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Xu XL, Xu JH, He JQ, Li YH, Cheng H. Novel prognostic nomograms for postoperative patients with oral cavity squamous cell carcinoma in the central region of China. BMC Cancer 2024; 24:730. [PMID: 38877437 PMCID: PMC11177417 DOI: 10.1186/s12885-024-12465-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 06/03/2024] [Indexed: 06/16/2024] Open
Abstract
BACKGROUND Oral cavity squamous cell carcinoma (OCSCC) is the most common pathological type in oral tumors. This study intends to construct a novel prognostic nomogram model based on China populations for these resectable OCSCC patients, and then validate these nomograms. METHODS A total of 607 postoperative patients with OCSCC diagnosed between June 2012 and June 2018 were obtained from two tertiary medical institutions in Xinxiang and Zhengzhou. Then, 70% of all the cases were randomly assigned to the training group and the rest to the validation group. The endpoint time was defined as overall survival (OS) and disease-free survival (DFS). The nomograms for predicting the 3-, and 5-year OS and DFS in postoperative OCSCC patients were established based on the independent prognostic factors, which were identified by the univariate analysis and multivariate analysis. A series of indexes were utilized to assess the performance and net benefit of these two newly constructed nomograms. Finally, the discrimination capability of OS and DFS was compared between the new risk stratification and the American Joint Committee on Cancer (AJCC) stage by Kaplan-Meier curves. RESULTS 607 postoperative patients with OCSCC were selected and randomly assigned to the training cohort (n = 425) and validation cohort (n = 182). The nomograms for predicting OS and DFS in postoperative OCSCC patients had been established based on the independent prognostic factors. Moreover, dynamic nomograms were also established for more convenient clinical application. The C-index for predicting OS and DFS were 0.691, 0.674 in the training group, and 0.722, 0.680 in the validation group, respectively. Besides, the calibration curve displayed good consistency between the predicted survival probability and actual observations. Finally, the excellent performance of these two nomograms was verified by the NRI, IDI, and DCA curves in comparison to the AJCC stage system. CONCLUSION The newly established and validated nomograms for predicting OS and DFS in postoperative patients with OCSCC perform well, which can be helpful for clinicians and contribute to clinical decision-making.
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Affiliation(s)
- Xue-Lian Xu
- Department of Radiotherapy Oncology, The First Affiliated Hospital of Xinxiang Medical University, 88 Jiankang Road, Xinxiang, 453100, Henan, China
| | - Jin-Hong Xu
- Department of Otolaryngology, AnYang District Hospital, Anyang, 455000, Henan, China
| | - Jia-Qi He
- Department of Radiotherapy Oncology, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, 450000, Henan, China
| | - Yi-Hao Li
- Department of Radiotherapy Oncology, The First Affiliated Hospital of Xinxiang Medical University, 88 Jiankang Road, Xinxiang, 453100, Henan, China
| | - Hao Cheng
- Department of Radiotherapy Oncology, The First Affiliated Hospital of Xinxiang Medical University, 88 Jiankang Road, Xinxiang, 453100, Henan, China.
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Szewczyk M, Pazdrowski J, Golusiński P, Więckowska B, Golusiński W. Oral cancer in young adults: should we approach these patients differently? Front Oncol 2024; 14:1297752. [PMID: 38646430 PMCID: PMC11026602 DOI: 10.3389/fonc.2024.1297752] [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: 09/20/2023] [Accepted: 03/21/2024] [Indexed: 04/23/2024] Open
Abstract
Objective The influence of age on treatment outcomes in oral cancer is unclear. We aimed to determine the prevalence of oral cancer in adults under age 45 and to compare treatment outcomes by age. Methods Retrospective study of 284 patients treated for oral cancer from 2010 to 2021. The primary analysis involved the full cohort stratified by age (< vs. ≥ 45y). The second analysis included all patients under age 45 (n=44) matched 1:1 by sex and stage to older patients (age 55-70). Results In the primary analysis, the only significant difference was more comorbidities in the older group (p<0.001). In the matched-pair analysis, older patients were more likely to be smokers (75% vs. 54%; p=0.045) and had more comorbidities (p=0.007). The mean PLR and NLR values were significantly higher in the younger group. Conclusions No significant differences were observed between age groups in disease stage or outcomes, suggesting that other variables are more important.
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Affiliation(s)
- Mateusz Szewczyk
- Department of Head and Neck Surgery, Poznań University of Medical Sciences, The Greater Poland Cancer Center, Poznań, Poland
| | - Jakub Pazdrowski
- Department of Head and Neck Surgery, Poznań University of Medical Sciences, The Greater Poland Cancer Center, Poznań, Poland
| | - Paweł Golusiński
- Department of Otolaryngology and Maxillofacial Surgery, University of Zielona Góra, Zielona Góra, Poland
| | - Barbara Więckowska
- Department of Computer Science and Statistics, Poznan University of Medical Sciences, Poznan, Poland
| | - Wojciech Golusiński
- Department of Head and Neck Surgery, Poznań University of Medical Sciences, The Greater Poland Cancer Center, Poznań, Poland
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Valero C, León X, Quer M. Host-related indexes in head and neck cancer. Curr Opin Otolaryngol Head Neck Surg 2024; 32:113-117. [PMID: 38116851 DOI: 10.1097/moo.0000000000000954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
PURPOSE OF REVIEW Peripheral blood host-related indexes have been widely studied in cancer patients. Several authors have shown the prognostic capacity of these indexes in head and neck cancer. Therefore, there has been an increasing interest in this topic recently. RECENT FINDINGS The main variables analyzed and used to create these host-related indexes are peripheral blood leukocytes - including neutrophils, monocytes and lymphocytes - albumin and hemoglobin levels. Other factors with proven prognostic capacity in some studies are: platelets, C-reactive protein, and BMI. Among all the combined indexes, the neutrophil-to-lymphocyte ratio has been the most accepted and used worldwide. Nonetheless, there are other indexes which group multiple of these factors that have shown better prognostic capacity, and are promising in the near future. SUMMARY Host-related indexes are ideal biomarkers to be used on our daily-basis. There is enough evidence to start considering them when assessing patients with head and neck cancer.
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Affiliation(s)
- Cristina Valero
- Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona
| | - Xavier León
- Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid
- UVIC. Universitat Central de Catalunya, Vic, Spain
| | - Miquel Quer
- Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid
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Lee Y, Lee L, Huang Y, Kao H, Chang Y, Hung S, Lu C, Chang Y, Yu J, Chang K. Comparison between a novel salivary marker and several clinical prognosticators in oral cavity cancer. Laryngoscope Investig Otolaryngol 2023; 8:1547-1556. [PMID: 38130271 PMCID: PMC10731513 DOI: 10.1002/lio2.1166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 09/03/2023] [Accepted: 09/23/2023] [Indexed: 12/23/2023] Open
Abstract
Objectives This study aimed to investigate the association between salivary matrix metalloproteinase-1 (MMP-1) and clinicopathological parameters of oral cavity squamous cell carcinoma (OSCC) and compare the prognostic efficacy of salivary MMP-1 and other established circulating markers for OSCC. Methods Saliva specimens from 479 OSCC subjects were examined using an enzyme-linked immunosorbent assay. The area under the curve (AUC) values of salivary MMP-1 and other markers were calculated, and survival analyses were conducted using Kaplan-Meier and multivariate regression methods. Results Salivary MMP-1 showed good discrimination in predicting overall survival, with an AUC of 0.638, which was significantly higher than that of albumin (0.530, p = .021) and Charlson comorbidity index (0.568, p = .048) and comparable with neutrophil-to-lymphocyte ratio (0.620, p = .987), platelet-to-lymphocyte ratio (0.575, p = .125), and squamous cell carcinoma antigen (0.609, p = .605). Elevated levels of salivary MMP-1 were significantly associated with higher pT classification, pN classification, overall pathological stage, positive extranodal extension, tumor differentiation, positive lymphovascular invasion, positive perineural invasion, and tumor depth (p all <.05). Multivariate analyses indicated that a higher level of salivary MMP-1 (≥2060.0 pg/mL) was an independent predictive factor of poorer overall survival (adjusted hazard ratio: 1.421 [95% confidential interval: 1.014-1.989], p = .041). Conclusion The study found that the salivary MMP-1 level was significantly associated with many adverse clinicopathological parameters of OSCC. In OSCC, it was found to have superior efficacy in predicting prognosis and was an independent prognostic factor of post-treatment outcome. Level of evidence 3.
