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Zhai Y, Sun S, Zhang W, Tian H. The prognostic value of the systemic immune inflammation index in patients with IgA nephropathy. Ren Fail 2024; 46:2381613. [PMID: 39039867 DOI: 10.1080/0886022x.2024.2381613] [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: 04/26/2024] [Accepted: 07/13/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND Immune and inflammatory factors are considered the basic underlying mechanisms of IgA nephropathy (IgAN). The systemic immune inflammation index (SII) is a new inflammatory biomarker and has been identified as a prognostic indicator for various diseases. However, limited studies have been conducted on the prognostic value of the SII in patients with IgAN, and we aimed to address this gap. METHODS A total of 374 patients with IgAN confirmed by renal biopsy performed from 1 January 2015 to 1 April 2019, were retrospectively included. The follow-up period of all patients was at least 12 months after diagnosis, and the endpoint was defined as end-stage kidney disease (ESKD). Patients were further divided into a high-risk group (SII ≥ 456.21) and a low-risk group (SII < 456.21) based on the optimal cutoff value of the SII determined by receiver operating characteristic (ROC) curve analysis. Baseline clinicopathological parameters were compared between the groups, and Cox proportional hazards analyses and Kaplan-Meier analysis were performed to assess renal survival in IgAN patients. RESULTS After a median follow-up period of 32.5 months, a total of 53 patients eventually reached ESKD. Patients in the high-SII group tended to have a lower hemoglobin level (p = 0.032) and eGFR (p < 0.001), a higher serum creatinine level (p = 0.023) and 24-hour total protein level (p = 0.004), more severe tubular atrophy and interstitial fibrosis (p = 0.002) and more crescents (p = 0.030) than did those in the low-SII group. Univariate and multivariate Cox regression analyses demonstrated that an SII ≥456.21 was an independent risk factor for poor renal survival in IgAN patients (HR 3.028; 95% CI 1.486-6.170; p = 0.002). Kaplan-Meier analysis revealed that a high SII was significantly associated with poor renal prognosis (p < 0.001) and consistently exhibited remarkable discriminatory ability across different subgroups in terms of renal survival. CONCLUSION A high SII was associated with more severe baseline clinical and pathological features, and an SII ≥456.21 was an independent risk factor for progression to ESKD in IgAN patients.
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Affiliation(s)
- Yaling Zhai
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- The Renal Research Institution of Zhengzhou University, Zhengzhou, China
| | - Shuaigang Sun
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- The Renal Research Institution of Zhengzhou University, Zhengzhou, China
| | - Wenhui Zhang
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- The Renal Research Institution of Zhengzhou University, Zhengzhou, China
| | - Huijuan Tian
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- The Renal Research Institution of Zhengzhou University, Zhengzhou, China
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2
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Mangone A, Favero V, Prete A, Elhassan YS, Asia M, Hardy R, Mantovani G, Chiodini I, Ronchi CL. Inflammation-based scores in a large cohort of adrenocortical carcinoma and adrenocortical adenoma: role of the hormonal secretion pattern. J Endocrinol Invest 2024:10.1007/s40618-024-02426-y. [PMID: 38965182 DOI: 10.1007/s40618-024-02426-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 06/26/2024] [Indexed: 07/06/2024]
Abstract
BACKGROUND Serum inflammation-based scores can predict clinical outcome in several cancer types, including adrenocortical carcinoma (ACC). It is unclear whether the extent of inflammation-based scores alterations in ACC reflects malignancy, steroid excess, or both. METHODS We investigated a large retrospective cohort of adrenocortical adenomas (ACA, n = 429) and ACC (n = 61) with available baseline full blood count and hormonal evaluation. We examined the relationship between different inflammation-based scores [neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), systemic immune-inflammation index (SII), and prognostic nutrition index (PNI)] and both malignancy and steroid secretion patterns. RESULTS All inflammation-based scores differed between ACC and ACA: patients with ACC had higher NLR, PLR, SII and lower LMR and PNI levels compared to ACA (all p values < 0.001). NLR showed a positive correlation with cortisol levels after overnight 1 mg-dexamethasone suppression test (1 mg-DST), both in ACC and ACA (p < 0.01). The ROC curve analysis determined NLR > 2.6 as the best cut-off to discriminate ACC from ACA [AUC = 0.846, p < 0.01]. At multivariable analysis, NLR > 2.6 was independently associated with ACC, 1 mg-DST cortisol levels and age, but not with tumour size. Considering the ACC, NLR and SII were higher and PNI was lower in patients with cortisol excess compared to those without cortisol excess (p = 0.002, p = 0.007, and p = 0.044 respectively). Finally, LMR and NLR differed between inactive-ACC (n = 10) and inactive-ACA (n = 215) (p = 0.040 and p = 0.031, respectively). CONCLUSION Inflammation-based scores are related to steroid secretion both in ACC and ACA. ACCs present a higher grade of inflammation regardless of their hormonal secretion, likely as a feature of malignancy itself.
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Affiliation(s)
- A Mangone
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - V Favero
- Department of Biotechnology and Translational Medicine, University of Milan, Milan, Italy
- Endocrinology Unit, Ospedale Niguarda Ca' Granda, Milan, Italy
| | - A Prete
- Institute of Metabolism and Systems Research, University of Birmingham, Edgbaston, B152TT, UK
- Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK
- Department of Endocrinology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Y S Elhassan
- Institute of Metabolism and Systems Research, University of Birmingham, Edgbaston, B152TT, UK
- Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK
- Department of Endocrinology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - M Asia
- Department of Endocrinology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - R Hardy
- Institute of Metabolism and Systems Research, University of Birmingham, Edgbaston, B152TT, UK
- Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
| | - G Mantovani
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - I Chiodini
- Department of Biotechnology and Translational Medicine, University of Milan, Milan, Italy
- Endocrinology Unit, Ospedale Niguarda Ca' Granda, Milan, Italy
| | - C L Ronchi
- Institute of Metabolism and Systems Research, University of Birmingham, Edgbaston, B152TT, UK.
- Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK.
- Department of Endocrinology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
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Kubo K, Igaue S, Utsunomiya D, Kubo Y, Kanematsu K, Kurita D, Ishiyama K, Oguma J, Goto K, Daiko H. Preoperative neutrophil-to-lymphocyte ratio predicts recurrence of esophageal squamous cell carcinoma after neoadjuvant triplet chemotherapy. Gen Thorac Cardiovasc Surg 2024:10.1007/s11748-024-02053-7. [PMID: 38913280 DOI: 10.1007/s11748-024-02053-7] [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: 04/10/2024] [Accepted: 06/13/2024] [Indexed: 06/25/2024]
Abstract
BACKGROUND Neoadjuvant chemotherapy followed by esophagectomy is the standard treatment for resectable advanced esophageal squamous cell carcinoma (ESCC) in Japan. Triplet chemotherapy is the standard neoadjuvant regimen. Inflammatory markers such as neutrophil-to-lymphocyte ratio (NLR) are well-known prognostic factors for esophageal cancer. However, their usefulness in patients with resectable advanced disease undergoing esophagectomy after neoadjuvant triplet chemotherapy is unknown. METHOD We examined 144 ESCC patients who underwent neoadjuvant triplet chemotherapy followed by esophagectomy between January 2015 and December 2020 to investigate the relationship between inflammatory markers and recurrence-free survival (RFS). Optimal marker cutoff values for RFS were determined using receiver operating characteristic curve analysis. Patients were divided into high and low NLR groups (NLR cutoff, 3.0). RESULTS NLR was high in 61 patients and low in 83. Univariate analyses demonstrated that low NLR was significantly associated with worse RFS (p = 0.049). Multivariate analyses demonstrated that high NLR was an independent predictor of RFS (odds ratio, 1.911; 95% confidence interval, 1.098-3.327; p = 0.022). RFS significantly differed between the low and high NLR groups. RFS did not significantly differ between the patients when stratified according to the other inflammatory markers. CONCLUSION Preoperative NLR is an easily obtained and useful predictor of RFS in patients with resectable advanced ESCC treated with neoadjuvant triplet chemotherapy followed by esophagectomy.
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Affiliation(s)
- Kentaro Kubo
- Department of Esophageal Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, Japan
- Department of Comprehensive Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Shota Igaue
- Department of Esophageal Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, Japan
| | - Daichi Utsunomiya
- Department of Esophageal Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, Japan
| | - Yuto Kubo
- Department of Esophageal Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, Japan
| | - Kyohei Kanematsu
- Department of Esophageal Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, Japan
| | - Daisuke Kurita
- Department of Esophageal Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, Japan
| | - Koshiro Ishiyama
- Department of Esophageal Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, Japan
| | - Junya Oguma
- Department of Esophageal Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, Japan
| | - Koichi Goto
- Department of Comprehensive Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Hiroyuki Daiko
- Department of Esophageal Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, Japan.
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Tang W, Long G. Retrospective study of a novel hematological parameter for predicting the survival of patients with nasopharyngeal carcinoma. PeerJ 2024; 12:e17573. [PMID: 38915379 PMCID: PMC11195549 DOI: 10.7717/peerj.17573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 05/24/2024] [Indexed: 06/26/2024] Open
Abstract
Purpose This study aims to explore the prognostic values of routine pre-treatment hematological parameters in patients with nasopharyngeal carcinoma (NPC). Methods The hematological parameters and clinical data of patients with NPC were collected from January 2012 to December 2013 at Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology. The survival statistics were obtained by regularly following-up the patients. The cut-off values for the hematological parameters were calculated using X-tile software. SPSS version 24.0 was used for the statistical analysis. The relationship between the hematological parameters and the prognosis of patients with NPC was analyzed using the Kaplan-Meier method and Cox multivariate regression. The discriminating abilities of the factors, which predict the prognosis, were evaluated by utilizing the receiver operating characteristic (ROC) area under the curve (AUC). Results This study included 179 patients with NPC. Multivariate analysis shows that pretreatment platelet-to-lymphocyte ratio (PLR; hazard ratio; HR = 0.44, 95% CI [0.21-0.91], p = 0.029), serum albumin (ALB; HR = 2.49, 95% CI [1.17-5.30], p = 0.018), and globulin (GLO; HR = 0.44, 95% CI [0.21-0.90], p = 0.024) are independent predictors for 5-year overall survival (OS) in patients with NPC. In addition, pre-treatment PLR (HR = 0.47, 95% CI [0.25-0.90], p = 0.022) and pre-treatment GLO (HR = 0.37, 95% CI [0.19-0.72], p = 0.001) are associated with 5-year progression-free survival (PFS) in patients with NPC. Based on the results of the multivariate analysis, we proposed a new biomarker GLO-PLR, which is observably correlated with the T stage, N stage and clinical stage in patients with NPC. The OS resolving ability of the GLO-PLR evaluated by AUC is 0.714, which is better than those of GLO and PLR. The PFS resolving ability of the GLO-PLR evaluated by AUC was 0.696, which is also better than those of GLO and PLR. Conclusion Pre-treatment PLR, ALB, and GLO are independent predictors of 5-year OS in patients with NPC, where PLR and GLO are also independent predictors of 5-year FPS. Compared with other hematological parameters, the proposed GLO-PLR is an inexpensive, effective, objective, and easy-to-measure marker for predicting the prognosis of NPC.
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Affiliation(s)
- Wenhua Tang
- Department of Oncology and Southwest Cancer Center, Southwest Hospital, Army Medical University, Chongqing, Chongqing, China
| | - Guoxian Long
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Ma H, Liu Y, Ye H, Gao F, Li Z, Qin S. The prognostic value of preoperative laboratory data indicators in patients with esophageal carcinoma: An observational study. Medicine (Baltimore) 2024; 103:e38477. [PMID: 38875403 PMCID: PMC11175890 DOI: 10.1097/md.0000000000038477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/16/2024] Open
Abstract
Preoperative laboratory data indicators significantly affect the prognosis of a variety of tumors. Nevertheless, the combined effect of systemic immune-inflammation index (SII) and prognostic nutritional index (PNI) on overall survival (OS) in patients with esophageal carcinoma remains unclear. Thus, we examined these associations among patients with postoperative staged T3N0M0 esophageal carcinoma. The data of 246 patients with postoperative staged T3N0M0 esophageal carcinoma from January 1, 2010, to December 31, 2022, were retrospectively analyzed. OS was measured from the date of pathological diagnosis until either death or the last follow-up. The Kaplan-Meier method and multivariate Cox regression model were used to analyze the relationship between neutrophil-to-lymphocyte ratio (NLR), Platelet-to-lymphocyte ratio (PLR), Platelet-to-lymphocyte ratio (LMR), SII, PNI, and OS. The predictive value of SII and PNI as a combined index was analyzed by the receiver operating characteristic curve (ROC). A total of 246 patients aged 65.5 ± 7.4 years were included in this study and 181 (73.6%) were male. The univariate analysis revealed that differentiation, vessel involvement, postoperative treatment, NLR, SII, PLR, LMR, PNI were predictors of OS (P < .05). After adjusted for potential confounds, multivariate Cox regression analysis showed that the differentiation, SII, PNI, and postoperative treatment were independent prognostic factors correlated with OS in patients with postoperative staged T3N0M0 esophageal carcinoma (P < .05). SII and PNI, as a combined indicator, have a higher predictive value for OS. The NLR, SII, PLR, LMR, and PNI could all be used as independent predictors of OS in patients with postoperative staged T3N0M0 esophageal carcinoma. The combination of SII and PNI can significantly improve the accuracy of prediction.
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Affiliation(s)
- Hui Ma
- Department of Radiation Oncology, The First Affiliated Hospital of Soochow University, Su Zhou, P.R. China
- Department of Radiation Oncology, Taixing People' s Hospital Affiliated to Yangzhou University, Tai Xing, P.R. China
| | - Yangchen Liu
- Department of Radiation Oncology, Taixing People' s Hospital Affiliated to Yangzhou University, Tai Xing, P.R. China
| | - Hongxun Ye
- Department of Radiation Oncology, Taixing People' s Hospital Affiliated to Yangzhou University, Tai Xing, P.R. China
| | - Fei Gao
- Department of Radiation Oncology, Taixing People' s Hospital Affiliated to Yangzhou University, Tai Xing, P.R. China
| | - Zhu Li
- Department of Radiation Oncology, Taixing People' s Hospital Affiliated to Yangzhou University, Tai Xing, P.R. China
| | - Songbing Qin
- Department of Radiation Oncology, The First Affiliated Hospital of Soochow University, Su Zhou, P.R. China
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Sugiyama F, Kanda M, Shimizu D, Umeda S, Inokawa Y, Hattori N, Hayashi M, Tanaka C, Nakayama G, Kodera Y. Absence of Hypercoagulation Status after Neoadjuvant Treatment is Associated with Favorable Prognosis in Patients Undergoing Subtotal Esophagectomy for Esophageal Squamous Cell Carcinoma. Ann Surg Oncol 2024; 31:3417-3425. [PMID: 38245650 DOI: 10.1245/s10434-024-14938-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 12/29/2023] [Indexed: 01/22/2024]
Abstract
BACKGROUND Abnormal activation of the coagulation system is associated with malignant tumor progression. Although neoadjuvant treatment (NAT) for resectable esophageal squamous cell carcinoma (ESCC) is the standard of care, the correlation between coagulation status and prognosis of patients undergoing preoperative treatment is insufficiently understood. METHODS Patients (n = 200) who underwent radical subtotal esophagectomy after preoperative treatment for ESCC between January 2012 and December 2021were included in the analysis. Plasma D-dimer and fibrinogen levels and their combined indices (non-hypercoagulation; D-dimer and fibrinogen levels within the upper normal limit, or hypercoagulation; D-dimer or fibrinogen levels above the upper normal limit) were determined before and after NAT and correlated to clinicopathological factors and prognosis. RESULTS The nonhypercoagulation group achieved superior overall survival (OS) than the hypercoagulation group (5-year OS rates = 89% vs. 55%; hazard ratio 3.62, P = 0.0008) when determined according to coagulation status after NAT. Multivariate analysis showed that hypercoagulation after NAT served as an independent factor for poor postoperative OS (hazard ratio 3.20; P = 0.0028). The nonhypercoagulation group achieved significantly better disease-free survival (76% vs. 54%; P = 0.0065) than the hypercoagulation group that experienced a significantly higher rate of hematogenous metastasis as an initial recurrence (P = 0.0337). CONCLUSIONS Hypercoagulation state after NAT served as a valid indicator correlating with postoperative outcomes of patients with ESCC who underwent NAT followed by radical subtotal esophagectomy.
