institution from January 2007 to December 2013 and received at least 1 dose of the study drug were included. Cox regression models were used to estimate multivariable-adjusted hazard ratio (HR) and 95% confidence interval. RESULTS In 243 study patients (median age, 62 y [range, 26 to 82 y]; 55% male), treatment included chemotherapy only (14%), targeted therapy (41%), chemotherapy+targeted therapy (42%), and others (2%) for the following disease types: pancreatic (42%), colorectal (34%), gastroesophageal (10%), hepatobiliary (13%), and others (2%). Response rate was 4%, with 38% achieving stable disease and 42% having progressive disease. Median survival was 5.8 months (range, 0.2 to 52.4 mo). Our multivariable Cox regression analyses included the following as predictors of survival: Eastern Cooperative Oncology Group performance score ≥1 (HR=1.76), prior systemic therapies ≥2 (HR=1.63), lactate dehydrogenase >618 IU/L (HR=1.85), sodium >135 mmol/L (HR=0.46), and white blood count >6×10/L (HR=1.5). Our data set was consistent with previous prognostic scores. CONCLUSIONS This is the largest study to assess clinical outcomes in this patient population. Phase I trials provide clinical benefit to patients with advanced GI malignancies and should be recommended as a treatment option in appropriate patients.
Collapse
|
5
|
Survival outcome and prognostic model of patients with colorectal cancer on phase 1 trials. Invest New Drugs 2018; 37:490-497. [PMID: 30315379 DOI: 10.1007/s10637-018-0675-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 10/02/2018] [Indexed: 12/22/2022]
Abstract
Background Patients with metastatic colorectal cancer (mCRC) who progress on standard therapies may be eligible for phase I trials. To better delineate the risk-benefit ratio, we assessed toxicities, clinical outcomes and prognostic factors. Methods Records of mCRC patients on phase I trials at our institution over 18 years were reviewed. Univariable (UVA) and multivariable analyses (MVA) were undertaken and a prognostic model developed. Results There were 187 enrollments on 37 phase I trials. Median age was: 59 (29-83) years and number of prior therapies: 3 (0-8). The clinical benefit rate (CBR): response (5.6%) + stable disease, was 43.1%. Median progression free survival (PFS) and overall survival (OS) was 7.7 weeks and 43.7 weeks, respectively. The MVA identified age > 60 years (HR 1.63, p < 0.004), albumin<3.5 g/dL (HR 3.69, p < 0.001), direct bilirubin>ULN (HR1.69, p < 0.01), and WBC ≥ 5.2 k/uL (HR 1.97, p < 0.001) as negative prognostic factors. A risk score based on the MVA revealed that patients with a score of 0-1 had an improved OS (58.7 weeks) compared to a score of 2 (49.9 weeks, p < 0.01) and 3 (14.1 weeks, p < 0.001). Conclusions Phase 1 trials may offer similar or better clinical outcome for mCRC patients than standard third line therapies; the prognostic model could assist in selecting appropriate patients.
Collapse
|
6
|
Escande A, Haie-Meder C, Maroun P, Gouy S, Mazeron R, Leroy T, Bentivegna E, Morice P, Deutsch E, Chargari C. Neutrophilia in locally advanced cervical cancer: A novel biomarker for image-guided adaptive brachytherapy? Oncotarget 2018; 7:74886-74894. [PMID: 27713124 PMCID: PMC5342709 DOI: 10.18632/oncotarget.12440] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 09/19/2016] [Indexed: 12/24/2022] Open
Abstract
Objective To study the prognostic value of leucocyte disorders in a prospective cohort of cervical cancer patients receiving definitive chemoradiation plus image—guided adaptive brachytherapy (IGABT). Results 113 patients were identified. All patients received a pelvic irradiation concomitant with chemotherapy, extended to the para-aortic area in 13 patients with IVB disease. Neutrophilia and leukocytosis were significant univariate prognostic factors for poorer local failure-free survival (p = 0.000 and p = 0.002, respectively), associated with tumor size, high-risk clinical target volume (HR-CTV) and anemia. No effect was shown for distant metastases but leukocytosis and neutrophila were both poor prognostic factors for in-field relapses (p = 0.003 and p < 0.001). In multivariate analysis, HR-CTV volume (p = 0.026) and neutrophils count > 7,500/μl (p = 0.018) were independent factors for poorer survival without local failure, with hazard ratio (HR) of 3.1. Materials and methods We examined patients treated in our Institution between April 2009 and July 2015 by concurrent chemoradiation (45 Gy in 25 fractions +/− lymph node boosts) followed by a magnetic resonance imaging (MRI)-guided adaptive pulse-dose rate brachytherapy (15 Gy to the intermediate-risk clinical target volume). The prognostic value of pretreatment leucocyte disorders was examined. Leukocytosis and neutrophilia were defined as a leukocyte count or a neutrophils count exceeding 10,000 and 7,500/μl, respectively. Conclusions Neutrophilia is a significant prognostic factor for local relapse in locally advanced cervical cancer treated with MRI-based IGABT. This biomarker could help identifying patients with higher risk of local relapse and requiring dose escalation.