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Affiliation(s)
- Yi‐Chan Lee
- Department of Otolaryngology‐Head and Neck SurgeryChang Gung Memorial HospitalKeelungTaiwan
- College of MedicineChang Gung UniversityTaoyuanTaiwan
| | - Li‐Yu Lee
- College of MedicineChang Gung UniversityTaoyuanTaiwan
- Department of PathologyChang Gung Memorial HospitalTaoyuanTaiwan
| | - Yenlin Huang
- Department of PathologyChang Gung Memorial HospitalTaoyuanTaiwan
- School of MedicineNational Tsing‐Hua UniversityHsinchuTaiwan
- Institute of Stem Cell and Translational Cancer ResearchChang Gung Memorial HospitalTaoyuanTaiwan
| | - Huang‐Kai Kao
- College of MedicineChang Gung UniversityTaoyuanTaiwan
- Department of Plastic and Reconstructive SurgeryChang Gung Memorial HospitalTaoyuanTaiwan
| | - Ya‐Ting Chang
- Molecular Medicine Research CenterChang Gung UniversityTaoyuanTaiwan
| | - Shao‐Yu Hung
- Department of Plastic and Reconstructive SurgeryChang Gung Memorial HospitalTaoyuanTaiwan
| | - Chuieng‐Yi Lu
- Department of Plastic and Reconstructive SurgeryChang Gung Memorial HospitalTaoyuanTaiwan
| | - Yu‐Sun Chang
- Molecular Medicine Research CenterChang Gung UniversityTaoyuanTaiwan
| | - Jau‐Song Yu
- Molecular Medicine Research CenterChang Gung UniversityTaoyuanTaiwan
- Department of Cell and Molecular Biology, College of MedicineChang Gung UniversityTaoyuanTaiwan
| | - Kai‐Ping Chang
- College of MedicineChang Gung UniversityTaoyuanTaiwan
- Department of Otolaryngology‐Head and Neck SurgeryChang Gung Memorial HospitalTaoyuanTaiwan
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Systemic inflammation with sarcopenia predicts survival in patients with gastric cancer. J Cancer Res Clin Oncol 2023; 149:1249-1259. [PMID: 35435489 DOI: 10.1007/s00432-022-03925-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 01/12/2022] [Indexed: 12/29/2022]
Abstract
OBJECTIVE The levels of platelet-related inflammation indicators and sarcopenia have been reported to affect the survival of patients with cancer. To evaluate the prognostic influence of platelet count (PLT), platelet lymphocyte ratio (PLR), and systemic immune inflammation index (SII), and SII combined with sarcopenia on the survival of patients with gastric cancer (GC). METHODS A total of 1133 patients with GC (812 male and 321 female, average age: 59.43 years) were evaluated. Receiver-operating characteristic curves were used to determine the best cutoff values of PLT, PLR, and SII, and univariate and multivariate Cox risk regression models were used to evaluate whether SII is an independent predictor of overall survival (OS). The prognostic SS (SII-sarcopenia) was established based on SII and sarcopenia. Finally, a comprehensive analysis of the prognostic SS was performed. RESULTS SII had the strongest prognostic effect. The SII and OS of patients with GC were in an inverted U-shape (adjusted HR = 1.07; 95% CI 0.97-1.19; adjusted P = 0.179). In patients with SII > 1800, SII was negatively correlated with OS (adjusted HR = 0.57; 95% CI 0.29-1.12; adjusted P = 0.102), however, there is no statistical difference. Interestingly, a high SS was associated with a poorer prognosis. The higher the SS score was, the worse the OS (P < 0.001). CONCLUSION SII is an independent prognostic indicator of GC, and high SII is related to poor prognosis. A higher SS score had worse survival. Thus, the prognostic SS is a reliable predictor of OS in patients with GC.
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Chen X, Li Z, Zhou J, Wei Q, Wang X, Jiang R. Identification of prognostic factors and nomogram model for patients with advanced lung cancer receiving immune checkpoint inhibitors. PeerJ 2022; 10:e14566. [PMID: 36540802 PMCID: PMC9760026 DOI: 10.7717/peerj.14566] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 11/22/2022] [Indexed: 12/23/2022] Open
Abstract
Background and aim Some patients with lung cancer can benefit from immunotherapy, but the biomarkers that predict immunotherapy response were not well defined. Baseline characteristic of patients may be the most convenient and effective markers. Therefore, our study was designed to explore the association between baseline characteristics of patients with lung cancer and the efficacy of immunotherapy. Methods A total of 216 lung cancer patients from Tianjin Medical University Cancer Institute & Hospital who received immunotherapy between 2017 and 2021 were included in the retrospective analysis. All baseline characteristic data were collected and then univariate log-rank analysis and multivariate COX regression analysis were performed. Kaplan-Meier analysis was used to evaluate patients' progression-free survival (PFS). A nomogram based on significant biomarkers was constructed to predict PFS rate of patients receiving immunotherapy. We evaluated the prediction accuracy of nomogram using C-indices and calibration curves. Results Univariate analysis of all collected baseline factors showed that age, clinical stage, white blood cell (WBC), lymphocyte (LYM), monocyte (MON), eosinophils (AEC), hemoglobin (HB), lactate dehydrogenase (LDH), albumin (ALB) and treatment line were significantly associated with PFS after immunotherapy. Then these 10 risk factors were included in a multivariate regression analysis, which indicated that age (HR: 1.95, 95% CI [1.01-3.78], P = 0.048), MON (HR: 1.74, 95% CI [1.07-2.81], P = 0.025), LDH (HR: 0.59, 95% CI [0.36-0.95], P = 0.030), and line (HR: 0.57, 95% CI [0.35-0.94], P = 0.026) were significantly associated with PFS in patients with lung cancer receiving immunotherapy. Patients with higher ALB showed a greater trend of benefit compared with patients with lower ALB (HR: 1.58, 95% CI [0.94-2.66], P = 0.084). Patients aged ≥51 years, with high ALB, low LDH, first-line immunotherapy, and high MON had better response rates and clinical benefits. The nomogram based on age, ALB, MON, LDH, line was established to predict the prognosis of patients treated with immune checkpoint inhibitor (ICI). The C-index of training cohort and validation cohort were close, 0.71 and 0.75, respectively. The fitting degree of calibration curve was high, which confirmed the high prediction value of our nomogram. Conclusion Age, ALB, MON, LDH, line can be used as reliable predictive biomarkers for PFS, response rate and cancer control in patients with lung cancer receiving immunotherapy. The nomogram based on age, ALB, MON, LDH, line was of great significance for predicting 1-year-PFS, 2-year-PFS and 3-year-PFS in patients with advanced lung cancer treated with immunotherapy.