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Affiliation(s)
- Fumitake Sugiyama
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Mitsuro Kanda
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
| | - Dai Shimizu
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shinichi Umeda
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoshikuni Inokawa
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Norifumi Hattori
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masamichi Hayashi
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Chie Tanaka
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Goro Nakayama
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yasuhiro Kodera
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Man Q, Li P, Fan J, Yang S, Xing C, Bai Y, Hu M, Wang B, Zhang K. The prognostic role of pre-treatment neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in esophageal squamous cell carcinoma treated with concurrent chemoradiotherapy. BMC Cancer 2024; 24:464. [PMID: 38616289 PMCID: PMC11017504 DOI: 10.1186/s12885-024-12242-5] [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: 11/30/2023] [Accepted: 04/09/2024] [Indexed: 04/16/2024] Open
Abstract
PURPOSE In this study, we retrospectively investigated the prognostic role of pre-treatment neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) in esophageal squamous cell carcinoma patients (ESCC) treated with concurrent chemo-radiotherapy (CCRT). METHODS We retrospectively analyzed the records of 338 patients with pathologically diagnosed esophageal squamous cell carcinoma that underwent concurrent chemo-radiotherapy from January 2013 to December 2017. Univariate and multivariate analyses were used to identify prognostic factors for progression free survival (PFS) and overall survival (OS). RESULTS The result showed that the thresholds for NLR and PLR were 2.47 and 136.0 by receiver operating characteristic curve. High NLR and PLR were both associated with tumor length (P < 0.05). High NLR and PLR were significantly associated with poor PFS and OS. Multivariate analyses identified NLR, PLR and TNM stage were independent risk factors for PFS and OS. CONCLUSIONS We show that the pre-treatment NLR and PLR may serve as prognostic indicators for esophageal squamous cell carcinoma treated with concurrent chemo-radiotherapy.
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Affiliation(s)
- Qirong Man
- Department of Oncology, Tengzhou Central People's Hospital, Shandong, China
| | - Peishun Li
- Department of Oncology, Tengzhou Central People's Hospital, Shandong, China
| | - Jing Fan
- Department of Oncology, Tengzhou Central People's Hospital, Shandong, China
| | - Sen Yang
- Department of Oncology, Tengzhou Central People's Hospital, Shandong, China
| | - Chao Xing
- Department of Oncology, Tengzhou Central People's Hospital, Shandong, China
| | - Yunling Bai
- Department of Oncology, Tengzhou Central People's Hospital, Shandong, China
| | - Miaomiao Hu
- Department of Oncology, Tengzhou Central People's Hospital, Shandong, China
| | - Baohu Wang
- Department of Oncology, Tengzhou Central People's Hospital, Shandong, China
| | - Kaixian Zhang
- Department of Oncology, Tengzhou Central People's Hospital, Shandong, China.
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Liu CQ, Yu ZB, Gan JX, Mei TM. Preoperative blood markers and intra-abdominal infection after colorectal cancer resection. World J Gastrointest Surg 2024; 16:451-462. [PMID: 38463368 PMCID: PMC10921215 DOI: 10.4240/wjgs.v16.i2.451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 12/16/2023] [Accepted: 01/23/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Colorectal cancer (CRC) has one of the highest morbidity and mortality rates among digestive tract tumors. Intra-abdominal infection (IAI) is a common postoperative complication that affects the clinical outcomes of patients with CRC and hinders their rehabilitation process. However, the factors influencing abdominal infection after CRC surgery remain unclear; further, prediction models are rarely used to analyze preoperative laboratory indicators and postoperative complications. AIM To explore the predictive value of preoperative blood markers for IAI after radical resection of CRC. METHODS The data of 80 patients who underwent radical resection of CRC in the Anorectal Surgery Department of Suzhou Hospital affiliated with Anhui Medical University were analyzed. These patients were categorized into IAI (n = 15) and non-IAI groups (n = 65) based on whether IAI occurred. Influencing factors were compared; general data and laboratory indices of both groups were identified. The relationship between the indicators was assessed. Further, a nomogram prediction model was developed and evaluated; its utility and clinical applicability were assessed. RESULTS The risk factors for IAI after radical resection of CRC were neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and carcinoembryonic antigen (CEA) levels. NLR was correlated with PLR and SII (r = 0.604, 0.925, and 0.305, respectively), while PLR was correlated with SII (r = 0.787). The nomogram prediction model demonstrated an area under the curve of 0.968 [95% confidence interval (CI): 0.948-0.988] in the training set (n = 60) and 0.926 (95%CI: 0.906-0.980) in the validation set (n = 20). The average absolute errors of the calibration curves for the training and validation sets were 0.032 and 0.048, respectively, indicating a good model fit. The decision curve analysis curves demonstrated high net income above the 5% threshold, indicating the clinical practicality of the model. CONCLUSION The nomogram model constructed using NLR, PLR, SII, and CEA levels had good accuracy and reliability in predicting IAI after radical resection of CRC, potentially aiding clinical treatment decision-making.
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Affiliation(s)
- Chang-Qing Liu
- Department of Gastrointestinal Anorectal Surgery, Suzhou Hospital Affiliated to Anhui Medical University, Suzhou 234000, Anhui Province, China
| | - Zhong-Bei Yu
- Department of Gastrointestinal Anorectal Surgery, Suzhou Hospital Affiliated to Anhui Medical University, Suzhou 234000, Anhui Province, China
| | - Jin-Xian Gan
- Department of Gastrointestinal Anorectal Surgery, Suzhou Hospital Affiliated to Anhui Medical University, Suzhou 234000, Anhui Province, China
| | - Tian-Ming Mei
- Department of Gastrointestinal Anorectal Surgery, Suzhou Hospital Affiliated to Anhui Medical University, Suzhou 234000, Anhui Province, China
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Kagansky N, Levy Y, Awar A, Derazne E, Shilovsky A, Kagansky D, Chepelev V, Mazurez E, Stambler I, Levtzion-Korach O. Do Neutrophil-Lymphocyte Ratio and Platelet-Lymphocyte Ratio Need to Be Stratified for Age and Comorbidities in COVID-19 Disease? A Subgroup Analysis of Two Distinct Cohorts over Disease Course. J Clin Med 2024; 13:605. [PMID: 38276111 PMCID: PMC10816969 DOI: 10.3390/jcm13020605] [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: 12/16/2023] [Revised: 01/16/2024] [Accepted: 01/19/2024] [Indexed: 01/27/2024] Open
Abstract
Several studies described neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) as markers of COVID-19 severity. In a recently published study, age and frailty affected NLR and PLR more than disease severity. The study compared two distinct cohorts. The first comprised older frailer patients positive for SARS-CoV-2, with mild or asymptomatic disease, admitted to designated COVID-19 departments in a large geriatric medical center (GMC). The second cohort comprised COVID-19 patients admitted to a large general hospital (GH) for symptomatic disease. This was a follow-up study comparing a subgroup of patients who had NLR and PLR values measured a week after admission. Only 100 of 177 patients in the original GMC cohort had a second NLR test compared to almost all (287 of 289) patients in the general hospital (GH) cohort. The subgroup baseline characteristics did not change significantly from that of the original cohort. Disease symptoms were more prevalent in the GH cohort. In the GMC group, the median second NLR rose from 3.9 to 4.6, while in the GH cohort, the NLR value dropped from 3.5 to 2.8, enhancing the NLR differences between the groups. Smaller changes were observed in the second PLR. These results strengthen the prior results that age and frailty seem to have a stronger impact on NLR and PLR than disease severity.
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Affiliation(s)
- Nadya Kagansky
- School of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
- Shmuel Harofe Geriatric Medical Center, Be’er Ya’akov 70350, Israel
| | - Yochai Levy
- School of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
- Shmuel Harofe Geriatric Medical Center, Be’er Ya’akov 70350, Israel
| | - Anas Awar
- Shmuel Harofe Geriatric Medical Center, Be’er Ya’akov 70350, Israel
| | - Estela Derazne
- School of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | | | | | - Victor Chepelev
- Shmuel Harofe Geriatric Medical Center, Be’er Ya’akov 70350, Israel
| | - Evelina Mazurez
- Shmuel Harofe Geriatric Medical Center, Be’er Ya’akov 70350, Israel
| | - Ilia Stambler
- Shmuel Harofe Geriatric Medical Center, Be’er Ya’akov 70350, Israel
| | - Osnat Levtzion-Korach
- School of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
- Shamir Medical Center, Rishon Le-Zion 70300, Israel
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10
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Yan C, Su C, Ye YF, Liu J. A Linear Regression Equation for Predicting the Residual Volume of Chronic Subdural Hematoma 1 Week After Surgery. Neuropsychiatr Dis Treat 2023; 19:2787-2796. [PMID: 38111595 PMCID: PMC10726707 DOI: 10.2147/ndt.s436127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 12/07/2023] [Indexed: 12/20/2023] Open
Abstract
Objective The outcome of chronic subdural hematoma (CSDH) is influenced not only by the choice of treatment but also by various baseline characteristics. The main objective of this study is to identify the risk factors that can affect the prognosis of CSDH and develop a regression equation based on these risk factors. Methods A total of 212 patients with CSDH were included in the study. We collected clinical data including age, gender, and so on, and radiological data including preoperative hematoma volume (V1), effusion volume 1 day after surgery (V2), gas volume 1 day after surgery (V3), and so on. These were considered independent variables, while residual volume 1 week after surgery (V4) was the dependent variable. Univariate linear regression analysis was performed to identify factors that were significantly related. Subsequently, multivariate linear regression analysis was conducted to determine the relationship between each independent variable and the dependent variable. Multiple linear regression analysis was used to obtain a regression equation predicting V4. Results We have found that age (t = 3.109, P = 0.002), aspirin (t = 2.762, P = 0.006), hemostatic agents (haemocoagulase, t = 3.731, P < 0.001; vitamin K, t = 2.824, P = 0.005 < 0.05), V2 (t = 8.73, P < 0.001), and V3 (t = 5.968, P < 0.001) are significantly associated with V4. Furthermore, we have developed a regression equation that can predict this volume with CSDH. The fit of the model is robust with an R-squared value of 65.2% > 50%. Conclusion Age, aspirin, hemostatic agent, V2, and V3 are significantly associated with V4. We developed a regression equation to predict this volume with CSDH.
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Affiliation(s)
- Chao Yan
- Department of Neurosurgery, the Sixth Affiliated Hospital of Wenzhou Medical University, Lishui, Zhejiang, 323000, People’s Republic of China
| | - Chang Su
- Department of Neurosurgery, the Sixth Affiliated Hospital of Wenzhou Medical University, Lishui, Zhejiang, 323000, People’s Republic of China
| | - Yu-fei Ye
- Department of Neurosurgery, Qingyuan People’s Hospital, Lishui, Zhejiang, 323800, People’s Republic of China
| | - Jin Liu
- Department of Neurosurgery, the Sixth Affiliated Hospital of Wenzhou Medical University, Lishui, Zhejiang, 323000, People’s Republic of China
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11
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Demir M, Demircan NC. The Naples prognostic score in esophagus cancer: Prognostic and beyond. Bull Cancer 2023; 110:1027-1040. [PMID: 37516650 DOI: 10.1016/j.bulcan.2023.06.007] [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: 03/08/2023] [Revised: 05/20/2023] [Accepted: 06/07/2023] [Indexed: 07/31/2023]
Abstract
OBJECTIVES The role of inflammation in tumor biology has been better understood over time. The utility of the Naples prognostic score (NPS), which is a novel inflammation-based marker, was shown in esophageal carcinoma (EC) patients treated with surgery. We herein presented the prognostic and predictive value of NPS in EC patients treated with upfront chemoradiotherapy (CRT). METHODS Adult EC patients with squamous cell carcinoma or adenocarcinoma were included. Median survival was compared by log-rank test. Cox regression analyses were performed to establish the independent prognostic effect of NPS. RESULTS Of 153 patients, 97 (63.4%) and 56 (36.6%) patients were treated with CRT alone and CRT followed by surgery, respectively. The median overall survival (OS) was significantly different among the Naples prognostic groups (NPG) (60+ months [CI 95%: NA], 27 months [CI 95%: 16.8-37.5], and 18.5 months [CI 95%: 15.3-30.7] for NPG 0,1, and 2, respectively; P=0.007). Surgery following CRT provided survival benefit in NPG 1 (65+ months with surgery vs. 17.3 months without surgery, P<0.001) and in NPG 2 (33 months with surgery vs. 15 months without surgery, P=0.009). Multivariate Cox regression analysis showed that the NPS is an independent prognostic marker for OS (HR is 1.28 for OS [CI 95%: 1.03-1.59], P=0.02). CONCLUSION NPS might be useful as a prognostic marker in also EC patients treated with upfront CRT. Patients with high NPS may have a high risk of recurrence. Surgery might be planned in EC at the diagnosis in NPG 1 and 2.
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Affiliation(s)
- Metin Demir
- Erzurum Regional Training and Research Hospital, Department of Medical Oncology, 25100 Erzurum, Turkey.
| | - Nazım Can Demircan
- Erzurum Regional Training and Research Hospital, Department of Medical Oncology, 25100 Erzurum, Turkey.
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12
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Lee SH, Oh JS, Choi YH, Lim JY. Predictive Performance Neutrophil-to-Lymphocyte Ratio of Acute Tonsillitis with Deep Neck Space Infection in Adult Patients. Emerg Med Int 2023; 2023:8456427. [PMID: 37790946 PMCID: PMC10545454 DOI: 10.1155/2023/8456427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 08/08/2023] [Accepted: 09/01/2023] [Indexed: 10/05/2023] Open
Abstract
The aim of this study was to examine the neutrophil-to-lymphocyte ratio (NLR) in patients diagnosed with a deep neck infection (DNI) to identify helpful indicators for the initial differential diagnosis. This study was conducted as a single-center, retrospective cohort study that utilized data from the electronic medical records of patients who visited the emergency department in a tertiary university hospital between February 2018 and April 2022. The study enrolled patients aged ≥18 years who were diagnosed with tonsillitis with or without DNI during the study period. The NLR of patients without DNI was 6.1 ± 5.03, and the NLR of patients with acute tonsillitis with DNI was 8.0 ± 5.67, showing significant differences. The rate of admission in the general wards (GWs) and ICUs was significantly higher in patients with DNI, and the length of hospital stay was also significantly longer in patients with DNI. Older age, male, lower body temperature, C-reactive protein, and NLR were significant independent risk factors for DNI in patients with tonsillitis. The cutoff value for predicting DNI in patients with body temperature <37.5 was 3.09. The NLR of patients with tonsillitis, especially those with normal body temperature, can be used to predict their prognosis.
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Affiliation(s)
- Sun Hwa Lee
- Department of Emergency Medicine, Ewha Womans University Mokdong Medical Center, Ewha Womans University, 911-1 Mokdong, Yangcheon-gu, Seoul 07985, Republic of Korea
| | - Jong Seok Oh
- Seoul National University, Economics, 1 Gwanak-ro, Gwanak-gu, Seoul, Republic of Korea
| | - Yun Hyung Choi
- Department of Emergency Medicine, Ewha Womans University Mokdong Medical Center, Ewha Womans University, 911-1 Mokdong, Yangcheon-gu, Seoul 07985, Republic of Korea
| | - Ji Yeon Lim
- Department of Emergency Medicine, Ewha Womans University Seoul Medical Center, Ewha Womans University, 260, Gonghang-daero, Gangseo-gu, Seoul 07804, Republic of Korea
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13
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Lin CW, Lin PW, Chiu LW, Chai HT, Chang CT, Friedman M, Salapatas AM, Rahavi-Ezabadi S, Lin HC. Inflammatory biomarkers of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in 563 severe OSA patients before and after surgery. J Otolaryngol Head Neck Surg 2023; 52:49. [PMID: 37501207 PMCID: PMC10375829 DOI: 10.1186/s40463-023-00653-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 07/14/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND Evidence has proved that high neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were risk factors for cardiovascular comorbidities. The alterations of NLR and PLR following obstructive sleep apnea (OSA) treatment were under studied and thus should be investigated. This study aimed to evaluate the changes of inflammatory biomarkers including NLR and PLR in severe OSA patients after surgical interventions of the upper airway, and their relationships with improvements in polysomnographic (PSG) parameters. METHODS This retrospective cohort study included 563 consecutive severe OSA patients at a tertiary academic medical center who received OSA surgery, as well as underwent pre- and post-operative polysomnographic (PSG) examinations and blood tests. The changes of major PSG estimates, NLR, and PLR before and at least 3 months after OSA surgery were analyzed using paired t-tests with subgroup analyses. Pearson's correlations were performed to discover which PSG parameter contributed to the improvement of the values. RESULTS After OSA surgery, the major PSG estimates, NLR and PLR dropped significantly in the overall population. In those with a higher preoperative NLR (pre-operative NLR≧3) and PLR (pre-operative PLR≧150), the mean (SD) difference of NLR (- 0.8 [1.6], 95% CI - 1.5 to - 0.2) and PLR (- 41.6 [40], 95% CI - 52.8 to - 30.5) were even more substantial. The changes of the "apnea, longest (r = 0.298, P = .037)" and "hypopnea, longest (r = 0.321, P = .026)" were found significantly related to the improvement of PLR. CONCLUSION NLR and PLR did significantly drop in severe OSA patients following OSA surgery, and this could be related to the alterations of sleep indices. The findings could possess clinical importance for severe OSA patients after OSA surgeries in reducing possible OSA-associated cardiovascular comorbidities.
