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Rodríguez-Bejarano OH, Parra-López C, Patarroyo MA. A review concerning the breast cancer-related tumour microenvironment. Crit Rev Oncol Hematol 2024; 199:104389. [PMID: 38734280 DOI: 10.1016/j.critrevonc.2024.104389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 04/29/2024] [Accepted: 05/06/2024] [Indexed: 05/13/2024] Open
Abstract
Breast cancer (BC) is currently the most common malignant tumour in women and one of the leading causes of their death around the world. New and increasingly personalised diagnostic and therapeutic tools have been introduced over the last few decades, along with significant advances regarding the study and knowledge related to BC. The tumour microenvironment (TME) refers to the tumour cell-associated cellular and molecular environment which can influence conditions affecting tumour development and progression. The TME is composed of immune cells, stromal cells, extracellular matrix (ECM) and signalling molecules secreted by these different cell types. Ever deeper understanding of TME composition changes during tumour development and progression will enable new and more innovative therapeutic strategies to become developed for targeting tumours during specific stages of its evolution. This review summarises the role of BC-related TME components and their influence on tumour progression and the development of resistance to therapy. In addition, an account on the modifications in BC-related TME components associated with therapy is given, and the completed or ongoing clinical trials related to this topic are presented.
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Affiliation(s)
- Oscar Hernán Rodríguez-Bejarano
- Health Sciences Faculty, Universidad de Ciencias Aplicadas y Ambientales (U.D.C.A), Calle 222#55-37, Bogotá 111166, Colombia; Molecular Biology and Immunology Department, Fundación Instituto de Inmunología de Colombia (FIDIC), Carrera 50#26-20, Bogotá 111321, Colombia; PhD Programme in Biotechnology, Faculty of Sciences, Universidad Nacional de Colombia, Carrera 45#26-85, Bogotá 111321, Colombia
| | - Carlos Parra-López
- Microbiology Department, Faculty of Medicine, Universidad Nacional de Colombia, Carrera 45#26-85, Bogotá 111321, Colombia.
| | - Manuel Alfonso Patarroyo
- Molecular Biology and Immunology Department, Fundación Instituto de Inmunología de Colombia (FIDIC), Carrera 50#26-20, Bogotá 111321, Colombia; Microbiology Department, Faculty of Medicine, Universidad Nacional de Colombia, Carrera 45#26-85, Bogotá 111321, Colombia.
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Li JJX, Ni SYB, Tsang JYS, Chan WY, Hung RKW, Lui JWH, Ng SWY, Shum LK, Tang YF, Tse GM. Neutrophil-lymphocyte ratio reflects tumour-infiltrating lymphocytes and tumour-associated macrophages and independently predicts poor outcome in breast cancers with neoadjuvant chemotherapy. Histopathology 2024; 84:810-821. [PMID: 38192219 DOI: 10.1111/his.15125] [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: 09/17/2023] [Revised: 12/09/2023] [Accepted: 12/12/2023] [Indexed: 01/10/2024]
Abstract
AIMS The neutrophil-lymphocyte ratio (NLR) is a systemic reflection of cancer-associated inflammation and a prognostic marker for breast cancer. For the local tumour microenvironment, tumour-infiltrating lymphocytes (TILs) and tumour-associated macrophages (TAMs) are also highly correlated with breast cancer survival. This study aimed to explore the relationship between the circulating and local immune microenvironment, and to further delineate the prognostic role of NLR in breast cancer patients receiving neoadjuvant chemotherapy (NAC). METHODS A cohort of breast cancer patients receiving NAC with subsequent surgery was retrieved. Clinical data were reviewed. Histological slides and CD8 immunohistochemistry from biopsy (pre-chemotherapy) and excision (postchemotherapy) specimens were assessed for TILs and TAMs. RESULTS A total of 146 patients were included. There was a significant positive correlation between pre- and postsurgery NLR at a cut-off of 2.6 (median pre-chemotherapy NLR) (P < 0.001). NLR pre-chemotherapy was associated positively with necrosis on biopsy (P = 0.027) and excision (P = 0.021) and TAMs on excision (P = 0.049). NLR 1 year postsurgery was associated with high tumour stage (P = 0.050) and low histological grade (P = 0.008). TIL count was lower in NLR-high cases at almost all time-points by histological assessment and CD8 immunostaining (P < 0.050). In multivariate analysis, postsurgery NLR is an independent predictor for overall survival [OS; hazard ratio (HR) = 9.524, P < 0.001], breast cancer-specific survival (BCSS) (HR = 10.059, P = 0.001) and disease-free survival (DFS; HR = 2.824, P = 0.016). CONCLUSIONS The association between NLR with tumour necrosis, TAMs and TILs illustrates an interaction between the circulating and local immune microenvironment. Late NLR is a strong indicator of outcome and may be useful for prognostication and disease monitoring.
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Affiliation(s)
- Joshua J X Li
- Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Shelly Y B Ni
- Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Julia Y S Tsang
- Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Wai Yin Chan
- Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ray K W Hung
- Department of Surgery, North District Hospital, Sheung Shui, Hong Kong
| | - Joshua W H Lui
- Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Sally W Y Ng
- Department of Surgery, North District Hospital, Sheung Shui, Hong Kong
| | - Leong Kwong Shum
- Deparment of Pathology, North District Hospital, Sheung Shui, Hong Kong
| | - Ying Fei Tang
- Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Gary M Tse
- Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
- Deparment of Pathology, North District Hospital, Sheung Shui, Hong Kong
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Huang J, Zhang JL, Ang L, Li MC, Zhao M, Wang Y, Wu Q. Proposing a novel molecular subtyping scheme for predicting distant recurrence-free survival in breast cancer post-neoadjuvant chemotherapy with close correlation to metabolism and senescence. Front Endocrinol (Lausanne) 2023; 14:1265520. [PMID: 37900131 PMCID: PMC10602753 DOI: 10.3389/fendo.2023.1265520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 09/12/2023] [Indexed: 10/31/2023] Open
Abstract
Background High relapse rates remain a clinical challenge in the management of breast cancer (BC), with distant recurrence being a major driver of patient deterioration. To optimize the surveillance regimen for distant recurrence after neoadjuvant chemotherapy (NAC), we conducted a comprehensive analysis using bioinformatics and machine learning approaches. Materials and methods Microarray data were retrieved from the GEO database, and differential expression analysis was performed with the R package 'Limma'. We used the Metascape tool for enrichment analyses, and 'WGCNA' was utilized to establish co-expression networks, selecting the soft threshold power with the 'pickSoftThreshold' algorithm. We integrated ten machine learning algorithms and 101 algorithm combinations to identify key genes associated with distant recurrence in BC. Unsupervised clustering was performed with the R package 'ConsensusCluster Plus'. To further screen the key gene signature of residual cancer burden (RCB), multiple knockdown studies were analyzed with the Genetic Perturbation Similarity Analysis (GPSA) database. Single-cell RNA sequencing (scRNA-seq) analysis was conducted through the Tumour Immune Single-cell Hub (TISCH) database, and the XSum algorithm was used to screen candidate small molecule drugs based on the Connectivity Map (CMAP) database. Molecular docking processes were conducted using Schrodinger software. GMT files containing gene sets associated with metabolism and senescence were obtained from GSEA MutSigDB database. The GSVA score for each gene set across diverse samples was computed using the ssGSEA function implemented in the GSVA package. Results Our analysis, which combined Limma, WGCNA, and machine learning approaches, identified 16 RCB-relevant gene signatures influencing distant recurrence-free survival (DRFS) in BC patients following NAC. We then screened GATA3 as the key gene signature of high RCB index using GPSA analysis. A novel molecular subtyping scheme was developed to divide patients into two clusters (C1 and C2) with different distant recurrence risks. This molecular subtyping scheme was found to be closely associated with tumor metabolism and cellular senescence. Patients in cluster C2 had a poorer DRFS than those in cluster C1 (HR: 4.04; 95% CI: 2.60-6.29; log-rank test p < 0.0001). High GATA3 expression, high levels of resting mast cell infiltration, and a high proportion of estrogen receptor (ER)-positive patients contributed to better DRFS in cluster C1. We established a nomogram based on the N stage, RCB class, and molecular subtyping. The ROC curve for 5-year DRFS showed excellent predictive value (AUC=0.91, 95% CI: 0.95-0.86), with a C-index of 0.85 (95% CI: 0.81-0.90). Entinostat was identified as a potential small molecule compound to reverse high RCB after NAC. We also provided a comprehensive review of the EDCs exposures that potentially impact the effectiveness of NAC among BC patients. Conclusion This study established a molecular classification scheme associated with tumor metabolism and cancer cell senescence to predict RCB and DRFS in BC patients after NAC. Furthermore, GATA3 was identified and validated as a key gene associated with BC recurrence.
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Affiliation(s)
- Jin Huang
- Department of Pathology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Department of Pathology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Jian-Lin Zhang
- Department of Emergency Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Lin Ang
- Department of Pathology, The Second People’s Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, China
| | - Ming-Cong Li
- Department of Pathology, The Second People’s Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, China
| | - Min Zhao
- Department of Pathology, The Second People’s Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, China
| | - Yao Wang
- Digestive Endoscopy Department, Jiangsu Provincial People’s Hospital, The First Afliated Hospital of Nanjing Medical University, Nanjing, China
| | - Qiang Wu
- Department of Pathology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Department of Pathology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
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McDonald SJ, Bullard BM, VanderVeen BN, Cardaci TD, Chatzistamou I, Fan D, Murphy EA. Emodin reduces surgical wounding-accelerated tumor growth and metastasis via macrophage suppression in a murine triple-negative breast cancer model. Physiol Rep 2023; 11:e15813. [PMID: 37821408 PMCID: PMC10567645 DOI: 10.14814/phy2.15813] [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: 07/11/2023] [Revised: 08/23/2023] [Accepted: 08/23/2023] [Indexed: 10/13/2023] Open
Abstract
It has been suspected that tumor resection surgery itself may accelerate breast cancer (BC) lung metastasis in some patients. Emodin, a natural anthraquinone found in the roots and rhizomes of various plants, exhibits anticancer activity. We examined the perioperative use of emodin in our established surgery wounding murine BC model. Emodin reduced primary BC tumor growth and metastasis in the lungs in both sham and surgical wounded mice, consistent with a reduction in proliferation and enhanced apoptosis (primary tumor and lungs). Further, emodin reduced systemic inflammation, most notably the number of monocytes in the peripheral blood and reduced pro-tumoral M2 macrophages in the primary tumor and the lungs. Consistently, we show that emodin reduces gene expression of select macrophage markers and associated cytokines in the primary tumor and lungs of wounded mice. Overall, we demonstrate that emodin is beneficial in mitigating surgical wounding accelerated lung metastasis in a model of triple-negative BC, which appears to be mediated, at least in part, by its actions on macrophages. These data support the development of emodin as a safe, low-cost, and effective agent to be used perioperatively to alleviate the surgery triggered inflammatory response and consequential metastasis of BC to the lungs.
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Affiliation(s)
- Sierra J. McDonald
- Department of Pathology, Microbiology & Immunology, School of MedicineUniversity of South CarolinaColumbiaSouth CarolinaUSA
| | - Brooke M. Bullard
- Department of Pathology, Microbiology & Immunology, School of MedicineUniversity of South CarolinaColumbiaSouth CarolinaUSA
| | - Brandon N. VanderVeen
- Department of Pathology, Microbiology & Immunology, School of MedicineUniversity of South CarolinaColumbiaSouth CarolinaUSA
| | - Thomas D. Cardaci
- Department of Pathology, Microbiology & Immunology, School of MedicineUniversity of South CarolinaColumbiaSouth CarolinaUSA
| | - Ioulia Chatzistamou
- Department of Pathology, Microbiology & Immunology, School of MedicineUniversity of South CarolinaColumbiaSouth CarolinaUSA
| | - Daping Fan
- Department of Cell Biology and Anatomy, School of MedicineUniversity of South CarolinaColumbiaSouth CarolinaUSA
- AcePre, LLCColumbiaSouth CarolinaUSA
| | - E. Angela Murphy
- Department of Pathology, Microbiology & Immunology, School of MedicineUniversity of South CarolinaColumbiaSouth CarolinaUSA
- AcePre, LLCColumbiaSouth CarolinaUSA
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Zheng C, Xu X, Wu M, Xue L, Zhu J, Xia H, Ding S, Fu S, Wang X, Wang Y, He G, Liu X, Deng X. Neutrophils in triple-negative breast cancer: an underestimated player with increasingly recognized importance. Breast Cancer Res 2023; 25:88. [PMID: 37496019 PMCID: PMC10373263 DOI: 10.1186/s13058-023-01676-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 06/17/2023] [Indexed: 07/28/2023] Open
Abstract
Triple-negative breast cancer (TNBC) is the most lethal subtype of breast cancer, with limited therapeutic options readily available. Immunotherapy such as immune checkpoint inhibition has been investigated in TNBC but still encounters low overall response. Neutrophils, the most abundant leukocytes in the body, are increasingly recognized as an active cancer-modulating entity. In the bloodstream, neutrophils escort circulating tumor cells to promote their survival and stimulate their proliferation and metastasis. In the tumor microenvironment, neutrophils modulate the immune milieu through polarization between the anti-tumor and the pro-tumor phenotypes. Through a comprehensive review of recently published literature, it is evident that neutrophils are an important player in TNBC immunobiology and can be used as an important prognostic marker of TNBC. Particularly, in their pro-tumor form, neutrophils facilitate TNBC metastasis through formation of neutrophil extracellular traps and the pre-metastatic niche. These findings will help advance the potential utilization of neutrophils as a therapeutic target in TNBC.
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Affiliation(s)
- Chanjuan Zheng
- Key Laboratory of Translational Cancer Stem Cell Research, Department of Pathophysiology, Hunan Normal University School of Medicine, Changsha, Hunan, China
| | - Xi Xu
- Key Laboratory of Translational Cancer Stem Cell Research, Department of Pathophysiology, Hunan Normal University School of Medicine, Changsha, Hunan, China
| | - Muyao Wu
- Key Laboratory of Translational Cancer Stem Cell Research, Department of Pathophysiology, Hunan Normal University School of Medicine, Changsha, Hunan, China
| | - Lian Xue
- Key Laboratory of Translational Cancer Stem Cell Research, Department of Pathophysiology, Hunan Normal University School of Medicine, Changsha, Hunan, China
| | - Jianyu Zhu
- Key Laboratory of Translational Cancer Stem Cell Research, Department of Pathophysiology, Hunan Normal University School of Medicine, Changsha, Hunan, China
- Department of Biochemistry and Molecular Biology, Jishou University, Jishou, Hunan, China
| | - Hongzhuo Xia
- Key Laboratory of Translational Cancer Stem Cell Research, Department of Pathophysiology, Hunan Normal University School of Medicine, Changsha, Hunan, China
| | - Siyu Ding
- Key Laboratory of Translational Cancer Stem Cell Research, Department of Pathophysiology, Hunan Normal University School of Medicine, Changsha, Hunan, China
| | - Shujun Fu
- Key Laboratory of Translational Cancer Stem Cell Research, Department of Pathophysiology, Hunan Normal University School of Medicine, Changsha, Hunan, China
| | - Xinyu Wang
- Key Laboratory of Translational Cancer Stem Cell Research, Department of Pathophysiology, Hunan Normal University School of Medicine, Changsha, Hunan, China
| | - Yian Wang
- Key Laboratory of Translational Cancer Stem Cell Research, Department of Pathophysiology, Hunan Normal University School of Medicine, Changsha, Hunan, China
- Key Laboratory of Study and Discovery of Small Targeted Molecules of Hunan Province, Hunan Normal University School of Medicine, Changsha, Hunan, China
| | - Guangchun He
- Key Laboratory of Translational Cancer Stem Cell Research, Department of Pathophysiology, Hunan Normal University School of Medicine, Changsha, Hunan, China
| | - Xia Liu
- Department of Toxicology and Cancer Biology, University of Kentucky, Lexington, KY, USA.
| | - Xiyun Deng
- Key Laboratory of Translational Cancer Stem Cell Research, Department of Pathophysiology, Hunan Normal University School of Medicine, Changsha, Hunan, China.
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Miao S, Zhang Q. Circulating circRNA: a social butterfly in tumors. Front Oncol 2023; 13:1203696. [PMID: 37546422 PMCID: PMC10401440 DOI: 10.3389/fonc.2023.1203696] [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: 04/11/2023] [Accepted: 06/20/2023] [Indexed: 08/08/2023] Open
Abstract
Circular RNAs (circRNAs) are a class of single-stranded non-coding RNAs that form circular structures through irregular splicing or post-splicing events. CircRNAs are abnormally expressed in many cancers and regulate the occurrence and development of tumors. Circulating circRNAs are cell-free circRNAs present in peripheral blood, they are considered promising biomarkers due to their high stability. In recent years, more and more studies have revealed that circulating circRNAs participate in various cellular communication and regulate the occurrence and development of tumors, which involve many pathological processes such as tumorigenesis, tumor-related immunity, tumor angiogenesis, and tumor metastasis. Understanding the role of cell communication mediated by circulating circRNAs in tumor will further reveal the value and significance behind their use as biomarkers and potential therapeutic targets. In this review, we summarize the recent findings and provide an overview of the cell-cell communication mediated by circulating circRNAs, aiming to explore the role and application value of circulating circRNAs in tumors.