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Affiliation(s)
- Xiuqiong Chen
- Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China,Key Laboratory of Cancer Prevention and Therapy, Tianjin, China,Tianjin’s Clinical Research Center for Cancer, Tianjin, China,Department of Thoracic Oncology, Tianjin Lung Cancer Center, Tianjin Cancer Institute and Hospital, Tianjin Medical University, Tianjin, China
| | - Zhaona Li
- Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China,Key Laboratory of Cancer Prevention and Therapy, Tianjin, China,Tianjin’s Clinical Research Center for Cancer, Tianjin, China,Department of Thoracic Oncology, Tianjin Lung Cancer Center, Tianjin Cancer Institute and Hospital, Tianjin Medical University, Tianjin, China
| | - Jing Zhou
- Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China,Key Laboratory of Cancer Prevention and Therapy, Tianjin, China,Tianjin’s Clinical Research Center for Cancer, Tianjin, China,Department of Thoracic Oncology, Tianjin Lung Cancer Center, Tianjin Cancer Institute and Hospital, Tianjin Medical University, Tianjin, China
| | - Qianhui Wei
- Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China,Key Laboratory of Cancer Prevention and Therapy, Tianjin, China,Tianjin’s Clinical Research Center for Cancer, Tianjin, China,Department of Thoracic Oncology, Tianjin Lung Cancer Center, Tianjin Cancer Institute and Hospital, Tianjin Medical University, Tianjin, China
| | - Xinyue Wang
- Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China,Key Laboratory of Cancer Prevention and Therapy, Tianjin, China,Tianjin’s Clinical Research Center for Cancer, Tianjin, China,Department of Thoracic Oncology, Tianjin Lung Cancer Center, Tianjin Cancer Institute and Hospital, Tianjin Medical University, Tianjin, China
| | - Richeng Jiang
- Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China,Key Laboratory of Cancer Prevention and Therapy, Tianjin, China,Tianjin’s Clinical Research Center for Cancer, Tianjin, China,Department of Thoracic Oncology, Tianjin Lung Cancer Center, Tianjin Cancer Institute and Hospital, Tianjin Medical University, Tianjin, China
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Wan M, Zhao D, Liu W, Huang Z, Xu X, Zheng B, Xiao S, Sun Y, Wang W. Pretherapy platelet-to-lymphocyte ratio as a prognostic parameter for locally advanced hypopharyngeal cancer patients treated with radiotherapy combined with chemotherapy. Eur Arch Otorhinolaryngol 2022; 279:5859-5868. [PMID: 35849189 DOI: 10.1007/s00405-022-07495-4] [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: 03/05/2022] [Accepted: 06/07/2022] [Indexed: 01/04/2023]
Abstract
PURPOSE This study aimed to identify whether the platelet-to-lymphocyte ratio (PLR) correlated with the prognosis of patients with locally advanced hypopharyngeal squamous cell carcinoma (LA-HPSCC) undergoing radiotherapy combined with chemotherapy. METHODS This study enrolled 103 patients diagnosed with LA-HPSCC and treated with radiotherapy combined with chemotherapy between 2008 and 2021. The optimal PLR cut-off value was chosen from the receiver operating characteristic (ROC) curve analysis. According to the cut-off value of PLR, patients were divided into two groups: a low PLR group (< 133.06) and a high PLR group (≥ 133.06). Propensity score matching (PSM) was used to balance the confounding factors between the two PLR groups. Univariate and multivariate Cox proportional hazard regression models, the Kaplan-Meier curve by the log-rank test, and univariate and multivariate Fine-Gray competing risk models were all used for assessment. RESULTS After PSM, 27 pairs were left, and the high PLR group correlated with higher local failure (sHR 6.91, 95% CI 2.14-22.35, p = 0.001) in the multivariate Fine-Gray competing risk model. Moreover, the low PLR group had a significantly longer 3-year progression-free survival (43.7% vs. 29.2%, p = 0.038) and overall survival (55.1% vs. 32.1%, p = 0.034) than the high PLR group had. Multivariate Cox analysis showed that a low PLR was an independent protective factor for PFS (HR 0.43, 95% CI 0.21-0.92, p = 0.019) and OS (HR 0.46, 95% CI 0.22-0.96, p = 0.039) in patients with LA-HPSCC. CONCLUSION Pretherapy PLR might be a factor in predicting the risk of local failure and survival in LA-HPSCC patients undergoing radiotherapy combined with chemotherapy.
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Affiliation(s)
- Meng Wan
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital and Institute, No.52 Fucheng Road, Haidian District, Beijing, 100142, People's Republic of China
| | - Dan Zhao
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital and Institute, No.52 Fucheng Road, Haidian District, Beijing, 100142, People's Republic of China
| | - Weixin Liu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital and Institute, No.52 Fucheng Road, Haidian District, Beijing, 100142, People's Republic of China
| | - Zhou Huang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital and Institute, No.52 Fucheng Road, Haidian District, Beijing, 100142, People's Republic of China
| | - Xiaolong Xu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital and Institute, No.52 Fucheng Road, Haidian District, Beijing, 100142, People's Republic of China
| | - Baomin Zheng
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital and Institute, No.52 Fucheng Road, Haidian District, Beijing, 100142, People's Republic of China
| | - Shaowen Xiao
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital and Institute, No.52 Fucheng Road, Haidian District, Beijing, 100142, People's Republic of China
| | - Yan Sun
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital and Institute, No.52 Fucheng Road, Haidian District, Beijing, 100142, People's Republic of China.
| | - Weihu Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital and Institute, No.52 Fucheng Road, Haidian District, Beijing, 100142, People's Republic of China.
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Pre-transplant platelet-to- lymphocyte ratio predicts outcome after allogeneic hematopoietic stem cell transplantation. Sci Rep 2022; 12:18948. [PMID: 36347969 PMCID: PMC9643448 DOI: 10.1038/s41598-022-23344-0] [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: 02/21/2022] [Accepted: 10/30/2022] [Indexed: 11/11/2022] Open
Abstract
For many patients with hematological malignancies such as acute leukemia or myelodysplastic syndrome allogeneic hematopoietic stem cell transplantation (allogeneic HSCT) is the only curative treatment option. Despite the curative potential of this treatment many patients experience relapse of their underlying disease or die due to multiple complications e.g. infections. Risk scores could help to assess the individual prognosis and guide patients and treating physicians to choose between different treatment options. Parameters reflecting the inflammatory status, such as neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR), have been demonstrated to be associated with prognosis and treatment complications in patients with various cancers. In this study, we evaluate pre-HSCT NLR, MLR and PLR as predictive markers in patients undergoing allogeneic HSCT. We demonstrate that a high (> 133) PLR level is associated with better clinical outcome. Patients with high pre-HSCT PLR show a significant better overall survival (p = 0.001), less relapses (p = 0.016), lower non-relapse-mortality (p = 0.022), less transfusions of red blood cells, platelets and fresh frozen plasma (p = 0.000), fewer episodes of fever (p = 0.002), considerably less different antibiotics (p = 0.005), fewer intensive care unit treatment (p = 0.017) and a lower in-hospital mortality (p = 0.024). Pre-HSCT PLR is easy to calculate by daily routine and could help to predict patient outcome after allogeneic HSCT.