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Affiliation(s)
- Chung-Wei Lin
- Department of Education, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Pei-Wen Lin
- Division of Glaucoma, Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Sleep Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Li-Wen Chiu
- Department of Education, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Han-Tan Chai
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Chun-Tuan Chang
- Department of Business Management, Institute of Healthcare Management, Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Michael Friedman
- Department of Otolaryngology, Division of Sleep Surgery, Rush University Medical Center, Chicago, IL, USA
- Department of Otolaryngology, Advanced Center for Specialty Care, Advocate Illinois Masonic Medical Center, Chicago, IL, USA
| | - Anna M Salapatas
- Department of Otolaryngology, Advanced Center for Specialty Care, Advocate Illinois Masonic Medical Center, Chicago, IL, USA
| | - Sara Rahavi-Ezabadi
- Otorhinolaryngology Head and Neck Surgery Department, Otorhinolaryngology Research Center, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hsin-Ching Lin
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.
- Sleep Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
- Department of Business Management, Institute of Healthcare Management, Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan.
- Department of Otolaryngology, Robotic Surgery Center and Center for Quality Management, Kaohsiung Chang Gung Memorial Hospital, 123, Ta-Pei Rd., Niao-Sung District, Kaohsiung, 833, Taiwan.
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14
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Levy Y, Derazne E, Shilovsky A, Kagansky D, Derkath A, Chepelev V, Mazurez E, Stambler I, Kagansky N. Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio, are they markers of COVID-19 severity or old age and frailty? A comparison of two distinct cohorts. Front Med (Lausanne) 2023; 10:1222692. [PMID: 37575993 PMCID: PMC10413384 DOI: 10.3389/fmed.2023.1222692] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 06/26/2023] [Indexed: 08/15/2023] Open
Abstract
The neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are simple markers of systemic inflammatory responses. It has been previously suggested that they can predict COVID-19 severity. Age and frailty may also influence their values. This study aimed to evaluate the impact of COVID-19 severity versus age and frailty on NLR and PLR values. This was a retrospective, observational two cohorts' comparative study. The first cohort is comprised of patents positive for SARS-CoV-2, with mild or asymptomatic disease, admitted to designated COVID-19 departments in a large geriatric medical center (GMC). The second included patients with COVID-19 admitted to designated COVID-19 departments in a large general hospital for symptomatic disease from March 2020 to March 2021. We compared baseline characteristics including comorbidities and chronic medications, disease symptoms, laboratory tests and compared the NLR and PLR between the two groups. The 177 patients admitted to the COVID-designated department in the GMC were over three decades older than the 289 COVID-19 patients admitted to the general hospital care (HC). They had substantially more comorbidities and chronic medications. All common disease symptoms were significantly more common in the HC group. Almost two thirds of the GMC patients remained asymptomatic compared to 2.1% in the HC group. Inflammatory markers, such as CRP and LDH, were significantly higher in the HC group. The NLR and PLR were both significantly higher in the GMC cohort comprised of older frailer patients with milder disease. NLR and PLR seem to be affected more by age and frailty than COVID-19 severity.
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Affiliation(s)
- Yochai Levy
- Rabin Medical Center, Beilinson Hospital, Petah-Tikva, Israel
- Sackler School of Medicine, Tel Aviv, Israel
| | | | - Alex Shilovsky
- Shmuel Harofe Geriatric Medical Center, Be'er Ya'akov, Israel
| | | | - Alex Derkath
- Shmuel Harofe Geriatric Medical Center, Be'er Ya'akov, Israel
| | - Victor Chepelev
- Shmuel Harofe Geriatric Medical Center, Be'er Ya'akov, Israel
| | - Evelina Mazurez
- Shmuel Harofe Geriatric Medical Center, Be'er Ya'akov, Israel
| | | | - Nadya Kagansky
- Sackler School of Medicine, Tel Aviv, Israel
- Shmuel Harofe Geriatric Medical Center, Be'er Ya'akov, Israel
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15
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Li N, Gao L, Ge Y, Zhao L, Bai C, Wang Y. Prognostic and predictive significance of circulating biomarkers in patients with advanced upper gastrointestinal cancer undergoing systemic chemotherapy. Front Oncol 2023; 13:1195848. [PMID: 37346066 PMCID: PMC10280739 DOI: 10.3389/fonc.2023.1195848] [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: 03/29/2023] [Accepted: 05/09/2023] [Indexed: 06/23/2023] Open
Abstract
Objective The prognosis of patients with advanced cancers of the upper gastrointestinal (UGI) tract is poor. Systemic chemotherapy forms the basis for their treatment, with limited efficacy. Biomarkers have been introduced into clinical practice for cancer management. This study aimed to investigate the predictive and prognostic values of circulating biomarkers in patients with advanced esophageal and gastric cancers receiving chemotherapy. Design Overall, 92 patients with advanced esophageal squamous cell carcinoma (ESCC; n = 38) and gastric adenocarcinoma (GAC; n = 54) were enrolled. We analyzed the association of circulating lymphocyte subsets, inflammatory markers, and blood cell counts with treatment efficacy and patient survival. Results Significant differences were identified in peripheral blood parameters between the groups with different clinicopathological features. Hemoglobin (Hb, p = 0.014), eosinophil counts (p = 0.028), CD4+CD28+T/CD4+T percentage (p = 0.049), CD8+CD38+T/CD8+T percentage (p = 0.044), memory CD4+T (p = 0.007), and CD4+CD28+T (p = 0.007) were determined as predictors for achieving non-PD (progression disease) in the ESCC cohort. High levels of eosinophils (p = 0.030) and memory CD4+T cells (p = 0.026) and high eosinophil-to-lymphocyte ratio (ELR, p = 0.013) were predictors of non-PD in patients with GAC. The combined detection models exhibited good ability to distinguish between partial response (PR)/non-PR and PD/non-PD in patients with ESCC and GAC, respectively. Using the multivariate Cox model, the Eastern Cooperative Oncology Group (ECOG) score status (hazard ratio [HR]: 4.818, 95% confidence intervals [CI]: 2.076-11.184, p < 0.001) and eosinophil count (HR: 0.276, 95% CI: 0.120-0.636, p = 0.003) were independent prognostic factors of progression-free survival (PFS) in patients with ESCC. Metastatic sites (HR: 2.092, 95% CI: 1.307-3.351, p = 0.002) and eosinophil-to-lymphocyte ratio (ELR; HR: 0.379, 95% CI: 0.161-0.893, p = 0.027) were independent prognostic factors for overall survival (OS) in patients with ESCC. Differentiation (HR: 0.041, 95% CI: 0.200-0.803, p = 0.010), memory CD4+T (HR: 0.304, 95% CI: 0.137-0.675, p = 0.003), NK cells (HR: 2.302, 95% CI: 1.044-3.953, p = 0.037), and C-reactive protein-to-lymphocyte ratio (CLR; HR: 2.070, 95% CI: 1.024-4.186, p = 0.043) were independent prognostic factors for PFS in patients with GAC. Total lymphocyte counts (HR: 0.260, 95% CI: 0.086-0.783, p = 0.017), CD8+T (HR: 0.405, 95% CI: 0.165-0.997, p = 0.049), NK cells (HR: 3.395, 95% CI: 1.592-7.238, p = 0.002), and monocyte-to-lymphocyte ratio (MLR; HR: 3.076, 95% CI: 1.488-6.360, p = 0.002) were identified as independent prognostic factors associated with OS of GAC. Conclusion Lymphocyte subsets, blood cell counts, and inflammatory parameters may predict the chemotherapeutic response and prognosis in ESCC and GAC. A combination of these markers can be used to stratify patients into risk groups, which could improve treatment strategies.
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Affiliation(s)
- Ningning Li
- Department of Medical Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Liwei Gao
- Department of Radiation Oncology, China-Japan Friendship Hospital, Beijing, China
| | - Yuping Ge
- Department of Medical Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lin Zhao
- Department of Medical Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Chunmei Bai
- Department of Medical Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yingyi Wang
- Department of Medical Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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16
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Qi W, Wang X, Li C, Li S, Li H, Xu F, Chen J, Zhao S, Li H. Pretreatment absolute lymphocyte count is an independent predictor for survival outcomes for esophageal squamous cell carcinoma patients treated with neoadjuvant chemoradiotherapy and pembrolizumab: An analysis from a prospective cohort. Thorac Cancer 2023; 14:1556-1566. [PMID: 37089116 PMCID: PMC10260499 DOI: 10.1111/1759-7714.14898] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/30/2023] [Accepted: 04/02/2023] [Indexed: 04/25/2023] Open
Abstract
BACKGROUND The aim of the study was to analyze the relationship between pretreatment inflammatory biomarkers (IBs) and survival outcomes for patients with esophageal squamous cell carcinoma (ESCC) treated with neoadjuvant chemoradiotherapy (neo-CRT) and pembrolizumab. METHODS Clinical variables and IBs (absolute monocyte count [AMC], absolute lymphocyte count [ALC], platelet count [PLT], neutrophil-to-lymphocyte ratio [NLR], platelet-to-lymphocyte ratio [PLR], lymphocyte-to-monocyte ratio [LMR], pan-immune inflammation value [PIV], systemic immunoinflammatory index [SII], systemic immunoreactivity index [SIRI] and prognostic nutritional index [PNI]) were collected. Univariate and multivariate analysis were performed to identify the independent factors for outcomes of ESCC. RESULTS A total of 51 patients were included. Of these, 35 patients achieved pathological complete response (pCR) after neo-CRT and pembrolizumab (pCR: 68.6%). With a median follow-up of 20 months, the two-year PFS and OS of the cohort was 64% and 91%, respectively. Multivariate logistic regression analysis indicated that ALC (overall response [OR] 4.4, p = 0.051) and PLT (OR 6.7, p = 0.023) were two independent predictors for achieving pCR among ESCC treated with neo-CRT and pembrolizumab. Multivariate Cox regression analysis showed that ALC (HR 0.27, p = 0.028) and SIRI (HR 3.13, p = 0.048) were two independent predictors associated with PFS. Kaplan Meier analysis demonstrated that the PFS of ESCC with high baseline ALC was significantly better than those with low ALC (2-year PFS: 77% vs. 47%, p = 0.027), but not for overall survival (2-year OS: 96% vs. 87%, p = 0.46). CONCLUSIONS This retrospective analysis based on a prospective cohort for the first time demonstrates that pretreatment ALC is an independent predictor for achieving pCR and favorable outcomes of ESCC treated with neo-CRT and pembrolizumab.
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Affiliation(s)
- Wei‐Xiang Qi
- Department of Radiation Oncology, Ruijin HospitalShanghai Jiaotong University School of MedicineShanghaiChina
| | - Xiaoyan Wang
- Department of Radiation OncologyThe Third Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina
| | - Chengqiang Li
- Department of Thoracic Surgery, Ruijin HospitalShanghai Jiaotong University School of MedicineShanghaiChina
| | - Shuyan Li
- Department of Radiation Oncology, Ruijin HospitalShanghai Jiaotong University School of MedicineShanghaiChina
| | - Huan Li
- Department of Radiation Oncology, Ruijin HospitalShanghai Jiaotong University School of MedicineShanghaiChina
| | - Feifei Xu
- Department of Radiation Oncology, Ruijin HospitalShanghai Jiaotong University School of MedicineShanghaiChina
| | - Jiayi Chen
- Department of Radiation Oncology, Ruijin HospitalShanghai Jiaotong University School of MedicineShanghaiChina
| | - Shengguang Zhao
- Department of Radiation Oncology, Ruijin HospitalShanghai Jiaotong University School of MedicineShanghaiChina
| | - Hecheng Li
- Department of Radiation OncologyThe Third Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina
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17
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Toya Y, Shimada T, Hamada K, Watanabe K, Nakamura J, Fukushi D, Hatta W, Shinkai H, Ito H, Matsuhashi T, Fujimori S, Iwai W, Hanabata N, Shiroki T, Sasaki Y, Fujishima Y, Tsuji T, Yorozu H, Yoshimura T, Horikawa Y, Takahashi Y, Takahashi H, Kondo Y, Fujiwara T, Mizugai H, Gonai T, Tatsuta T, Onochi K, Kudara N, Abe K, Ohira T, Horikawa Y, Ishihata R, Hikichi T, Satoh K, Takahashi F, Masamune A, Iijima K, Fukuda S, Matsumoto T. Prediction model of 3-year survival after endoscopic submucosal dissection for early gastric cancer in elderly patients aged ≥ 85 years: EGC-2 model. J Cancer Res Clin Oncol 2023; 149:1521-1530. [PMID: 35546359 DOI: 10.1007/s00432-022-04024-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 04/11/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE Little is known about the prognostic factors for survival after endoscopic submucosal dissection (ESD) in elderly patients with early gastric cancer (EGC). The aim of this study is to determine prognostic factors and a prediction model of 3-year survival after ESD for EGC in patients aged ≥ 85 years. METHODS We retrospectively evaluated the clinical outcomes of 740 patients with EGC aged ≥ 85 years, who were treated by ESD at 30 institutions in Japan. Overall survival (OS) and disease-specific survival (DSS) were calculated with the Kaplan-Meier method. Prediction models for 3-year OS after ESD were estimated using the Cox proportional hazards model based on Uno's C-statistics. RESULTS During the follow-up period, 309 patients died of any cause and 10 patients died of gastric cancer. OS and DSS after 3 years were 82.7% and 99.2%, respectively. No significant differences in OS were found among curability categories. The Cox proportional hazards model revealed the geriatric nutritional risk index (GNRI) and the Charlson comorbidity index (CCI) to be predictors of 3-year survival. We established a final model (EGC-2 model) expressed by GNRI - (2.2×CCI) with a cutoff value of 96. The overall survival rate was significantly lower in the model value < 96 group than in the model value ≥ 96 group (P < 0.001). CONCLUSIONS The prediction model using GNRI and CCI will be useful to support decision-making for the treatment of EGC in elderly patients aged ≥ 85 years.
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Affiliation(s)
- Yosuke Toya
- Division of Gastroenterology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Idaidori 1-1-1, Yahaba, 028-3694, Japan.
| | - Tomohiro Shimada
- Department of Gastroenterology, Sendai City Medical Center, Sendai, Japan
| | - Koichi Hamada
- Department of Minimally Invasive Surgical and Medical Oncology, Fukushima Medical University, Fukushima, Japan
| | - Ko Watanabe
- Department of Gastroenterology, Ohara General Hospital, Fukushima, Japan
| | - Jun Nakamura
- Department of Endoscopy, Fukushima Medical University Hospital, Fukushima, Japan
| | - Daisuke Fukushi
- Division of Gastroenterology, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Waku Hatta
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hirohiko Shinkai
- Department of Gastroenterology, Iwate Prefectural Isawa Hospital, Oshu, Japan
| | - Hirotaka Ito
- Department of Gastroenterology, Osaki Citizen Hospital, Osaki, Japan
| | - Tamotsu Matsuhashi
- Department of Gastroenterology and Neurology, Akita University Graduate School of Medicine, Akita, Japan
| | - Shusei Fujimori
- Department of Gastroenterology, Yokote Municipal Hospital, Yokote, Japan
| | - Wataru Iwai
- Department of Gastroenterology, Miyagi Cancer Center, Natori, Japan
| | - Norihiro Hanabata
- Division of Endoscopy, Aomori Prefectural Central Hospital, Aomori, Japan
| | - Takeharu Shiroki
- Department of Gastroenterology, Iwate Prefectural Central Hospital, Morioka, Japan
| | - Yu Sasaki
- Department of Gastroenterology, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Yuukou Fujishima
- Division of Gastroenterology, Noshiro Kosei Medical Center, Noshiro, Japan
| | - Tsuyotoshi Tsuji
- Department of Gastroenterology, Akita City Hospital, Akita, Japan
| | - Haruka Yorozu
- Digestive Disease Center, Akita Red Cross Hospital, Akita, Japan
| | | | - Yohei Horikawa
- Department of Gastroenterology, Hiraka General Hospital, Yokote, Japan
| | - Yasushi Takahashi
- Department of Gastroenterology, National Hospital Organization Sendai Medical Center, Sendai, Japan
| | - Hiroshi Takahashi
- Department of Gastroenterology, Iwate Prefectural Ninohe Hospital, Ninohe, Japan
| | - Yutaka Kondo
- Division of Gastroenterology, Tohoku Rosai Hospital, Sendai, Japan
| | - Takao Fujiwara
- Department of Gastroenterology, Japanese Red Cross Morioka Hospital, Morioka, Japan
| | - Hisata Mizugai
- Department of Gastroenterology, Hachinohe Red Cross Hospital, Hachinohe, Japan
| | - Takahiro Gonai
- Department of Gastroenterology, Iwate Prefectural Kuji Hospital, Kuji, Japan
| | - Tetsuya Tatsuta
- Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Kengo Onochi
- Department of Gastroenterology, Omagari Kosei Medical Center, Daisen, Japan
| | - Norihiko Kudara
- Department of Internal Medicine and Gastroenterology, Iwate Prefectural Ofunato Hospital, Ofunato, Japan
| | - Keinosuke Abe
- Department of Gastroenterology, Iwate Prefectural Miyako Hospital, Miyako, Japan
| | - Tetsuya Ohira
- Department of Gastroenterology, Sendai City Medical Center, Sendai, Japan
| | - Yoshinori Horikawa
- Department of Gastroenterology, Southern-Tohoku General Hospital, Fukushima, Japan
| | - Ryoichi Ishihata
- Department of Gastroenterology, Ohara General Hospital, Fukushima, Japan
| | - Takuto Hikichi
- Department of Endoscopy, Fukushima Medical University Hospital, Fukushima, Japan
| | - Kennichi Satoh
- Division of Gastroenterology, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Fumiaki Takahashi
- Division of Medical Engineering, Department of Information Science, School of Medicine, Iwate Medical University, Yahaba, Japan
| | - Atsushi Masamune
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Katsunori Iijima
- Department of Gastroenterology and Neurology, Akita University Graduate School of Medicine, Akita, Japan
| | - Shinsaku Fukuda
- Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Takayuki Matsumoto
- Division of Gastroenterology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Idaidori 1-1-1, Yahaba, 028-3694, Japan
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Elevated platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio in patients with polymyositis/dermatomyositis: a retrospective study. Clin Rheumatol 2023; 42:1615-1624. [PMID: 36781682 DOI: 10.1007/s10067-023-06542-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 01/25/2023] [Accepted: 02/05/2023] [Indexed: 02/15/2023]
Abstract
OBJECTIVES This study aimed to examine the diagnostic and prognostic value of the platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) in patients with polymyositis/dermatomyositis (PM/DM). METHOD Clinical data of 200 patients with PM/DM and 204 healthy controls were retrospectively reviewed. We examined whether the PLR and NLR were associated with PM/DM. RESULTS The PLR and NLR were higher in patients with PM/DM than in controls (both P < 0.001). The PLR and NLR were higher in patients with DM than in those with PM (both P < 0.01). The PLR was higher in the anti-melanoma differentiation-associated protein-5 (anti-MDA5) + PM/DM group than in the anti-MDA5- PM/DM group (P = 0.002). The NLR in non-survivors was higher than that in survivors (P = 0.01). The NLR was positively correlated with the occurrence of interstitial lung disease (ILD). The PLR and NLR were independent predictors of PM/DM, as well as risk factors (both P < 0.001). Moreover, the NLR had a predictive value for PM/DM-ILD and was closely related to mortality (P = 0.033, P = 0.003, respectively). CONCLUSIONS Patients with PM/DM have a higher NLR and PLR than healthy controls, especially in those with anti-MDA5+. The PLR and NLR are independent risk factors for PM/DM and have some predictive value. The NLR is correlated with ILD and associated with an increased risk of mortality in patients with PM/DM. The NLR and PLR may be simple, economical, and accurate diagnostic and prognostic markers for patients with PM/DM. Key points • The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been studied in numerous inflammatory diseases as potential markers, but their clinical significance in polymyositis/dermatomyositis (PM/DM) remains unclear. • We examined the changes in the NLR and PLR between patients with PM/DM and healthy controls, as well as their association with mortality, interstitial lung disease, and anti-melanoma differentiation-associated protein-5. • Patients with PM/DM may benefit from using the NLR and PLR as simple, economical, and accurate diagnostic and prognostic markers.