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Affiliation(s)
- Shuo Miao
- Department of Urology, Affiliated Hospital of Qingdao University, Qingdao, China
- School of Basic Medicine, Qingdao University, Qingdao, China
| | - Qingsong Zhang
- Department of Urology, Affiliated Hospital of Qingdao University, Qingdao, China
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Jadoon SK, Soomro R, Ahsan MN, Ijaz Khan RM, Iqbal S, Yasmin F, Najeeb H, Saleem N, Cho N, Shaikh TG, Saba Hasan SF, Khalid MZ, Alvi S, Rizvi AM, Asghar MS. Association of neutrophil-to-lymphocyte ratio with clinical, pathological, radiological, laboratory features and disease outcomes of invasive breast cancer patients: A retrospective observational cohort study. Medicine (Baltimore) 2023; 102:e33811. [PMID: 37335707 DOI: 10.1097/md.0000000000033811] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/21/2023] Open
Abstract
Inflammatory conditions play part in the progression of malignancies, and markers signifying growth of these factors can indicate prognosis. Neutrophil-to-lymphocyte (NLR) is used as a marker of subclinical inflammation that may become an integral part of workup to indicate prognosis and associated pathology. This study aims to explore the association of NLR ratio with clinical characteristics, radiological assessment and staging, histopathology, and disease outcomes of breast cancer. A retrospective cohort study was conducted in a tertiary care center to include breast cancer patients that were diagnosed between January 2001 and December 2020. Data including tumor size, lymph nodes, metastasis, histological grading, ER/PR/HER2-neu status, molecular subtypes, clinical staging); nodal findings (sentinel and axillary); pathology from frozen section; and disease outcomes were assessed. Multivariable regression and Kaplan-Meier survival curves were employed to indicate the association of NLR with breast cancer features and disease-free survival. A total of 2050 patients had a median age of 50 years, median NLR levels of 2.14, most common pathology ductal followed by lobular, and most common site of metastasis being lungs followed by bones. Disease-free rate was 7.6%, and a recurrence rate of 1.8%, while 1.6% deaths were reported. NLR was found associated with age, treatment outcomes, tumor size, lymph nodes, metastasis and clinical staging. Other positive correlations were with Ki67 proliferation index, molecular subtypes, and tumor size on frozen section (at transverse and craniocaudal dimensions). Negative correlations were seen with estrogen and progesterone receptors. However, NLR was not found predictable of disease-free survival (P = .160). Significant predictors of disease-free survival were histological grading, ER, PR status, molecular subtype, and Ki67 proliferation index. NLR being a readily available marker has shown novel findings in its association with tumor staging, disease outcomes and characteristics of breast malignancy.
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Affiliation(s)
| | - Rufina Soomro
- Department of General Surgery, Liaquat National Hospital and Medical College, Karachi, Pakistan
| | | | | | - Sadia Iqbal
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Farah Yasmin
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Hala Najeeb
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Nida Saleem
- Department of Nephrology, Dow University of Health Sciences, Karachi, Pakistan
| | - Namiya Cho
- Department of Nephrology, Dow University of Health Sciences, Karachi, Pakistan
| | - Taha Gul Shaikh
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | | | - Muhammad Zain Khalid
- Department of General Surgery, Liaquat National Hospital and Medical College, Karachi, Pakistan
| | - Sarosh Alvi
- Teaching Assistant, Faculty of Medicine, University of Bakht Al-Ruda, Khartoum, Sudan
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Perez-Fidalgo JA, Guerra E, García Y, Iglesias M, Hernández-Sosa M, Estevez-García P, Manso Sánchez L, Santaballa A, Oaknin A, Redondo A, Rubio MJ, González-Martín A. Clinical and molecular signature of survival and resistance to olaparib plus pegylated liposomal doxorubicin in platinum-resistant ovarian cancer: a stratified analysis from the phase II clinical trial ROLANDO, GEICO-1601. Int J Gynecol Cancer 2023:ijgc-2022-004028. [PMID: 36759001 DOI: 10.1136/ijgc-2022-004028] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
OBJECTIVE To determine the potential prognostic value of clinical and molecular biomarkers in the survival of patients with platinum-resistant ovarian cancer treated with olaparib and pegylated liposomal doxorubicin. METHODS ROLANDO was a single-arm phase II trial that included patients with high-grade serous or endometrioid tumors and at least one previous platinum-resistant recurrence regardless of BRCA status. Patients received 6 cycles of pegylated liposomal doxorubicin every 28 days plus olaparib 300 mg twice daily. followed by olaparib 300 mg twice daily; monotherapy until progression or unacceptable toxicity. Prognostic factors including previous lines (and platinum-containing ones), BRCA mutation status, previous bevacizumab, CA-125 levels, and the neutrophil/lymphocyte ratio, lymphocyte/monocyte ratio, and platelet/lymphocyte ratio calculated at inclusion were analyzed through a multivariate logistic regression and factor analysis of mixed data. RESULTS Thirty-one patients were included. Median age was 57 years (range 43-75), Eastern Cooperative Oncolgy Group performance status 0/1: 32.3%/67.7% and BRCA mutated: 16.1%. Prior treatment lines were >2 lines: 14 (45.2%) patients, ≥2 platinum lines: 21 patients (67.7%) and previous bevacizumab 19 (61.3%) patients. CA-125 was >2 upper limit normal in 24 (77.4%) patients. A high neutrophil/lymphocyte ratio was associated with worse overall survival by univariate/multivariate regression model (HR=11.18; 95% CI 1.1 to 114.5; p=0.042). No other factors were associated with overall survival in the multivariate model. A multifactorial signature based on clinical and molecular baseline characteristics was capable of defining six patient clusters. Three of these clusters had significantly better prognosis, with a median overall survival of 21.3 months (95% CI 12.2 to not reached). CONCLUSIONS High neutrophil/lymphocyte ratio at platinum-resistant relapse indicated poor prognosis in patients treated with olaparib plus pegylated liposomal doxorubicin. A multifactorial clinical signature was more precise than single variables for implying the prognosis and may help in therapeutic assignment after further validation in large prospective cohorts.
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Affiliation(s)
| | - Eva Guerra
- Department of Medical Oncology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Yolanda García
- Department of Medical Oncology, Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí I3PT. Universitat Autònoma de Barcelona, Sabadell, Spain
| | - María Iglesias
- Department of Medical Oncology, Hospital Son Llatzer, Palma De Mallorca, Palma de Mallorca, Spain
| | - María Hernández-Sosa
- Department of Medical Oncology, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas De Gran Canaria, Spain
| | | | - Luis Manso Sánchez
- Department of Medical Oncology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Ana Santaballa
- Department of Medical Oncology, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Ana Oaknin
- Department of Medical Oncology, Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Andres Redondo
- Department of Medical Oncology, Hospital Universitario La Paz-IdiPAZ, Madrid, Spain
| | - M Jesús Rubio
- Department of Medical Oncology, Hospital Universitario Reina Sofia, Cordoba, Spain
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Sifón MDR, Marcolini N, Barber MJ, Mclean I, Rizzo M, Rivero S, Costanzo MV, Nervo A, Crimi G, Perazzo F, Levy EM, Mandó P. Lack of Prognostic Value of Pretreatment Neutrophil-to-Lymphocyte Ratio in Early Breast Cancer. Breast Care (Basel) 2022; 17:546-553. [PMID: 36590145 PMCID: PMC9801394 DOI: 10.1159/000525287] [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: 03/11/2022] [Accepted: 05/24/2022] [Indexed: 01/04/2023] Open
Abstract
Background Breast cancer is a highly heterogeneous disease with large differences in the risk of recurrence. An elevated neutrophil-to-lymphocyte ratio (NLR) is correlated with a poor prognosis in a variety of tumors, and although it is still controversial in breast cancer, there are multiple studies, including meta-analysis, suggesting this. The purpose of this study was to analyze the prognostic value of preoperative NLR in an Argentine population of patients with nonmetastatic breast cancer, not exposed to neoadjuvant treatment. Methods Retrospective multicenter cohort study that includes patients over 18 years of age from three centers in the city and province of Buenos Aires who have had surgery for early breast cancer between January 1, 1999, and December 31, 2014. Based on the previous literature, a cutoff value of 2.0 was defined. Results A total of 791 patients were eligible for the analysis. Median age was 55 years (IQR 45-65). Median NLR was 1.92 (IQR 1.50-2.56). The distribution of groups according to the 8th edition of the AJCC was 54.1% for stage I, 35.6% stage II, and 10.4% stage III. Among the different tumor phenotypes, 79.0% were HR+/HER2-, 11.4% were HR+ or-/HER2+, and 9.2% were HR-/HER2-. With a median follow-up of 5.3 years, 112 patients (14.2%) had disease recurrence. Stage III patients had a higher NLR than stage I and stage II patients (p = 0.002). The rest of the clinical and pathological characteristics did not show differences in the groups according to NLR. There were no differences in relapse-free survival according to the NLR (p = 0.37), and it did not change after adjusting for other prognostic variables. Conclusion We consider it is important to determine the efficacy of prognostic markers that are easily accessible and of simple, systematic application. However, NLR does not appear to be an independent prognostic factor for recurrence in our population. In this sense, we consider it is important to publish negative results in order to avoid publication bias.
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Affiliation(s)
- Maria del Rosario Sifón
- Clinical Oncology, Centro de Educación médica e Investigaciones Clínicas (CEMIC), Buenos Aires, Argentina
| | - Nicolas Marcolini
- Clinical Oncology, Hospital Universitario Austral (HUA), Buenos Aires, Argentina
| | - Maria Julia Barber
- Breast Surgery Unit, Hospital Universitario Austral (HUA), Buenos Aires, Argentina
| | - Ignacio Mclean
- Breast Surgery Unit, Hospital Universitario Austral (HUA), Buenos Aires, Argentina
| | - Manglio Rizzo
- Clinical Oncology, Hospital Universitario Austral (HUA), Buenos Aires, Argentina
| | - Sergio Rivero
- Clinical Oncology, Instituto Alexander Fleming (IAF), Buenos Aires, Argentina
| | | | - Adrian Nervo
- Clinical Oncology, Instituto Alexander Fleming (IAF), Buenos Aires, Argentina
| | - Gabriel Crimi
- Breast Surgery Unit, Centro de Educación médica e Investigaciones Clínicas (CEMIC), Buenos Aires, Argentina
| | - Florencia Perazzo
- Clinical Oncology, Centro de Educación médica e Investigaciones Clínicas (CEMIC), Buenos Aires, Argentina
| | | | - Pablo Mandó
- Clinical Oncology, Centro de Educación médica e Investigaciones Clínicas (CEMIC), Buenos Aires, Argentina
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10
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Savioli F, Morrow ES, Dolan RD, Romics L, Lannigan A, Edwards J, McMillan DC. Prognostic role of preoperative circulating systemic inflammatory response markers in primary breast cancer: meta-analysis. Br J Surg 2022; 109:1206-1215. [PMID: 36130112 DOI: 10.1093/bjs/znac319] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/27/2022] [Accepted: 08/17/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND Circulating markers of the systemic inflammatory response are prognostic in several cancers, but their role in operable breast cancer is unclear. A systematic review and meta-analysis of the literature was carried out. METHODS A search of electronic databases up to August 2020 identified studies that examined the prognostic value of preoperative circulating markers of the systemic inflammatory response in primary operable breast cancer. A meta-analysis was carried out for each marker with more than three studies, reporting a HR and 95 per cent confidence interval for disease-free survival (DFS), breast cancer-specific survival (BCSS) or overall survival (OS). RESULTS In total, 57 studies were reviewed and 42 were suitable for meta-analysis. Higher neutrophil-to-lymphocyte ratio (NLR) was associated with worse overall survival (OS) (pooled HR 1.75, 95 per cent c.i. 1.52 to 2.00; P < 0.001), disease-free survival (DFS) (HR 1.67, 1.50 to 1.87; P < 0.001), and breast cancer-specific survival (BCSS) (HR 1.89, 1.35 to 2.63; P < 0.001). This effect was also seen with an arithmetically-derived NLR (dNLR). Higher platelet-to-lymphocyte ratio (PLR) was associated with worse OS (HR 1.29, 1.10 to 1.50; P = 0.001) and DFS (HR 1.58, 1.33 to 1.88; P < 0.001). Higher lymphocyte-to-monocyte ratio (LMR) was associated with improved DFS (HR 0.65, 0.51 to 0.82; P < 0.001), and higher C-reactive protein (CRP) level was associated with worse BCSS (HR 1.22, 1.07 to 1.39; P = 0.002) and OS (HR 1.24, 1.14 to 1.35; P = 0.002). CONCLUSION Current evidence suggests a role for preoperative NLR, dNLR, LMR, PLR, and CRP as prognostic markers in primary operable breast cancer. Further work should define their role in clinical practice, particularly reproducible thresholds and molecular subtypes for which these may be of most value.
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Affiliation(s)
- Francesca Savioli
- Academic Unit of Surgery, School of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Elizabeth S Morrow
- Academic Unit of Surgery, School of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Ross D Dolan
- Academic Unit of Surgery, School of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Laszlo Romics
- Academic Unit of Surgery, School of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Alison Lannigan
- Department of Breast Surgery, University Hospital Wishaw, Wishaw, UK
| | - Joanne Edwards
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - Donald C McMillan
- Academic Unit of Surgery, School of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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11
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McDonald SJ, VanderVeen BN, Bullard BM, Cardaci TD, Madero SS, Chatzistamou I, Fan D, Murphy EA. Surgical wounding enhances pro-tumor macrophage responses and accelerates tumor growth and lung metastasis in a triple negative breast cancer mouse model. Physiol Rep 2022; 10:e15497. [PMID: 36325601 PMCID: PMC9630756 DOI: 10.14814/phy2.15497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 09/12/2022] [Accepted: 09/16/2022] [Indexed: 11/06/2022] Open
Abstract
Approximately one-third of all breast cancer mortality results from metastatic recurrence after initial success of surgery and/or therapy. Although primary tumor removal is widely accepted as beneficial, it has long been suspected that surgery itself contributes to accelerated metastatic recurrence. We investigated surgical wounding's impact on tumor progression and lung metastasis in a murine model of triple negative breast cancer (TNBC). Ten-week-old female mice were inoculated with 4 T1 cells (week 0) and were either subjected to a 2 cm long cutaneous contralateral incision (wounded) or control (non-wounded) on week 2 and monitored for 3 weeks (week 5). Mice with surgical wounding displayed significantly accelerated tumor growth observable as early as 1-week post wounding. This was confirmed by increased tumor volume and tumor weight, post-mortem. Further, surgical wounding increased metastasis to the lungs, as detected by IVIS imaging, in vivo and ex vivo (week 5). As expected then, wounded mice displayed decreased apoptosis and increased proliferation in both the primary tumor and in the lungs. Flow cytometry revealed that primary tumors from wounded mice exhibited increased tumor associated macrophages and specifically M2-like macrophages, which are important in promoting tumor development, maintenance, and metastasis. Immunofluorescence staining and gene expression data further confirms an increase in macrophages in both the primary tumor and the lungs of wounded mice. Our data suggests that surgical wounding accelerates tumor progression and lung metastasis in a mouse model of TNBC, which is likely mediated, at least in part by an increase in macrophages.