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Prognostic Abilities of Pre- and Post-Treatment Inflammatory Markers in Oral Squamous Cell Carcinoma: Stepwise Modelling. Medicina (B Aires) 2022; 58:medicina58101426. [PMID: 36295584 PMCID: PMC9606996 DOI: 10.3390/medicina58101426] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/01/2022] [Accepted: 10/05/2022] [Indexed: 11/16/2022] Open
Abstract
Background and Objectives: Studies examining the importance of inflammatory markers before treatment as prognosticators of OSCC are available, but information on post-therapy inflammatory markers and their prognostic significance is limited. This study aimed to evaluate the prognostic abilities of pre- and post-treatment inflammatory markers in patients with OSCC. Materials and Methods: In this retrospective analysis, information on 151 OSCC patients’ socio-demographic, clinico-pathological, recurrence, metastasis, and survival data were gathered from clinical records. A multivariable Cox proportional hazards regression (stepwise model) was conducted to identify the prognostic predictors of OS and DFS. The multivariable models’ performances were evaluated using Harrell’s concordance statistics. Results: For OS, high pre-treatment LMR (HR 3.06, 95%CI 1.56, 5.99), and high post-treatment PLC (HR 3.35, 95%CI 1.71, 6.54) and PLR (HR 5.26, 95%CI 2.62, 10.58) were indicative of a poor prognosis. For DFS, high pre-treatment SII (HR 2.59, 95%CI 1.50, 4.48) and high post-treatment PLC (HR 1.92, 95%CI 1.11, 3.32) and PLR (HR 3.44, 95%CI 1.98, 5.07) were associated with increased mortality. The fitness of the OS and DFS stepwise Cox regression models were proven with a time-dependent AUC of 0.8787 and 0.8502, respectively. Conclusions: High pre-treatment levels of LMR and SII and high post-treatment levels of PLC and PLR are independent predictors of a poor prognosis for patients with OSCC.
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Khazravi M, Shirkhoda M, Saffar H, Jalaeefar A. Prognostic Value of Lymph Node Density Compared to Pre-operative Platelet-to-Lymphocyte Ratio and Neutrophil-to-Lymphocyte Ratio in Patients with Tongue Squamous Cell Carcinoma. J Maxillofac Oral Surg 2022; 21:845-855. [PMID: 36274869 PMCID: PMC9474769 DOI: 10.1007/s12663-021-01524-1] [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: 07/06/2020] [Accepted: 02/03/2021] [Indexed: 10/22/2022] Open
Abstract
Background We aimed to investigate the prognostic significance of lymph node density (LND), and pre-operative neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) for outcome measuring in tongue squamous cell carcinoma (TSCC)' patients. Methods A total of 129 patients who underwent surgery for TSCC were enrolled in this retrospective study. LND and pre-operative NLR and PLR were used as outcome measures and their correlations with different clinicopathological features were examined. Results The cutoff values for NLR, PLR, and LND were obtained 1.21, 97.81, and 0.02, respectively, by receiver operating characteristic (ROC) curve approach. Only LND was found to be significantly associated with decreased overall survival (HR = 4.24; 95% CI 1.49-12.10; P = 0.007) and disease-free survival (HR = 3.48; 95% CI 1.43-8.45; P = 0.006) both in univariate and multivariate analyzes. Conclusion Based on the findings, the LND has superiority over pre-operative NLR and PLR in predicting outcomes for the patients with TSCC.
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Affiliation(s)
- Mona Khazravi
- Department of Surgical Oncology, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
- Cancer Research Center of Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Shirkhoda
- Department of Surgical Oncology, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hana Saffar
- Department of Pathology, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirmohsen Jalaeefar
- Department of Surgical Oncology, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
- Cancer Research Center of Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
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Wu R, Li D, Zhang F, Bai Y, Wang X, Han P. Prognostic Value of Platelet-to-Lymphocyte Ratio in Non-Muscle Invasive Bladder Cancer Patients: Intravesical Bacillus Calmette-Guerin Treatment After Transurethral Resection of Bladder Tumor. Front Surg 2022; 9:907485. [PMID: 36034368 PMCID: PMC9411071 DOI: 10.3389/fsurg.2022.907485] [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: 03/29/2022] [Accepted: 04/28/2022] [Indexed: 01/04/2023] Open
Abstract
The objective of this study was to investigate the platelet-to-lymphocyte ratio (PLR) in patients who underwent intravesical treatment for non-muscle invasive bladder cancer (NMIBC). A total of 197 patients who underwent intravesical Bacillus Calmette-Guerin treatment after transurethral resection of bladder (TURB) were included. We divided the patients into different groups according to the treatment stage before and during induction treatment as Group 1 and Group 2, and set the change value of PLR as the Group 3. The cutoff values of PLR were determined through receiver operation characteristics curves analysis. we found a significant difference in recurrence-free survival (RFS) and progression-free survival (PFS) between patients with high serum PLR and those with low serum PLR in Group 1, as well as Group 2. Cox multivariate analysis revealed that tumor number ≥3, high grade, and history of carcinoma in situ (CIS) were significant factors predicting RFS and PFS. The PLR values before and during induction therapy could be used as predictors for the progression and recurrence of NMIBC patients receiving BCG immunotherapy. the PLR values after induction therapy have a stronger predictive power.
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Kubota K, Ito R, Narita N, Tanaka Y, Furudate K, Akiyama N, Chih CH, Komatsu S, Kobayashi W. Utility of prognostic nutritional index and systemic immune-inflammation index in oral cancer treatment. BMC Cancer 2022; 22:368. [PMID: 35392843 PMCID: PMC8991673 DOI: 10.1186/s12885-022-09439-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 03/21/2022] [Indexed: 12/24/2022] Open
Abstract
PURPOSE This study aimed to evaluate the utility of inflammation-based prognostic scores (IBPS) and systemic immune-inflammation index (SII) in the treatment of oral cancer patients. METHODS For the 183 patients enrolled in this study, IBPS and SII were calculated from peripheral blood samples obtained before and after treatment and at the time of relapse. We examined overall survival (OS) and disease-free survival (DFS) using previously reported cut-off values for IBPS. Cut-off values of neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), and prognostic nutritional index (PNI) were analyzed as NLR 1.79, PLR 114.97, LMR 5, and PNI 52.44. The cut-off value for SII was set at 569. OS and DFS were analyzed by Kaplan-Meier methods using the cutoff of each IBPS and SII. Univariate analysis and multivariate analysis using Cox proportional hazards were performed for OS and DFS. RESULTS Kaplan-Meier methods showed the high-PNI group showed good prognosis including OS and DFS, while the high-SII group displayed poor DFS. Univariate analysis showed that pre-treatment high PNI and low SII were significantly associated with better prognosis. Multivariate analysis identified pre-treatment PNI as independently associated with OS. For DFS, univariate analysis using Cox proportional hazards modeling showed that pre-treatment high NLR and high SII were significantly associated with worse prognosis, while high PNI was significantly associated with better prognosis. Multivariate analysis identified pre-treatment PNI and SII as independently associated with DFS. Parameters of PNI and SII components were compared between pre-treatment, post-treatment and at relapse in the high- and low-PNI groups. PNI was predominantly decreased in both high- and low-PNI groups at post-treatment and at relapse compared to pre-treatment. This trend was also observed for albumin. CONCLUSIONS Higher pre-treatment PNI was associated with better OS, while lower pre-treatment PNI and higher treatment SII were associated with poorer DFS in oral cancer patients. Our data indicated that PNI and SII might offer useful biomarkers for gauging prognosis and the efficacy of conventional therapies.