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Wen H, Yu H. Correlation analysis of carotid plaque in young patients with newly diagnosed type 2 diabetes and platelet-to-lymphocyte ratio and neutrophil-lymphocyte ratio. Vascular 2023; 31:90-97. [PMID: 35085053 DOI: 10.1177/17085381211052362] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Platelet-to-lymphocyte ratio (PLR) and neutrophil-lymphocyte ratio (NLR) have been reported to be related to atherosclerosis. The relationship between PLR, NLR, and carotid atherosclerotic plaque in young patients with newly diagnosed type 2 diabetes has not been clinically reported. This study aimed to analyze the relationship between PLR, NLR, and carotid plaques in young patients with newly diagnosed type 2 diabetes. METHOD The total 268 patients were divided into the intima-media-thickening (IMT) group (116 cases) and plaque group (152 cases). The plaque group was divided into grade I (62 cases), grade II (47 cases), and grade III groups (43 cases). The counts of platelets, neutrophils, and lymphocytes were determined. RESULTS The diagnostic effect of PLR and NLR was evaluated by the receiver-operating characteristic curve (ROC) and areas under the curve (AUC). The PLR and NLR values in the observation group were higher than those in the control group; these two values in the plaque group were also higher than those in the IMT group. The two values in the grade III plaque group were higher than those in grade II. The values in the grade II plaque group were also higher than those in the grade I plaque group. The ROC of PLR and NLR were 0.722 and 0.653, and the AUC of PLR and NLR were 111.086 and 2.240. PLR yielded a sensitivity of 0.789 and a specificity of 0.612. Neutrophil-lymphocyte ratio yielded a sensitivity of 0.809 and a specificity of 0.511. CONCLUSION The PLR and NLR may be related to carotid inflammation in patients and positively correlated with carotid plaque.
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Affiliation(s)
- Huijun Wen
- Department of Neurology, Baoji Municipal Central Hospital, Baoji, Shaanxi, P.R. China
| | - Hai Yu
- Department of Neurology, Baoji Municipal Central Hospital, Baoji, Shaanxi, P.R. China
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Erge E, Kiziltunc C, Balci SB, Atak Tel BM, Bilgin S, Duman TT, Aktas G. A Novel Inflammatory Marker for the Diagnosis of Hashimoto's Thyroiditis: Platelet-Count-to-Lymphocyte-Count Ratio. Diseases 2023; 11:diseases11010015. [PMID: 36810529 PMCID: PMC9944872 DOI: 10.3390/diseases11010015] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/19/2023] [Accepted: 01/20/2023] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Hashimoto's thyroiditis (HT) is a chronic autoimmune thyroiditis that causes systemic inflammation in the body, leading to hypothyroidism and an enlargement of the thyroid gland. OBJECTIVES This study aims to reveal whether there is a relationship between Hashimoto's thyroiditis and the platelet-count-to-lymphocyte-count ratio (PLR), which is used as a new inflammatory marker. METHODS In this retrospective study, we compared the PLR of the euthyroid HT group and the hypothyroid-thyrotoxic HT group to the controls. We also evaluated the values of thyroid-stimulating hormone (TSH), free T4 (fT4), C-reactive protein (CRP), aspartate transaminase (AST), alanine transaminase (ALT), white blood cell count, lymphocyte count, hemoglobin, hematocrit, and platelet count in each group. RESULTS The PLR of the subjects with Hashimoto's thyroiditis was found to be significantly different from the control group (p < 0.001), with the rankings as follows: hypothyroid-thyrotoxic HT 177% (72-417) > euthyroid HT 137% (69-272) > control group 103% (44-243). In addition to the increased PLR values, an increase in CRP values was also observed, revealing a strong positive correlation between the PLR and CRP in the HT patients. CONCLUSION In this study, we found out that the PLR was higher in the hypothyroid-thyrotoxic HT and euthyroid HT patients than in a healthy control group.
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Liu J, Wang Z, Liu G, Liu Z, Lu H, Ji S. Assessment of Naples prognostic score in predicting survival for small cell lung cancer patients treated with chemoradiotherapy. Ann Med 2023; 55:2242254. [PMID: 37552770 PMCID: PMC10411310 DOI: 10.1080/07853890.2023.2242254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 05/08/2023] [Accepted: 07/24/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUNDS The Naples prognosis score (NPS) is a novel prognostic biomarker-based immune and nutritional status and that can be used to evaluate prognosis. Our study aimed to investigate the prognostic role of NPS in SCLC patients. METHODS Patients treated with chemoradiotherapy were retrospectively analyzed between June 2012 and August 2017. We divided patients into three groups depending on the NPS: group 0, n = 31; group 1, n = 100; and group 2, n = 48, and associations between clinical characteristics and NPS group were analyzed. The univariable and multivariable Cox analyses were used to evaluate the prognostic value of clinicopathological characteristics and laboratory indicators for overall survival (OS) and progression-free survival (PFS). RESULTS Data from 179 patients were analyzed. Treatment modality (p < 0.001) and serum CEA (p = 0.03) were significantly different among the NPS groups. The age, sex, smoking status, KPS, Karnofsky performance score (KPS), disease extent, and number of metastatic sites were not correlated with NPS (all p > 0.05). KPS, disease extent, prophylactic cranial irradiation, treatment response and NPS Group were associated with OS. In addition, KPS, disease extent, prophylactic cranial irradiation, treatment response and NPS Group were associated with PFS. Multivariate analysis results showed that NPS was identified as an independent prognostic factor for OS (Group 1: hazard ratio [HR] = 2.704, 95% confidence interval [CI] = 1.403-5.210; p = 0.003; Group 2: HR = 5.154, 95% CI = 2.614-10.166; p < 0.001) and PFS (Group 1: HR = 2.018, 95% CI = 1.014-4.014; p = 0.045; Group 2: HR = 3.339, 95% CI = 1.650-6.756; p = 0.001). CONCLUSIONS NPS is related to clinical outcomes in patients with SCLC.
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Affiliation(s)
- Jiafeng Liu
- Department of Radiotherapy & Oncology, Rizhao Central Hospital, Rizhao, China
| | - Zuosheng Wang
- Department of Radiotherapy & Oncology, Rizhao Central Hospital, Rizhao, China
| | - Guibao Liu
- Department of Radiotherapy & Oncology, Rizhao Central Hospital, Rizhao, China
| | - Zhengcao Liu
- Department of Radiotherapy & Oncology, The affiliated Suzhou Hospital of Nanjing Medical University, Gusu School, Nanjing Medical University, Suzhou, China
| | - Huiling Lu
- Department of Radiotherapy & Oncology, The affiliated Suzhou Hospital of Nanjing Medical University, Gusu School, Nanjing Medical University, Suzhou, China
| | - Shengjun Ji
- Department of Radiotherapy & Oncology, The affiliated Suzhou Hospital of Nanjing Medical University, Gusu School, Nanjing Medical University, Suzhou, China
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Xie T, Hou D, Wang J, Zhao S. Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio as predictive markers in hepatoblastoma. Front Pediatr 2023; 11:904730. [PMID: 37124183 PMCID: PMC10130377 DOI: 10.3389/fped.2023.904730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 03/24/2023] [Indexed: 05/02/2023] Open
Abstract
Background The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been presented to be a prognostic indicator in several cancers. We were supposed to evaluate the prognostic role of such inflammatory markers in hepatoblastoma (HB). Methods Total of 101 children, diagnosed with hepatoblastoma between January 2010 and January 2018, were enrolled before treatment in the study. The clinicopathological parameters, and outcomes were collected through laboratory analyses and patient follow-up. The association between NLR, PLR, and clinicopathological characters were analyzed with Wilcoxon test, Chi-Squared test, Kaplan-Meier, Log-rank and Cox regression analyses. Results NLR and PLR were significantly elevated in HB patients (P < 0.001), and related to age (P < 0.001), risk stratification system (P < 0.001), and pretreatment extent of disease (P < 0.0001). NLR was significantly related to alpha-fetoprotein (P = 0.034) and lactate dehydrogenase (P = 0.026). The 3-year overall survival (OS) and event-free survival (EFS) were poor in the high-NLR group (OS: 44.3% vs. 90.3%, P < 0.0001, EFS: 38.6% vs. 80.6%, P = 0.0001). The 3-year OS and EFS were poor in the high-PLR group (OS: 49.1% vs. 68.8%, P = 0.016, EFS: 39.6% vs. 64.6%, P = 0.0117). The multivariate analysis suggested that NLR (HR: 11.359, 95% CI: 1.218-105.947; P = 0.033) and risk stratification (HR: 44.905, 95% CI: 2.458-820.36; P = 0.01), were independent predictors of OS. Conclusion Our research showed that elevated NLR and PLR were the poor prognostic factors in HB patients before treatment. The NLR was an independent prognostic factor for OS.
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Affiliation(s)
- Tan Xie
- Pediatric Surgery Department, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Dongliang Hou
- Pediatric Surgery, Henan Children's Hospital, Zhengzhou, China
| | - Jiaxiang Wang
- Pediatric Surgery Department, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Correspondence: Jiaxiang Wang Song Zhao
| | - Song Zhao
- Thoracic Surgery Department, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Correspondence: Jiaxiang Wang Song Zhao
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Mikami T, Funayama A, Niimi K, Haga K, Kawaharada M, Nakamura A, Katagiri W, Kobayashi T. Prognostic value of preoperative systemic inflammatory response as a prognostic indicator in patients with early-stage oral squamous cell carcinoma. Medicine (Baltimore) 2022; 101:e30855. [PMID: 36343034 PMCID: PMC9646510 DOI: 10.1097/md.0000000000030855] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
To determine the usefulness of lymphocyte-to-monocyte ratio (LMR), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and inflammatory response biomarker (IRB) score for predicting disease-specific survival and delayed cervical lymph node metastasis in early-stage oral squamous cell carcinoma (OSCC). We retrospectively analyzed 72 patients with early-stage OSCC. Receiver operating characteristic curve analysis was used to determine the cutoff values for LMR, NLR, and PLR. IRB score was determined as follows: high LMR, high NLR, and low PLR, which were each rated as 1. These scores were added to obtain IRB score (range: 0-3). From univariate analysis, gender, poor mode of invasion, and high IRB score were identified as significant risk factors for disease-specific survival. However, there were no independent factors for poor prognosis in multivariate analysis. On the other hand, for delayed cervical lymph node metastasis, poor mode of invasion, low LMR, high NLR, high PLR, and high IRB score were identified as significant risk factors from univariate analysis, and in multivariate analysis, poor mode of invasion and high IRB score were confirmed as independent risk factors. IRB score and mode of invasion are potentially independent risk factors for delayed cervical lymph node metastasis in early-stage OSCC.
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Affiliation(s)
- Toshihiko Mikami
- Division of Reconstructive Surgery for Oral and Maxillofacial Region, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
- Department of Dentistry and Oral Surgery, Niigata Medical Center, Niigata, Japan
| | - Akinori Funayama
- Division of Reconstructive Surgery for Oral and Maxillofacial Region, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
- *Correspondence: Akinori Funayama, Division of Reconstructive Surgery for Oral and Maxillofacial Region, Faculty of Dentistry & Graduate School of Medical and Dental sciences, Niigata University, 2-5274 Gakkocho-Dori, Chuo-ku, Niigata 951-8514, Japan (e-mail: )
| | - Kanae Niimi
- Division of Reconstructive Surgery for Oral and Maxillofacial Region, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Kenta Haga
- Division of Reconstructive Surgery for Oral and Maxillofacial Region, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Masami Kawaharada
- Division of Reconstructive Surgery for Oral and Maxillofacial Region, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Akihiko Nakamura
- Division of Reconstructive Surgery for Oral and Maxillofacial Region, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Wataru Katagiri
- Department of Oral and Maxillofacial Surgery, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Tadaharu Kobayashi
- Division of Reconstructive Surgery for Oral and Maxillofacial Region, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
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Pretreatment platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio as a predictor of pathological complete response to neoadjuvant chemotherapy in patients with breast cancer: single center experience from Turkey. Anticancer Drugs 2022; 33:1150-1155. [DOI: 10.1097/cad.0000000000001389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Prognostic Abilities of Pre- and Post-Treatment Inflammatory Markers in Oral Squamous Cell Carcinoma: Stepwise Modelling. Medicina (B Aires) 2022; 58:medicina58101426. [PMID: 36295584 PMCID: PMC9606996 DOI: 10.3390/medicina58101426] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/01/2022] [Accepted: 10/05/2022] [Indexed: 11/16/2022] Open
Abstract
Background and Objectives: Studies examining the importance of inflammatory markers before treatment as prognosticators of OSCC are available, but information on post-therapy inflammatory markers and their prognostic significance is limited. This study aimed to evaluate the prognostic abilities of pre- and post-treatment inflammatory markers in patients with OSCC. Materials and Methods: In this retrospective analysis, information on 151 OSCC patients’ socio-demographic, clinico-pathological, recurrence, metastasis, and survival data were gathered from clinical records. A multivariable Cox proportional hazards regression (stepwise model) was conducted to identify the prognostic predictors of OS and DFS. The multivariable models’ performances were evaluated using Harrell’s concordance statistics. Results: For OS, high pre-treatment LMR (HR 3.06, 95%CI 1.56, 5.99), and high post-treatment PLC (HR 3.35, 95%CI 1.71, 6.54) and PLR (HR 5.26, 95%CI 2.62, 10.58) were indicative of a poor prognosis. For DFS, high pre-treatment SII (HR 2.59, 95%CI 1.50, 4.48) and high post-treatment PLC (HR 1.92, 95%CI 1.11, 3.32) and PLR (HR 3.44, 95%CI 1.98, 5.07) were associated with increased mortality. The fitness of the OS and DFS stepwise Cox regression models were proven with a time-dependent AUC of 0.8787 and 0.8502, respectively. Conclusions: High pre-treatment levels of LMR and SII and high post-treatment levels of PLC and PLR are independent predictors of a poor prognosis for patients with OSCC.