Collapse
Affiliation(s)
- Alexandre Escande
- Radiotherapy Department, Brachytherapy Unit, Gustave Roussy Cancer Campus, Villejuif, France
| | - Christine Haie-Meder
- Radiotherapy Department, Brachytherapy Unit, Gustave Roussy Cancer Campus, Villejuif, France
| | - Pierre Maroun
- Radiotherapy Department, Brachytherapy Unit, Gustave Roussy Cancer Campus, Villejuif, France.,Faculté de Médecine PARIS Sud, Université Paris Sud, Université Paris Saclay, France
| | - Sébastien Gouy
- Department of Surgery, Gustave Roussy, Villejuif, France
| | - Renaud Mazeron
- Radiotherapy Department, Brachytherapy Unit, Gustave Roussy Cancer Campus, Villejuif, France
| | - Thomas Leroy
- Radiotherapy Department, Oscar Lambret Comprehensive Cancer Center, Lille, France
| | | | - Philippe Morice
- Faculté de Médecine PARIS Sud, Université Paris Sud, Université Paris Saclay, France.,Department of Surgery, Gustave Roussy, Villejuif, France.,INSERM1030, Gustave Roussy Cancer Campus, Villejuif, France
| | - Eric Deutsch
- Radiotherapy Department, Brachytherapy Unit, Gustave Roussy Cancer Campus, Villejuif, France.,Faculté de Médecine PARIS Sud, Université Paris Sud, Université Paris Saclay, France.,INSERM1030, Gustave Roussy Cancer Campus, Villejuif, France
| | - Cyrus Chargari
- Radiotherapy Department, Brachytherapy Unit, Gustave Roussy Cancer Campus, Villejuif, France.,Faculté de Médecine PARIS Sud, Université Paris Sud, Université Paris Saclay, France.,INSERM1030, Gustave Roussy Cancer Campus, Villejuif, France.,French Military Health Services Academy, Ecole du Val-de-Grâce, Paris, France.,Institut de Recherche Biomédicale des Armées, Bretigny-sur-Orge, France
| |
Collapse
|
7
|
Prognostic value of the pretreatment neutrophil-to-lymphocyte ratio in cervical cancer: a meta-analysis and systematic review. Oncotarget 2017; 8:13400-13412. [PMID: 28077792 PMCID: PMC5355107 DOI: 10.18632/oncotarget.14541] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 12/28/2016] [Indexed: 12/21/2022] Open
Abstract
The prognostic value of pretreatment neutrophil-to-lymphocyte ratio (NLR) in cervical cancer remains controversial. We conducted a meta-analysis based on the data from 13 studies with 3729 patients to evaluate the association between the pretreatment NLR and the clinical outcomes of overall survival and progression-free survival in patients with cervical cancer. The relationship between NLR and clinicopathological parameters was also assessed. Hazard ratio (HR) or odds ratio (OR) with its 95% confidence interval (CI) was used as the effect size estimate. Our analysis indicated that elevated pretreatment NLR was a poor prognostic marker for patients with cervical cancer because it predicted unfavorable overall survival (HR = 1.375, 95% CI: 1.200–1.576) and progression-free survival (HR = 1.646, 95% CI: 1.313–2.065). Increased NLR is also significantly associated with the larger tumor size (OR = 1.780, 95% CI: 1.090–2.908), advanced clinical stage (OR = 2.443, 95% CI: 1.730–3.451), and positive lymph node metastasis (OR = 2.380, 95% CI: 1.775–3.190). By these results, high pretreatment NLR predicted a shorter survival period for patients with cervical cancer, and it could be served as a novel index of prognostic evaluation in patients with cervical cancer.