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Affiliation(s)
- Sierra J. McDonald
- Department of Pathology, Microbiology & ImmunologyUniversity of South Carolina School of MedicineColumbiaSouth CarolinaUSA
| | - Brandon N. VanderVeen
- Department of Pathology, Microbiology & ImmunologyUniversity of South Carolina School of MedicineColumbiaSouth CarolinaUSA
- AcePre, LLCColumbiaSouth CarolinaUSA
| | - Brooke M. Bullard
- Department of Pathology, Microbiology & ImmunologyUniversity of South Carolina School of MedicineColumbiaSouth CarolinaUSA
| | - Thomas D. Cardaci
- Department of Pathology, Microbiology & ImmunologyUniversity of South Carolina School of MedicineColumbiaSouth CarolinaUSA
| | - Sarah S. Madero
- Department of Pathology, Microbiology & ImmunologyUniversity of South Carolina School of MedicineColumbiaSouth CarolinaUSA
| | - Ioulia Chatzistamou
- Department of Pathology, Microbiology & ImmunologyUniversity of South Carolina School of MedicineColumbiaSouth CarolinaUSA
| | - Daping Fan
- AcePre, LLCColumbiaSouth CarolinaUSA
- Department of Cell Biology and AnatomyUniversity of South Carolina School of MedicineColumbiaSouth CarolinaUSA
| | - E. Angela Murphy
- Department of Pathology, Microbiology & ImmunologyUniversity of South Carolina School of MedicineColumbiaSouth CarolinaUSA
- AcePre, LLCColumbiaSouth CarolinaUSA
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12
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Tommasi C, Pellegrino B, Diana A, Palafox Sancez M, Orditura M, Scartozzi M, Musolino A, Solinas C. The Innate Immune Microenvironment in Metastatic Breast Cancer. J Clin Med 2022; 11:jcm11205986. [PMID: 36294305 PMCID: PMC9604853 DOI: 10.3390/jcm11205986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/27/2022] [Accepted: 10/09/2022] [Indexed: 11/30/2022] Open
Abstract
The immune system plays a fundamental role in neoplastic disease. In the era of immunotherapy, the adaptive immune response has been in the spotlight whereas the role of innate immunity in cancer development and progression is less known. The tumor microenvironment influences the terminal differentiation of innate immune cells, which can explicate their pro-tumor or anti-tumor effect. Different cells are able to recognize and eliminate no self and tumor cells: macrophages, natural killer cells, monocytes, dendritic cells, and neutrophils are, together with the elements of the complement system, the principal players of innate immunity in cancer development and evolution. Metastatic breast cancer is a heterogeneous disease from the stromal, immune, and biological point of view and requires deepened exploration to understand different patient outcomes. In this review, we summarize the evidence about the role of innate immunity in breast cancer metastatic sites and the potential targets for optimizing the innate response as a novel treatment opportunity.
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Affiliation(s)
- Chiara Tommasi
- Medical Oncology and Breast Unit, University Hospital of Parma, 43126 Parma, Italy
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
- GOIRC (Gruppo Oncologico Italiano di Ricerca Clinica), 43126 Parma, Italy
- Correspondence:
| | - Benedetta Pellegrino
- Medical Oncology and Breast Unit, University Hospital of Parma, 43126 Parma, Italy
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
- GOIRC (Gruppo Oncologico Italiano di Ricerca Clinica), 43126 Parma, Italy
| | - Anna Diana
- Medical Oncology Unit, Ospedale del Mare, 80147 Naples, Italy
| | - Marta Palafox Sancez
- Tumor Heterogeneity, Metastasis and Resistance Laboratory, University of Basel, 4001 Basel, Switzerland
| | - Michele Orditura
- Division of Medical Oncology, Department of Precision Medicine, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
| | - Mario Scartozzi
- Medical Oncology Department, University of Cagliari, 09042 Cagliari, Italy
| | - Antonino Musolino
- Medical Oncology and Breast Unit, University Hospital of Parma, 43126 Parma, Italy
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
- GOIRC (Gruppo Oncologico Italiano di Ricerca Clinica), 43126 Parma, Italy
| | - Cinzia Solinas
- Medical Oncology Department, University of Cagliari, 09042 Cagliari, Italy
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13
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In Early Breast Cancer, the Ratios of Neutrophils, Platelets and Monocytes to Lymphocytes Significantly Correlate with the Presence of Subsets of Circulating Tumor Cells but Not with Disseminated Tumor Cells. Cancers (Basel) 2022; 14:cancers14143299. [PMID: 35884360 PMCID: PMC9320225 DOI: 10.3390/cancers14143299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 06/30/2022] [Accepted: 07/01/2022] [Indexed: 12/10/2022] Open
Abstract
Simple Summary Circulating tumor cells (CTCs) are potential precursors of metastasis and while travelling through the peripheral blood, they crosstalk with different blood cells before a few of them manage to settle down as disseminated tumor cells (DTCs). Little is known about the correlation of blood cells with CTCs/DTCs in early breast cancer (BC). We retrospectively recorded clinical data, results for CTCs, DTCs and blood cell counts from 171 early staged diagnosed BC patients and demonstrated that the presence of epithelial CTCs was related to reduced lymphocyte and monocyte counts, to elevated neutrophil to lymphocyte and platelet to lymphocyte ratios while CTCs in epithelial mesenchymal transition associated with a reduced monocyte to lymphocyte ratio. No significant correlations were found for DTCs, however, DTC-positive patients, harboring a lower platelet to lymphocyte ratio, had a significant shorter overall survival. We confirm that pro-inflammatory markers in blood are closely related to the presence of CTC subtypes, the precursors of metastasis. Abstract Circulating tumor cells (CTCs) crosstalk with different blood cells before a few of them settle down as disseminated tumor cells (DTCs). We evaluated the correlation between CTC subtypes, DTCs and the neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and monocyte to lymphocyte ratio (MLR) for better prognostication of 171 early staged diagnosed breast cancer (BC) patients. —Clinical data and blood values before treatment were retrospectively recorded, representing the 75% percentile, resulting in 3.13 for NLR, 222.3 for PLR and 0.39 for MLR, respectively. DTCs were analyzed by immunocytochemistry using the pan-cytokeratin antibodyA45-B/B3. CTCs were determined applying the AdnaTests BreastCancerDetect and EMT (Epithelial Mesenchymal Transition) Detect. —Reduced lymphocyte (p = 0.007) and monocyte counts (p = 0.012), an elevated NLR (p = 0.003) and PLR (p = 0.001) significantly correlated with the presence of epithelial CTCs while a reduced MLR was related to EMT-CTCs (p = 0.045). PLR (p = 0.029) and MLR (p = 0.041) significantly related to lymph node involvement and monocyte counts significantly correlated with OS (p = 0.034). No correlations were found for NLR, PLR and MLR with DTCs, however, DTC-positive patients, harboring a lower PLR, had a significant shorter OS (p = 0.043). —Pro-inflammatory markers are closely related to different CTC subsets. This knowledge might improve risk prognostication of these patients.
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14
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Hadjigol S, Shah BA, O’Brien-Simpson NM. The ‘Danse Macabre’—Neutrophils the Interactive Partner Affecting Oral Cancer Outcomes. Front Immunol 2022; 13:894021. [PMID: 35784290 PMCID: PMC9243430 DOI: 10.3389/fimmu.2022.894021] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 05/12/2022] [Indexed: 12/11/2022] Open
Abstract
Over the past few decades, tremendous advances in the prevention, diagnosis, and treatment of cancer have taken place. However for head and neck cancers, including oral cancer, the overall survival rate is below 50% and they remain the seventh most common malignancy worldwide. These cancers are, commonly, aggressive, genetically complex, and difficult to treat and the delay, which often occurs between early recognition of symptoms and diagnosis, and the start of treatment of these cancers, is associated with poor prognosis. Cancer development and progression occurs in concert with alterations in the surrounding stroma, with the immune system being an essential element in this process. Despite neutrophils having major roles in the pathology of many diseases, they were thought to have little impact on cancer development and progression. Recent studies are now challenging this notion and placing neutrophils as central interactive players with other immune and tumor cells in affecting cancer pathology. This review focuses on how neutrophils and their sub-phenotypes, N1, N2, and myeloid-derived suppressor cells, both directly and indirectly affect the anti-tumor and pro-tumor immune responses. Emphasis is placed on what is currently known about the interaction of neutrophils with myeloid innate immune cells (such as dendritic cells and macrophages), innate lymphoid cells, natural killer cells, and fibroblasts to affect the tumor microenvironment and progression of oral cancer. A better understanding of this dialog will allow for improved therapeutics that concurrently target several components of the tumor microenvironment, increasing the possibility of constructive and positive outcomes for oral cancer patients. For this review, PubMed, Web of Science, and Google Scholar were searched for manuscripts using keywords and combinations thereof of “oral cancer, OSCC, neutrophils, TANs, MDSC, immune cells, head and neck cancer, and tumor microenvironment” with a focus on publications from 2018 to 2021.
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Affiliation(s)
- Sara Hadjigol
- *Correspondence: Neil M. O’Brien-Simpson, ; Sara Hadjigol,
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15
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Mahmud Z, Rahman A, Mishu ID, Kabir Y. Mechanistic insights into the interplays between neutrophils and other immune cells in cancer development and progression. Cancer Metastasis Rev 2022; 41:405-432. [PMID: 35314951 DOI: 10.1007/s10555-022-10024-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 03/09/2022] [Indexed: 12/12/2022]
Abstract
Cancer is considered a major public health concern worldwide and is characterized by an uncontrolled division of abnormal cells. The human immune system recognizes cancerous cells and induces innate immunity to destroy those cells. However, sustained tumors may protect themselves by developing immune escape mechanisms through multiple soluble and cellular mediators. Neutrophils are the most plenteous leukocytes in the human blood and are crucial for immune defense in infection and inflammation. Besides, neutrophils emancipate the antimicrobial contents, secrete different cytokines or chemokines, and interact with other immune cells to combat and successfully kill cancerous cells. Conversely, many clinical and experimental studies signpost that being a polarized and heterogeneous population with plasticity, neutrophils, particularly their subpopulations, act as a modulator of cancer development by promoting tumor metastasis, angiogenesis, and immunosuppression. Studies also suggest that tumor infiltrating macrophages, neutrophils, and other innate immune cells support tumor growth and survival. Additionally, neutrophils promote tumor cell invasion, migration and intravasation, epithelial to mesenchymal transition, survival of cancer cells in the circulation, seeding, and extravasation of tumor cells, and advanced growth and development of cancer cells to form metastases. In this manuscript, we describe and review recent studies on the mechanisms for neutrophil recruitment, activation, and their interplay with different immune cells to promote their pro-tumorigenic functions. Understanding the detailed mechanisms of neutrophil-tumor cell interactions and the concomitant roles of other immune cells will substantially improve the clinical utility of neutrophils in cancer and eventually may aid in the identification of biomarkers for cancer prognosis and the development of novel therapeutic approaches for cancer treatment.
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Affiliation(s)
- Zimam Mahmud
- Department of Biochemistry and Molecular Biology, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Atiqur Rahman
- Department of Biochemistry and Molecular Biology, University of Dhaka, Dhaka, 1000, Bangladesh
| | | | - Yearul Kabir
- Department of Biochemistry and Molecular Biology, University of Dhaka, Dhaka, 1000, Bangladesh.
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16
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Rotolo S, Di Giorgio A, Cintoni M, Rinninella E, Palombaro M, Pulcini G, Schena CA, Chiantera V, Vizzielli G, Gasbarrini A, Pacelli F, Mele MC. Body composition and immunonutritional status in patients treated with pressurized intraperitoneal aerosol chemotherapy (PIPAC) for gastrointestinal peritoneal metastases: a prospective single-center analysis. Pleura Peritoneum 2022; 7:9-17. [PMID: 35602923 PMCID: PMC9069500 DOI: 10.1515/pp-2021-0142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 02/02/2022] [Indexed: 11/15/2022] Open
Abstract
Abstract
Objectives
Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is a novel drug administration method with promising efficacy for the treatment of peritoneal metastases (PM). This study aimed to evaluate the prognostic value of an immunonutritional assessment on the feasibility, safety, and survival in this setting.
Methods
Data of PM patients undergoing PIPAC between September 2018 and May 2020 were prospectively recorded. A CT scan-derived body composition assessment was performed for each patient.
Results
Fifty-one patients were enrolled, of which 30 (58%) underwent multiple PIPAC cycles, with a pathological response rate of 55%. Prognostic nutritional index (PNI) and neutrophil-to-lymphocytes predicted completion of more than one PIPAC cycle, with a cut off of 36.5 and 4.8 respectively. Muscle attenuation and body fat tissues were associated with pathological response. At multivariate Cox regression analysis, only the presence of a low PNI (HR 2.41, 95% CI 1.08–5.46) was significantly associated with a worse OS.
Conclusions
A pretreatment immunonutritional assessment may provide valuable information for PIPAC patients’ selection and survival, while body composition parameters are able to predict pathological response. Further larger studies are needed to validate the role of these biomarkers in tailoring the treatment and monitoring PM patients undergoing PIPAC.
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Affiliation(s)
- Stefano Rotolo
- Dipartimento di Scienze Mediche e Chirurgiche , UOC Chirurgia del Peritoneo e del Retroperitoneo, Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy
- Dipartimento di Discipline Chirurgiche, Oncologiche e Stomatologiche (Di.Chir.On.S.) , Università degli Studi di Palermo , Palermo , Italy
| | - Andrea Di Giorgio
- Dipartimento di Scienze Mediche e Chirurgiche , UOC Chirurgia del Peritoneo e del Retroperitoneo, Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy
| | - Marco Cintoni
- Dipartimento di Scienze Mediche e Chirurgiche , UOC di Nutrizione Clinica, Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy
| | - Emanuele Rinninella
- Dipartimento di Scienze Mediche e Chirurgiche , UOC di Nutrizione Clinica, Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy
| | - Marta Palombaro
- Dipartimento di Scienze Mediche e Chirurgiche , UOSD di Nutrizione Avanzata in Oncologia, Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy
| | - Gabriele Pulcini
- Dipartimento di Scienze Mediche e Chirurgiche , UOSD di Nutrizione Avanzata in Oncologia, Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy
| | - Carlo Alberto Schena
- Dipartimento di Scienze Mediche e Chirurgiche , UOC Chirurgia del Peritoneo e del Retroperitoneo, Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy
| | - Vito Chiantera
- Dipartimento di Discipline Chirurgiche, Oncologiche e Stomatologiche (Di.Chir.On.S.) , Università degli Studi di Palermo , Palermo , Italy
| | - Giuseppe Vizzielli
- Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica , UOC Ginecologia Oncologica, Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy
| | - Antonio Gasbarrini
- Dipartimento di Scienze Mediche e Chirurgiche , UOC Medicina Interna e Gastroenterologia, Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy
- Dipartimento di Medicina e Chirurgia Traslazionale , Università Cattolica Del Sacro Cuore , Rome , Italy
| | - Fabio Pacelli
- Dipartimento di Scienze Mediche e Chirurgiche , UOC Chirurgia del Peritoneo e del Retroperitoneo, Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy
| | - Maria Cristina Mele
- Dipartimento di Scienze Mediche e Chirurgiche , UOSD di Nutrizione Avanzata in Oncologia, Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy
- Dipartimento di Medicina e Chirurgia Traslazionale , Università Cattolica Del Sacro Cuore , Rome , Italy
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Li X, Wang J, Fu J, Xie X, Xie X. Prognostic significance of preoperative serum inflammation markers in patients with male breast cancer. Transl Cancer Res 2022; 10:4002-4008. [PMID: 35116698 PMCID: PMC8797497 DOI: 10.21037/tcr-21-693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 07/23/2021] [Indexed: 11/06/2022]
Abstract
Background There were no predictive prognosis factors of serum in male breast cancer, while breast cancer is a heterogeneous disease. The purpose of our study was to determine the prognostic implications of the pretreatment neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and lymphocyte-to-monocyte ratio (LMR) in the serum of patients with male breast cancer. Methods We retrospectively identified a random cohort of male breast cancer patients treated at the Sun Yat-sen University Cancer Center between Jan 1, 1996 and Dec 31, 2016. A number of 108 patients had different inflammation markers recorded pre-operation. Survival status was retrieved from our cancer center registry and phone follow-up. Cox proportional hazards regression model was used to analyze the disease-free survival (DFS) and overall survival (OS). Results Among these patients in this study, 13 (12.0%) had disease recurrence, and 7 (6.5%) patients appeared distant metastasis. No statistically significant association of the preoperative NLR, PLR or LMR level with patients' different outcomes was found. Conclusions In short, we were unable to establish a connection between preoperative inflammation biomarkers and male breast cancer patients' survival. Neither NLR, PLR nor LMR is useful for predicting prognosis in male breast cancer patients, and prospective studies to evaluate the above biomarkers as a simple prognostic trail is necessary.