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Affiliation(s)
- Kosei Kubota
- Department of Dentistry and Oral Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan.
| | - Ryohei Ito
- Department of Dentistry and Oral Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan
| | - Norihiko Narita
- Department of Dentistry and Oral Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan
| | - Yusuke Tanaka
- Department of Dentistry and Oral Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan
| | - Ken Furudate
- Department of Dentistry and Oral Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan.,Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Natsumi Akiyama
- Department of Dentistry and Oral Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan
| | - Chuang Hao Chih
- Department of Dentistry and Oral Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan
| | - Shotaro Komatsu
- Department of Dentistry and Oral Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan
| | - Wataru Kobayashi
- Department of Dentistry and Oral Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan
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Zhou J, Chen L, Chen L, Zeng X, Zhang Y, Yuan Y. Emerging role of nanoparticles in the diagnostic imaging of gastrointestinal cancer. Semin Cancer Biol 2022; 86:580-594. [DOI: 10.1016/j.semcancer.2022.04.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 04/21/2022] [Accepted: 04/25/2022] [Indexed: 12/11/2022]
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Zhou X, Luo G. A meta-analysis of the platelet-lymphocyte ratio: A notable prognostic factor in renal cell carcinoma. Int J Biol Markers 2022; 37:123-133. [PMID: 35238678 DOI: 10.1177/03936155221081536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The platelet-lymphocyte ratio (PLR) has been assessed in some studies on renal cell carcinoma (RCC), but the results have been inconsistent. This meta-analysis aims to review and report the latest data regarding the prognostic role of the PLR in RCC patients. METHOD Articles were searched in the PubMed, EMBASE, and Cochrane Library electronic databases. Studies were filtered according to a selection strategy, and data corresponding to the index of interest were extracted. A fixed-effects model or random-effects model was selected based on heterogeneity. The sensitivity analysis was carried out by eliminating the studies one by one. Finally, funnel plots and Egger's test were used to assess publication bias, and the trim and fill method was used to assess the impact of bias on the results. RESULTS In total, 15,193 patients with RCC from 44 studies were included in this meta-analysis. The pooled analysis indicated that the higher the PLR was, the poorer the prognosis for RCC patients in terms of overall survival (hazard ratio (HR) = 1.01 (95% confidence interval (CI) 1.00, 1.02), P = 0.010), cancer-special survival (CSS) (HR = 1.21 (95% CI 1.00, 1.46), P = 0.05), progression-free survival (HR = 1.44 (95% CI 1.28, 1.62), P < 0.00001), recurrence-free survival (HR = 1.73 (95% CI 1.11, 2.71), P = 0.02), disease-free survival (HR = 1.63 (95% CI 0.91, 2.94), P = 0.01) and metastasis-free survival (HR = 1.223 (95% CI 0.712, 2.099), P = 0.466). In the subgroup analysis of high PLR, targeted treatment, TKI use, nivolumab use, surgical treatment, clear cell RCC, metastasis, Asian race, and high PLR were related to poor prognosis. CONCLUSION This study showed that a high PLR was associated with the poor prognosis of RCC patients, but more studies are needed to confirm the value of the PLR.
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Affiliation(s)
- Xiao Zhou
- Department of Urology, 66366Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Guangcheng Luo
- Department of Urology, 66366Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
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Wei Y, Feng J, Ma J, Chen D, Xu H, Yin L, Chen J. Characteristics of platelet-associated parameters and their predictive values in Chinese patients with affective disorders. BMC Psychiatry 2022; 22:150. [PMID: 35216557 PMCID: PMC8874305 DOI: 10.1186/s12888-022-03775-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 02/09/2022] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE Platelets are increasingly considered to play an important role in inflammation and are being regarded as a putative bridge linking mental diseases and inflammatory response. Platelet-associated haematological parameters including mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT), systemic immune-inflammation index (SII), platelet to lymphocyte ratio (PLR), platelet to albumin ratio (PAR) and red blood cell distribution width (RDW) to platelet ratio (RPR), have been recently investigated as simple, easily available, and inexpensive inflammatory markers. In this study, we aimed is to use large-scale clinical data to study platelet parameters in patients with affective disorders, to further investigate the predictive power of platelet parameters for major depressive disorder (MDD) and bipolar disorder (BD). METHODS The retrospective, naturalistic, cross-sectional study analysed the data of 14,007 Chinese affective disorder patients, including 4,801 patients with first-episode MDD, 4,098 patients with recurrent MDD, 3,444 patients with BD manic episodes and 1,664 patients with BD depressive episodes. Meanwhile, 6,847 healthy subjects were served as the control group. The differences in the MPV, PDW, PCT, SII, PLR, PAR, RPR and albumin among different groups were compared, and the contributing factors for the occurrence of MDD or BD were analysed. RESULTS There were significant differences in MPV, PDW, PCT, SII, PLR, RPR and albumin values among the study groups. In the subjects, patients experiencing BD manic episodes had the highest mean values of MPV and SII, patients experiencing BD depressive episodes had the lowest mean values of platelet counts and PAR, and patients with MDD had the highest mean values of PLR and RDW. The levels of MPV, PDW and albumin were independently correlated with MDD and BD, and they are important predictors for differentiating patients with MDD or BD from healthy controls. CONCLUSIONS Our study demonstrated that different affective disorders have unique platelet parameter variation patterns, highlighting the role of platelet parameters and systemic inflammation in the pathophysiology of MDD and BD.
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Affiliation(s)
- Yanyan Wei
- grid.11135.370000 0001 2256 9319Beijing Hui-Long-Guan Hospital, Peking University, Beijing, 100096 China
| | - Junhui Feng
- Jining Psychiatric Hospital, Jidai Road 1#, Jining, 272000 Shandong, China
| | - Jinbao Ma
- grid.414373.60000 0004 1758 1243Beijing Tongren Hospital, Dongjiaomin Road 1#, Beijing, 100000 China
| | - Dongning Chen
- grid.414373.60000 0004 1758 1243Beijing Tongren Hospital, Dongjiaomin Road 1#, Beijing, 100000 China
| | - Haiting Xu
- grid.11135.370000 0001 2256 9319Beijing Hui-Long-Guan Hospital, Peking University, Beijing, 100096 China
| | - Lu Yin
- grid.11135.370000 0001 2256 9319Beijing Hui-Long-Guan Hospital, Peking University, Beijing, 100096 China
| | - Jingxu Chen
- Beijing Hui-Long-Guan Hospital, Peking University, Beijing, 100096, China.
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Huang CH, Lue KH, Chen PR, Hsieh TC, Chou YF. Association between Sarcopenia and Immediate Complications and Mortality in Patients with Oral Cavity Squamous Cell Carcinoma Undergoing Surgery. Cancers (Basel) 2022; 14:cancers14030785. [PMID: 35159050 PMCID: PMC8833832 DOI: 10.3390/cancers14030785] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 01/28/2022] [Accepted: 02/01/2022] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Surgery remains the mainstay treatment for oral cavity squamous cell carcinoma (OSCC). Up to 40% of patients with OSCC experience postoperative complications, most within the first 30 days since surgery. The early detection of postoperative complications is challenging. Sarcopenia has been shown to be a negative predictor of the surgical and oncological outcomes of patients with OSCC. The effect of sarcopenia associated with immediate complications and impaired survival after surgery for OSCC is still unknown. This study comprehensively investigated the clinical risk factors and biomarkers associated with 30-day postoperative complications and 5- and 8-year survival of patients with OSCC. Sarcopenia was an independent risk factor associated with 30-day complications, increased reoperation rate, and reduced short- and long-term overall and disease-free survival. Sarcopenia should be assessed before surgery to identify high-risk patients who require a more intensive approach to minimize complications and may be clinically helpful in tailoring treatment strategies for patients with OSCC. Abstract Sarcopenia negatively affects oncologic outcomes. However, studies have yet to reveal whether it is associated with postoperative complications and survival among patients with oral cavity squamous cell carcinoma (OSCC). This study retrospectively enrolled 592 patients undergoing primary OSCC surgery with available computed tomography (CT) images of their third cervical vertebrae (C3) within 30 days before surgery between January 2011 and December 2020. Preoperative sarcopenia, nutritional and frailty status, tumor characteristics, comorbidities, and inflammatory markers were assessed. The outcome variables included 30-day complications based on the Buzby and Dindo classification, reoperation, 5- and 8-year overall survival, and disease-free survival. A total of 318 (53.7%) had sarcopenia; of these patients, 217 (68.2%) presented with postoperative complications, and 48 (15.1%) underwent reoperations. Sarcopenia and higher systemic immune-inflammatory index were independently associated with local to systemic 30-day complications. Sarcopenia, advanced-stage disease, and extracapsular spread were correlated with 5- and 8-year survival. The presence of sarcopenia is associated with the 30-day complications and short- and long-term survival of patients who had OSCC and underwent surgery.
