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Kumar A, Gurram L, Naga Ch P, Nayak P, Mulye G, Chopra S, Engineer R, Shrivastava SK, Gupta S, Ghosh J, Gulia S, Agarwal JP, Mahantshetty U. Correlation of Hematological Parameters With Clinical Outcomes in Cervical Cancer Patients Treated With Radical Radio(chemo)therapy: A Retrospective Study. Int J Radiat Oncol Biol Phys 2024; 118:182-191. [PMID: 37506980 DOI: 10.1016/j.ijrobp.2023.07.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 07/02/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023]
Abstract
PURPOSE Variations in the levels of systemic inflammatory biomarker levels have been linked with outcomes in various malignancies including cervical cancer. In this study, we investigated prognostic implications of pretreatment hematological factors/indices in locally advanced cervical cancers treated with radical radio(chemo)therapy. METHODS AND MATERIALS Electronic medical records of 1051 patients with cervical cancer of FIGO (International Federation of Gynecology and Obstetrics) stage IB2-IVA treated in various prospective trials at our institute between 2003 and 2017 were reviewed. All clinical parameters such as age (dichotomized at the median), stage (IB2-IIB vs III-IVA), histologic type (squamous vs others), and hematological parameters (hemoglobin, platelets, absolute neutrophil count, absolute lymphocyte count, absolute monocyte count) were recorded. Neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and prognostic nutritional index (PNI; defined as 10 × albumin concentration [g/dL] + 0.005 × total lymphocyte count [μL]) were calculated. Univariate and multivariate (Cox regression) analyses were performed to evaluate these factors with disease-free survival (DFS) and overall survival (OS). RESULTS With a median follow-up of 69 months, the 5-year DFS and OS were 65% and 69%, respectively. On multivariate analysis, FIGO stage (hazard ratio [HR], 1.9; P = .000) and PLR (HR, 1.002; P = .008) significantly affected DFS while FIGO stage (HR, 1.804; P = .000), LMR (HR, 0.92; P = .018), PNI (HR, 0.96; P = .013), and PLR (HR, 1.002; P = .006) significantly affected OS. Apart from FIGO stage, PLR significantly affected both DFS and OS. This correlation of hematological parameters is stronger in stage IIIB cervical cancer. CONCLUSIONS Hematological indices, including PNI, PLR, and LMR, can serve as reliable prognostic indicators for patients with cervical cancer. By incorporating these indices into routine assessment and monitoring, clinicians can better stratify patients, personalize treatment plans, and more accurately predict outcomes, ultimately improving patient care and management.
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Affiliation(s)
- Amrendra Kumar
- Department of Radiation Oncology, Tata Memorial hospital, Tata Memorial Centre, Homi Bhabha National Institute, Parel, Mumbai, Maharashtra, India
| | - Lavanya Gurram
- Department of Radiation Oncology, Tata Memorial hospital, Tata Memorial Centre, Homi Bhabha National Institute, Parel, Mumbai, Maharashtra, India.
| | - Pushpa Naga Ch
- Department of Radiation Oncology, Apollo Cancer Centre Amalodbhavi Nagar, Naga, Bengaluru, Karnataka, India
| | - Prashant Nayak
- Department of Radiation Oncology, Tata Memorial hospital, Tata Memorial Centre, Homi Bhabha National Institute, Parel, Mumbai, Maharashtra, India
| | - Gargee Mulye
- Department of Radiation Oncology, Tata Memorial hospital, Tata Memorial Centre, Homi Bhabha National Institute, Parel, Mumbai, Maharashtra, India
| | - Supriya Chopra
- Department of Radiation Oncology, Tata Memorial hospital, Tata Memorial Centre, Homi Bhabha National Institute, Parel, Mumbai, Maharashtra, India
| | - Reena Engineer
- Department of Radiation Oncology, Tata Memorial hospital, Tata Memorial Centre, Homi Bhabha National Institute, Parel, Mumbai, Maharashtra, India
| | - Shyam Kishore Shrivastava
- Department of Radiation Oncology, HCG ICS Khubchandani Cancer Centre Colaba, Mumbai, Maharashtra, India
| | - Sudeep Gupta
- Department of Medical Oncology, Tata Memorial Hospital, Tata Memorial Centre, Homi Bhabha National Institute, Parel, Mumbai, Maharashtra, India
| | - Jaya Ghosh
- Department of Medical Oncology, Tata Memorial Hospital, Tata Memorial Centre, Homi Bhabha National Institute, Parel, Mumbai, Maharashtra, India
| | - Seema Gulia
- Department of Medical Oncology, Tata Memorial Hospital, Tata Memorial Centre, Homi Bhabha National Institute, Parel, Mumbai, Maharashtra, India
| | - Jai Prakash Agarwal
- Department of Radiation Oncology, Tata Memorial hospital, Tata Memorial Centre, Homi Bhabha National Institute, Parel, Mumbai, Maharashtra, India