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Affiliation(s)
- Xing Li
- Department of Breast Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Jin Wang
- Department of Breast Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Juan Fu
- Department of Ultrasonography, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Xinhua Xie
- Department of Breast Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Xiaoming Xie
- Department of Breast Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
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18
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Zanoni DK, Mayor CV, McGill MR, Montero PH, Shah JP, Wong RJ, Ganly I, Patel SG. Distant metastasis in oral squamous cell carcinoma: Does the neutrophil-to-lymphocyte ratio act as a surrogate of the host immune status? Oral Oncol 2022; 124:105641. [PMID: 34864297 PMCID: PMC9377276 DOI: 10.1016/j.oraloncology.2021.105641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 11/15/2021] [Accepted: 11/21/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVES Distant metastasis (DM) is an important prognostic factor for oral squamous cell carcinoma (OSCC). The aim of this study is to evaluate the influence of host and tumor factors in development of DM. MATERIALS AND METHODS After IRB approval, 1369 patients with OSCC undergoing primary surgery were eligible for the study. The primary endpoint was the development of distant metastasis (DM). Patients were pathologically staged according to the American Joint Committee on Cancer, 8th Edition. Pre-operative peripheral blood counts were used to calculate neutrophil-to-lymphocyte ratio (NLR). RESULTS Median follow-up was 39 months (range 1-221). DM were identified in 126 patients during follow-up. When analyzed as a time-dependent covariate, neck recurrence (NR) was a significant predictor of DM (HR 16.35, 95% CI: 11.39-23.47, p < 0.001). NLR, margin status, vascular invasion, perineural invasion (PNI), grade, pT, number of metastatic lymph nodes, level IV involvement, and extra nodal-extension (ENE) were also significant. In multivariable analysis, NLR, margins, PNI, number of metastatic lymph nodes, and ENE maintained independent predictive capacity. Patients with NLR ≥ 5.7 were 3 times more likely to develop DM compared to NLR ≤ 2.9 (95% CI: 1.74-5.59, p < 0.001), patients with ≥ 5 metastatic lymph nodes were 2 times more likely to develop DM (95% CI: 1.18-3.60, p = 0.011), and those with ENE were 4 times more likely (95% CI: 2.67-8.20, p < 0.001) when compared to pNx/pN0 patients. CONCLUSIONS NLR, number of metastatic lymph nodes, and ENE were the strongest independent predictors of DM in OSCC treated with primary surgery and appropriate adjuvant therapy.
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19
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Valero C, Adilbay D, Fitzgerald CWR, Yuan A, Mimica X, Gupta P, Wong RJ, Shah JP, Patel SG, Cohen MA, Ganly I. Predictors of distant metastases in sinonasal and skull base cancer patients treated with surgery. Oral Oncol 2021; 122:105575. [PMID: 34689008 DOI: 10.1016/j.oraloncology.2021.105575] [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: 08/27/2021] [Revised: 10/09/2021] [Accepted: 10/12/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Sinonasal and skull base tumors comprise a heterogeneous group of malignancies with a significant rate of distant recurrence (DR). The aim of this study was to analyze tumor and host factors, including pretreatment neutrophil-to-lymphocyte ratio (NLR), that predict DR in these patients. MATERIALS AND METHODS We retrospectively reviewed sinonasal tumors and/or tumors involving the skull base treated with surgery between 1973 and 2015 (n = 473). We stratified NLR using the top 5 percentile as cutoff. Factors predictive of outcome were determined by Cox proportional hazards model. RESULTS Most tumors were primary (81%) and 67% had skull base resection. The most common site was the nasal cavity (37%) and the most common histology was squamous cell carcinoma (34%). Most patients presented with advanced primary tumor stage (pT3/T4; 80%) and most had no regional neck disease (pNx/N0; 93%). A total of 104 patients developed DR. The 5-year overall and disease-specific survival for patients who developed DR were 36.4% and 35.8%, compared to 69.0% and 74.9% for patients who did not. Patients with DR had a higher percentage of NLR-high patients compared patients without DR (11% vs 3%, p = .006). In a multivariable analysis, melanoma histology (HR = 5.469, 95% CI 3.171-9.433), pT3/T4 (HR = 2.686, 95% CI 1.150-6.275), pN+ (HR = 6.864, 95% CI 3.450-13.653), and NLR-high (HR = 3.489, 95% CI 1.593-7.639) were independent predictors of DR. CONCLUSION Melanoma histology, pT, pN, and high NLR predict DR, suggesting that both tumor and host factors need to be considered. NLR may act as a surrogate marker of the host́s immune system.
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Affiliation(s)
- Cristina Valero
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Dauren Adilbay
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Conall W R Fitzgerald
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Avery Yuan
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Ximena Mimica
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Piyush Gupta
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Richard J Wong
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Jatin P Shah
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Snehal G Patel
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Marc A Cohen
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Ian Ganly
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.
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20
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Kim KM, Choi HS, Noh H, Cho IJ, Lim ST, Lee JI, Han A. Neutrophil to Lymphocyte Ratio after Treatment Completion as a Potential Predictor of Survival in Patients with Triple-Negative Breast Cancer. J Breast Cancer 2021; 24:443-454. [PMID: 34652080 PMCID: PMC8561138 DOI: 10.4048/jbc.2021.24.e43] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 08/17/2021] [Accepted: 09/27/2021] [Indexed: 01/12/2023] Open
Abstract
Purpose Triple-negative breast cancer (TNBC) has been associated with worse prognosis, and biomarkers are needed to identify high-risk patients who may benefit from clinical trials or escalated treatment after completion of standard treatment. We aimed to assess whether the post-treatment neutrophil-to-lymphocyte ratio (NLR) can reflect patient prognosis and determine the follow-up period that can provide the most feasible data. Methods In this retrospective analysis involving patients with TNBC, clinicopathological data, including those on peripheral complete blood cell count, were collected. The prognostic powers of serial NLRs obtained at baseline and after treatment completion were compared. Kaplan-Meier curves were generated to compare the overall survival (OS) and distant disease-free survival (DDFS). Results In total, 210 patients were enrolled. Forty-three (20.5%) events were detected. Two-thirds of the events (29/43) were related to breast cancer. Most recurrent breast cancer-related diseases (27/29) were detected within 5 years of the initial diagnosis. In contrast, half of the events due to secondary malignancies or non-breast-related diseases (7/14) occurred 5 years after the initial diagnosis. Comparison of the prognostic performance of NLRs at baseline and at 6, 12, and 24 months after treatment completion revealed the strongest prognostic performance at 6 months after treatment completion (area under the curve = 0.745). The high NLR group (NLR >2.47) showed worse OS (p = 0.006) and DDFS (p < 0.001) than low NLR group. Conclusion Elevated post-treatment NLR was significantly associated with worse survival in patients with TNBC. We believe that it can be a useful surrogate marker for identifying high-risk patients with TNBC.
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Affiliation(s)
- Kwang-Min Kim
- Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Hyang Suk Choi
- Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Hany Noh
- Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - In-Jeong Cho
- Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Seung Taek Lim
- Department of Oncology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jong-In Lee
- Department of Oncology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Airi Han
- Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea.
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Neutrophil-to-lymphocyte ratio is associated with sensitivity to platinum-based chemotherapy and prognosis in patients with advanced serous ovarian carcinoma. Mol Clin Oncol 2021; 15:217. [PMID: 34476101 PMCID: PMC8408678 DOI: 10.3892/mco.2021.2381] [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: 03/10/2021] [Accepted: 05/11/2021] [Indexed: 01/01/2023] Open
Abstract
The role of the neutrophil-to-lymphocyte ratio (NLR) in predicting sensitivity to chemotherapy and prognosis has attracted great interest in several types of cancer. In the present study, the correlation between pre-chemotherapy NLR and sensitivity to platinum-based chemotherapy and prognosis in patients with advanced serous ovarian carcinoma was examined by retrospectively reviewing the medical records of 50 patients with stage III-IV serous ovarian carcinoma from 2005 to 2012. Patients were divided into high-NLR (32 patients) and low-NLR (18 patients) groups according to a cutoff value of 2.47. This cutoff was calculated using a receiver operating characteristic (ROC) curve that demonstrated 84% specificity and 60% sensitivity. Patient characteristics, sensitivity to platinum-based chemotherapy and prognosis were subsequently compared. The results revealed no significant difference in patient characteristics between the two groups. In the low-NLR group, 14 of 18 patients (77.8%) were sensitive to platinum-based chemotherapy, whereas 11 of 32 were sensitive in the high-NLR group (34.4%) (P=0.007). Overall and disease-free survival (DFS) were significantly longer in the low-NLR than in the high-NLR group (P=0.013 and P=0.043, respectively). The current results suggested that pre-chemotherapeutical NLR may serve as a biomarker of sensitivity to platinum-based chemotherapy and prognosis in patients with advanced serous ovarian carcinoma.
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22
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Neutrophil in the Pancreatic Tumor Microenvironment. Biomolecules 2021; 11:biom11081170. [PMID: 34439836 PMCID: PMC8394314 DOI: 10.3390/biom11081170] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 07/30/2021] [Accepted: 08/05/2021] [Indexed: 12/20/2022] Open
Abstract
Pancreatic ductal adenocarcinoma (PDAC) is a malignancy with a poor prognosis and low survival rates. PDAC is characterized by a fibroinflammatory tumor microenvironment enriched by abundant fibroblasts and a variety of immune cells, contributing to its aggressiveness. Neutrophils are essential infiltrating immune cells in the PDAC microenvironment. Recent studies have identified several cellular mechanisms by which neutrophils are recruited to tumor lesion and promote tumorigenesis. This review summarizes the current understanding of the interplay between neutrophils, tumor cells, and other components in the PDAC tumor microenvironment. The prognosis and therapeutic implications of neutrophils in PDAC are also discussed.
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Ryu HH, Ahn SH, Kim SO, Kim JE, Kim JS, Ahn JH, Jung KH, Kim SB, Ko BS, Lee JW, Son BH, Shin HJ, Kim HH, Gong GY, Kim HJ. Comparison of metabolic changes after neoadjuvant endocrine and chemotherapy in ER-positive, HER2-negative breast cancer. Sci Rep 2021; 11:10510. [PMID: 34006898 PMCID: PMC8131718 DOI: 10.1038/s41598-021-89651-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 04/06/2021] [Indexed: 12/26/2022] Open
Abstract
Survival of breast cancer patients has improved, and treatment-related changes regarding metabolic profile deterioration after neoadjuvant systemic treatment (NST) become important issues in cancer survivors. We sought to compare metabolic profile changes and the neutrophil-to-lymphocyte ratio (NLR) between patients undergoing neoadjuvant chemotherapy (NCT) and neoadjuvant endocrine therapy (NET) 3 years after the treatment. In a prospective, randomized, phase III trial which compared 24 weeks of NCT with adriamycin and cyclophosphamide followed by docetaxel and NET with goserelin and tamoxifen (NEST), 123 patients in the Asan Medical Center were retrospectively reviewed to evaluate metabolic changes, such as body mass index (BMI), blood pressure (BP), total cholesterol (TC), fasting glucose, and the NLR. The mean age of patients was 42 years. The changes in BMI, serum glucose, and TC during NST and after 3 years were significantly different between NCT and NET. The proportion of overweight + obese group and the mean BMI were significantly increased during NCT (26.6% to 37.5%, 22.84 kg/m2 to 23.87 kg/m2, p < 0.05), and these attributes found to have normalized at the 3-year follow-up. In the NET group, BMI changes were not observed (p > 0.05, all). There were no differences in changes over time among in the Hypertension group during NCT and NET (p = 0.96). The mean value of serum TC and fasting glucose significantly increased (< 0.05, both) during NCT and decreased 3 years after NCT (p < 0.05); however, no significant changes were observed in the NET group. The NLR was increased from 1.83 to 3.18 after NCT (p < 0.05) and decreased from 1.98 to 1.43 (p < 0.05) after NET. Compared with minimal metabolic effect of NET, NCT worsens metabolic profiles, which were recovered over 3 years. The NLR was increased after NCT but decreased after NET.
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Affiliation(s)
- Ho Hyun Ryu
- Department of Breast Surgery, University of Ulsan, College of Medicine, Asan Medical Center, 88 Olympic ro 43 gil, song pa gu, Seoul, 138-736, Korea
| | - Sei Hyun Ahn
- Department of Breast Surgery, University of Ulsan, College of Medicine, Asan Medical Center, 88 Olympic ro 43 gil, song pa gu, Seoul, 138-736, Korea
| | - Seon Ok Kim
- Department of Clinical Epidemiology and Biostatistics, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea
| | - Jeong Eun Kim
- Department of Oncology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea
| | - Ji Sun Kim
- Department of Breast Surgery, University of Ulsan, College of Medicine, Asan Medical Center, 88 Olympic ro 43 gil, song pa gu, Seoul, 138-736, Korea
| | - Jin-Hee Ahn
- Department of Oncology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea
| | - Kyung Hae Jung
- Department of Oncology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea
| | - Sung-Bae Kim
- Department of Oncology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea
| | - Beom Seok Ko
- Department of Breast Surgery, University of Ulsan, College of Medicine, Asan Medical Center, 88 Olympic ro 43 gil, song pa gu, Seoul, 138-736, Korea
| | - Jong Won Lee
- Department of Breast Surgery, University of Ulsan, College of Medicine, Asan Medical Center, 88 Olympic ro 43 gil, song pa gu, Seoul, 138-736, Korea
| | - Byung Ho Son
- Department of Breast Surgery, University of Ulsan, College of Medicine, Asan Medical Center, 88 Olympic ro 43 gil, song pa gu, Seoul, 138-736, Korea
| | - Hee Jung Shin
- Department of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea
| | - Hak Hee Kim
- Department of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea
| | - Gyung Yub Gong
- Department of Pathology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea
| | - Hee Jeong Kim
- Department of Breast Surgery, University of Ulsan, College of Medicine, Asan Medical Center, 88 Olympic ro 43 gil, song pa gu, Seoul, 138-736, Korea.
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Neutrophil-to-Lymphocyte Ratio Is a Useful Marker for Predicting Histological Types of Early Gastric Cancer. J Clin Med 2021; 10:jcm10040791. [PMID: 33669317 PMCID: PMC7920243 DOI: 10.3390/jcm10040791] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 02/11/2021] [Accepted: 02/15/2021] [Indexed: 12/14/2022] Open
Abstract
Background: The indications for endoscopic submucosal dissection (ESD) for gastric cancer are based on preoperative histological assessment; however, examination of tissue biopsy is not always reliable as only a limited portion of the lesion can be obtained. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are markers of inflammatory response and are potentially associated with the grade of malignancy in gastric cancer. We aimed to investigate the association between NLR and PLR and the histology of gastric cancer. Methods: This study included 218 patients who underwent ESD for gastric cancer. The relationship between NLR/PLR and histological diagnosis was investigated. Results: Patients with adenocarcinomas showed significantly higher NLR and PLR than those with adenomas (p < 0.001 and p < 0.05, respectively). Further, patients with undifferentiated adenocarcinoma showed a significantly higher NLR (p < 0.05) than those with differentiated adenocarcinoma. Conclusion: This study suggests that NLR could be a useful marker for assessing early gastric cancer.
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Zhang Q, Lai Q, Wang S, Meng Q, Mo Z. Clinical Value of Postoperative Neutrophil-to-Lymphocyte Ratio Change as a Detection Marker of Bladder Cancer Recurrence. Cancer Manag Res 2021; 13:849-860. [PMID: 33542658 PMCID: PMC7853415 DOI: 10.2147/cmar.s289986] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 01/13/2021] [Indexed: 12/19/2022] Open
Abstract
Purpose This study investigated the clinical significance of postoperative neutrophil-to-lymphocyte ratio (NLR) changes in bladder cancer recurrence. Patients and Methods For evaluating the predictive value of postoperative dynamic change of NLR, a retrospective cohort study was performed to analyze 213 patients with bladder cancer who underwent surgical treatment from January 2013 to December 2019 at the Affiliated Tumor Hospital of Guangxi Medical University. Baseline characteristics and recurrence-free survival (RFS) were statistically compared, and a multivariate analysis was used to identify prognostic factors. Results Compared with preoperative NLR levels, postoperative decreased NLR in 130 patients and postoperative increased NLR in 83 patients were detected. The 1-, 3- and 5-year RFS rates were 88.0%, 75.4% and 75.4% in the decreased postoperative NLR group, respectively, and 51.2%, 25.8% and 16.1% in the increased postoperative NLR group, respectively (P < 0.05). Kaplan–Meier curves showed that the cumulative DFS rate in the increased group was significantly lower than that in the decreased group (P < 0.05). The preoperative NLR showed significant difference with postoperative NLR in the total cohort, high-grade non-muscle-invasive bladder cancer (HG-NMIBC) and muscle-invasive bladder cancer (MIBC) group, while there was no significant difference between postoperative NLR and NLR of recurrence or last follow-up. Multivariate analysis suggested that postoperative-preoperative NLR was an independent predictor for RFS (HR=6.206, 95% CI: 3.826–10.067, P < 0.001) in the total cohort, RFS (HR=9.373, 95% CI: 2.724–32.245, P < 0.001) in the LG-NMIBC group, RFS rates (HR=6.873, 95% CI: 2.486–18.999, P < 0.001) in the HG-NMIBC group and RFS rates (HR=6.109, 95% CI: 2.847–13.109, P < 0.001) in the MIBC group. Conclusion The dynamic change of postoperative NLR is a potential marker for the early detection of bladder cancer recurrence. Patients with increased NLR after surgery tend to have higher risk of recurrence.