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Chen W, Li D, Bian X, Wu Y, Xu M, Wu M, Tao M. Peripheral Blood Markers Predictive of Progression-Free Survival in Advanced Esophageal Squamous Cell Carcinoma Patients Treated With PD-1 Inhibitors Plus Chemotherapy as First-Line Therapy. Nutr Cancer 2022; 75:207-218. [PMID: 36190755 DOI: 10.1080/01635581.2022.2123533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Aim: To determine the prognostic value of peripheral blood markers in advanced esophageal squamous cell carcinoma (ESCC) patients receiving programmed cell death protein 1 inhibitors plus chemotherapy as first-line therapy. Methods: A retrospective analysis of 54 patients with advanced ESCC was performed to assess 12 blood markers involving inflammation, nutrition, and tumor burden. Analysis of variance or Kruskal-Wallis tests were used to explore the difference in markers among different response to therapy. Survival curves were constructed using the Kaplan-Meier method. Multivariate Cox models were applied to identify independent predictors of outcome. Results: Patients who achieved response had significantly higher prealbumin, increased BMI, and lower hs-CRP levels at baseline compared with those who experienced disease progression. In the univariate analysis, ALI > 23.55, PNI > 45.175, NLR ≤ 5, and hs-CRP ≤ 6.7 mg/L were significantly associated with a better progression-free survival. Cox regression analysis revealed that ALI >23.55 (P = 0.037) and hs-CRP ≤6.7 mg/L (P = 0.043) were independently associated with superior PFS. Increased tumor abnormal protein (TAP) levels post two cycles was significantly associated with a worse prognosis (P = 0.004). Conclusions: A baseline signature of low ALI and high hs-CRP as well as an early increase in TAP in ESCC appear to be predictive of inferior PFS.
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Affiliation(s)
- Wei Chen
- Department of Oncology, the First Affiliated Hospital of Soochow University, Suzhou, China
| | - Dapeng Li
- Department of Oncology, the First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xuyu Bian
- Department of Oncology, the First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yan Wu
- Department of Oncology, the First Affiliated Hospital of Soochow University, Suzhou, China
| | - Mengdan Xu
- Department of Oncology, the First Affiliated Hospital of Soochow University, Suzhou, China
| | - Mengyao Wu
- Department of Oncology, the First Affiliated Hospital of Soochow University, Suzhou, China
| | - Min Tao
- Department of Oncology, the First Affiliated Hospital of Soochow University, Suzhou, China.,Department of Oncology, DuShu Lake Hospital Affiliated to Soochow University, Suzhou, China
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Fan Y, Wu D, Zhang X, Jiang W, Nie M, Liu X, Xiang T, Liu M, Chen Y, Feng D, Huang J, Gao C, Jiang R. The inflammatory cellular feature in the peripheral blood of chronic subdural hematoma patients. J Clin Lab Anal 2022; 36:e24706. [PMID: 36114782 PMCID: PMC9551118 DOI: 10.1002/jcla.24706] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 08/17/2022] [Accepted: 09/08/2022] [Indexed: 11/06/2022] Open
Abstract
Background Chronic subdural hematoma (CSDH) is a common neurosurgical disease with an increasing incidence. The absorption route of CSDH is not clear. Whether inflammatory factors enter the peripheral blood and cause systemic reactions is unknown. Methods We screened 105 CSDH patients and 105 control individuals. Their clinical characteristics and blood routine results were collected and compared. The blood routine changes of CSDH patients before and after treatment were compared. Age‐stratified analysis was performed due to age may affect the inflammatory markers. Results The white blood cell count, absolute neutrophil count, neutrophil percentage, neutrophil‐lymphocyte count ratio (NLR), and platelet to lymphocyte count ratio (PLR) of CSDH patients before treatment were within the normal range, while were significantly higher than the control individuals (p < 0.001). The absolute lymphocyte count and lymphocyte percentage of control individuals were higher than those of patients (p < 0.001). The inflammatory cells in patients of different age groups were similar. After the patient was cured, the white blood cell count, the absolute value and percentage of neutrophils decreased (p < 0.05), while the number of monocytes increased. Conclusions CSDH caused slight systemic inflammatory responses in the peripheral blood, implying that there is a non‐hematologic route for the absorption of hematoma.
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Affiliation(s)
- Yibing Fan
- Department of Neurosurgery Tianjin Medical University General Hospital Tianjin China
- Key Laboratory of Post‐Neuroinjury Neuro‐Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City Tianjin Neurological Institute Tianjin China
| | - Di Wu
- Department of Neurosurgery Tianjin Medical University General Hospital Tianjin China
- Key Laboratory of Post‐Neuroinjury Neuro‐Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City Tianjin Neurological Institute Tianjin China
| | - Xinjie Zhang
- Department of Neurosurgery Tianjin Medical University General Hospital Tianjin China
- Key Laboratory of Post‐Neuroinjury Neuro‐Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City Tianjin Neurological Institute Tianjin China
| | - Weiwei Jiang
- Department of Neurosurgery Tianjin Medical University General Hospital Tianjin China
- Key Laboratory of Post‐Neuroinjury Neuro‐Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City Tianjin Neurological Institute Tianjin China
| | - Meng Nie
- Department of Neurosurgery Tianjin Medical University General Hospital Tianjin China
- Key Laboratory of Post‐Neuroinjury Neuro‐Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City Tianjin Neurological Institute Tianjin China
| | - Xuanhui Liu
- Department of Neurosurgery Tianjin Medical University General Hospital Tianjin China
- Key Laboratory of Post‐Neuroinjury Neuro‐Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City Tianjin Neurological Institute Tianjin China
| | - Tangtang Xiang
- Department of Neurosurgery Tianjin Medical University General Hospital Tianjin China
- Key Laboratory of Post‐Neuroinjury Neuro‐Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City Tianjin Neurological Institute Tianjin China
| | - Mingqi Liu
- Department of Neurosurgery Tianjin Medical University General Hospital Tianjin China
- Key Laboratory of Post‐Neuroinjury Neuro‐Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City Tianjin Neurological Institute Tianjin China
| | - Yupeng Chen
- Department of Neurosurgery Tianjin Medical University General Hospital Tianjin China
- Key Laboratory of Post‐Neuroinjury Neuro‐Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City Tianjin Neurological Institute Tianjin China
| | - Dongyi Feng
- Department of Neurosurgery Tianjin Medical University General Hospital Tianjin China
- Key Laboratory of Post‐Neuroinjury Neuro‐Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City Tianjin Neurological Institute Tianjin China
| | - Jinhao Huang
- Department of Neurosurgery Tianjin Medical University General Hospital Tianjin China
- Key Laboratory of Post‐Neuroinjury Neuro‐Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City Tianjin Neurological Institute Tianjin China
| | - Chuang Gao
- Department of Neurosurgery Tianjin Medical University General Hospital Tianjin China
- Key Laboratory of Post‐Neuroinjury Neuro‐Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City Tianjin Neurological Institute Tianjin China
| | - Rongcai Jiang
- Department of Neurosurgery Tianjin Medical University General Hospital Tianjin China
- Key Laboratory of Post‐Neuroinjury Neuro‐Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City Tianjin Neurological Institute Tianjin China
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Zhang X, Zhang X, Luo H, Shu R, Guo L, Zhou J, Tan B, Guo X, Wang Y, Tian Y. Platelet-To-Lymphocyte and Neutrophil-To-Lymphocyte Ratios Predict Intestinal Injury in Male Heroin Addicts. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:2195330. [PMID: 35880090 PMCID: PMC9308521 DOI: 10.1155/2022/2195330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 06/24/2022] [Accepted: 06/30/2022] [Indexed: 11/24/2022]
Abstract
Objective To explore the potential link between gut damage and proinflammatory cytokines in heroin-dependent patients. Methods We retrospectively analyzed and compared partial blood counts and biomarkers of intestinal injury and their potential correlations in 38 male heroin abuse patients and 29 healthy male participants. In addition, we compared and assessed proinflammatory cytokines and immune cells in 10 heroin abuse patients and 10 healthy participants. Results Neutrophil counts, platelets/lymphocytes (PLR), neutrophils/lymphocytes (NLR), gut injury biomarkers, and proinflammatory cytokines, CD19+B in patients compared with healthy subjects' cells increased significantly. The number of lymphocytes, CD3 CD4 T cells, and CD3 CD8 T cells decreased in patients compared to healthy individuals. When distinguishing between heroin addicts and healthy people, ROC/AUC analysis showed that a cutoff of 142.42 for PLR and 2.18 for NLR yielded a sensitivity of 65% and 85% and a specificity of 96.5% and 89.7%, respectively (p = 0.001, p < 0.001). For predicting intestinal injury, ROC/AUC analysis showed that a cutoff of 135.7 for PLR and 0.15 for NLR yielded a sensitivity of 52% and 60% and a specificity of 82% and 86.4%, respectively (p = 0.003, p = 0.009). Male heroin addicts are subject to intestinal injury and present with increased proinflammatory cytokine levels. Conclusion NLR and PLR are possible indirect biomarkers for heroin dependence based on intestinal injury.
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Affiliation(s)
- Xinfeng Zhang
- Department of Gastrointestinal and Hernia Surgery, The First Affiliated Hospital of Kunming Medical University, China Kunming, Yunnan 650032
| | - Xiaoli Zhang
- Department of Gastrointestinal and Hernia Surgery, The First Affiliated Hospital of Kunming Medical University, China Kunming, Yunnan 650032
| | - Huayou Luo
- Department of Gastrointestinal and Hernia Surgery, The First Affiliated Hospital of Kunming Medical University, China Kunming, Yunnan 650032
| | - Ruo Shu
- Department of Gastrointestinal and Hernia Surgery, The First Affiliated Hospital of Kunming Medical University, China Kunming, Yunnan 650032
| | - Li Guo
- Department of Gastrointestinal and Hernia Surgery, The First Affiliated Hospital of Kunming Medical University, China Kunming, Yunnan 650032
| | - Jinghong Zhou
- Department of Gastrointestinal and Hernia Surgery, The First Affiliated Hospital of Kunming Medical University, China Kunming, Yunnan 650032
| | - Bowen Tan
- Department of Gastrointestinal and Hernia Surgery, The First Affiliated Hospital of Kunming Medical University, China Kunming, Yunnan 650032
| | - Xiao Guo
- Department of Gastrointestinal and Hernia Surgery, The First Affiliated Hospital of Kunming Medical University, China Kunming, Yunnan 650032
| | - Yuhan Wang
- Department of Gastrointestinal and Hernia Surgery, The First Affiliated Hospital of Kunming Medical University, China Kunming, Yunnan 650032
| | - Yan Tian
- Department of Gastrointestinal and Hernia Surgery, The First Affiliated Hospital of Kunming Medical University, China Kunming, Yunnan 650032
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Tomás TC, Eiriz I, Vitorino M, Vicente R, Gramaça J, Oliveira AG, Luz P, Baleiras M, Spencer AS, Costa LL, Liu P, Mendonça J, Dinis M, Padrão T, Correia M, Atalaia G, Silva M, Fiúza T. Neutrophile-to-lymphocyte, lymphocyte-to-monocyte, and platelet-to-lymphocyte ratios as prognostic and response biomarkers for resectable locally advanced gastric cancer. World J Gastrointest Oncol 2022; 14:1307-1323. [PMID: 36051098 PMCID: PMC9305575 DOI: 10.4251/wjgo.v14.i7.1307] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/19/2021] [Accepted: 06/26/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Perioperative fluorouracil plus leucovorin, oxaliplatin, and docetaxel (FLOT) improves prognosis in locally advanced gastric cancer (LAGC). Neutrophil-to-lymphocyte (NLR), lymphocyte-to-monocyte (LMR), and platelet-to-lymphocyte (PLR) ratios are prognostic biomarkers but not predictive factors.
AIM To assess blood ratios’ (NLR, LMR and PLR) potential predictive response to FLOT and survival outcomes in resectable LAGC patients.
METHODS This was a multicentric retrospective study investigating the clinical potential of NLR, LMR, and PLR in resectable LAGC patients, treated with at least one preoperative FLOT cycle, from 12 Portuguese hospitals. Means were compared through non-parametric Mann-Whitney tests. Receiver operating characteristic curve analysis defined the cut-off values as: High PLR > 141 for progression and > 144 for mortality; high LMR > 3.56 for T stage regression (TSR). Poisson and Cox regression models the calculated relative risks/hazard ratios, using NLR, pathologic complete response, TSR, and tumor regression grade (TRG) as independent variables, and overall survival (OS) as the dependent variable.
RESULTS This study included 295 patients (mean age, 63.7 years; 59.7% males). NLR was correlated with survival time (r = 0.143, P = 0.014). PLR was associated with systemic progression during FLOT (P = 0.022) and mortality (P = 0.013), with high PLR patients having a 2.2-times higher risk of progression [95% confidence interval (CI): 0.89-5.26] and 1.5-times higher risk of mortality (95%CI: 0.92-2.55). LMR was associated with TSR, and high LMR patients had a 1.4-times higher risk of achieving TSR (95%CI: 1.01-1.99). OS benefit was found with TSR (P = 0.015) and partial/complete TRG (P < 0.001). Patients without TSR and with no evidence of pathological response had 2.1-times (95%CI: 1.14-3.96) and 2.8-times (95%CI: 1.6-5) higher risk of death.
CONCLUSION Higher NLR is correlated with longer survival time. High LMR patients have a higher risk of decreasing T stage, whereas high PLR patients have higher odds of progressing under FLOT and dying. Patients with TSR and a pathological response have better OS and lower risk of dying.
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Affiliation(s)
- Tiago Cruz Tomás
- Department of Medical Oncology, Hospital Professor Doutor Fernando Fonseca EPE, Amadora 2720-276, Portugal
| | - Inês Eiriz
- Department of Medical Oncology, Hospital Professor Doutor Fernando Fonseca EPE, Amadora 2720-276, Portugal
| | - Marina Vitorino
- Department of Medical Oncology, Hospital Professor Doutor Fernando Fonseca EPE, Amadora 2720-276, Portugal
| | - Rodrigo Vicente
- Department of Medical Oncology, Hospital Professor Doutor Fernando Fonseca EPE, Amadora 2720-276, Portugal
| | - João Gramaça
- Department of Medical Oncology, Centro Hospitalar Barreiro-Montijo EPE, Barreiro 2830-003, Portugal
| | | | - Paulo Luz
- Department of Medical Oncology, Centro Hospitalar Universitário do Algarve EPE, Algarve 8000-386, Portugal
| | - Mafalda Baleiras
- Department of Medical Oncology, Hospital São Francisco Xavier, Centro Hospitalar Lisboa Ocidental EPE, Lisboa 1449-005, Portugal
| | - Ana Sofia Spencer
- Department of Medical Oncology, Hospital Santo António dos Capuchos, Centro Hospital Lisboa Central EPE, Lisboa 1169-050, Portugal
| | - Luísa Leal Costa
- Department of Medical Oncology, Hospital Beatriz Ângelo, Loures 2674-514, Portugal
| | - Patrícia Liu
- Department of Medical Oncology, Centro Hospitalar de Trás-os-Montes e Alto Douro EPE, Vila Real 5000-508, Portugal
| | - Joana Mendonça
- Department of Medical Oncology, Hospital da Senhora da Oliveira EPE, Guimarães 4835-044, Portugal
| | - Magno Dinis
- Department of Medical Oncology, Hospital Garcia de Orta EPE, Almada 2805-267, Portugal
| | - Teresa Padrão
- Department of Medical Oncology, Hospital da Luz, Lisboa 1500-650, Portugal
| | - Marisol Correia
- Department of Medical Oncology, Hospital Distrital de Santarém EPE, Santarém 2005-177, Portugal
| | - Gonçalo Atalaia
- Department of Medical Oncology, Hospital Professor Doutor Fernando Fonseca EPE, Amadora 2720-276, Portugal
| | - Michelle Silva
- Department of Medical Oncology, Hospital Professor Doutor Fernando Fonseca EPE, Amadora 2720-276, Portugal
| | - Teresa Fiúza
- Department of Medical Oncology, Hospital Professor Doutor Fernando Fonseca EPE, Amadora 2720-276, Portugal
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Development and Validation of a Nomogram for Predicting Overall Survival to Concurrent Chemoradiotherapy in Patients with Locally Advanced Esophageal Squamous Cell Carcinoma. BIOMED RESEARCH INTERNATIONAL 2022; 2022:6455555. [PMID: 35872847 PMCID: PMC9303138 DOI: 10.1155/2022/6455555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 05/24/2022] [Accepted: 06/22/2022] [Indexed: 12/15/2022]
Abstract
This study aims to develop and validate a effective prognostic nomogram for locally advanced esophageal squamous cell carcinoma (LA-ESCC) patients undergoing concurrent chemoradiotherapy (CCRT). Retrospective analysis of 503 patients with LA-ESCC given CCRT in our hospital from 2009 to 2016 was conducted. Two-thirds of the patients were randomly assigned to the training set (n = 335), and one-third were assigned to the validation set (n = 168). In order to generate the nomogram, multivariate cox regression analysis was undertaken in the training set for uncovering significant prognostic variables for overall survival. The C-index and calibration plot were used to verify nomogram discrimination and calibration, respectively. Five independent prognostic variables were found and incorporated into a nomogram: age, N stage, location, tumor response, and MLR (monocyte/lymphocyte ratio). The C-indexes of the training set and the validation set were 0.730 and 0.745, respectively. The discrimination and calibration of this nomogram showed good predictive power in both sets. Conclusively, the proposed nomogram may be served as an effective tool for prognostic evaluation of LA-ESCC patients receiving CCRT.