Collapse
|
8
|
Neutrophil–lymphocyte ratio dynamics during concurrent chemo-radiotherapy for glioblastoma is an independent predictor for overall survival. J Neurooncol 2017; 132:463-471. [DOI: 10.1007/s11060-017-2395-y] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 02/26/2017] [Indexed: 12/16/2022]
|
9
|
Real-Time Label-Free Embolus Detection Using In Vivo Photoacoustic Flow Cytometry. PLoS One 2016; 11:e0156269. [PMID: 27227413 PMCID: PMC4881933 DOI: 10.1371/journal.pone.0156269] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Accepted: 05/11/2016] [Indexed: 11/19/2022] Open
Abstract
Thromboembolic events are one of the world's leading causes of death among patients. Embolus or clot formations have several etiologies including paraneoplastic, post-surgery, cauterization, transplantation, or extracorporeal circuits. Despite its medical significance, little progress has been made in early embolus detection, screening and control. The aim of our study is to test the utility of the in vivo photoacoustic (PA) flow cytometry (PAFC) technique for non-invasive embolus detection in real-time. Using in vivo PAFC, emboli were non-invasively monitored in the bloodstream of two different mouse models. The tumor-free mouse model consisted of two groups, one in which the limbs were clamped to produce vessel stasis (7 procedures), and one where the mice underwent surgery (7 procedures). The melanoma-bearing mouse model also consisted of two groups, one in which the implanted tumor underwent compression (8 procedures), and one where a surgical excision of the implanted tumor was performed (8 procedures). We demonstrated that the PAFC can detect a single embolus, and has the ability to distinguish between erythrocyte-rich (red) and leukocyte/platelet-rich (white) emboli in small vessels. We show that, in tumor-bearing mice, the level of circulating emboli was increased compared to tumor-free mice (p = 0.0013). The number of circulating emboli temporarily increased in the tumor-free control mice during vessel stasis (p = 0.033) and after surgical excisions (signed-rank p = 0.031). Similar observations were noted during tumor compression (p = 0.013) and after tumor excisions (p = 0.012). For the first time, it was possible to detect unlabeled emboli in vivo non-invasively, and to confirm the presence of pigmented tumor cells within circulating emboli. The insight on embolus dynamics during cancer progression and medical procedures highlight the clinical potential of PAFC for early detection of cancer and surgery-induced emboli to prevent the fatal thromboembolic complications by well-timed therapy.
Collapse
|
10
|
Kawano M, Mabuchi S, Matsumoto Y, Sasano T, Takahashi R, Kuroda H, Kozasa K, Hashimoto K, Isobe A, Sawada K, Hamasaki T, Morii E, Kimura T. The significance of G-CSF expression and myeloid-derived suppressor cells in the chemoresistance of uterine cervical cancer. Sci Rep 2015; 5:18217. [PMID: 26666576 PMCID: PMC4678366 DOI: 10.1038/srep18217] [Citation(s) in RCA: 111] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 10/29/2015] [Indexed: 12/12/2022] Open
Abstract
Granulocyte-colony stimulating factor (G-CSF) producing malignant tumor has been reported to occur in various organs, and has been associated with poor clinical outcome. The aim of this study is to investigate the significance of tumor G-CSF expression in the chemosensitivity of uterine cervical cancer. The clinical data of recurrent or advanced cervical cancer patients who were treated with platinum-based chemotherapy were analyzed. Clinical samples, cervical cancer cell lines, and a mouse model of cervical cancer were employed to examine the mechanisms responsible for the development of chemoresistance in G-CSF-producing cervical cancer, focusing on myeloid-derived suppressor cells (MDSC). As a result, the tumor G-CSF expression was significantly associated with increased MDSC frequencies and compromised survival. In vitro and in vivo experiments demonstrated that the increased MDSC induced by tumor-derived G-CSF is involved in the development of chemoresistance. The depletion of MDSC via splenectomy or the administration of anti-Gr-1 antibody sensitized G-CSF-producing cervical cancer to cisplatin. In conclusion, tumor G-CSF expression is an indicator of an extremely poor prognosis in cervical cancer patients that are treated with chemotherapy. Combining MDSC-targeting treatments with current standard chemotherapies might have therapeutic efficacy as a treatment for G-CSF-producing cervical cancer.