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Affiliation(s)
- Qingyun Zhang
- Department of Urology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region 530021, People's Republic of China.,Institute of Urology and Nephrology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region 530021, People's Republic of China.,Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region 530021, People's Republic of China
| | - Qinqiao Lai
- Department of Urology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region 530021, People's Republic of China
| | - Shan Wang
- Department of Research, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region 530021, People's Republic of China
| | - Qinggui Meng
- Department of Urology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region 530021, People's Republic of China
| | - Zengnan Mo
- Institute of Urology and Nephrology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region 530021, People's Republic of China.,Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region 530021, People's Republic of China.,Department of Urology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region 530021, People's Republic of China
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Lusho S, Durando X, Bidet Y, Molnar I, Kossai M, Bernadach M, Lacrampe N, Veyssiere H, Cavaille M, Gay-Bellile M, Radosevic-Robin N, Abrial C. PERCEPTION Trial protocol: Comparison of predictive and prognostic capacities of neutrophil, lymphocyte, and platelet counts and tumor-infiltrating lymphocytes in triple negative breast cancer. Medicine (Baltimore) 2020; 99:e23418. [PMID: 33327268 PMCID: PMC7738079 DOI: 10.1097/md.0000000000023418] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Triple negative breast cancer affects 10% to 20% of all women diagnosed with breast cancer. Due to its characteristics, treatment strategies are limited and metastatic recurrences are common in the first 5 years after treatment. However, not all patients affected by this disease develop metastases. Tumor-infiltrating lymphocytes have shown to be reliable predictive biomarkers of treatment response and metastatic recurrences. However, we need to develop simpler and faster ways to predict response to cytotoxic treatment and the possibility of eventual cancer relapse by identifying new biomarkers. Recently, new studies are emerging, suggesting a predictive role of circulating blood cells in different types of cancer. In this study, we will assess the correlation between tumor-infiltrating lymphocytes and different elements of the blood count in patients diagnosed with triple negative breast cancer. METHODS The main objective of this study is to evaluate the correlation between the peripheral neutrophil-to-lymphocyte ratio and the amount of tumor-infiltrating lymphocytes, assessed in triple negative breast cancer patients at diagnosis. Secondary objectives include evaluation of the correlation between tumor-infiltrating lymphocytes at diagnosis and the baseline absolute neutrophil, lymphocyte, and platelet counts, as well as the platelet-to-lymphocyte ratio. The triple negative breast cancer patients will be enrolled in the PERCEPTION trial during the first year after the treatment completion. Two supplementary blood tests, at 12 months after the end of treatment and at the time of the first metastatic recurrence, will be performed. DISCUSSION The discovery of new prognostic and predictive biomarkers is crucial for triple negative breast cancer. We set up the PERCEPTION clinical trial in order to evaluate certain blood counts as early biomarkers and to assess their correlation with tumor-infiltrating lymphocytes. Demonstration of comparative predictive and/or prognostic capacities of peripheral blood counts and tumor-infiltrating lymphocytes would allow introduction of the former as simple and cheap biomarkers in triple negative breast cancer patient management. TRIAL REGISTRATION The PERCEPTION study has been registered in the French National Agency of Medical Security registry on the 2nd of July 2019 under the number 2019-A01861-56 and in the ClinicalTrials.org registry under the number NCT04068623.
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Affiliation(s)
- Sejdi Lusho
- Université Clermont Auvergne, INSERM UMR 1240 «Imagerie Moléculaire et Stratégies Théranostiques», Centre Jean Perrin, 58 rue Montalembert, 63000 Clermont-Ferrand
- Délégation Recherche Clinique & Innovation, Centre Jean Perrin, 58 rue Montalembert, F-63011 Clermont-Ferrand
- Centre d’Investigation Clinique, UMR501, F-63001 Clermont-Ferrand
| | - Xavier Durando
- Université Clermont Auvergne, INSERM UMR 1240 «Imagerie Moléculaire et Stratégies Théranostiques», Centre Jean Perrin, 58 rue Montalembert, 63000 Clermont-Ferrand
- Délégation Recherche Clinique & Innovation, Centre Jean Perrin, 58 rue Montalembert, F-63011 Clermont-Ferrand
- Centre d’Investigation Clinique, UMR501, F-63001 Clermont-Ferrand
| | - Yannick Bidet
- Université Clermont Auvergne, INSERM UMR 1240 «Imagerie Moléculaire et Stratégies Théranostiques», Centre Jean Perrin, 58 rue Montalembert, 63000 Clermont-Ferrand
- Centre Jean PERRIN, Laboratoire d’oncologie moléculaire
| | - Ioana Molnar
- Université Clermont Auvergne, INSERM UMR 1240 «Imagerie Moléculaire et Stratégies Théranostiques», Centre Jean Perrin, 58 rue Montalembert, 63000 Clermont-Ferrand
- Délégation Recherche Clinique & Innovation, Centre Jean Perrin, 58 rue Montalembert, F-63011 Clermont-Ferrand
- Centre d’Investigation Clinique, UMR501, F-63001 Clermont-Ferrand
| | - Myriam Kossai
- Université Clermont Auvergne, INSERM UMR 1240 «Imagerie Moléculaire et Stratégies Théranostiques», Centre Jean Perrin, 58 rue Montalembert, 63000 Clermont-Ferrand
- Centre Jean Perrin, Département d’anatomie et de cytologie pathologiques
| | - Maureen Bernadach
- Université Clermont Auvergne, INSERM UMR 1240 «Imagerie Moléculaire et Stratégies Théranostiques», Centre Jean Perrin, 58 rue Montalembert, 63000 Clermont-Ferrand
- Délégation Recherche Clinique & Innovation, Centre Jean Perrin, 58 rue Montalembert, F-63011 Clermont-Ferrand
| | - Nathalie Lacrampe
- Université Clermont Auvergne, INSERM UMR 1240 «Imagerie Moléculaire et Stratégies Théranostiques», Centre Jean Perrin, 58 rue Montalembert, 63000 Clermont-Ferrand
- Centre Jean Perrin, Département d’anatomie et de cytologie pathologiques
| | - Hugo Veyssiere
- Université Clermont Auvergne, INSERM UMR 1240 «Imagerie Moléculaire et Stratégies Théranostiques», Centre Jean Perrin, 58 rue Montalembert, 63000 Clermont-Ferrand
- Délégation Recherche Clinique & Innovation, Centre Jean Perrin, 58 rue Montalembert, F-63011 Clermont-Ferrand
- Centre d’Investigation Clinique, UMR501, F-63001 Clermont-Ferrand
| | - Mathias Cavaille
- Université Clermont Auvergne, INSERM UMR 1240 «Imagerie Moléculaire et Stratégies Théranostiques», Centre Jean Perrin, 58 rue Montalembert, 63000 Clermont-Ferrand
- Centre Jean Perrin, Département d’oncogénétique, 58 rue Montalembert, 63011 Clermont-Ferrand, France
| | - Mathilde Gay-Bellile
- Université Clermont Auvergne, INSERM UMR 1240 «Imagerie Moléculaire et Stratégies Théranostiques», Centre Jean Perrin, 58 rue Montalembert, 63000 Clermont-Ferrand
- Centre Jean Perrin, Département d’oncogénétique, 58 rue Montalembert, 63011 Clermont-Ferrand, France
| | - Nina Radosevic-Robin
- Université Clermont Auvergne, INSERM UMR 1240 «Imagerie Moléculaire et Stratégies Théranostiques», Centre Jean Perrin, 58 rue Montalembert, 63000 Clermont-Ferrand
- Centre Jean Perrin, Département d’anatomie et de cytologie pathologiques
| | - Catherine Abrial
- Université Clermont Auvergne, INSERM UMR 1240 «Imagerie Moléculaire et Stratégies Théranostiques», Centre Jean Perrin, 58 rue Montalembert, 63000 Clermont-Ferrand
- Délégation Recherche Clinique & Innovation, Centre Jean Perrin, 58 rue Montalembert, F-63011 Clermont-Ferrand
- Centre d’Investigation Clinique, UMR501, F-63001 Clermont-Ferrand
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Tumor-associated neutrophils as new players in immunosuppressive process of the tumor microenvironment in breast cancer. Life Sci 2020; 264:118699. [PMID: 33137368 DOI: 10.1016/j.lfs.2020.118699] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 10/17/2020] [Accepted: 10/28/2020] [Indexed: 02/06/2023]
Abstract
Despite the conventional reputation of neutrophils to have antibacterial properties, recent studies have put emphasis and are interested in the role of neutrophils in the spread and treatment of cancer. It has been shown that the infiltration of neutrophils, either by exerting pro- or anti-tumoral effects, probably affects tumor prognosis. Tumor-associated neutrophils (TANs) probably participate in tumor promotion and development in different ways, such as increasing genomic instability, induction of immunosuppression, and increasing angiogenesis. Despite major advances in breast cancer treatment, it is the second leading cause of death in American women. It has been revealed that inflammation is a fundamental issue in the treatment of this cancer because tumor growth, invasion, metastasis, and vascularization can be affected by inflammatory factors. It is demonstrated that enhanced neutrophil to lymphocyte ratio probably contributes to the raised rate of mortality and decreased survival among breast cancer cases. The present review explores the biology of TANs, their suspected interactions in the breast cancer microenvironment, and their functions in preserving the tumor microenvironment and progression of tumors. Furthermore, their potential as therapeutic targets and clinical biomarkers has been discussed in this paper.
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Naito E, Yuki M, Hirano T, Kainuma D, Aoyama R. Prognostic utility of preoperative neutrophil-lymphocyte ratio in cats with malignant mammary tumors. Res Vet Sci 2020; 135:349-354. [PMID: 33129575 DOI: 10.1016/j.rvsc.2020.10.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 10/19/2020] [Accepted: 10/20/2020] [Indexed: 01/04/2023]
Abstract
Although studies have determined the neutrophil-lymphocyte ratio (NLR) to be a useful prognostic predictor in various human cancers, little is known regarding its preoperative prognostic significance in feline mammary tumors (FMTs). Thus, the present study aimed to determine the prognostic utility of preoperative peripheral blood NLR in malignant FMTs. Accordingly, medical records of 34 cats that had undergone mastectomy were searched, after which those histopathologically confirmed to have malignant FMTs were included. Univariate analysis was used to determine the effect of each variable on one-year survival time. Factors determined to be significant during univariate analysis were subsequently included for multivariate analysis. Receiver operating characteristic analysis was used to assess the accuracy of the tests for predicting one-year survival. Univariate analysis showed that a high NLR and large tumor size were significantly associated with shorter survival times (P < 0.01, for both). No significant differences in other factors were observed. Multivariate analysis showed that a high NLR (hazard ratio, 25.03; 95% confidence interval, 2.98-210.40; P < 0.01), but not tumor size and age, was an independent prognostic factor for poor outcomes. The sensitivity and specificity of the NLR (cut-off, 5.67) for predicting one-year survival were 93.8% and 88.9%, respectively. This study suggests that the NLR could potentially be used as a preoperative prognostic factor in FMTs. Preoperative NLR may help to establish therapeutic modalities by allowing prognostic evaluation among cats with mammary tumors.
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Affiliation(s)
- Eiji Naito
- Yuki Animal Hospital, 2-99, Kiba-cho, Minato-ku, Nagoya, Aichi, Japan
| | - Masashi Yuki
- Yuki Animal Hospital, 2-99, Kiba-cho, Minato-ku, Nagoya, Aichi, Japan.
| | - Takashi Hirano
- Yuki Animal Hospital, 2-99, Kiba-cho, Minato-ku, Nagoya, Aichi, Japan
| | - Daiki Kainuma
- Yuki Animal Hospital, 2-99, Kiba-cho, Minato-ku, Nagoya, Aichi, Japan
| | - Reina Aoyama
- Yuki Animal Hospital, 2-99, Kiba-cho, Minato-ku, Nagoya, Aichi, Japan
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Inflammatory Blood Markers as Prognostic and Predictive Factors in Early Breast Cancer Patients Receiving Neoadjuvant Chemotherapy. Cancers (Basel) 2020; 12:cancers12092666. [PMID: 32962003 PMCID: PMC7564656 DOI: 10.3390/cancers12092666] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 09/10/2020] [Accepted: 09/11/2020] [Indexed: 12/13/2022] Open
Abstract
Simple Summary Predictive and prognostic factors are necessary to evaluate the future of women with early breast cancer. Inflammatory blood markers such as neutrophil to lymphocytes ratio and platelet to lymphocytes ratio have been reported to be a predictive factor for pathological complete response and a prognostic factor in breast cancer, with conflicting results. Here we evaluate these inflammatory blood markers in patients with early breast cancer receiving neo adjuvant chemotherapy since neo adjuvant treatment is more and more developed in early breast cancer. Abstract Background: Inflammatory blood markers, such as neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR), have been reported as putative prognostic factors for survival and predictive factors for pathological complete response and toxicity in cancers, however with conflicting results. Methods: We retrospectively analyzed data of 280 patients with early breast cancer receiving neo-adjuvant chemotherapy between 2005 and 2013 in our center. Neutrophil count, lymphocyte count and platelet count before treatment were collected as well as data on pathological complete response, toxicity, recurrence and survival. Results: In multivariate analysis, high PLR was an independent prognostic factor for relapse-free survival (hazard ratio [HR] = 1.91; 95%CI = 1.15–3.16; p = 0.012) and for shorter overall survival (HR = 1.83; 95%CI = 1.03–3.24; p = 0.039). NLR was an independent predictive factor for febrile neutropenia (HR = 0.28; 95%CI = 0.13–0.58; p = 0.001). In triple negative breast cancer molecular subtype, low white blood cell count (<6.75 G/L) was predictive for a higher pathological complete response rate (odds ratio [OR] = 0.29; 95%CI = 0.14–0.61; p < 0.01). Conclusion: In the present study, PLR was found as an independent prognostic factor for survival, while NLR was an independent predictive factor for febrile neutropenia.
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Li L, Wang J, Meng S, Li Z, Huang Z, Sun J, Wang G, Luo F, Yang K. Peripheral Blood Leukocytes and Platelets Serve as Prognostic Factors in Breast Cancer. Cancer Biother Radiopharm 2020; 36:167-173. [PMID: 32608994 DOI: 10.1089/cbr.2019.3032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Background: Tumor-infiltrating lymphocytes have been reported to be associated with response to neoadjuvant chemotherapy and survival in breast cancer (BC) patients. However, little is known about the value of peripheral blood parameter in predicting the prognosis in BC. Methods: In this study, parameters of complete blood count from 417 BC patients with a median 7.6-year follow-up after surgery were collected and correlated with patient survival. Results: It was found that leukocyte counts were positively correlated with disease-free survival (DFS, p = 0.016) and overall survival (OS, p = 0.014), whereas platelet counts were negatively correlated with DFS (p = 0.003) and OS (p = 0.082) in BC. Leukocyte and platelet counts were independent prognostic factors for the BC patient survival. Besides, the prognostic value of leukocyte and platelet counts was further evaluated in the BC patients with different molecular subtypes. Together, BC patients with high leukocyte counts and low platelet counts had better DFS (p = 0.001) and OS (p = 0.017) than the other patients. Conclusion: Parameters of complete blood count could be acquired easily and serve as cost-effective prognostic biomarkers in BC.