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Taşkömür AT, Erten Ö. Relationship of inflammatory and metabolic parameters in adolescents with PCOS: BMI matched case-control study. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2022; 66:2359-3997000000497. [PMID: 35657129 PMCID: PMC9832847 DOI: 10.20945/2359-3997000000497] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 02/10/2022] [Indexed: 02/01/2023]
Abstract
Objective Polycystic ovary syndrome (PCOS) begins in adolescence and has cardiovascular and metabolic components in later years. Cystatin C and high-sensitivity C-reactive protein (hs-CRP) levels and neutrophil-lymphocyte and platelet-lymphocyte ratios are associated with metabolic and inflammatory events. Here, we evaluated inflammatory and metabolic parameters in normal and overweight adolescents with PCOS. Materials and methods This prospective case-control study enrolled 90 adolescents with PCOS and 100 matched by age and BMI healthy adolescents classified as either normal weight (NW) and overweight (OW). Groups were compared based on inflammatory and metabolic parameters (serum cystatin C, hs-CRP, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), lipids, fasting blood glucose-insulin (FBG-FI), HOMA-IR levels, waist circumference [WC], and waist-hip ratio [WHR]). The relationship between the parameters were compared and predictive abilities were evaluated. Results Cystatin C, hs-CRP, NLR, triglyceride (TG), FBG-FI, HOMA-IR, WC, and WHR were significantly higher in those with PCOS. The NW PCOS group had significantly higher TG, cystatin C, hs-CRP, and NLR versus OW controls. The highest HOMA-IR values were observed in OW PCOS (p < .05). Cystatin C and hs-CRP sensitivity and specificity were significant (p < 0.05). Cystatin C and hs-CRP were positively correlated with other metabolic parameters. Conclusion Independent of BMI, inflammatory and metabolic parameters are significantly higher in adolescents with PCOS compared to controls and even worse in those who are also OW. Therefore, adolescents with PCOS should be encouraged to maintain healthy lifestyles and weights to avoid metabolic risks. Hs-CRP and cystatin C could be promising markers to predictive of future metabolic risks.
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Affiliation(s)
- Aysun Tekeli Taşkömür
- Amasya University, Faculty of Medicine, Department of Obstetrics and Gynecology, Amasya, Turkey,
| | - Özlem Erten
- Kütahya Health Sciences University, Faculty of Medicine, Department of Gynecology and Obstetrics, Kütahya, Turkey
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Pre-Treatment and Preoperative Neutrophil-to-Lymphocyte Ratio Predicts Prognostic Value of Glioblastoma: A Meta-Analysis. Brain Sci 2022; 12:brainsci12050675. [PMID: 35625061 PMCID: PMC9139478 DOI: 10.3390/brainsci12050675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/16/2022] [Accepted: 05/17/2022] [Indexed: 02/01/2023] Open
Abstract
Objective: Although some meta-analyses have shown a correlation between a high neutrophil-to-lymphocyte ratio (NLR) and low survival in patients with gliomas, their conclusions are controversial, and no study has specifically explored the relationship between a high pre-treatment and pre-operative NLR and low survival in patients with glioblastoma (GBM). Therefore, we further investigated this correlation through meta-analysis. Methods: We searched the PubMed, Metstr, and Cochrane databases in March 2022 for published literature related to high pre-treatment and pre-operative NLR and low survival in patients with GBM. The literature was rigorously searched according to inclusion and exclusion criteria to calculate the overall hazard ratio (HR) and 95% confidence interval (CI) corresponding to a high NLR using a random effects model. Results: The total HR for the pre-treatment and pre-operative NLR was 1.46 (95% CI: 1.17–1.75, p = 0.000, I2 = 76.5%), indicating a significant association between a high pre-treatment and pre-operative NLR, and low overall survival in patients with GBM. Sub-group analysis was performed because of the high heterogeneity. The results for the sub-group with a cut-off value of 4 showed an HR of 1.39 (95% CI: 1.12–1.65, p = 0.000, I2 = 22.2%), with significantly low heterogeneity, whereas those for the sub-group without a cut-off value of 4 showed an HR of 1.45 (95% CI: 1.01–1.89, p = 0.000, I2 = 83.3%). Conclusions: The results of this study demonstrate that a high pre-treatment and pre-operative NLR suggests low survival in patients with GBM based on data from a large sample. Furthermore, the meta-regression analysis results indicate that underlying data, such as age and extent of surgical resection, lead to a high degree of heterogeneity, providing a theoretical basis for further research.
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Tankel J, Calderone A, Garcia-Luna JLR, Mueller CL, Najmeh S, Spicer J, Mulder D, Ferri L, Cools-Lartigue J. Changes in Perioperative Platelet Lymphocyte Ratio Predict Survival in Oesophago-Gastric Adenocarcinoma. Ann Surg Oncol 2022; 29:10.1245/s10434-022-11475-7. [PMID: 35377063 DOI: 10.1245/s10434-022-11475-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 02/02/2022] [Indexed: 12/07/2022]
Abstract
BACKGROUND Platelet to lymphocyte ratio (PLR) is associated with survival in oesophageal cancer. We explored whether PLR changes during different stages of treatment correlate with survival outcomes. METHODS A retrospective single-centre study was performed. Consecutive patients who received neoadjuvant chemotherapy followed by surgery for oesophageal adenocarcinoma were identified. Changes in PLR were calculated during two time periods: the first spanning the neoadjuvant period (T1); the second the perioperative period (T2). Differences in PLR were calculated for clinicopathological variables during both T1 and T2 and for variables with regards to their association with median overall survival (OS). Variables found to be significant on univariate analysis were included in a multivariate Cox regression model. Using ROC analysis, optimal cut-offs for PLR changes were identified and plotted on a Kaplan-Meir curve. RESULTS Of the 370 patients identified, 110 (29.7%) were included in the analysis. During T1 a positive correlation was noted between higher positive lymph node ratio and PLR change. During T2, PLR change was positively higher in patients who suffered major postoperative complications. Median survival for the cohort as a whole was 42.3 months and 5-year OS was 57.3%. Survival at 5 years was associated with lower PLR changes during T2. On univaraite analysis, median OS was significantly less for patients with a tumour size > 3 cm, poor differentiation and change in PLR ≥ 43.4 during T2. The latter two variables remained significant on multivariate analysis. Using the same PLR threshold, the survival curve comparing changes in PLR during T2 remained statistically significant. CONCLUSION Perioperative PLR changes are highly prognostic of survival outcomes in patients treated for oesophageal adenocarcinoma.
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Affiliation(s)
- James Tankel
- Division of Thoracic and Upper Gastrointestinal Surgery, Montreal General Hospital, McGill University Health Centre, Montreal, Quebec, Canada
| | - Alexander Calderone
- Division of Thoracic and Upper Gastrointestinal Surgery, Montreal General Hospital, McGill University Health Centre, Montreal, Quebec, Canada
| | - Jose Luis Ramirez Garcia-Luna
- Division of Thoracic and Upper Gastrointestinal Surgery, Montreal General Hospital, McGill University Health Centre, Montreal, Quebec, Canada
| | - Carmen L Mueller
- Division of Thoracic and Upper Gastrointestinal Surgery, Montreal General Hospital, McGill University Health Centre, Montreal, Quebec, Canada
| | - Sarah Najmeh
- Division of Thoracic and Upper Gastrointestinal Surgery, Montreal General Hospital, McGill University Health Centre, Montreal, Quebec, Canada
| | - Jonathan Spicer
- Division of Thoracic and Upper Gastrointestinal Surgery, Montreal General Hospital, McGill University Health Centre, Montreal, Quebec, Canada
| | - David Mulder
- Division of Thoracic and Upper Gastrointestinal Surgery, Montreal General Hospital, McGill University Health Centre, Montreal, Quebec, Canada
| | - Lorenzo Ferri
- Division of Thoracic and Upper Gastrointestinal Surgery, Montreal General Hospital, McGill University Health Centre, Montreal, Quebec, Canada
| | - Jonathan Cools-Lartigue
- Division of Thoracic and Upper Gastrointestinal Surgery, Montreal General Hospital, McGill University Health Centre, Montreal, Quebec, Canada.
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Wang J, Li H, Xu R, Lu T, Zhao J, Zhang P, Qu L, Zhang S, Guo J, Zhang L. The MLR, NLR, PLR and D-dimer are associated with clinical outcome in lung cancer patients treated with surgery. BMC Pulm Med 2022; 22:104. [PMID: 35337299 PMCID: PMC8957174 DOI: 10.1186/s12890-022-01901-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 03/21/2022] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE The study objective was to investigate the use of peripheral blood biomarkers as predictors of patient survival. The aim of this study was to identify the baseline peripheral blood biomarkers associated with clinical outcome in patients with early lung cancer (stage I-II) treated with surgery. METHODS We included and analysed data from 376 patients with early-stage lung cancer who underwent a standard lobectomy. Univariate and multivariate Cox regression analyses were performed on all patients to assess the relationships between progression-free survival (PFS) and overall survival (OS) and the peripheral blood biomarker metrics measured before surgical treatment. The peripheral blood parameters included monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and dimeric fibrin fragment D (D-dimer). RESULTS After univariate Cox regression analysis, low MLR, low NLR, low PLR and low D-dimer values were significantly associated with both better OS and PFS (all p < 0.05). In multivariate Cox regression analysis, a low MLR was significantly and independently associated with both better overall survival and better progression-free survival (both p <0.05). A low D-dimer level was significantly and independently associated with better overall survival (p <0.05). Furthermore, the categorization of patients according to the number of factors with favourable results revealed that those without favourable results had significantly worse outcomes than that of those patients with at least one. CONCLUSION A baseline signature of low MLR, low NLR, low PLR, and low D-dimer values was associated with a better survival outcome for patients treated with surgery. Patients with more favourable results had better survival outcomes.
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Affiliation(s)
- Jun Wang
- Department of Thoracic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Huawei Li
- Department of Thoracic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Ran Xu
- Department of Thoracic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Tong Lu
- Department of Thoracic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Jiaying Zhao
- Department of Thoracic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Pengfei Zhang
- Department of Thoracic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Lidong Qu
- Department of Thoracic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Shengqiang Zhang
- Department of Thoracic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Jida Guo
- Department of Thoracic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Linyou Zhang
- Department of Thoracic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
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Ramon-Rodriguez J, De-Armas-Conde N, Jaén-Torrejimeno I, Prada-Villaverde A, Rojas-Holguín A, López-Guerra D, Blanco-Fernández G. Prognostic value of pre-operative systemic immune-inflammation index and platelet to lymphocyte ratio in peritoneal carcinomatosis of ovarian origin. Surg Oncol 2022; 42:101750. [DOI: 10.1016/j.suronc.2022.101750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 02/26/2022] [Accepted: 03/22/2022] [Indexed: 02/07/2023]
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Konopka K, Frączek P, Lubaś M, Micek A, Kwinta Ł, Streb J, Potocki P, Wysocki PJ. Reduction of Cancer-Induced Thrombocytosis as a Biomarker of Improved Outcomes in Advanced Gastric Cancer. J Clin Med 2022; 11:jcm11051213. [PMID: 35268305 PMCID: PMC8911022 DOI: 10.3390/jcm11051213] [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: 02/08/2022] [Revised: 02/21/2022] [Accepted: 02/23/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Interplay between non-specific inflammatory reaction and tumor microenvironment in gastric cancer (GC) can be measured indirectly by assessing fluctuations in concentration of platelets. Cytotoxic chemotherapy affects these morphotic elements directly by inducing myelosuppression. It was hypothesized that chemotherapy not only directly affects malignant cells, but also through immunomodulation related to myelosuppression. METHODS Metastatic GC patients (N: 155) treated with chemotherapy +/- trastuzumab were enrolled in this retrospective study. Platelet pretreatment concentration (PLT-count) and the deepest level of platelet reduction, as well as other inflammatory and general confounders were collected in the first 12 weeks of treatment (PLT-red). Martingale residuals were used to visualize the relationship between PLT-count, PLT-red, and overall survival (OS). Multiple multivariate Cox regression models were built to assess the impact of platelet reduction on OS and progression-free survival (PFS). RESULTS Reduction of PLT (PLT-red) to 60% of baseline concentration was associated with improved survival rates (HR = 0.60, p = 0.026 for OS and HR 0.56, p = 0.015 for PFS). Cross-classification into four groups based on PLT-count (high vs low) and PLT-red (high vs low) showed significantly worse survival rates in both high PLT-count (HR = 3.60, p = 0.007 for OS and HR = 2.97, p = 0.024 for PFS) and low PLT-count (HR = 1.75, p = 0.035 for OS and HR = 1.80, p = 0.028 for PFS) patients with insufficient platelets reduction. CONCLUSION Thrombocytosis reduction represents a novel, clinically important, prognostic factor for OS and PFS in patients with stage IV GC.
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Affiliation(s)
- Kamil Konopka
- Department of Oncology, Jagiellonian University Medical College, 31-007 Cracow, Poland
- Correspondence:
| | - Paulina Frączek
- Department of Medical Oncology, University Hospital in Cracow, 30-688 Cracow, Poland
| | - Maciej Lubaś
- Department of Medical Oncology, University Hospital in Cracow, 30-688 Cracow, Poland
| | - Agnieszka Micek
- Department of Nursing Management and Epidemiology Nursing, Jagiellonian University Medical College, 31-007 Cracow, Poland
| | - Łukasz Kwinta
- Department of Oncology, Jagiellonian University Medical College, 31-007 Cracow, Poland
| | - Joanna Streb
- Department of Oncology, Jagiellonian University Medical College, 31-007 Cracow, Poland
| | - Paweł Potocki
- Department of Oncology, Jagiellonian University Medical College, 31-007 Cracow, Poland
| | - Piotr J. Wysocki
- Department of Oncology, Jagiellonian University Medical College, 31-007 Cracow, Poland
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Xuan J, Peng J, Wang S, Cai Y. Prognostic significance of Naples prognostic score in non-small-cell lung cancer patients with brain metastases. Future Oncol 2022; 18:1545-1555. [PMID: 35107367 DOI: 10.2217/fon-2021-1530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aims: The authors aimed to evaluate the prognostic value of Naples prognostic score (NPS) in advanced non-small-cell lung cancer patients with brain metastases. Materials & methods: A total of 186 consecutive advanced non-small-cell lung cancer patients were retrospectively analyzed. Kaplan-Meier survival analysis and Cox proportional regression models were used to assess the significance of NPS in overall survival and disease-free survival. Results: Multivariate Cox proportional regression analysis revealed that NPS was a significant independent predictive indicator for overall survival (hazard ratio: 1.897; 95% CI: 1.184-3.041; p = 0.008) and disease-free survival (hazard ratio: 2.169; 95% CI: 1.367-3.44; p = 0.001). Conclusion: NPS was a powerful prognostic indicator for outcome in advanced non-small-cell lung cancer patients with brain metastases.
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Affiliation(s)
- Junmei Xuan
- Department of General medicine, Shaoxing People's Hospital, Shaoxing City, 312000, China
| | - Jianghua Peng
- Department of General medicine, Shaoxing People's Hospital, Shaoxing City, 312000, China
| | - Shuai Wang
- Department of Thoracic surgery, Yidu Central Hospital of Weifang, Weifang City, 261000, China
| | - Yaojie Cai
- Department of Neurology, Zhuji Affiliated Hospital of Shaoxing University, Shaoxing City, 312000, China
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Meng X, Wang X, Jiang C, Zhang S, Cheng S. Correlation analysis of lymphocyte-monocyte ratio with pathological complete response and clinical prognosis of neoadjuvant chemotherapy in patients with breast cancer. Transl Oncol 2022; 18:101355. [PMID: 35121221 PMCID: PMC8818569 DOI: 10.1016/j.tranon.2022.101355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/13/2022] [Accepted: 01/23/2022] [Indexed: 01/12/2023] Open
Abstract
We evaluated the impact of LMR on pCR and prognosis in breast cancer patients. High LMR predicts increased pCR in HER2(+) breast cancer patients. High LMR predicts a better prognosis in neoadjuvant chemotherapy patients. LMR is an economical and easy detection index for patients.