Collapse
Affiliation(s)
- Mahiru Kawano
- Department of Obstetrics and Gynecology Osaka University Graduate School of Medicine; 2-2 Yamadaoka; Suita; Osaka; 565-0871; Japan
| | - Seiji Mabuchi
- Department of Obstetrics and Gynecology Osaka University Graduate School of Medicine; 2-2 Yamadaoka; Suita; Osaka; 565-0871; Japan
| | - Yuri Matsumoto
- Department of Obstetrics and Gynecology Osaka University Graduate School of Medicine; 2-2 Yamadaoka; Suita; Osaka; 565-0871; Japan
| | - Tomoyuki Sasano
- Department of Obstetrics and Gynecology Osaka University Graduate School of Medicine; 2-2 Yamadaoka; Suita; Osaka; 565-0871; Japan
| | - Ryoko Takahashi
- Department of Obstetrics and Gynecology Osaka University Graduate School of Medicine; 2-2 Yamadaoka; Suita; Osaka; 565-0871; Japan
| | - Hiromasa Kuroda
- Department of Obstetrics and Gynecology Osaka University Graduate School of Medicine; 2-2 Yamadaoka; Suita; Osaka; 565-0871; Japan
| | - Katsumi Kozasa
- Department of Obstetrics and Gynecology Osaka University Graduate School of Medicine; 2-2 Yamadaoka; Suita; Osaka; 565-0871; Japan
| | - Kae Hashimoto
- Department of Obstetrics and Gynecology Osaka University Graduate School of Medicine; 2-2 Yamadaoka; Suita; Osaka; 565-0871; Japan
| | - Aki Isobe
- Department of Obstetrics and Gynecology Osaka University Graduate School of Medicine; 2-2 Yamadaoka; Suita; Osaka; 565-0871; Japan
| | - Kenjiro Sawada
- Department of Obstetrics and Gynecology Osaka University Graduate School of Medicine; 2-2 Yamadaoka; Suita; Osaka; 565-0871; Japan
| | - Toshimitsu Hamasaki
- Department of Biomedical Statistics Osaka University Graduate School of Medicine; 2-2 Yamadaoka; Suita; Osaka; 565-0871; Japan
| | - Eiichi Morii
- Department of Molecular Pathology; Osaka University Graduate School of Medicine; 2-2 Yamadaoka; Suita; Osaka; 565-0871; Japan
| | - Tadashi Kimura
- Department of Obstetrics and Gynecology Osaka University Graduate School of Medicine; 2-2 Yamadaoka; Suita; Osaka; 565-0871; Japan
| |
Collapse
|
11
|
Su Z, Mao YP, OuYang PY, Tang J, Xie FY. Initial Hyperleukocytosis and Neutrophilia in Nasopharyngeal Carcinoma: Incidence and Prognostic Impact. PLoS One 2015; 10:e0136752. [PMID: 26336064 PMCID: PMC4559377 DOI: 10.1371/journal.pone.0136752] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 08/07/2015] [Indexed: 02/07/2023] Open
Abstract
Background This study aimed to evaluate initial hyperleukocytosis and neutrophilia as prognostic indicators in patients with nasopharyngeal carcinoma. Methods A retrospective analysis of 5,854 patients identified from a cohort of 6,035 patients diagnosed with nasopharyngeal carcinoma was performed with initial hyperleukocytosis and neutrophilia analyzed as prognostic factors. Multivariate Cox proportional hazards analyses were applied. Results Hyperleukocytosis was observed in 508 patients (8.7%). Multivariate analysis showed that initial hyperleukocytosis was an independent predictor of death (HR 1.40, 95%CI 1.15–1.70, p = 0.001), progression (HR 1.25, 95%CI 1.06–1.47, p = 0.007) and, marginally, distant metastasis (HR 1.21, 95%CI 0.97–1.52, p = 0.088). Neutrophilia was also an independent predictor of death (HR 1.46, 95%CI 1.18–1.81, p = 0.001), progression (HR 1.31, 95%CI 1.10–1.56, p = 0.003), and distant metastasis (HR 1.29, 95%CI 1.02–1.65, p = 0.036), after adjusting for prognostic factors and excluding hyperleukocytosis. Conclusion Initial hyperleukocytosis and neutrophilia were independent, poor prognostic factors and may be convenient and useful biological markers for survival of patients with nasopharyngeal carcinoma.