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Affiliation(s)
- Li Li
- Department of Thyroid and Breast Surgery, The First People's Hospital of Yunnan Province (the Affiliated Kunhua Hospital of Kunming University of Science and Technology), Kunming, China
| | - Jianjun Wang
- Department of Thyroid and Breast Surgery, The First People's Hospital of Yunnan Province (the Affiliated Kunhua Hospital of Kunming University of Science and Technology), Kunming, China
| | - Shaoda Meng
- Department of Thyroid and Breast Surgery, The First People's Hospital of Yunnan Province (the Affiliated Kunhua Hospital of Kunming University of Science and Technology), Kunming, China
| | - Zhongquan Li
- Department of Thyroid and Breast Surgery, The People's Armed Police Hospital of Yunnan Province, Kunming, China
| | - Zhenfan Huang
- Department of Thyroid and Breast Surgery, The First People's Hospital of Yunnan Province (the Affiliated Kunhua Hospital of Kunming University of Science and Technology), Kunming, China
| | - Jiangxia Sun
- Department of Thyroid and Breast Surgery, The First People's Hospital of Yunnan Province (the Affiliated Kunhua Hospital of Kunming University of Science and Technology), Kunming, China
| | - Guowei Wang
- Department of Thyroid and Breast Surgery, The First People's Hospital of Yunnan Province (the Affiliated Kunhua Hospital of Kunming University of Science and Technology), Kunming, China
| | - Feipeng Luo
- Department of Surgery Four, The Second People's Hospital of Baoshan City, Baoshan, China
| | - Kunxian Yang
- Department of Thyroid and Breast Surgery, The First People's Hospital of Yunnan Province (the Affiliated Kunhua Hospital of Kunming University of Science and Technology), Kunming, China
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Lee JW, Kim SY, Han SW, Lee JE, Lee HJ, Heo NH, Lee SM. [ 18F]FDG uptake of bone marrow on PET/CT for predicting distant recurrence in breast cancer patients after surgical resection. EJNMMI Res 2020; 10:72. [PMID: 32607957 PMCID: PMC7326752 DOI: 10.1186/s13550-020-00660-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 06/23/2020] [Indexed: 02/07/2023] Open
Abstract
Background The objective of this study was to investigate the prognostic value of 2-Deoxy-2-[18F]fluoro-D-glucose ([18F]FDG) uptake of bone marrow (BM) and metabolic parameters of primary tumor on positron emission tomography/computed tomography (PET/CT) for predicting distant recurrence in patients with breast cancer. Methods Pretreatment [18F]FDG PET/CT images of 345 breast cancer patients were retrospectively evaluated. Maximum standardized uptake value, metabolic tumor volume, and total lesion glycolysis (TLG) of primary breast cancer and bone marrow-to-liver uptake ratio (BLR) on PET/CT were measured. A Cox proportional hazard regression model was used to evaluate the prognostic potential of parameters for predicting recurrence-free survival (RFS) and distant RFS. For Kaplan-Meier analysis, the specific cutoff values pf BLR and TLG were determined by the maximal chi-square method. Results The median follow-up duration of the enrolled patients was 48.7 months, and during follow-up, 36 patients (10.4%) experienced the cancer recurrence. BLR was significantly correlated with T stage, serum inflammatory markers, and recurrence pattern (p < 0.05). Patients with high BLR and TLG showed worse RFS and distant RFS than those with low BLR and TLG. On multivariate analysis, BLR was significantly associated with both RFS and distant RFS after adjusting for T stage, estrogen receptor status, and TLG (p = 0.001 for both). Only 0.5% of patients with TLG < 9.64 g and BLR < 0.91 experienced distant recurrence. However, patients with TLG ≥ 9.64 g and BLR ≥ 0.91 had a distant recurrence rate of 40.7%. Conclusions BLR on pretreatment [18F]FDG PET/CT were significant predictors for RFS and distant RFS in patients with breast cancer. By combining [18F]FDG uptake of BM and volumetric PET/CT index of breast cancer, the risk of distant recurrence could be stratified.
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Affiliation(s)
- Jeong Won Lee
- Department of Nuclear Medicine, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Simgok-ro 100-gil 25, Seo-gu, Incheon, 22711, South Korea
| | - Sung Yong Kim
- Department of Surgery, Soonchunhyang University Cheonan Hospital, 31 Suncheonhyang 6-gil, Dongnam-gu, Cheonan, Chungcheongnam-do, 31151, South Korea
| | - Sun Wook Han
- Department of Surgery, Soonchunhyang University Cheonan Hospital, 31 Suncheonhyang 6-gil, Dongnam-gu, Cheonan, Chungcheongnam-do, 31151, South Korea
| | - Jong Eun Lee
- Department of Surgery, Soonchunhyang University Cheonan Hospital, 31 Suncheonhyang 6-gil, Dongnam-gu, Cheonan, Chungcheongnam-do, 31151, South Korea
| | - Hyun Ju Lee
- Department of Pathology, Soonchunhyang University Cheonan Hospital, 31 Suncheonhyang 6-gil, Dongnam-gu, Cheonan, Chungcheongnam-do, 31151, South Korea
| | - Nam Hun Heo
- Clinical Trial Center, Soonchunhyang University Cheonan Hospital, 31 Suncheonhyang 6-gil, Dongnam-gu, Cheonan, Chungcheongnam-do, 31151, South Korea
| | - Sang Mi Lee
- Department of Nuclear Medicine, Soonchunhyang University Cheonan Hospital, 31 Suncheonhyang 6-gil, Dongnam-gu, Cheonan, Chungcheongnam-do, 31151, South Korea.
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The Association between Leukocyte and Its Subtypes and Benign Breast Disease: The TCLSIH Cohort Study. JOURNAL OF ONCOLOGY 2020; 2020:3560593. [PMID: 32565800 PMCID: PMC7281813 DOI: 10.1155/2020/3560593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 05/13/2020] [Indexed: 11/18/2022]
Abstract
Inflammation plays a crucial role in the formation of benign breast disease. Given the limited study to explore the association between leukocyte as an indicator of immune system and benign breast disease, we used data from a large cross-sectional study to investigate association between leukocyte and its subtypes and benign breast disease among women in the general population. The data were derived from baseline data of the Tianjin chronic low-grade systemic inflammation and health (TCLSIH) cohort study during 2014 and 2016. Breast thickness and nodules status were assessed by using ultrasonography. Leukocyte and its subtype counts were carried out using the automated hematology analyzer. Multiple logistic regression analysis was used to examine the association between leukocyte and its subtypes and prevalence of benign breast disease. In the present study, the prevalence of benign breast disease was 20.9%. After adjustments for potentially confounding factors, the odds ratios (95% confidence interval) for benign breast disease across lymphocyte quintiles were as follows: 1.00 (reference), 0.99 (0.82, 1.2), 0.85 (0.69, 1.04), 0.84 (0.68, 1.02), and 0.75 (0.61, 0.92) (P for trend = 0.002). An inverse association between lymphocyte counts and benign breast disease was found, but leukocyte and other subtypes have nothing to do with benign breast disease. Further prospective studies are needed to determine the findings.
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Guo SW, Shen J, Gao JH, Shi XH, Gao SZ, Wang H, Li B, Yuan WL, Lin L, Jin G. A preoperative risk model for early recurrence after radical resection may facilitate initial treatment decisions concerning the use of neoadjuvant therapy for patients with pancreatic ductal adenocarcinoma. Surgery 2020; 168:1003-1014. [PMID: 32321665 DOI: 10.1016/j.surg.2020.02.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 01/05/2020] [Accepted: 02/07/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Neoadjuvant chemotherapy may benefit patients with pancreatic ductal adenocarcinoma with resectable and borderline disease. Inappropriate use of neoadjuvant therapy, however, may lead to the loss of therapeutic opportunities. Until an effective prediction model of individual drug sensitivity is established, no accurate model exists to help surgeons decide on the appropriate use of neoadjuvant chemotherapy. We hypothesized that early recurrence in patients undergoing upfront, early resection may be an indication for neoadjuvant chemotherapy. Therefore, we aimed to use preoperative clinical parameters to establish a model of early recurrence to select patients at high risk for neoadjuvant chemotherapy. METHODS Patients who underwent resection for pancreatic ductal adenocarcinoma between January 2014 and November 2017 were analyzed retrospectively. After the minimum P-value approach, the patients were divided into three groups: early recurrence, middle recurrence, and late/non-recurrence. Preoperative clinicopathologic factors that could predict early recurrence were included in a Cox proportional hazards regression model for univariate and multivariate analyses. The factors related to early recurrence were included to establish nomogram and decision tree models, which were then validated in 68 patients. RESULTS We found that 235 (72.5%) of 324 patients had recurrence with a median recurrence-free survival of 210 days. The early recurrence, middle recurrence, and late/non-recurrence groups differed in preoperative carbohydrate antigen 19-9 and carcinoembryonic antigen levels, "resectability" on cross-sectional imaging, resection requiring a vascular resection, T stage, tumor size, and adjuvant chemotherapy. The best cutoff value of early recurrence was the first 162 days postoperatively. Univariate and multivariate analyses showed that selected preoperative chief complaints, lymph node enlargement and resectability on cross-sectional imaging, preoperative carbohydrate antigen 19-9 levels >210 kU/L, and a neutrophil/lymphocyte ratio >4.2 were independent predictors for early recurrence. CONCLUSION We have successfully built a prediction model of early recurrence of patients with pancreatic ductal adenocarcinoma with the optimal cutoff early-recurrence value of 162 days. Our nomogram and decision tree models may be used to select those at high risk for early recurrence to guide preoperative decision-making concerning the use of neoadjuvant therapy in those patients who have "resectable" disease and not only the more classic criteria of borderline resectability.
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Affiliation(s)
- Shi-Wei Guo
- Department of Hepatobiliary Pancreatic Surgery, Changhai Hospital, Navy Military Medical University (Second Military Medical University), 200433 Shanghai, China
| | - Jing Shen
- Department of Hepatobiliary Pancreatic Surgery, Changhai Hospital, Navy Military Medical University (Second Military Medical University), 200433 Shanghai, China; Department of General Surgery, No.971 Hospital of Navy, 266071, Qingdao, Shandong, China
| | - Jun-Hui Gao
- Shanghai Biotecan Pharmaceuticals Co., Ltd., Zhangjiang Center for Translational Medicine, 201204 Shanghai, China
| | - Xiao-Han Shi
- Department of Hepatobiliary Pancreatic Surgery, Changhai Hospital, Navy Military Medical University (Second Military Medical University), 200433 Shanghai, China
| | - Sui-Zhi Gao
- Department of Hepatobiliary Pancreatic Surgery, Changhai Hospital, Navy Military Medical University (Second Military Medical University), 200433 Shanghai, China
| | - Huan Wang
- Department of Hepatobiliary Pancreatic Surgery, Changhai Hospital, Navy Military Medical University (Second Military Medical University), 200433 Shanghai, China
| | - Bo Li
- Department of Hepatobiliary Pancreatic Surgery, Changhai Hospital, Navy Military Medical University (Second Military Medical University), 200433 Shanghai, China
| | - Wei-Lan Yuan
- Shanghai Biotecan Pharmaceuticals Co., Ltd., Zhangjiang Center for Translational Medicine, 201204 Shanghai, China
| | - Ling Lin
- Shanghai Biotecan Pharmaceuticals Co., Ltd., Zhangjiang Center for Translational Medicine, 201204 Shanghai, China
| | - Gang Jin
- Department of Hepatobiliary Pancreatic Surgery, Changhai Hospital, Navy Military Medical University (Second Military Medical University), 200433 Shanghai, China.
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Azab B, Amundson JR, Cioci A, Stuart H, Yakoub D, Avisar E, Moffat F, Livingstone AS, Franceschi D. The Usefulness of the Pretreatment Neutrophil/Lymphocyte Ratio as a Predictor of the 5-Year Survival in Stage 1-3 Triple Negative Breast Cancer Patients. Breast Care (Basel) 2020; 16:43-49. [PMID: 33716631 DOI: 10.1159/000506463] [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: 10/29/2018] [Accepted: 01/16/2020] [Indexed: 11/19/2022] Open
Abstract
Background We have previously shown that the neutrophil/lymphocyte ratio (NLR) is a predictor of survival among breast cancer patients. The aim of this study was to determine the predictive value of NLR among different nodal and chemotherapy subgroups of triple negative breast cancer (TNBC). Methods Patients with stage 1-3 TNBC who underwent treatment from 2007 to 2014 and had blood counts prior to treatments were included. Patients were categorized into high (≥2) and low (<2) NLR groups. Primary outcomes were overall survival (OS) and disease-free survival (DFS). Results The average follow-up time was 54 months. The high NLR group had worse OS (HR 2.8, CI 1.3-5.9, p < 0.001) and DFS (HR 2.3, CI 1.2-4.2, p < 0.001) than the low NLR group. After adjusting for confounding variables, high NLR was an independent prognostic factor for both OS (HR 5.5, CI 2.2-13.7, p < 0.0001) and DFS (HR 5.2, CI 2.3-11.6, p < 0.0001). Categorization of TNBC patients by NLR (high vs. low) and nodal status (positive vs. negative) resulted in four groups with significantly different OS and DFS (log rank p < 0.0001). Significant improvements in OS (p < 0.001) and DFS (p < 0.001) were observed for patients who received chemotherapy and had high NLR but not for patients with low NLR (p = 0.65 and p = 0.07, respectively). Conclusion High pretreatment NLR is an independent predictor of poor OS and DFS among TNBC patients. Combining NLR and pN provides better risk stratification for TNBC patients. Chemotherapy appears to be beneficial only in patients with high NLR. Larger prospective studies are needed to validate these findings.
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Affiliation(s)
- Basem Azab
- Surgical Oncology, Sentara Healthcare, Hampton, Virginia, USA
| | - Julia R Amundson
- Department of Surgery, University of Chicago, Chicago, Illinois, USA
| | - Alessia Cioci
- Department of Surgical Oncology, University of Miami, Miami, Florida, USA
| | - Heather Stuart
- Department of Surgical Oncology, University of British Colombia, Vancouver, British Columbia, Canada
| | - Danny Yakoub
- Department of Surgical Oncology, University of Tennessee, Memphis, Tennessee, USA
| | - Eli Avisar
- Department of Surgical Oncology, University of Miami, Miami, Florida, USA
| | - Fredrick Moffat
- Department of Surgical Oncology, University of Miami, Miami, Florida, USA
| | - Alan S Livingstone
- Department of Surgical Oncology, University of Miami, Miami, Florida, USA
| | - Dido Franceschi
- Department of Surgical Oncology, University of Miami, Miami, Florida, USA
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Corbeau I, Jacot W, Guiu S. Neutrophil to Lymphocyte Ratio as Prognostic and Predictive Factor in Breast Cancer Patients: A Systematic Review. Cancers (Basel) 2020; 12:E958. [PMID: 32295078 PMCID: PMC7226461 DOI: 10.3390/cancers12040958] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 03/26/2020] [Accepted: 04/09/2020] [Indexed: 02/07/2023] Open
Abstract
Inflammatory blood markers (IBM), such as the neutrophil to lymphocyte ratio (NLR), have emerged as potential prognostic factors in various cancers, including breast cancer (BC), potentially allowing an easy, minimally invasive evaluation of a given cancer's prognosis and treatment outcome. We report here a systematic overview of the published data evaluating NLR as a prognostic factor or predictive factor for pathological complete response (PCR) and toxicity in early and advanced BC. A total of 45 articles were identified. NLR was found to be an independent prognostic factor for survival in most of the adjuvant treatment studies. However, no significant correlation was found between survival and NLR for early BC patients receiving neo-adjuvant chemotherapy (NACT) and advanced BC patients. Most studies failed to find a significant correlation between NLR and PCR after NACT. Finally, some data showed that IBM could be predictive of chemotherapy-related toxicity.
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Affiliation(s)
- Iléana Corbeau
- Department of Medical Oncology, Institut du Cancer de Montpellier (ICM), 208 Avenue des Apothicaires, 34 298 Montpellier, France; (W.J.); (S.G.)
- IRCM, INSERM U1194, Univerité de Montpellier, ICM, 208 Avenue des Apothicaires, 34 298 Montpellier, France
| | - William Jacot
- Department of Medical Oncology, Institut du Cancer de Montpellier (ICM), 208 Avenue des Apothicaires, 34 298 Montpellier, France; (W.J.); (S.G.)
- IRCM, INSERM U1194, Univerité de Montpellier, ICM, 208 Avenue des Apothicaires, 34 298 Montpellier, France
| | - Séverine Guiu
- Department of Medical Oncology, Institut du Cancer de Montpellier (ICM), 208 Avenue des Apothicaires, 34 298 Montpellier, France; (W.J.); (S.G.)
- IRCM, INSERM U1194, Univerité de Montpellier, ICM, 208 Avenue des Apothicaires, 34 298 Montpellier, France
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Szilasi Z, Jósa V, Zrubka Z, Mezei T, Vass T, Merkel K, Helfferich F, Baranyai Z. Neutrophil-To-Lymphocyte and Platelet-To-Lymphocyte Ratios as Prognostic Markers of Survival in Patients with Head and Neck Tumours-Results of a Retrospective Multicentric Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051742. [PMID: 32155982 PMCID: PMC7084240 DOI: 10.3390/ijerph17051742] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 02/27/2020] [Accepted: 03/03/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND The neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) may be useful for drawing conclusions about the survival of head and neck squamous cell carcinoma (HNSCC) patients. METHODS Clinical data of 156 patients managed for HNSCC at two head and neck surgery centres were analyzed retrospectively. We studied the relationships between survival and PLR as well as NLR. RESULTS With regards to 5-year survival, the difference between the two groups with PLR values lower or higher than the threshold was statistically significant (p = 0.004), and we found the same for disease-free survival (p = 0.05), and tumour-specific mortality (p = 0.009). Concerning NLR, the difference in tumour-specific survival was statistically significant (p = 0.006). According to the multivariate analysis, NLR values higher than the threshold indicated an enhanced risk for overall as well as for tumour-specific mortality. CONCLUSION In HNSCC patients, a high NLR may be considered as an independent risk factor for 5-year overall survival.