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Affiliation(s)
- Chun-Hou Huang
- Department of Nursing, Tzu Chi University, Hualien 970374, Taiwan;
| | - Kun-Han Lue
- Department of Medical Imaging and Radiological Sciences, Tzu Chi University of Science and Technology, Hualien 970302, Taiwan;
| | - Peir-Rorg Chen
- Department of Otolaryngology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970473, Taiwan;
- School of Medicine, College of Medicine, Tzu Chi University, Hualien 970374, Taiwan
| | - Tsung-Cheng Hsieh
- Institute of Medical Sciences, Tzu Chi University, Hualien 970374, Taiwan;
| | - Yu-Fu Chou
- Department of Otolaryngology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970473, Taiwan;
- School of Medicine, College of Medicine, Tzu Chi University, Hualien 970374, Taiwan
- Correspondence: ; Tel.: +886-3-856-1825-12234
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17
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Brkic FF, Stoiber S, Friedl M, Maier T, Heiduschka G, Kadletz-Wanke L. The Potential Prognostic Value of a Novel Hematologic Marker Fibrinogen-to-Lymphocyte Ratio in Head and Neck Adenoid-Cystic Carcinoma. J Pers Med 2021; 11:jpm11111228. [PMID: 34834580 PMCID: PMC8620294 DOI: 10.3390/jpm11111228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/09/2021] [Accepted: 11/17/2021] [Indexed: 11/16/2022] Open
Abstract
Many patients with adenoid-cystic carcinoma (ACC) experience an indolent course of disease over many years but face late recurrence, and long-term survivors are rare. Due to its infrequent occurrence, it is hard to predict outcome in these patients. The fibrinogen-to-lymphocyte ratio (FLR) was recently proposed as an outcome prognosticator in different cancer entities. We aimed to investigate its prognostic relevance in patients with head and neck ACC. This retrospective analysis was performed including all patients treated for ACC between 1998 and 2020. The FLR ratio was calculated based on pretreatment values (0-7 days). The study cohort was dichotomized based on optimized threshold value and compared for differences in outcome (overall survival (OS) and disease-free survival (DFS)). In the cohort of 39 included patients, the OS was significantly longer in the low (n = 28) compared to the high pretreatment FLR group (n = 11) (median OS 150.5 months, 95% confidence intervals (CI) 85.3-215.7 months vs. 29.4 months, 95% CI not reached; p = 0.0093). Similarly, the DFS was significantly longer in the low FLR group (median DFS 74.5 months, 95% CI 30.6-118.4 months vs. 11.0 months, 95% CI 5.1-16.9 months; p = 0.019). The FLR is an easily obtainable and simple marker and may be a valuable outcome prognosticator in patients with ACC. Further studies are needed for validation of our results.
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Affiliation(s)
- Faris F. Brkic
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, 1090 Vienna, Austria; (F.F.B.); (M.F.); (T.M.); (G.H.)
| | - Stefan Stoiber
- Department of Pathology, Medical University of Vienna, 1090 Vienna, Austria;
- Christian Doppler Laboratory for Applied Metabolomics, Medical University of Vienna, 1090 Vienna, Austria
| | - Marlene Friedl
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, 1090 Vienna, Austria; (F.F.B.); (M.F.); (T.M.); (G.H.)
| | - Tobias Maier
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, 1090 Vienna, Austria; (F.F.B.); (M.F.); (T.M.); (G.H.)
| | - Gregor Heiduschka
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, 1090 Vienna, Austria; (F.F.B.); (M.F.); (T.M.); (G.H.)
| | - Lorenz Kadletz-Wanke
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, 1090 Vienna, Austria; (F.F.B.); (M.F.); (T.M.); (G.H.)
- Correspondence: ; Tel.: +43-1-40-400-20830
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18
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Yu L, Guo Y, Chang Z, Zhang D, Zhang S, Pei H, Pang J, Zhao ZJ, Chen Y. Bidirectional Interaction Between Cancer Cells and Platelets Provides Potential Strategies for Cancer Therapies. Front Oncol 2021; 11:764119. [PMID: 34722319 PMCID: PMC8551800 DOI: 10.3389/fonc.2021.764119] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 09/28/2021] [Indexed: 12/13/2022] Open
Abstract
Platelets are essential components in the tumor microenvironment. For decades, clinical data have demonstrated that cancer patients have a high risk of thrombosis that is associated with adverse prognosis and decreased survival, indicating the involvement of platelets in cancer progression. Increasing evidence confirms that cancer cells are able to induce production and activation of platelets. Once activated, platelets serve as allies of cancer cells in tumor growth and metastasis. They can protect circulating tumor cells (CTCs) against the immune system and detachment-induced apoptosis while facilitating angiogenesis and tumor cell adhesion and invasion. Therefore, antiplatelet agents and platelet-based therapies should be developed for cancer treatment. Here, we discuss the mechanisms underlying the bidirectional cancer-platelet crosstalk and platelet-based therapeutic approaches.
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Affiliation(s)
- Liuting Yu
- Edmond H. Fischer Translational Medical Research Laboratory, Scientific Research Center, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China
| | - Yao Guo
- Edmond H. Fischer Translational Medical Research Laboratory, Scientific Research Center, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China
| | - Zhiguang Chang
- Edmond H. Fischer Translational Medical Research Laboratory, Scientific Research Center, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China
| | - Dengyang Zhang
- Edmond H. Fischer Translational Medical Research Laboratory, Scientific Research Center, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China
| | - Shiqiang Zhang
- Department of Urology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Hanzhong Pei
- Edmond H. Fischer Translational Medical Research Laboratory, Scientific Research Center, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China
| | - Jun Pang
- Department of Urology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Zhizhuang Joe Zhao
- Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Yun Chen
- Edmond H. Fischer Translational Medical Research Laboratory, Scientific Research Center, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China
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Huang CH, Chen PR, Lue KH, Hsieh TC, Chou YF. Evaluation of Sarcopenia, Frailty, and Inflammation on Adverse Events and Survival Outcomes in Patients with Oral Cavity Squamous Cell Carcinoma under Adjuvant Chemoradiotherapy. J Pers Med 2021; 11:jpm11090936. [PMID: 34575713 PMCID: PMC8464994 DOI: 10.3390/jpm11090936] [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: 08/04/2021] [Revised: 09/06/2021] [Accepted: 09/17/2021] [Indexed: 12/21/2022] Open
Abstract
In this study, we aimed to evaluate the prognostic impact of sarcopenia, five-item modified frailty index (mFI-5), neutrophil/lymphocyte ratio (NLR), and platelet/lymphocyte ratio (PLR) in patients with oral cavity squamous cell carcinoma (OSCC) treated with adjuvant chemoradiotherapy (CRT) and their survival outcomes. We retrospectively enrolled 175 patients with OSCC undergoing adjuvant CRT between 2011 and 2018, who were divided into groups with (n = 112) and without (n = 63) sarcopenia. Logistic regression analysis and Cox proportional hazards models were used to determine prognostic factors for CRT-related toxicity, three-year overall survival (OS), and disease-free survival (DFS). Sarcopenia and high PLR were independently associated with CRT-induced anemia (CIA); advanced tumor stage was related to poor three-year OS. CRT and survival did not differ by mFI-5 and NLR. Our results indicate that sarcopenia and high PLR are significant predictors of adjuvant CRT, increasing toxicity outcomes and indicating worse short-term OS. Accurately identifying sarcopenia and high PLR in patients with OSCC is critical to help better select candidates for adjuvant CRT to improve their outcomes.