Purpose Inflammation plays an important role in tumor proliferation, metastasis, and chemotherapy resistance. Peripheral blood lymphocyte-monocyte ratio (LMR) has been reported to be closely associated with the prognosis of many tumors, such as certain hematologic malignancies and gastric cancer. However, the association in breast cancer is still not clear. This study investigated the relationship between LMR with pathological complete response and clinical prognosis of neoadjuvant chemotherapy in patients with breast cancer, to provide convenient and accurate predictive indicators for pathological complete response (pCR) and prognosis. Methods The clinicopathological data of 192 female breast cancer patients who received neoadjuvant chemotherapy and surgery in Harbin Medical University Tumor Hospital from January 2013 to August 2017 were retrospectively analyzed. Blood lymphocytes and monocytes were obtained by peripheral venous punctures. Results Compared with the low LMR group, pCR was more easily obtained in the high LMR group (P=0.020); Subgroup analysis showed that patients with the high LMR and HER-2(+) group were more likely to obtain pCR (P=0.011).Univariate andmultivariate results showed that the overall survival (OS) and disease free survival (DFS) of the high LMR group were longer than that of the low LMR group. Conclusion LMR and HER-2 status are correlated with pCR of neoadjuvant chemotherapy in breast cancer patients and are independent predictors of pCR after neoadjuvant chemotherapy in breast cancer patients. Meanwhile, both LMR and T stage of tumor are independent prognostic factors of breast cancer patients, with good predictive value.
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Affiliation(s)
- Xiangyu Meng
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, Harbin 150081, China
| | - Xueying Wang
- Department of Head and Neck Surgery, Harbin Medical University Cancer Hospital, Harbin 150081, China
| | - Cong Jiang
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, Harbin 150081, China
| | - Shuai Zhang
- The Fourth Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin 150081, China
| | - Shaoqiang Cheng
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, Harbin 150081, China.
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Hiraoka SI, Shimada Y, Kawasaki Y, Akutagawa M, Tanaka S. Preoperative nutritional evaluation, surgical site infection, and prognosis in patients with oral cancer. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 134:168-175. [PMID: 35430178 DOI: 10.1016/j.oooo.2022.01.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/05/2022] [Accepted: 01/08/2022] [Indexed: 10/19/2022]
Abstract
OBJECTIVES The risk of postoperative infection after reconstructive oral cancer surgery is high and poses a problem in perioperative management. The objective of this study was to verify the association between preoperative nutritional indicators, surgical site infection (SSI), and long-term prognosis after reconstruction for oral cancer. STUDY DESIGN Sixty-seven patients admitted to a dental hospital were enrolled. The following nutritional indicators were examined: serum albumin level, modified Glasgow Prognostic Score, Miki's Glasgow Prognostic Score, prognostic nutritional index, platelet/lymphocyte ratio, neutrophil/lymphocyte ratio, lymphocyte/monocyte ratio, and the Controlling Nutritional Status tool. Statistical analyses were conducted to determine potential risk factors for SSI. RESULTS The Cox proportional hazards model demonstrated that SSI and platelet/lymphocyte ratio ≥211.4 were independent prognostic factors affecting survival. The results demonstrated that albumin <4.0 and platelet/lymphocyte ratio ≥211.4 were risk factors for SSI. Furthermore, albumin <4.0, platelet/lymphocyte ratio ≥211.4, and SSI were correlated with prognosis. Preoperative nutritional indicators were associated with SSI and prognosis in patients with oral cancer after reconstructive surgery. CONCLUSION Preoperative nutritional therapy is crucial for improving therapeutic outcomes in patients with oral cancer who require reconstructive surgery.
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Affiliation(s)
- Shin-Ichiro Hiraoka
- First Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Osaka University, Suita, Osaka, Japan.
| | - Yasuyuki Shimada
- Department of Oral and Maxillofacial Surgery, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
| | - Yohei Kawasaki
- Faculty of Nursing, Japanese Red Cross College of Nursing, Shibuya-ku, Tokyo, Japan; Biostatistics Section, Clinical Research Center, Chiba University Hospital, Chuo-ku, Chiba, Japan
| | - Maiko Akutagawa
- School of Pharmaceutical Sciences, University of Shizuoka, Division of Drug Evaluation & Informatics, Suruga-ku, Shizuoka, Japan
| | - Susumu Tanaka
- First Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Osaka University, Suita, Osaka, Japan
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Soibi-Harry AP, Amaeshi LC, Garba SR, Anorlu RI. The relationship between pre-operative lymphocyte to monocyte ratio and serum cancer antigen-125 among women with epithelial ovarian cancer in Lagos, Nigeria. Ecancermedicalscience 2021; 15:1288. [PMID: 34824611 PMCID: PMC8580589 DOI: 10.3332/ecancer.2021.1288] [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: 02/27/2021] [Indexed: 12/09/2022] Open
Abstract
Ovarian cancer (OC) is the second most common genital cancer worldwide, and the most lethal of all genital cancers. The role of inflammation and markers of systemic inflammation such as neutrophils, lymphocytes and monocytes in cancer biology have been investigated and reported in many studies. Cancer antigen 125 (CA-125) is currently in use as an adjunct to diagnosis, prognostication and monitoring of epithelial OC (EOC). This test is not readily available in many centres in sub-Saharan Africa, creating a need to identify alternative markers that are available and affordable. This study aimed to determine the relationship between pre-operative serum lymphocyte to monocyte ratio (LMR) and CA-125 in EOC. This was a retrospective cross-sectional study among 70 women, diagnosed with EOC in Lagos University Teaching Hospital from January 2013 to December 2019. Data were extracted from the case notes of the patients. LMR was calculated as the absolute lymphocyte count divided by the absolute monocyte count and analysed using Statistical Package for Social Sciences (SPSS) version 25.0. The correlation between LMR and CA-125 was determined using Pearson’s correlation coefficient. The mean age of the patients was 48.57 ± 13.97 years. Serous adenocarcinoma was the most common subtype of EOC making up 94.3% of the cases. The median serum CA-125 was 393.5 (215.00–765.67) U/mL. The median LMR was 6.77 (1.28–43.0). There was a statistically significant negative correlation between CA-125 and LMR, r = −0.28, p = 0.02. LMR was negatively associated with CA-125 in women with EOC. LMR may be considered as a simple, affordable alternative marker to CA-125 in the management of EOC.
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Affiliation(s)
- Adaiah Priscilla Soibi-Harry
- Oncology & Pathological Studies Unit, Department of Obstetrics & Gynaecology, Lagos University Teaching Hospital, Lagos 101233, Nigeria
| | - Lemchukwu Chukwunonye Amaeshi
- Clinical Haematology and Oncology Unit, Department of Medicine, Lagos University Teaching Hospital, Lagos 101233, Nigeria
| | - Sunusi Rimi Garba
- Oncology & Pathological Studies Unit, Department of Obstetrics & Gynaecology, Lagos University Teaching Hospital, Lagos 101233, Nigeria
| | - Rose Ihuoma Anorlu
- Department of Obstetrics & Gynaecology, University of Lagos/Lagos University Teaching Hospital, Lagos 101233, Nigeria
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Takeda T, Yamada T, Tanimura K, Nakano T, Ishida M, Tachibana Y, Shiotsu S, Horiuchi S, Hibino M, Okada A, Chihara Y, Takayama K. Prognostic Markers of Survival among Japanese Patients with Anaplastic Lymphoma Kinase-Positive Non-Small-Cell Lung Cancer Receiving First-Line Alectinib. Diagnostics (Basel) 2021; 11:diagnostics11122170. [PMID: 34943412 PMCID: PMC8699991 DOI: 10.3390/diagnostics11122170] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 11/17/2021] [Accepted: 11/22/2021] [Indexed: 12/24/2022] Open
Abstract
The prognoses of patients with non-small-cell lung cancer (NSCLC) harboring anaplastic lymphoma kinase (ALK) gene rearrangement have dramatically improved with the use of ALK tyrosine kinase inhibitors. Although immunological and nutritional markers have been investigated to predict outcomes in patients with several cancers, their usefulness in targeted therapies is scarce, and their significance has never been reported in patients receiving first-line treatment with alectinib. Meanwhile, neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio (PLR) has been investigated during crizotinib treatment. This multicenter retrospective study evaluated 42 consecutive Japanese patients with ALK-positive NSCLC who received first-line treatment with alectinib. Immunological and nutritional markers were evaluated at baseline and 3 weeks after alectinib introduction, and their significance in predicting progression-free survival (PFS) was explored. PFS duration was significantly associated with baseline PLR (hazard ratio (HR): 2.49, p = 0.0473), systemic immune-inflammation index (SII; HR: 2.65, p = 0.0337), prognostic nutrition index (PNI; HR: 4.15, p = 0.00185), and the 3-week values for SII (HR: 2.85, p = 0.0473) and PNI (HR: 3.04, p = 0.0125). Immunological and nutritional markers could be useful in predicting the outcomes of first-line treatment with alectinib. Since PLR and SII consist of platelet counts, platelet count could be an important constituent of these markers.
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Affiliation(s)
- Takayuki Takeda
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daini Hospital, Kyoto 602-8026, Japan
| | - Tadaaki Yamada
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Keiko Tanimura
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daini Hospital, Kyoto 602-8026, Japan
| | - Takayuki Nakano
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daini Hospital, Kyoto 602-8026, Japan
| | - Masaki Ishida
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Yusuke Tachibana
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto 605-0981, Japan
| | - Shinsuke Shiotsu
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto 605-0981, Japan
| | - Shigeto Horiuchi
- Department of Respiratory Medicine, Shonan Fujisawa Tokushukai Hospital, Fujisawa 251-0041, Japan
| | - Makoto Hibino
- Department of Respiratory Medicine, Shonan Fujisawa Tokushukai Hospital, Fujisawa 251-0041, Japan
| | - Asuka Okada
- Department of Respiratory Medicine, Saiseikai Suita Hospital, Suita 564-0013, Japan
| | - Yusuke Chihara
- Department of Respiratory Medicine, Uji-Tokushukai Medical Center, Uji 611-0041, Japan
| | - Koichi Takayama
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
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Ekici H, Imamoglu M, Okmen F, Gencosman G, Ak G, Ergenoglu M. Evaluation of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in pregnant women with systemic lupus erythematosus. J OBSTET GYNAECOL 2021; 42:872-876. [PMID: 34565265 DOI: 10.1080/01443615.2021.1946022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Systemic lupus erythematosus (SLE) is associated with a higher risk of complications in pregnancy. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been evaluated in numerous inflammatory diseases. We evaluated the possible role of these markers in SLE pregnancies. Forty-six pregnant patients with an already established diagnosis of SLE were included in the study. Complete blood counts were obtained upon admission for delivery. Seven patients were diagnosed with a flare and managed with multiple medications, whereas rest of the patients were not on any treatment or managed with monotherapy. NLR and PLR values were also evaluated between two groups and no statistically significant difference was found (p=.44 and p=.80, respectively). This study is the first to evaluate the possible role of NLR and PLR in pregnant SLE patients in the literature. Further studies are warranted for an elaborate evaluation of NLR and PLR in lupus pregnancies.Impact StatementWhat is already known on this subject? Pregnancy in the setting of SLE is associated with a higher risk of complications. Active disease increases the risk of adverse outcomes further.What the results of this study add? This study is the first to evaluate NLR and PLR in pregnancies complicated by SLE. No significant association between the course of the disease in pregnancy and NLR/PLR was documented.What the implications are of these findings for clinical practice and/or further research? Further studies on the markers to predict prognosis of SLE in pregnancy are required to improve the maternal and neonatal outcomes in this exclusive group of high-risk patients.
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Affiliation(s)
- Huseyin Ekici
- Department of Obstetrics and Gynecology, Ege University School of Medicine, Izmir, Turkey
| | - Metehan Imamoglu
- Department of Obstetrics and Gynecology, Ege University School of Medicine, Izmir, Turkey.,Department of Obstetrics and Gynecology, Bridgeport Hospital/Yale New Haven Health, Bridgeport, CT, USA
| | - Firat Okmen
- Department of Obstetrics and Gynecology, Ege University School of Medicine, Izmir, Turkey
| | - Gizem Gencosman
- Department of Obstetrics and Gynecology, Ege University School of Medicine, Izmir, Turkey
| | - Gunes Ak
- Department of Clinical Biochemistry, Ege University School of Medicine, Izmir, Turkey
| | - Mete Ergenoglu
- Department of Obstetrics and Gynecology, Ege University School of Medicine, Izmir, Turkey
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Ozdin M, Kaya H, Gulacti U, Lok U, Kafadar H, Yucetas C. The diagnostic value of neutrophil to lymphocyte ratio in determining the severity of COVID-19. IMC JOURNAL OF MEDICAL SCIENCE 2021. [DOI: 10.55010/imcjms.16.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background: Changes in hematological parameters play a role in the pathogenesis of coronavirus disease 2019 (COVID-19). We aimed to investigate the significance of neutrophil-lymphocyte ratio (NLR) and hematologic parameters in determining the severity of COVID-19.
Methods: This retrospective cross-sectional study was conducted on adult patients diagnosed with COVID-19 in two pandemic hospitals between 01, April, and 01, July 2020. Using the COVID-19 diagnostic criteria of the world health organization (WHO), the patients were divided into two groups as severe and non-severe. Demographic and clinical characteristics, white blood cell (WBC), neutrophil, lymphocyte and platelet counts, and NLR of all patients were examined at the first admission. Multivariate analyzes were performed to determine the independent predictive data and ROC analysis to test the diagnostic accuracy of the hematological parameters.
Results: Of the 381 patients included in the study, 42 (11%) had severe COVID-19 infection. While the mean NLR was 7.61±7.48 in patients with severe COVID-19, the mean NLR of non-severe patients was 2.97±2.37 (95% CI: 2.294 to 6.984, p<0.001). Long duration of hospital stay, elevated NLR ratio, female gender were predictive variables of severe COVID-19 cases (OR =0.833, 95% CI: 0.744 to 0.934, p=0.002; OR=0.195, 95% CI: 0.057 to 0.6731, p=0.010; OR=0.664, 95% CI: 0.501 to 0.881, p=0.005, respectively). In ROC analysis, NLR ratio had 2.625 optimum cut-off value, 60% specificity (95% CI: 54.7 to 65.4), 86% sensitivity (95% CI: 71.5 to 94.6), positive likelihood ratio (PLR) of 4.2 (95% CI: 2.0 to 8.9) and negative likelihood ratio (NLR) of 0.46 (95% CI: 0.4 to 0.6) for severe COVID-19 cases.
Conclusion: The results of this study revealed that there might be a relationship between elevated NLR and severity in COVID-19 cases.
IMC J Med Sci 2022; 16(1): 001
*Correspondence: Dr. Umut Gulacti, Adiyaman University Training and Research Hospital, Emergency Medicine, Adiyaman, Turkey. E-mail: umutgulacti@gmail.com
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Affiliation(s)
- Mehmet Ozdin
- Sakarya University Training and Research Hospital, Medical Biochemistry Laboratory, Sakarya, Turkey
| | - Hakan Kaya
- Adıyaman University Faculty of Medicine, Department of Cardiology, Adıyaman, Turkey
| | - Umut Gulacti
- Adıyaman University Faculty of Medicine, Department of Emergency Medicine, Adıyaman, Turkey, Adıyaman, Turkey
| | - Uğur Lok
- Adıyaman University Faculty of Medicine, Department of Emergency Medicine, Adıyaman, Turkey, Adıyaman, Turkey
| | - Hüseyin Kafadar
- Adıyaman University Faculty of Medicine, Department of Forensic Medicine, Adıyaman, Turkey
| | - Cem Yucetas
- Adıyaman University Faculty of Medicine, Department of Neurosurgery, Adıyaman, Turkey
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Zhang K, Li H, Zhang L, Liao W, Cai L, Li X, Pan W, Zhang Q. The Change in the Neutrophil/Lymphocyte Ratio Predicts the Prognosis of Patients with Cryptococcal Meningitis. Mycopathologia 2021; 186:857-862. [PMID: 34467475 DOI: 10.1007/s11046-021-00553-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 04/10/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been studied in many diseases. However, their roles in cryptococcal meningitis (CM) are unclear. The purpose of this article was to analyse the roles of the PLR and NLR in CM patients during treatment. METHODS 139 newly diagnosed CM patients were enrolled. We divided patients into two groups: the successful group (n = 121) and the failure group (n = 18) based on the prognosis of patients. Then, we analyzed changes in clinical data of two groups, which were measured at the time of admission, after 2 weeks and 4 weeks in the hospital. Then the patients were divided into HIV group (n = 26) and non-HIV group (n = 113) to determine whether HIV status had an impact on the prognosis and clinical data of patients. RESULTS Most patients were male living in rural areas; headache was the most common symptom before admission. In the subgroup analysis based on HIV status, there were significantly fewer patients with HIV (26 individuals) than without HIV (113 individuals), and 40.7% non-HIV CM patients had no underlying diseases. There was no significant difference in prognosis (p = 0.746), lymphocytes (p = 0.109) or neutrophils (p = 0.269) between patients with and without HIV. A mixed-effect model indicated that there was no difference (p = 0.171) in PLR between successful group and failure group. However, the change of NLR was statistically significant (p = 0.004 < 0.05) between successful group and failure group. CONCLUSION An increase in the NLR during treatment may be used as an indicator of treatment failure.