Collapse
Affiliation(s)
- Zhen Su
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
| | - Yan-Ping Mao
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
| | - Pu-Yun OuYang
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
| | - Jie Tang
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
| | - Fang-Yun Xie
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
- * E-mail:
| |
Collapse
|
12
|
Stone SC, Rossetti RAM, Lima AM, Lepique AP. HPV associated tumor cells control tumor microenvironment and leukocytosis in experimental models. IMMUNITY INFLAMMATION AND DISEASE 2014; 2:63-75. [PMID: 25400927 PMCID: PMC4217549 DOI: 10.1002/iid3.21] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2013] [Revised: 04/07/2014] [Accepted: 04/09/2014] [Indexed: 01/09/2023]
Abstract
Human papillomavirus (HPV) is the main etiological factor for cervical cancer development. HPV is also associated with other anogenital and oropharyngeal tumors. HPV associated tumors are frequent and constitute a public health problem, mainly in developing countries. Therapy against such tumors is usually excisional, causing iatrogenic morbidity. Therefore, development of strategies for new therapies is desirable. The tumor microenvironment is essential for tumor growth, where inflammation is an important component, displaying a central role in tumor progression. Inflammation may be a causal agent, suppressor of anti-tumor T cell responses, or may have a role in angiogenesis, drug resistance, and metastasis. The aim of this work was to investigate the role of HPV transformed cells in the tumor microenvironment and tumor effects on myeloid populations in lymphoid organs in the host. We used experimental models, where we injected cervical cancer derived cell lines in immunodeficient mice, comparing HPV positive, SiHa, and HeLa cells (HPV 16 and HPV18, respectively), with HPV negative cell line, C33A. Our data shows that HPV positive cell lines were more efficient than the HPV negative cell line in leukocyte recruitment to the tumor microenvironment and increase in myeloid cell proliferation in the bone marrow and spleen. We also observed that HPV positive cells lines expressed significantly higher levels of IL-6 and IL-8, while C33A expressed significantly higher levels of IL-16 and IL-17. Finally, in spite of cytokine secretion by tumor cells, leukocytes infiltrating SiHa and HeLa tumors displayed almost negligible STAT3 and no NFκB phosphorylation. Only the inflammatory infiltrate of C33A tumors had NFκB and STAT3 activated isoforms. Our results indicate that, although from the same anatomical site, the uterine cervix, these cell lines display important differences regarding inflammation. These results are important for the design of immunotherapies against cervical cancer, and possibly against HPV associated tumors in other anatomical sites.