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Affiliation(s)
- Chun-Hou Huang
- Department of Nursing, Tzu Chi University, Hualien 97004, Taiwan;
| | - Peir-Rorg Chen
- Department of Otolaryngology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 97004, Taiwan;
- School of Medicine, Tzu Chi University, Hualien 97004, Taiwan
| | - Kun-Han Lue
- Department of Medical Imaging and Radiological Sciences, Tzu Chi University of Science and Technology, Hualien 97005, Taiwan;
| | - Tsung-Cheng Hsieh
- Institute of Medical Sciences, Tzu Chi University, Hualien 97004, Taiwan;
| | - Yu-Fu Chou
- Department of Otolaryngology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 97004, Taiwan;
- School of Medicine, Tzu Chi University, Hualien 97004, Taiwan
- Correspondence: ; Tel.: +886-3-856-1825
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Shui Y, Li M, Su J, Chen M, Gu X, Guo W. Prognostic and clinicopathological significance of systemic immune-inflammation index in pancreatic cancer: a meta-analysis of 2,365 patients. Aging (Albany NY) 2021; 13:20585-20597. [PMID: 34435973 PMCID: PMC8436945 DOI: 10.18632/aging.203449] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 08/02/2021] [Indexed: 12/31/2022]
Abstract
The prognostic value of the systemic immune-inflammation index (SII) in patients with pancreatic cancer is conflicting according to previous investigations. Therefore, we performed a meta-analysis to explore the association between SII and pancreatic cancer prognosis. Electronic databases were searched for studies exploring the association of SII with prognostic outcomes in pancreatic cancer. The endpoints were overall survival (OS), disease-free survival (DFS), recurrence-free survival (RFS), progression-free survival (PFS), cancer-specific survival (CSS), and clinicopathological parameters. The prognostic value of SII was estimated by hazard ratio (HR) or odds ratio (OR) with a 95% confidence interval (CI). Nine studies containing 11 cohorts with 2,365 subjects in total were included in this meta-analysis. Elevated SII was associated with poor OS (HR=1.50, 95% CI=1.15-1.96, p=0.002), RFS/PFS/DFS (HR=1.52, 95% CI=1.01-2.28, p=0.045), and CSS (HR=2.60, 95% CI=1.65-4.09, p < 0.001) in patients with pancreatic cancer. Additionally, there was no significant association between SII and other parameters in pancreatic cancer such as sex, tumor location, lymph node metastasis, tumor-node-metastasis stage, vascular invasion, and grade. This meta-analysis suggested that elevated SII was a significant prognostic marker for short-term and long-term survival outcomes in patients with pancreatic cancer.
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Affiliation(s)
- Yifang Shui
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China
- Henan Key Laboratory of Digestive Organ Transplantation, Zhengzhou 450052, Henan, China
- Open and Key Laboratory of Hepatobiliary and Pancreatic Surgery and Digestive Organ Transplantation at Henan Universities, Zhengzhou 450052, Henan, China
- Zhengzhou Key Laboratory of Hepatobiliary and Pancreatic Diseases and Organ Transplantation, Zhengzhou 450052, Henan, China
- Department of Breast Disease Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China
| | - Mengquan Li
- Department of Breast Disease Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China
| | - Jing Su
- Department of Breast Disease Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China
| | - Mingxun Chen
- Department of Hepatobiliary and Pancreatic Surgery, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou 450007, Henan, China
| | - Xiaobin Gu
- Department of Radiation Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China
| | - Wenzhi Guo
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China
- Henan Key Laboratory of Digestive Organ Transplantation, Zhengzhou 450052, Henan, China
- Open and Key Laboratory of Hepatobiliary and Pancreatic Surgery and Digestive Organ Transplantation at Henan Universities, Zhengzhou 450052, Henan, China
- Zhengzhou Key Laboratory of Hepatobiliary and Pancreatic Diseases and Organ Transplantation, Zhengzhou 450052, Henan, China
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21
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Nie Z, Zhao P, Shang Y, Sun B. Nomograms to predict the prognosis in locally advanced oral squamous cell carcinoma after curative resection. BMC Cancer 2021; 21:372. [PMID: 33827452 PMCID: PMC8028060 DOI: 10.1186/s12885-021-08106-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 03/24/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Oral squamous cell carcinoma (OSCC) is the dominant histologic type of oral cancer. Locally advanced OSCC remains a major therapeutic challenge. Our study aimed to develop and validate nomograms predicting survival prognosis in patients with locally advanced oral squamous cell carcinoma (OSCC) after curative resection. METHODS A total of 269 consecutive patients with primary OSCC who received curative resection between September 2007 and March 2020 were retrospectively enrolled in our study. Patients were randomly assigned to the training cohort (n = 201) or the validation cohort (n = 68). Multivariate Cox regression analyses were conducted to determine independent prognostic factors for overall survival (OS) and cancer specific survival (CSS) in the training set, which were used to develop nomogram models estimating 3-, and 5-year OS and CSS. We also evaluated the nomograms using concordance indices (c-index), calibration curves, and decision curve analyses (DCA), and compared those with the AJCC 8th staging system. The results were externally validated in the validation cohort. RESULTS Age, Kaplan-Feinstein (KFI) index, pT, the number of positive nodes and systemic inflammatory index (SII) were significant prognostic predictors for OS and CSS. The OS nomogram had c-index values of 0.712 in the training set and 0.697 in the validation set, while the CSS nomogram exhibited c-index values of 0.709 in the training set and 0.675 in the validation set. These data were superior to those of AJCC 8th staging system, suggesting high discriminative ability of the nomograms. Calibration curves exhibited good agreement between observed and predicted survival. DCA curves indicated the nomograms were with potential clinical usefulness. These results were validated in the validation set. CONCLUSIONS The novel nomograms incorporating clinically available characteristics for OS and CSS prediction were developed in the locally advanced OSCC patients after curative surgery. Validation revealed good discrimination and calibration, indicating the clinical utility of the nomograms in the individualized prognosis prediction of locally advanced OSCC after curative surgery.
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Affiliation(s)
- Zhiliang Nie
- First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China
| | - Pengcheng Zhao
- School of Stomatology, Dalian Medical University, Dalian, Liaoning, China
| | - Yishan Shang
- Dalian Municipal Women and Children's Medical Center, Dalian, Liaoning, China
| | - Bo Sun
- The Second Hospital of Dalian Medical University, Dalian, Liaoning, China.
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Lu Z, Yan W, Liang J, Yu M, Liu J, Hao J, Wan Q, Liu J, Luo C, Chen Y. Nomogram Based on Systemic Immune-Inflammation Index to Predict Survival of Tongue Cancer Patients Who Underwent Cervical Dissection. Front Oncol 2020; 10:341. [PMID: 32219070 PMCID: PMC7078378 DOI: 10.3389/fonc.2020.00341] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 02/27/2020] [Indexed: 12/24/2022] Open
Abstract
Aim: The aim of this study was to evaluate the prognostic significance of the preoperative systemic immune-inflammation index (SII) and to establish a nomogram for prediction of survival of tongue squamous cell carcinoma (TSCC) patients who underwent primary surgery and cervical dissection. Methods: 120 patients diagnosed with TSCC who underwent primary tumor and neck dissection without preoperative treatment were included to develop the nomogram. This model was externally validated in an independent data cohort of 50 TSCC patients. X-tile software was used to identify the optimal cut-off value. Prognostic factors were identified by Univariate and multivariate analyses. A nomogram based on the multivariate analysis results was built to predict the survival rate and calibration curves and concordance index (C-index) were used to determine predictive and discriminatory capacity. Results: The optimal cut-off value was 569×109/L for SII. In the training cohort, a high preoperative SII (>569) was significantly related to tumor size, histological grade, depth of invasion, lymph node density (LND). A Kaplan-Meier survival analysis showed that patients with a lower SII had a significantly better 5-year overall survival (OS) and disease-free survival (DFS) than patients with high SII (80.8% vs. 43.5% and 72.7% vs. 36.2%, respectively, P<0.001). Univariate analyses of training cohort revealed that age, clinical stage, depth of invasion, LND, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and SII were significant prognostic factors for OS. Moreover, the receiver operating characteristics (ROC) curve showed that SII was superior to NLR and PLR for predicting clinical outcomes. However, multivariate analysis found that age, LND, and SII were independent risk factors for OS. The C-index of the nomograms based on independent prognostic factors was 0.716 for OS and 0.723 for DFS. The C-indexes for external validation of OS and DFS were 0.852 and 0.754, respectively. The calibration curves showed good agreement between predicted and actual observations of OS and DFS. Conclusion: SII can serve as a novel independent prognostic factor for OS and DFS of patients with TSCC. The prognostic nomogram based on SII is a reliable model for predicting survival of patients with TSCC after surgery.