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Affiliation(s)
- Zsuzsanna Szilasi
- Department of Otorhinolaryngology and Head and Neck Surgery, HDF Medical Centre, H-1134 Budapest, Hungary;
- Correspondence: ; Tel.: +36-30-280-3053; Fax: +36-1-4752711
| | - Valéria Jósa
- Department of Otorhinolaryngology and Head and Neck Surgery, Jahn Ferenc Hospital, H-1204 Budapest, Hungary;
| | - Zsombor Zrubka
- Department of Health Economics, Corvinus University of Budapest, H-1093 Budapest, Hungary;
| | - Tünde Mezei
- Department of Urology, Jahn Ferenc Hospital, H-1204 Budapest, Hungary;
| | - Tamás Vass
- Department of Surgery, Szent Imre Hospital, H-1115 Budapest, Hungary; (T.V.); (K.M.)
| | - Keresztély Merkel
- Department of Surgery, Szent Imre Hospital, H-1115 Budapest, Hungary; (T.V.); (K.M.)
| | - Frigyes Helfferich
- Department of Otorhinolaryngology and Head and Neck Surgery, HDF Medical Centre, H-1134 Budapest, Hungary;
| | - Zsolt Baranyai
- 1st Department of Surgery, Semmelweis University, H-1082 Budapest, Hungary;
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Muñoz-Montaño W, Cabrera-Galeana P, Alvarado-Miranda A, Villarreal-Garza C, Mohar A, Olvera A, Bargallo-Rocha E, Lara-Medina F, Arrieta O. Prognostic Value of the Pretreatment Neutrophil-to-Lymphocyte Ratio in Different Phenotypes of Locally Advanced Breast Cancer During Neoadjuvant Systemic Treatment. Clin Breast Cancer 2020; 20:307-316.e1. [PMID: 32305297 DOI: 10.1016/j.clbc.2019.12.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 11/23/2019] [Accepted: 12/31/2019] [Indexed: 11/16/2022]
Abstract
PURPOSE Neutrophils are among the key cellular players in the inflammatory milieu produced in patients with breast cancer (BC), and strong evidence exists in terms of the prognostic value of assessing the neutrophil-to-lymphocyte ratio (NLR) in patients with BC. In this study we sought to determine whether the baseline NLR correlates with pathological complete response (pCR), disease-free survival (DFS), and overall survival (OS) in patients with locally advanced BC in the neoadjuvant chemotherapy (NAC) setting. METHODS We analyzed the pretreatment NLR from the first blood count of patients treated from 2007 to 2015 in terms of pCR, DFS, and OS in patients with locally advanced BC. Patients received standard medical care based on national guidelines. RESULTS A total of 1519 patients were included in the study. Median age was 49 years (22-88). The cutoff point for NLR was 2.0. NLR was not associated with pCR or DFS. However, patients with high NLR had worse OS in the presence of triple-negative BC (105.9 months; 95% confidence interval [CI], 100.2-111.5] vs. 98.7 months; 95% CI, 91.1-106.3; P = .029), Her2 overexpression (114.0 months; 95% CI, 110.5-118.0 vs. 100.8 months; 95% CI 95.7-105.9; P = .019), and residual disease after NAC for both phenotypes. Multivariate analysis showed that NLR was independently associated with OS (hazard ratio, 1.4; 95% CI, 1.02-1.95; P = .037). CONCLUSIONS Pretreatment NLR in patients with locally advanced BC correlates with OS as an independent prognostic factor. This influence depends on phenotype and residual disease. Routine assessment of this parameter could be an easy and affordable tool for defining prognosis.
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Affiliation(s)
| | | | | | | | - Alejandro Mohar
- Breast Epidemiology Unit, National Institute of Cancer, Mexico City, Mexico
| | - Alejandro Olvera
- Medical School, National Autonomous University of Mexico, Mexico City, Mexico
| | | | | | - Oscar Arrieta
- Research Unit, National Institute of Cancer, Mexico City, Mexico.
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Neutrophil-lymphocyte ratio in metastatic breast cancer is not an independent predictor of survival, but depends on other variables. Sci Rep 2019; 9:16979. [PMID: 31740715 PMCID: PMC6861311 DOI: 10.1038/s41598-019-53606-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 10/30/2019] [Indexed: 12/11/2022] Open
Abstract
The prognostic impact of neutrophil-lymphocyte ratio (NLR) in metastatic breast cancer (MBC) has been previously evaluated in early and metastatic mixed breast cancer cohorts or without considering other relevant prognostic factors. Our aim was to determine whether NLR prognostic and predictive value in MBC was dependent on other clinical variables. We studied a consecutive retrospective cohort of patients with MBC from a single centre, with any type of first line systemic treatment. The association of NLR at diagnosis of metastasis with progression free survival (PFS) and overall survival (OS) was evaluated using Cox univariate and multivariate proportional hazard models. In the full cohort, that included 263 MBC patients, a higher than the median (>2.32) NLR was significantly associated with OS in the univariate analysis (HR 1.36, 95% CI 1.00–1.83), but the association was non-significant (HR 1.12, 95% CI 0.80–1.56) when other clinical covariates (performance status, stage at diagnosis, CNS involvement, visceral disease and visceral crisis) were included in the multivariate analysis. No significant association was observed for PFS. In conclusion, MBC patients with higher baseline NLR had worse overall survival, but the prognostic impact of NLR is likely derived from its association with other relevant clinical prognostic factors.
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Pozza A, Pauletti B, Scarpa M, Ruffolo C, Bassi N, Massani M. Prognostic role of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in patients with midgut neuroendocrine tumors undergoing resective surgery. Int J Colorectal Dis 2019; 34:1849-1856. [PMID: 31520198 DOI: 10.1007/s00384-019-03356-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/17/2019] [Indexed: 02/04/2023]
Abstract
AIM Several studies demonstrated the prognostic value of the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and platelet-to-white blood cells ratio (PWR) in different types of tumors. However, there is no information about a possible role of NLR, PLR and PWR as predictor of presence of metastasis or multifocal disease in patients undergoing surgery with curative intent for midgut NET. The aim of our study was to test the role of preoperative NLR, PLR and PWR as predictors of patients undergoing surgery with curative intent for midgut NET. METHODS We retrospectively enrolled seven foregut, 35 midgut and six hindgut NET patients with gastrointestinal neuroendocrine tumors operated in our Units from January 2005 to June 2016. Details about preoperative laboratory data, surgical operation, histology and follow-up were retrieved. Non-parametric statistics, ROC curve analysis and survival analysis were used. RESULTS NLR was significantly higher in patients with distant metastasis (p = 0.04). The ROC curve analysis indicated that a threshold value of NLR of 2.6 predicted the presence of peritoneal metastasis with a specificity of 100% and a sensitivity of 71% and an overall accuracy of AUC = 0.81 (95%CI: 0.59-0.94), p = 0.05. PLR and PWR was not be associated to metastasis but tended to be associated to multifocal disease. CONCLUSION In patients with midgut NET, an impaired adaptive immune response, as suggested by a high NLR ratio, was associated to the presence of distant metastasis and in particular of peritoneal metastasis. This information may be helpful when planning the treatment of a patient with a midgut NET.
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Affiliation(s)
- Anna Pozza
- Department of Surgery, Azienda ULSS2 Marca Trevigiana, 31100, Treviso, Italy
| | - Bruno Pauletti
- Department of Surgery, Azienda ULSS2 Marca Trevigiana, 31100, Treviso, Italy
| | - Marco Scarpa
- General Surgery Unit, Azienda Ospedaliera di Padova, 35128, Padua, Italy.
| | - Cesare Ruffolo
- General Surgery Unit, Azienda Ospedaliera di Padova, 35128, Padua, Italy
| | - Nicolò Bassi
- Department of Surgery, Azienda ULSS2 Marca Trevigiana, 31100, Treviso, Italy
| | - Marco Massani
- Department of Surgery, Azienda ULSS2 Marca Trevigiana, 31100, Treviso, Italy
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Lecot P, Sarabi M, Pereira Abrantes M, Mussard J, Koenderman L, Caux C, Bendriss-Vermare N, Michallet MC. Neutrophil Heterogeneity in Cancer: From Biology to Therapies. Front Immunol 2019; 10:2155. [PMID: 31616408 PMCID: PMC6764113 DOI: 10.3389/fimmu.2019.02155] [Citation(s) in RCA: 86] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 08/28/2019] [Indexed: 12/12/2022] Open
Abstract
Neutrophils have been extensively described in the pathophysiology of autoimmune and infectious diseases. Accumulating evidence also suggests the important role of neutrophils in cancer progression through their interaction with cancer and immune cells in blood and in the tumor microenvironment (TME). Most studies have described neutrophils as key drivers of cancer progression, due to their involvement in various tumor promoting functions including proliferation, aggressiveness, and dissemination, as well as in immune suppression. However, such studies were focusing on late-stages of tumorigenesis, in which chronic inflammation had already developed. The role of tumor-associated neutrophils (TANs) at early stages of tumor development remains poorly described, though recent findings indicate that early-stage TANs may display anti-tumor properties. Beyond their role at tumor site, evidence supported by NLR retrospective studies and functional analyses suggest that blood neutrophils could also actively contribute to tumorigenesis. Hence, it appears that the phenotype and functions of neutrophils vary greatly during tumor progression, highlighting their heterogeneity. The origin of pro- or anti-tumor neutrophils is generally believed to arise following a change in cell state, from resting to activated. Moreover, the fate of neutrophils may also involve distinct differentiation programs yielding various subsets of pro or anti-tumor neutrophils. In this review, we will discuss the current knowledge on neutrophils heterogeneity across different tissues and their impact on tumorigenesis, as well as neutrophil-based therapeutic strategies that have shown promising results in pre-clinical studies, paving the way for the design of neutrophil-based next generation immunotherapy.
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Affiliation(s)
- Pacôme Lecot
- Department of Immunity, Virus, and Inflammation (IVI), Centre de Recherche en Cancérologie de Lyon, Centre Léon Bérard, University of Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Lyon, France
| | - Matthieu Sarabi
- Department of Immunity, Virus, and Inflammation (IVI), Centre de Recherche en Cancérologie de Lyon, Centre Léon Bérard, University of Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Lyon, France
| | - Manuela Pereira Abrantes
- Department of Immunity, Virus, and Inflammation (IVI), Centre de Recherche en Cancérologie de Lyon, Centre Léon Bérard, University of Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Lyon, France
| | - Julie Mussard
- Department of Immunity, Virus, and Inflammation (IVI), Centre de Recherche en Cancérologie de Lyon, Centre Léon Bérard, University of Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Lyon, France
| | - Leo Koenderman
- Department of Respiratory Medicine and Center of Translational Immunology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Christophe Caux
- Department of Immunity, Virus, and Inflammation (IVI), Centre de Recherche en Cancérologie de Lyon, Centre Léon Bérard, University of Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Lyon, France
| | - Nathalie Bendriss-Vermare
- Department of Immunity, Virus, and Inflammation (IVI), Centre de Recherche en Cancérologie de Lyon, Centre Léon Bérard, University of Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Lyon, France
| | - Marie-Cécile Michallet
- Department of Immunity, Virus, and Inflammation (IVI), Centre de Recherche en Cancérologie de Lyon, Centre Léon Bérard, University of Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Lyon, France
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Rivas M, Acevedo F, Dominguez F, Galindo H, Camus M, Oddo D, Villarroel A, Razmilic D, Peña J, Munoz Medel M, Navarro ME, Perez-Sepulveda A, Medina L, Merino T, Briones J, Kalergis A, Sanchez C. The Neutrophil to Lymphocyte Ratio Predicts the Response to Neoadjuvant Chemotherapy in Luminal B Breast Cancer. Asian Pac J Cancer Prev 2019; 20:2209-2212. [PMID: 31350986 PMCID: PMC6745205 DOI: 10.31557/apjcp.2019.20.7.2209] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Indexed: 12/24/2022] Open
Abstract
Objective: Tumor response to neoadjuvant chemotherapy (NAC) in breast cancer (BC) patients is a predictor for overall survival. The aim of our study was to determine a relationship between the neutrophil to lymphocyte ratio (NLR) prior to NAC, BC subtypes and the probability of a pathologic complete response (pCR). Materials and Methods: Medical records were collected retrospectively from Centro de Cancer at Red Salud UC-Christus. Clinical data collected included peripheral blood cell counts, BC subtype at diagnosis and the pathology report of surgery after chemotherapy. Results: A total of 88 patients were analyzed. Approximately, a 25% had a pCR, and displayed a significant correlation between BC subtype and pCR (p= 0.0138 Chi2); this was more frequent in epidermal growth factor receptor type 2 (HER2) enriched subtype patients (54%). Luminal B BC patients with a pCR had significantly lower NLR levels (t test, p= 0.0181). Conclusions: HER2-enriched tumors had a higher probability of pCR. In Luminal B tumors, NLR had a statistically significant relationship with the probability of pCR. In this subtype, NLR could be a useful biomarker to predict tumor response to NAC. Further studies including other clinical parameters for systemic inflammation such as platelet counts, intratumoral NLR or body mass index could help identify patients that would get the most benefit from NAC.
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Affiliation(s)
- Mauricio Rivas
- Department of Hematology and Oncology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.
| | - Francisco Acevedo
- Department of Hematology and Oncology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.
| | - Francisco Dominguez
- Department of Oncological and Maxillofacial Surgery, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Hector Galindo
- Department of Hematology and Oncology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.
| | - Mauricio Camus
- Department of Oncological and Maxillofacial Surgery, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - David Oddo
- Department of Anatomy and Pathology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Alejandra Villarroel
- Department of Anatomy and Pathology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Dravna Razmilic
- Department of Radiology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Jose Peña
- Department of Hematology and Oncology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.
| | - Matias Munoz Medel
- Department of Hematology and Oncology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.
| | - Maria Elena Navarro
- Department of Radiology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Alejandra Perez-Sepulveda
- Department of Hematology and Oncology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.
| | - Lidia Medina
- Centro de Cancer, Red de Salud UC-CHRISTUS, Santiago, Chile
| | - Tomas Merino
- Department of Hematology and Oncology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.
| | - Juan Briones
- Department of Hematology and Oncology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.
| | - Alexis Kalergis
- Millennium Institute on Immunology and Immunotherapy, Department of Molecular Genetics and Microbiology, Faculty of Biologic Sciences, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Cesar Sanchez
- Department of Hematology and Oncology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.
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Guo W, Lu X, Liu Q, Zhang T, Li P, Qiao W, Deng M. Prognostic value of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio for breast cancer patients: An updated meta-analysis of 17079 individuals. Cancer Med 2019; 8:4135-4148. [PMID: 31197958 PMCID: PMC6675722 DOI: 10.1002/cam4.2281] [Citation(s) in RCA: 105] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Revised: 04/25/2019] [Accepted: 05/10/2019] [Indexed: 12/11/2022] Open
Abstract
Aims This study aimed to evaluate the prognostic effect of neutrophil‐to‐lymphocyte ratio (NLR) and platelet‐to‐lymphocyte ratio (PLR) for patients with breast cancer (BC). Methods A literature search was performed by searching medical databases. Basic characteristics and prognostic data were extracted from included studies. Primary outcomes, such as overall survival (OS) and disease‐free survival (DFS), were synthesized and compared. Subgroup analyses were performed according to pathology, geographical region, cut‐off value, and tumor progression. Results A total of 39 studies comprising 17079 BC patients were included in this meta‐analysis. Among them, 28 studies with 142 64 BC patients investigated predicting role of NLR for OS, showing elevated NLR were associated poor prognosis (hazard ratio [HR]: 1.78, 95% confidence interval [CI]: 1.49‐2.13, P < 0.001). Twenty‐seven studies containing 115 04 patients explored the role of NLR in predicting DFS, showing elevated NLR was associated with poor DFS with HR of 1.60 (95% CI: 1.42‐1.96, P < 0.001). Twelve studies explored the role of PLR in predicting OS, showing patients with higher PLR were associated with a significantly worse prognosis with a pooled HR of 1.32 (95% CI: 1.11‐1.57, P = 0.002). Eleven studies with 5013 patients shown patients with elevated PLR were associated shorter DFS (HR: 1.43, 95% CI: 1.09‐1.86, P = 0.009). Subgroup analyses shown a greater magnitude of association between NLR and OS in triple‐negative BC patients than in HER2‐positive ones. Conclusions Our study suggested that elevated NLR and PLR were associated with poor OS as well as high risk of recurrence for BC patients. Subgroup analyses confirmed the prognostic effect of NLR and PLR in HER2‐positive BC patients. As easily accessible parameters, NLR and PLR should be identified as useful biomarkers in the management of BC.