Collapse
Affiliation(s)
- Simone Cardozo Stone
- Institute of Biomedical Sciences, Department of Immunology, University of Sao Paulo Av. Prof. Lineu Prestes, 1730, Room 136, 05508-900, Sao Paulo, SP, Brazil
| | - Renata Ariza Marques Rossetti
- Institute of Biomedical Sciences, Department of Immunology, University of Sao Paulo Av. Prof. Lineu Prestes, 1730, Room 136, 05508-900, Sao Paulo, SP, Brazil
| | - Aleida Maria Lima
- Institute of Biomedical Sciences, Department of Immunology, University of Sao Paulo Av. Prof. Lineu Prestes, 1730, Room 136, 05508-900, Sao Paulo, SP, Brazil
| | - Ana Paula Lepique
- Institute of Biomedical Sciences, Department of Immunology, University of Sao Paulo Av. Prof. Lineu Prestes, 1730, Room 136, 05508-900, Sao Paulo, SP, Brazil
| |
Collapse
|
13
|
De Schutter T, Andrei G, Topalis D, Duraffour S, Mitera T, van den Oord J, Matthys P, Snoeck R. Reduced tumorigenicity and pathogenicity of cervical carcinoma SiHa cells selected for resistance to cidofovir. Mol Cancer 2013; 12:158. [PMID: 24325392 PMCID: PMC4029382 DOI: 10.1186/1476-4598-12-158] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Accepted: 11/18/2013] [Indexed: 12/18/2022] Open
Abstract
Background Insights into the mechanisms associated with chemotherapy-resistance are important for implementation of therapeutic strategies and for unraveling the mode of action of chemotherapeutics. Although cidofovir (CDV) has proven efficacious in the treatment of human papillomavirus (HPV)-induced proliferation, no studies concerning the development of resistance to CDV in HPV-positive tumor cells have been performed yet. Methods From the cervical carcinoma SiHa cells (SiHaparental), which are HPV-16 positive, cidofovir-resistant cells (SiHaCDV) were selected, and differential gene expression profiles were analyzed by means of microarrays. We examined in vitro phenotyping of resistant cells compared to parental cells as well as tumorigenicity and pathogenicity in a mouse-xenograft model. Results SiHaCDV had a resistant phenotype and a reduced growth both in vitro and in vivo. A markedly diminished inflammatory response (as measured by production of host- and tumor-derived cytokines and number of neutrophils and macrophages in spleen) was induced by SiHaCDV than by SiHaparental in the xenograft model. Gene expression profiling identified several genes with differential expression upon acquisition of CDV-resistance and pointed to a diminished induction of inflammatory response in SiHaCDV compared to SiHaparental. Conclusions Our results indicate that acquisition of resistance to cidofovir in SiHa cells is linked to reduced pathogenicity. The present study contributes to our understanding on the antiproliferative effects of CDV and on the mechanisms involved, the inflammatory response playing a central role.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Robert Snoeck
- Rega Institute, Laboratory of Virology and Chemotherapy, KU Leuven, Leuven, Belgium.
| |
Collapse
|
14
|
Shimura K, Mabuchi S, Yokoi T, Sasano T, Sawada K, Hamasaki T, Kimura T. Utility of serum squamous cell carcinoma antigen levels at the time of recurrent cervical cancer diagnosis in determining the optimal treatment choice. J Gynecol Oncol 2013; 24:321-9. [PMID: 24167667 PMCID: PMC3805912 DOI: 10.3802/jgo.2013.24.4.321] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2013] [Revised: 06/08/2013] [Accepted: 06/12/2013] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To investigate the utility of serum squamous cell carcinoma antigen (SCC-Ag) levels upon the diagnosis of recurrent cervical cancer for decision making in patient management. METHODS Clinical records from 167 cervical cancer patients who developed recurrence between April 1996 and September 2010 were reviewed. A Cox proportional hazards regression model was used to investigate the prognostic significance of serum SCC-Ag levels at the time of recurrence. The effects of various salvage treatments on survival outcomes of recurrent cervical cancer were examined with respect to serum SCC-Ag levels. RESULTS Serum SCC-Ag levels were elevated (>2.0 ng/mL) in 125 patients (75%) when recurrence was diagnosed. These patients exhibited significantly shorter postrecurrence survival than those with normal SCC-Ag levels (log-rank; p=0.033). Multivariate analyses revealed that an elevated serum SCC-Ag level was an independent prognostic factor for poor postrecurrence survival. In patients with SCC-Ag levels <14.0 ng/mL, radiotherapy or surgery resulted in improved survival compared with chemotherapy or supportive care. In contrast, in patients with SCC-Ag levels of ≥14.0 ng/mL, salvage treatment with radiotherapy had only a minimal impact on postrecurrence survival. CONCLUSION The serum SCC-Ag level measured when cervical cancer recurrence is diagnosed can be useful for deciding upon the appropriate salvage treatment.
Collapse
Affiliation(s)
- Kotaro Shimura
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
| | | | | | | | | | | | | |
Collapse
|