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Affiliation(s)
- Zhiyuan Lu
- Department of Oral and Maxillofacial Surgery, Stomatology Medical Center, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Wangxiang Yan
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Jianfeng Liang
- Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Mei Yu
- Department of Oral and Maxillofacial Surgery, Stomatology Medical Center, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Jiayu Liu
- Department of Oral and Maxillofacial Surgery, Stomatology Medical Center, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Jiansuo Hao
- Department of Oral and Maxillofacial Surgery, Stomatology Medical Center, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Quan Wan
- Department of Oral and Maxillofacial Surgery, Stomatology Medical Center, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Jiameng Liu
- Department of Oral and Maxillofacial Surgery, Stomatology Medical Center, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Chongdai Luo
- Department of Oral and Maxillofacial Surgery, Stomatology Medical Center, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Yiyang Chen
- Department of Oral and Maxillofacial Surgery, Stomatology Medical Center, Guangzhou Women and Children's Medical Center, Guangzhou, China
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Bao Y, Wang Y, Li X, Pan M, Zhang H, Cheng Z, Wang X. Prognostic significance of platelet-to-lymphocyte ratio in urothelial carcinoma patients: a meta-analysis. Cancer Cell Int 2019; 19:315. [PMID: 31798344 PMCID: PMC6882352 DOI: 10.1186/s12935-019-1032-6] [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: 08/05/2019] [Accepted: 11/12/2019] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The prognostic value of pre-treatment platelet-to-lymphocyte ratio (PLR) in patients with urothelial carcinoma (UC) remains controversial. Therefore, this meta-analysis aimed to identify the prognostic impact of PLR on UC. METHODS The PubMed, Embase, Web of Science, and Cochrane Library databases were systematically searched. Hazard ratios (HRs) with 95% confidence intervals (CIs) were used to summarize the correlations between PLR and overall survival (OS), progression-free survival (PFS), disease-free survival (DFS), and cancer-specific survival (CSS). Odds ratios (ORs) with 95% CIs were used to measure the association between PLR and tumor clinicopathological factors. RESULTS The meta-analysis included 15 studies published from 2015 to 2019 with a total of 5354 patients. Overall, a high PLR was correlated to poorer PFS (HR = 1.81, 95% CI 1.28-2.56, p = 0.001) and DFS (HR = 1.09, 95% CI 1.31-2.16, p < 0.001) but not poor OS (HR = 1.23, 95% CI 0.95-1.59, p = 0.124) or CSS (HR = 1.000, 95% CI 0.998-1.002, p = 0.919) in UC. In addition, an elevated PLR was correlated with patient age > 65 years (OR = 1.72, 95% CI 1.25-2.38, p = 0.001) and hypertension (OR = 1.48, 95% CI 1.01-2.18, p = 0.046). However, no significant association was observed between PLR and sex (OR = 0.79, 95% CI 0.56-1.14, p = 0.206) or diabetes (OR = 1.29, 95% CI 0.77-2.15, p = 0.333). CONCLUSIONS Our results demonstrated a significant correlation between elevated PLR and poor prognosis in UC. The prognostic role of PLR may help guide the management and prognostication of UC patients.
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Affiliation(s)
- Yuhai Bao
- Department of Urology, General Hospital of Benxi Iron & Steel Industry Group of Liaoning Health Industry Group, Benxi, 117000 Liaoning China
| | - Yin Wang
- Department of Urology, General Hospital of Benxi Iron & Steel Industry Group of Liaoning Health Industry Group, Benxi, 117000 Liaoning China
| | - Xiaodong Li
- Department of Urology, General Hospital of Benxi Iron & Steel Industry Group of Liaoning Health Industry Group, Benxi, 117000 Liaoning China
| | - Mingjun Pan
- Department of Urology, General Hospital of Benxi Iron & Steel Industry Group of Liaoning Health Industry Group, Benxi, 117000 Liaoning China
| | - Hongze Zhang
- Department of Urology, General Hospital of Benxi Iron & Steel Industry Group of Liaoning Health Industry Group, Benxi, 117000 Liaoning China
| | - Zegen Cheng
- Department of Urology, General Hospital of Benxi Iron & Steel Industry Group of Liaoning Health Industry Group, Benxi, 117000 Liaoning China
| | - Xueyi Wang
- Department of Urology, General Hospital of Benxi Iron & Steel Industry Group of Liaoning Health Industry Group, Benxi, 117000 Liaoning China
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Chen Y, Zhang Z, Fang Q, Jian H. Prognostic impact of platelet-to-lymphocyte ratio on diffuse large B-cell lymphoma: a meta-analysis. Cancer Cell Int 2019; 19:245. [PMID: 31572062 PMCID: PMC6760064 DOI: 10.1186/s12935-019-0962-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 09/13/2019] [Indexed: 01/11/2023] Open
Abstract
Background Recently, some studies reported the prognostic value of platelet-to-lymphocyte ratio (PLR) in patients with diffuse large B-cell lymphoma (DLBCL), however, the results varied from different studies. Therefore, we performed a meta-analysis to explore the prognostic value of PLR in DLBCL. Methods A comprehensive literature retrieval was conducted by using PubMed, Embase, Web of Science, the Cochrane Library, the China National Knowledge Infrastructure (CNKI), and Wanfang. Pooled hazard ratio (HR) and 95% confidence interval (CI) were used to evaluate the association of PLR and overall survival (OS) and progression-free survival (PFS). Odd ratios (ORs) and 95% CIs for clinicopathological characteristics were statistically analyzed. Results Eight studies with 1931 patients were included for meta-analysis. The pooled analysis indicated that elevated PLR was significantly associated with poor OS (HR = 1.73, 95% CI 1.29–2.31, p < 0.001), but not PFS (HR = 0.85, 95% CI 0.57–1.27, p = 0.438). Furthermore, elevated PLR was significantly associated with presentation of B symptoms (OR = 2.27, 95% CI 1.29–3.98, p = 0.004), elevated lactate dehydrogenase (LDH) (OR = 2.76, 95% CI 2.05–3.72, p < 0.001), higher tumor stage (OR = 2.22, 95% CI 1.66–2.98, p < 0.001), and Eastern Cooperative Oncology Group (ECOG) performance status (PS) ≥ 2 (OR = 1.71, 95% CI 1.09–2.69, p = 0.019). However, elevated PLR was not significantly correlated with gender, age or cell of origin. Conclusion This meta-analysis revealed that PLR may be an effective and noninvasive biomarker for poor prognosis and aggressive disease characteristics for patients with DLBCL.
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Affiliation(s)
- Ying Chen
- 1Clinical Laboratory, Huzhou Central Hospital, Huzhou, 313000 Zhejiang China
| | - Zongxin Zhang
- 2Affiliated Central Hospital of Huzhou University, Huzhou Central Hospital, Huzhou, 313000 Zhejiang China
| | - Qiu Fang
- 3Department of Hematology, Huzhou Central Hospital, Huzhou, 313000 Zhejiang China
| | - Huiqin Jian
- 3Department of Hematology, Huzhou Central Hospital, Huzhou, 313000 Zhejiang China
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