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Affiliation(s)
- Keming Zhang
- Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Mycology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, 200003, People's Republic of China.,Department of Dermatology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, 200003, People's Republic of China
| | - Hang Li
- Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Mycology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, 200003, People's Republic of China.,Department of Dermatology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, 200003, People's Republic of China
| | - Lei Zhang
- Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Mycology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, 200003, People's Republic of China.,Department of Dermatology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, 200003, People's Republic of China
| | - Wanqing Liao
- Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Mycology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, 200003, People's Republic of China.,Department of Dermatology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, 200003, People's Republic of China
| | - Liangqi Cai
- Department of Dermatology, the First Affiliated Hospital of Xiamen University, Xiamen, 361000, People's Republic of China
| | - Xinhua Li
- Taiyuan Central Hospital, Taiyuan, 030009, Shanxi, People's Republic of China
| | - Weihua Pan
- Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Mycology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, 200003, People's Republic of China. .,Department of Dermatology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, 200003, People's Republic of China.
| | - Qilong Zhang
- Department of Neurology, Jiangxi Chest Hospital, Nanchang, 330000, Jiangxi, People's Republic of China.,Department of Neurology, Jiangxi Provincial People's Hospital, Nanchang, 330000, Jiangxi, People's Republic of China
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Konopka K, Micek A, Ochenduszko S, Streb J, Potocki P, Kwinta Ł, Wysocki PJ. Combined Neutrophil-to-Lymphocyte and Platelet-Volume-to-Platelet Ratio (NLR and PVPR Score) Represents a Novel Prognostic Factor in Advanced Gastric Cancer Patients. J Clin Med 2021; 10:3902. [PMID: 34501353 PMCID: PMC8432226 DOI: 10.3390/jcm10173902] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 08/20/2021] [Accepted: 08/27/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Chemotherapy is a cornerstone of treatment in advanced gastric cancer (GC) with a proven impact on overall survival, however, reliable predictive markers are missing. The role of various inflammatory markers has been tested in gastric cancer patients, but there is still no general consensus on their true clinical applicability. High neutrophil-to-lymphocyte (NLR) and low (medium)-platelets-volume-to-platelet ratio (PVPR) are known markers of unspecific immune system activation, correlating significantly with outcomes in advanced GC patients. METHODS Metastatic GC patients (N:155) treated with chemotherapy +/- trastuzumab were enrolled in this retrospective study. Pre-treatment NLR and PVPR, as well as other inflammatory markers were measured in peripheral blood. Univariate Cox regression was conducted to find markers with a significant impact on overall survival (OS) and progression-free survival (PFS). Spearman correlation and Cohen's kappa was used to analyze multicollinearity. Multiple multivariable Cox regression models were built to study the combined impact of NLR and PVPR, as well as other known prognostic factors on OS. RESULTS Elevated NLR was significantly associated with increased risk of death (HR = 1.95; 95% CI: 1.17-3.24), and lower PVPR was significantly associated with improved outcomes (HR = 0.53; 95% CI: 0.32-0.90). A novel inflammatory marker, based on a combination of NLR and PVPR, allows for the classification of GC patients into three prognostic groups, characterized by median OS of 8.4 months (95% CI 5.8-11.1), 10.5 months (95% CI 8.8-12.1), and 15.9 months (95% CI 13.5-18.3). CONCLUSION The NLR and PVPR score (elevated NLR and decreased PVPR) is a marker of detrimental outcome of advanced GC patients treated with chemotherapy.
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Affiliation(s)
- Kamil Konopka
- Department of Oncology, Jagiellonian University Medical College, 31-007 Cracow, Poland; (J.S.); (P.P.); (Ł.K.); (P.J.W.)
| | - Agnieszka Micek
- Department of Nursing Management and Epidemiology Nursing, Jagiellonian University Medical College, 31-007 Cracow, Poland;
| | | | - Joanna Streb
- Department of Oncology, Jagiellonian University Medical College, 31-007 Cracow, Poland; (J.S.); (P.P.); (Ł.K.); (P.J.W.)
| | - Paweł Potocki
- Department of Oncology, Jagiellonian University Medical College, 31-007 Cracow, Poland; (J.S.); (P.P.); (Ł.K.); (P.J.W.)
| | - Łukasz Kwinta
- Department of Oncology, Jagiellonian University Medical College, 31-007 Cracow, Poland; (J.S.); (P.P.); (Ł.K.); (P.J.W.)
| | - Piotr J. Wysocki
- Department of Oncology, Jagiellonian University Medical College, 31-007 Cracow, Poland; (J.S.); (P.P.); (Ł.K.); (P.J.W.)
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Kumarasamy C, Tiwary V, Sunil K, Suresh D, Shetty S, Muthukaliannan GK, Baxi S, Jayaraj R. Prognostic Utility of Platelet-Lymphocyte Ratio, Neutrophil-Lymphocyte Ratio and Monocyte-Lymphocyte Ratio in Head and Neck Cancers: A Detailed PRISMA Compliant Systematic Review and Meta-Analysis. Cancers (Basel) 2021; 13:cancers13164166. [PMID: 34439320 PMCID: PMC8393748 DOI: 10.3390/cancers13164166] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 08/14/2021] [Accepted: 08/16/2021] [Indexed: 01/19/2023] Open
Abstract
Simple Summary Inflammation plays a major role in cancer development and progression and has the potential to be used as a prognostic marker in cancer. Previous studies have attempted to evaluate PLR, NLR and MLR as indicators of inflammation/prognostic markers in cancer, but there is no common consensus on its application in clinical practice. The aim of this systematic review and meta-analysis (a) assess the prognostic efficacy of all three prognostic markers in comparison to each other and, (b) investigate the prognostic potential of these three markers in HNC. The study followed PRISMA guidelines, with literature being collated from multiple bibliographic databases. Preliminary and secondary screening were carried out using stringent inclusion/exclusion criteria. Abstract Inflammation plays a major role in cancer development and progression and has the potential to be used as a prognostic marker in cancer. Previous studies have attempted to evaluate Platelet-to-lymphocyte ratio (PLR), neutrophil–lymphocyte ratio (NLR) or monocyte–lymphocyte ratio (MLR) as indicators of inflammation/prognostic markers in cancer, but there is no common consensus on their application in clinical practice. The aim of this systematic review and meta-analysis is to (a) assess the prognostic efficacy of all three prognostic markers in comparison to each other and (b) investigate the prognostic potential of these three markers in HNC. The study followed PRISMA guidelines, with the literature being collated from multiple bibliographic databases. Preliminary and secondary screening were carried out using stringent inclusion/exclusion criteria. Meta-analysis was carried out on selected studies using CMA software and HR as the pooled effect size metric. A total of 49 studies were included in the study. The pooled HR values of PLR, NLR and MLR indicated that they were significantly correlated with poorer OS. The pooled effect estimates for PLR, NLR and MLR were 1.461 (95% CI 1.329–1.674), 1.639 (95% CI 1.429–1.880) and 1.002 (95% CI 0.720–1.396), respectively. Significant between-study heterogeneity was observed in the meta-analysis of all three. The results of this study suggest that PLR, NLR and MLR ratios can be powerful prognostic markers in head and neck cancers that can guide treatment. Further evidence from large-scale clinical studies on patient cohorts are required before they can be incorporated as a part of the clinical method. PROSPERO Registration ID: CRD42019121008
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Affiliation(s)
- Chellan Kumarasamy
- School of Health and Medical Sciences, Curtin University, Perth, WA 6102, Australia;
| | - Vaibhav Tiwary
- School of Biosciences and Technology, Vellore Institute of Technology (VIT), Vellore 632014, India; (V.T.); (G.K.M.)
| | - Krishnan Sunil
- Department of Radiation Oncology, Mayo Clinic Florida, Jacksonville, FL 32224, USA;
| | - Deepa Suresh
- Division of Endocrinology, Department of Internal Medicine, Mayo Clinic Florida, Jacksonville, FL 32224, USA;
| | - Sameep Shetty
- Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, A Constituent of MAHE, Manipal 576104, India;
| | | | - Siddhartha Baxi
- Radiation Oncology, Genesiscare Gold Coast, John Flynn Hospital, 42 Inland Drive, Tugun, QLD 4224, Australia;
| | - Rama Jayaraj
- Northern Territory Institute of Research and Training, Darwin, NT 0909, Australia
- Correspondence:
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Lymphocyte-to-C-Reactive Protein Ratio as a Novel Marker for Predicting Oncological Outcomes in Patients with Esophageal Cancer. World J Surg 2021; 45:3370-3377. [PMID: 34383091 DOI: 10.1007/s00268-021-06269-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Esophageal cancer has a poor prognosis because of its rapid progression and early and extensive lymph node metastasis. Simple, objective indicators for predicting long-term outcomes are needed to select optimal perioperative treatment and appropriate follow-up for patients with esophageal cancer. The aim of this study is to investigate the relationship between the lymphocyte-to-C-reactive protein ratio (LCR) and the survival of patients with esophageal cancer, by performing time-dependent receiver operating characteristic (ROC) curve analysis. The results were compared to those of traditional inflammation-based markers. METHODS This study enrolled 495 patients who underwent thoracic esophagectomy for esophageal cancer as the primary treatment between 2000 and 2019 in our department. We investigated the predictability of the LCR for oncological outcomes compared to that of other traditional inflammatory markers. RESULTS The 3-year overall survival (OS) and recurrence-free survival (RFS) were 72.6% and 57.5%, respectively. Low LCR was significantly associated with higher cancer stage, included depth of invasion (p < 0.001), lymph node metastasis (p < 0.001) and cStage (p < 0.001). The LCR had the highest AUC value (0.675) for predicting OS compared to the other examined inflammatory markers. In multivariate analysis, the LCR (optimal cutoff threshold = 19,000) was identified as a significant predictor of death (hazard ratio, 2.24; 95% confidence interval [CI], 1.61-3.12; p < 0.001) and recurrence (hazard ratio, 1.97; 95%CI, 1.48-2.63; p < 0.001). CONCLUSION The LCR is novel indicator for oncological outcomes for patients with esophageal cancer and may assist to facilitate personalized multidisciplinary treatments.
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Offi C, Romano RM, Cangiano A, Candela G, Docimo G. Clinical significance of neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, platelet-to-lymphocyte ratio and prognostic nutritional index in low-risk differentiated thyroid carcinoma. ACTA ACUST UNITED AC 2021; 41:31-38. [PMID: 33746220 PMCID: PMC7982751 DOI: 10.14639/0392-100x-n1089] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 10/26/2020] [Indexed: 01/06/2023]
Abstract
Objective Inflammation and nutritional status play an important role in the prognosis of cancer. Lymphocyte-to monocyte ratio (LMR), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and prognostic nutritional index (PNI) are independent prognostic scores in numerous cancers. However, any study showed their prognostic role in low-risk differentiated thyroid carcinoma (DTC). We aimed to clarify and identify the prognostic value of inflammation indices in low-risk DTC patients. Methods We analysed data from 116 patients, dividing the population into two groups, according to AJCC staging system (8th edition). The LMR, NLR, PLR and PNI cut-off value were determined using receiver operating characteristic (ROC) curve. Disease-free survival (DFS) was calculated with Kaplan-Meyer and Log-Rank tests and the risk of recurrence was calculated with univariate and multivariate Cox regression. Statistical significance was p < 0.05. Results We found a baseline NLR value ≥ 1.750 (75% sensitivity, 40.2% specificity) and a baseline LMR value of 3.83 (66.7% sensitivity, 48.9% specificity). Overall DFS was 74.995 ± 3.236 with a p value of 0.678. NLR showed a hazard ratio for recurrence with almost twice the risk of recurrence (Adjusted Hazard Ratio /HRA): 1.828, p-value = 0.019). Conclusions NLR can be considered a prognostic score with twice the risk of recurrence in low-risk DTC patients with NLR < 1.750.
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Affiliation(s)
- Chiara Offi
- Division of Thyroid Surgery, Department of Medical and Advanced Surgical Sciences, University of Campania "Luigi Vanvitelli", School of Medicine, Naples, Italy
| | - Roberto Maria Romano
- Division of Thyroid Surgery, Department of Medical and Advanced Surgical Sciences, University of Campania "Luigi Vanvitelli", School of Medicine, Naples, Italy
| | - Angelo Cangiano
- Division of Thyroid Surgery, Department of Medical and Advanced Surgical Sciences, University of Campania "Luigi Vanvitelli", School of Medicine, Naples, Italy
| | - Giancarlo Candela
- Division of Thyroid Surgery, Department of Medical and Advanced Surgical Sciences, University of Campania "Luigi Vanvitelli", School of Medicine, Naples, Italy
| | - Giovanni Docimo
- Division of Thyroid Surgery, Department of Medical and Advanced Surgical Sciences, University of Campania "Luigi Vanvitelli", School of Medicine, Naples, Italy
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Singh J, Shukla D, Gupta S, Shrivastav BR, Tiwari PK. Clinical epidemiology of gallbladder cancer in North-Central India and association of immunological markers, NLR, MLR and PLR in the diagnostic/prognostic prediction of GBC. Cancer Treat Res Commun 2021; 28:100431. [PMID: 34333247 DOI: 10.1016/j.ctarc.2021.100431] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 06/24/2021] [Accepted: 07/04/2021] [Indexed: 02/07/2023]
Abstract
INTRODUCTION The incidence of Gallbladder Cancer (GBC) is found to be increasing in the rural populations of north-central India. Role of multiple demographic factors, including poor socio-economic conditions, illiteracy and miserable primary healthcare services appear to be significant factors for this increase. Here, we aim to assess the present status of GBC in north-central India and evaluate the role of immunological markers in its management. METHODS A total of 1845 cases of different Gallbladder diseases, including GBC, from rural and urban areas both, registered at CHRI, Gwalior during 2009-2014 and 2018 were included in this study. The demographic and clinical information of the patients were analysed using various statistical tests. RESULTS Of all the cases (1845) included in this study, 1125 (60.97%) were diagnosed with GBC, of which, 707 (62.84%) were from rural background and 418 (37.15%) from urban settings. Mean age for GBC cases for both male and female was about 53.49 years. Females were more affected, being 70.37%, while male patients were only 29.63%. The pathological investigations showed elevated levels of total bilirubin and liver function enzymes both. The NLR, PLR and MLR were found to be significantly associated with different clinical parameters as well as OS. CONCLUSION We infer that the growing trend of GBC, particularly in rural areas, in north-central India is primarily associated with the lack of awareness, inadequate medical support and poor socio-economic conditions. Evaluation of haematological markers may help in the predictive diagnosis/ prognosis and or management of GBC cases in the studied population.
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Affiliation(s)
- Jyotsna Singh
- Centre for Genomics, Jiwaji University, Gwalior, Madhya Pradesh, India; School of Studies in Zoology, Jiwaji University, Gwalior, Madhya Pradesh, India
| | - Durgesh Shukla
- Gajra Raja Medical College, Gwalior, Madhya Pradesh, India
| | - Sanjiv Gupta
- Cancer Hospital and Research Institute (CHRI), Gwalior, Madhya Pradesh, India
| | - Braj Raj Shrivastav
- Cancer Hospital and Research Institute (CHRI), Gwalior, Madhya Pradesh, India
| | - Pramod Kumar Tiwari
- Centre for Genomics, Jiwaji University, Gwalior, Madhya Pradesh, India; School of Studies in Zoology, Jiwaji University, Gwalior, Madhya Pradesh, India.
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Ishibashi Y, Tsujimoto H, Sugasawa H, Kouzu K, Itazaki Y, Sugihara T, Harada M, Ito N, Kishi Y, Ueno H. Prognostic value of platelet-related measures for overall survival in esophageal squamous cell carcinoma: A systematic review and meta-analysis. Crit Rev Oncol Hematol 2021; 164:103427. [PMID: 34273499 DOI: 10.1016/j.critrevonc.2021.103427] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 05/11/2021] [Accepted: 07/12/2021] [Indexed: 01/21/2023] Open
Abstract
Platelet-related measures are considered important in predicting long-term outcomes in patients with esophageal squamous cell carcinoma (ESCC). We performed a systematic electronic research of studies evaluating the prognostic value of platelet-related measures in ESCC in Google Scholar, PubMed, Cochrane Library, and Embase. Then, to synthesize publications exploring the association between platelet-related measures and survival outcomes in ESCC, a meta-analysis was conducted using hazard ratio and 95 % confidence interval. In total, 14 retrospective articles were included in this study. Among them, 4 and 10 have evaluated the clinical impact of platelet count and platelet-to-lymphocyte ratio (PLR), respectively. Further, three studies reported about platelet distribution width (PDW) and mean platelet volume (MPV). Based on the synthesized results, high PLR was significantly associated with poor overall survival (OS). However, platelet count, PDW, and MPV were non-independent prognostic factors for OS. The Begg's funnel plots for PLR, PDW, and MPV indicated low publication bias.
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Affiliation(s)
- Yusuke Ishibashi
- Department of Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan
| | - Hironori Tsujimoto
- Department of Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan.
| | - Hidekazu Sugasawa
- Department of Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan
| | - Keita Kouzu
- Department of Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan
| | - Yujiro Itazaki
- Department of Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan
| | - Takao Sugihara
- Department of Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan
| | - Manabu Harada
- Department of Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan
| | - Nozomi Ito
- Department of Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan
| | - Yoji Kishi
- Department of Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan
| | - Hideki Ueno
- Department of Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan
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