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Affiliation(s)
- Wanying Guo
- Department of Breast Surgery, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
| | - Xin Lu
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
| | - Qipeng Liu
- Department of Breast Surgery, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
| | - Ting Zhang
- Department of Breast Surgery, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
| | - Peng Li
- Department of Breast Surgery, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
| | - Weiqiang Qiao
- Department of Breast Surgery, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
| | - Miao Deng
- Department of Breast Surgery, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
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Della Corte CM, Morgillo F. Early use of steroids affects immune cells and impairs immunotherapy efficacy. ESMO Open 2019; 4:e000477. [PMID: 30964127 PMCID: PMC6435247 DOI: 10.1136/esmoopen-2018-000477] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 11/30/2018] [Indexed: 11/21/2022] Open
Affiliation(s)
- Carminia Maria Della Corte
- Oncologia Medica, Dipartimento di Medicina di Precisione, Università degli studi della Campania 'Luigi Vanvitelli', Napoli, Italy
| | - Floriana Morgillo
- Oncologia Medica, Dipartimento di Medicina di Precisione, Università degli studi della Campania 'Luigi Vanvitelli', Napoli, Italy
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Patel DA, Xi J, Luo J, Hassan B, Thomas S, Ma CX, Campian JL. Neutrophil-to-lymphocyte ratio as a predictor of survival in patients with triple-negative breast cancer. Breast Cancer Res Treat 2019; 174:443-452. [PMID: 30604000 DOI: 10.1007/s10549-018-05106-7] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 12/16/2018] [Indexed: 12/25/2022]
Abstract
PURPOSE Peripheral blood lymphopenia and elevated neutrophil-to-lymphocyte ratio (NLR) have been associated with poor outcomes in various malignancies. However, existing literature has largely focused on baseline parameters. The aim of this study is to assess the impact of radiation therapy (RT) and chemotherapy on absolute lymphocyte counts (ALC) and NLR in relation to survival outcomes in patients with triple-negative breast cancer (TNBC). METHODS A retrospective analysis was performed on 126 patients with TNBC treated at Washington University between 2005 and 2010. Cox proportional hazard model with time-varying covariates was applied to estimate the effect of time-varying ALC and NLR separately on overall survival (OS) and disease-free survival (DFS). RESULTS All patients received RT and 112 patients received either neoadjuvant chemotherapy or adjuvant chemotherapy, or both. Patients deceased had lower ALC and higher NLR compared to patients alive throughout the treatment course, even 1 year after treatment completion (ALC, 1 vs. 1.3, P = 0.03 and NLR, 3.9 vs. 2.6, P = 0.03). High ALC was associated with superior OS on both continuous and binary scales (cutoff of 1 K/ul) (HR 0.14; 95% CI 0.05-0.34; P < 0.001 and HR 0.28; 95% CI 0.13-0.61; P = 0.01, respectively). Additionally, high NLR was weakly associated with inferior OS on continuous scales (HR 1.1; 95% CI 1.06-1.15; P < 0.001). CONCLUSIONS Post-treatment lymphopenia and NLR elevation can persist until 1 year after treatment completion. Both portend shorter survival for patients with TNBC. Our data support the use of ALC and NLR to identify high risk patients who may benefit from clinical trials rather than standard of care therapy.
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Affiliation(s)
- Dilan A Patel
- Washington University School of Medicine, St. Louis, MO, 63110, USA
- Vanderbilt University School of Medicine, Nashville, TN, 37232, USA
| | - Jing Xi
- Washington University School of Medicine, St. Louis, MO, 63110, USA
- St. Luke's Hospital, St. Louis, MO, 63017, USA
| | - Jingqin Luo
- Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Bilal Hassan
- Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Shana Thomas
- Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Cynthia X Ma
- Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Jian L Campian
- Washington University School of Medicine, St. Louis, MO, 63110, USA.
- Division of Oncology, Washington University School of Medicine, Campus Box 8056, 660 South Euclid Ave, St. Louis, MO, 63110, USA.
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Abhinav R, Rangarajan B. Beyond the tumor and tumor milieu - Factors affecting responses to immunotherapy. CANCER RESEARCH, STATISTICS, AND TREATMENT 2019. [DOI: 10.4103/crst.crst_105_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Abstract
The tumor-promoting functions of neutrophils have been mainly attributed to induction of tumor angiogenesis or suppression of anticancer immunity. However, a direct impact of neutrophils on tumor cell growth and metastasis remains largely uncharacterized. Here, we coupled a proteomic approach with a functional screen to interrogate the secretome of tumor-associated neutrophils. Surprisingly, the iron-transporting protein transferrin was identified as the major mitogen for tumor cells secreted by neutrophils. Depletion of neutrophils inhibited lung metastasis and transferrin production in the metastatic microenvironment. Deletion of transferrin receptor suppressed growth of lung-colonizing tumor cells. Also, media conditioned by neutrophils isolated from metastatic breast cancer patients stimulated growth of human breast cancer cells, an effect that was largely abolished by transferrin immunodepletion. We identified GM-CSF, which is produced primarily by tumor cells, as a selective inducer of de novo transferrin synthesis in neutrophils through the Jak/Stat5β pathway. GM-CSF neutralization or inhibition of Jak kinases curtailed neutrophil transferrin expression in vitro and in vivo as well as cancer metastasis. Thus, transferrin provides a mechanistic link between neutrophils and metastatic growth owing to the ability of tumor-infiltrating neutrophils to locally deliver this growth-promoting protein in response to GM-CSF stimulation. Our study identifies neutrophil-derived transferrin as a key regulator of metastatic tumor cell growth and a therapeutic target for antimetastatic treatment.
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Yi F, Gu Y, Chen S, Liu Y, Yin W, Zhang Y, Cao B. [Impact of the Pretreatment or Posttreatment NLR and PLR on the Response of First Line Chemotherapy and the Outcomes in Patients with Advanced Non-small Cell Lung Cancer]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2018; 21:481-492. [PMID: 29945708 PMCID: PMC6022033 DOI: 10.3779/j.issn.1009-3419.2018.06.02] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
背景与目的 中性粒细胞淋巴细胞比值(neutrophil-to-lymphocyte ratio, NLR)和血小板淋巴细胞比值(platelet-to-lymphocyte ratio, PLR)是机体系统性炎症的体现, 与多种肿瘤的预后有关。本研究旨在探讨NLR、PLR及其动态变化对非小细胞肺癌(non-small cell lung cancer, NSCLC)一线化疗疗效和预后的影响。 方法 回顾性分析68例2008年4月-2015年4月于北京大学第三医院接受一线化疗、符合入组标准的进展期NSCLC住院患者, 采集一线化疗前和2周期化疗后的NLR和PLR, 应用Kaplan-Meier方法进行生存分析, 单因素和Cox多因素分析NLR、PLR及其动态变化和各种临床特征与一线化疗疗效和总生存期(overall survival, OS)之间的关系。 结果 NLR在2周期化疗后显著下降, NLR2(2周期化疗后NLR)和NLR0(治疗前NLR)分别为(2.69±2.06)和(3.94±2.12)(P=0.000), PLR化疗前后无显著变化(P > 0.05);NLR2与一线化疗2周期和4周期的疗效显著相关(P < 0.05), 疾病进展患者中高NLR2的比例为100.0%, 显著高于部分缓解和疾病稳定组(P < 0.05);NLR0、NLR2和PLR0与OS显著相关(P < 0.05), 但与患者年龄、体力状况、病理类型、肿瘤分期、治疗状态、治疗方案均无关(P > 0.05);单因素分析显示OS与NLR0、NLR2、PLR0、二线治疗状态、二线方案选择、一线化疗2周期疗效、4周期疗效显著相关(P < 0.05), 与肿瘤分期、三线治疗状态及放疗状态无关(P > 0.05);多因素分析表明NLR0(P=0.004)、一线化疗4周期后疗效(P=0.022)、二线治疗状态(P=0.007)是OS的独立预测因素。 结论 治疗前NLR与NSCLC的预后显著相关, 化疗后NLR与一线治疗疗效显著相关。因此, NLR是预测进展期NSCLC一线化疗疗效和预后的理想指标, 也是治疗NSCLC潜在的干预靶点。
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Affiliation(s)
- Fumei Yi
- Department of Medical Oncology and Radiation Sickness, Peking University Third Hospital, Beijing 100191, China
| | - Yangchun Gu
- Department of Medical Oncology and Radiation Sickness, Peking University Third Hospital, Beijing 100191, China
| | - Sen Chen
- Department of Medical Oncology and Radiation Sickness, Peking University Third Hospital, Beijing 100191, China
| | - Yan'e Liu
- Department of Medical Oncology and Radiation Sickness, Peking University Third Hospital, Beijing 100191, China
| | - Wencheng Yin
- Department of Medical Oncology and Radiation Sickness, Peking University Third Hospital, Beijing 100191, China
| | - Yu Zhang
- Department of Medical Oncology and Radiation Sickness, Peking University Third Hospital, Beijing 100191, China
| | - Baoshan Cao
- Department of Medical Oncology and Radiation Sickness, Peking University Third Hospital, Beijing 100191, China
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Wang Z, Peng S, Xie H, Guo L, Jiang N, Shang Z, Niu Y. Neutrophil-lymphocyte ratio is a predictor of prognosis in patients with castration-resistant prostate cancer: a meta-analysis. Cancer Manag Res 2018; 10:3599-3610. [PMID: 30271208 PMCID: PMC6149871 DOI: 10.2147/cmar.s159105] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background The prognostic value of neutrophil–lymphocyte ratio (NLR) in patients with castration-resistant prostate cancer (CRPC) had been investigated in previous studies; however, the results remain inconsistent. This study was aimed to investigate the prognostic value of NLR in CRPC patients. Materials and methods Literature was identified from PubMed, Embase, Web of Science, and Cochrane, which investigated the relationship between pretreatment NLR and prognosis in CRPC patients. HRs for overall survival (OS) and progression-free survival (PFS) were extracted from eligible studies. Heterogeneity was assessed using the I2 value. The fixed-effects model was used if there was no evidence of heterogeneity; otherwise, the random-effects model was used. Publication bias was evaluated using Begg’s funnel plot test. Results A total of 5,705 patients from 16 studies were included in this analysis. The pooled results showed that an elevated NLR predict poor OS (pooled HR = 1.52, 95% CI: 1.41–1.63, P<0.001) and PFS (pooled HR = 1.50, 95% CI: 1.21–1.85, P<0.001) in patients with CRPC. Subgroup analysis revealed that an elevated NLR significantly predicted poor OS in Asian studies group (HR = 2.43, 95% CI: 1.47–4.01, P=0.001). The elevated NLR also significantly predicted poor PFS in Asian studies group (HR = 1.99, 95% CI: 1.30–3.06, P=0.002). Conclusion This study suggests that an elevated NLR predict poor prognosis in patients with CRPC.
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Affiliation(s)
- Zhun Wang
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin 300211, China, ,
| | - Shuanghe Peng
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin 300211, China, ,
| | - Hui Xie
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin 300211, China, ,
| | - Linpei Guo
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin 300211, China, ,
| | - Ning Jiang
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin 300211, China, ,
| | - Zhiqun Shang
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin 300211, China, ,
| | - Yuanjie Niu
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin 300211, China, ,
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Lee J, Kim DM, Lee A. Prognostic Role and Clinical Association of Tumor-Infiltrating Lymphocyte, Programmed Death Ligand-1 Expression with Neutrophil-Lymphocyte Ratio in Locally Advanced Triple-Negative Breast Cancer. Cancer Res Treat 2018; 51:649-663. [PMID: 30064200 PMCID: PMC6473269 DOI: 10.4143/crt.2018.270] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 07/26/2018] [Indexed: 11/27/2022] Open
Abstract
Purpose Tumor-infiltrating lymphocyte (TIL), programmed death-ligand 1 (PD-L1) expression and neutrophil-to-lymphocyte ratio (NLR) is associated to immunogenicity and prognosis of breast cancer. We analyzed baseline NLR, changes of NLR, TIL, and PD-L1 during neoadjuvant chemotherapy (NAC) and their clinical implication in triple-negative breast cancer (TNBC). Materials and Methods Between January 2008 to December 2015, 358 TNBC patients were analyzed. Baseline NLR, 50 paired NLR (initial diagnosis, after completion of NAC) and 34 paired tissues (initial diagnosis, surgical specimen after completion of NAC) were collected. Changes of TIL, CD4, CD8, forkhead box P3 (FOXP3), and PD-L1 expression were assessed with immunohistochemical stain. Results Low NLR (≤ 3.16) was associated to superior survival (overall survival: 41.83 months vs. 36.5 months, p=0.002; disease-free survival [DFS]: 37.85 months vs. 32.14 months, p=0.032). Modest NLR change after NAC (–30% < NLR change < 100%) showed prolonged DFS (38.37 months vs. 22.37 months, p=0.015). During NAC, negative or negative conversion of tumor PD-L1 expression was associated to poor DFS (34.77 months vs. 16.03 months, p=0.037), and same or increased TIL showed trends for superior DFS, but without statistical significance. Positive tumor PD-L1 expression (H-score ≥ 5) in baseline or post-NAC tissue was associated to superior DFS (57.6 months vs. 12.5 months, p=0.001 and 53.3 months vs. 18.9 months, p=0.040). Positive stromal PD-L1 expression in baseline was also associated to superior DFS (50.2 months vs. 20.4 months, p=0.002). Conclusion In locally advanced TNBC, baseline NLR, changes of NLR during NAC was associated to survival. Baseline PD-L1 expression and changes of PD-L1 expression in tumor tissue during NAC also showed association to prognosis.
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Affiliation(s)
- Jieun Lee
- Division of Medical Oncology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.,Cancer Research Institute, The Catholic University of Korea, Seoul, Korea
| | - Dong-Min Kim
- Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ahwon Lee
- Cancer Research Institute, The Catholic University of Korea, Seoul, Korea.,Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Petrillo A, Laterza MM, Tirino G, Pompella L, Ventriglia J, Pappalardo A, Famiglietti V, Martinelli E, Ciardiello F, Orditura M, Galizia G, De Vita F. Systemic-inflammation-based score can predict prognosis in metastatic gastric cancer patients before first-line chemotherapy. Future Oncol 2018; 14:2493-2505. [PMID: 29969285 DOI: 10.2217/fon-2018-0167] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
AIM Systemic inflammatory response affects survival of gastric cancer (GC) patients. This study was carried out to create a prognostic inflammatory-based score to predict survival in metastatic GC (mGC) before first-line chemotherapy. MATERIALS & METHODS We studied the prognostic value of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio in 151 patients with mGC at the diagnosis. RESULTS Median overall survival (OS) was significantly lower in patients with high NLR. Performance status 1-2 according to the Eastern Cooperative Oncology Group scale and NLR were predictors of shorter OS at multivariate analysis. Based on these results, we defined a prognostic OS score, showing a better median OS in favorable risk group. CONCLUSION Elevated pretreatment NLR and Eastern Cooperative Oncology Group are independent predictors of shorter OS in mGC patients before first-line chemotherapy.
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Affiliation(s)
- Angelica Petrillo
- University of Campania 'Luigi Vanvitelli' - School of Medicine, Department of Precision Medicine, Division of Medical Oncology, Via Pansini n.5, 80131 Naples, Italy
| | - Maria Maddalena Laterza
- University of Campania 'Luigi Vanvitelli' - School of Medicine, Department of Precision Medicine, Division of Medical Oncology, Via Pansini n.5, 80131 Naples, Italy
| | - Giuseppe Tirino
- University of Campania 'Luigi Vanvitelli' - School of Medicine, Department of Precision Medicine, Division of Medical Oncology, Via Pansini n.5, 80131 Naples, Italy
| | - Luca Pompella
- University of Campania 'Luigi Vanvitelli' - School of Medicine, Department of Precision Medicine, Division of Medical Oncology, Via Pansini n.5, 80131 Naples, Italy
| | - Jole Ventriglia
- University of Campania 'Luigi Vanvitelli' - School of Medicine, Department of Precision Medicine, Division of Medical Oncology, Via Pansini n.5, 80131 Naples, Italy
| | - Annalisa Pappalardo
- University of Campania 'Luigi Vanvitelli' - School of Medicine, Department of Precision Medicine, Division of Medical Oncology, Via Pansini n.5, 80131 Naples, Italy
| | - Vincenzo Famiglietti
- University of Campania 'Luigi Vanvitelli' - School of Medicine, Department of Precision Medicine, Division of Medical Oncology, Via Pansini n.5, 80131 Naples, Italy
| | - Erika Martinelli
- University of Campania 'Luigi Vanvitelli' - School of Medicine, Department of Precision Medicine, Division of Medical Oncology, Via Pansini n.5, 80131 Naples, Italy
| | - Fortunato Ciardiello
- University of Campania 'Luigi Vanvitelli' - School of Medicine, Department of Precision Medicine, Division of Medical Oncology, Via Pansini n.5, 80131 Naples, Italy
| | - Michele Orditura
- University of Campania 'Luigi Vanvitelli' - School of Medicine, Department of Precision Medicine, Division of Medical Oncology, Via Pansini n.5, 80131 Naples, Italy
| | - Gennaro Galizia
- University of Campania 'Luigi Vanvitelli'- Division of GI Tract Surgical Oncology, Department of Surgical Sciences, Via Pansini n.5, 80131 Naples, Italy
| | - Ferdinando De Vita
- University of Campania 'Luigi Vanvitelli' - School of Medicine, Department of Precision Medicine, Division of Medical Oncology, Via Pansini n.5, 80131 Naples, Italy
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