| | - Umesh Mahantshetty
- Homi Bhabha Cancer Hospital, Tata Memorial Centre, Homi Bhabha National Institute, Visakhapatnam, Andhra Pradesh, India
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Ishida N, Tani S, Asai Y, Miyazu T, Tamura S, Yamade M, Iwaizumi M, Hamaya Y, Osawa S, Furuta T, Sugimoto K. Lymphocyte to monocyte ratio and serum albumin changes predict tacrolimus therapy outcomes in patients with ulcerative colitis. Sci Rep 2022; 12:13572. [PMID: 35945329 PMCID: PMC9363406 DOI: 10.1038/s41598-022-17763-2] [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: 03/06/2022] [Accepted: 07/30/2022] [Indexed: 11/26/2022] Open
Abstract
Tacrolimus therapy for ulcerative colitis is ineffective in certain patients; these patients require biologics or colectomy. We examined the ability of serum albumin levels and leukocyte subtypes to predict the therapeutic efficacy of tacrolimus. Patients with ulcerative colitis treated with tacrolimus were divided into non-failure and failure (required colectomy or switch to biologics or systemic steroids) groups. Serum albumin levels and leukocyte subtypes at induction, week 1, and week 2 after reaching high trough levels were retrospectively examined. Tacrolimus therapy failed in 18/45 patients within 3 months. The week 2/week 1 albumin ratio was significantly different between the failure and non-failure groups (P < 0.001). The receiver operating characteristic curve analysis revealed optimal cut-off value of the week 2/week 1 albumin ratio was 1.06, and area under the curve was 0.815. Analysis of leukocyte subtypes revealed significant between-group difference in the week 1 lymphocyte to monocyte ratio (P < 0.001). Multivariate analysis showed week 2/week 1 albumin ratio ≤ 1.06 and week 1 lymphocyte to monocyte ratio ≤ 3.86. Therefore, a low week 2/week 1 albumin and low week 1 lymphocyte to monocyte ratio predicted failure within 3 months of tacrolimus induction; a combination of these markers could accurately predict failure.
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Affiliation(s)
- Natsuki Ishida
- First Department of Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu-shi, Shizuoka, 431-3192, Japan
| | - Shinya Tani
- First Department of Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu-shi, Shizuoka, 431-3192, Japan
| | - Yusuke Asai
- First Department of Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu-shi, Shizuoka, 431-3192, Japan
| | - Takahiro Miyazu
- First Department of Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu-shi, Shizuoka, 431-3192, Japan
| | - Satoshi Tamura
- Department of Laboratory Medicine, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Mihoko Yamade
- First Department of Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu-shi, Shizuoka, 431-3192, Japan
| | - Moriya Iwaizumi
- Department of Endoscopic and Photodynamic Medicine, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Yasushi Hamaya
- First Department of Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu-shi, Shizuoka, 431-3192, Japan
| | - Satoshi Osawa
- Department of Laboratory Medicine, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Takahisa Furuta
- Center for Clinical Research, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Ken Sugimoto
- First Department of Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu-shi, Shizuoka, 431-3192, Japan.
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Zhang X, Jin F, Jiang S, Cao J, Meng Y, Xu Y, ChunmengWang, Chen Y, Yang H, Kong Y, Liu X, Luo Z. Rh-endostatin combined with chemotherapy in patients with advanced or recurrent mucosal melanoma: retrospective analysis of real-world data. Invest New Drugs 2022; 40:453-460. [PMID: 34731354 DOI: 10.1007/s10637-021-01172-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 08/26/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Mucosal melanoma is rare and has distinct clinical and genetic features. Even with advances in targeted and immune therapies, the survival of patients with advanced or recurrent mucosal melanomas remains poor. The standard treatment remains controversial and we conducted this real-world study aimed to explore continuous intravenous recombinant human endostatin (Rh-endostatin) infusion plus chemotherapy in this population in the first-line setting. METHODS Overall, 43 patients with advanced or recurrent mucosal melanoma treated at Fudan University Shanghai Cancer Center between April 2017 and August 2020 were retrospectively included. Patients received dacarbazine plus cisplatin or temozolomide plus cisplatin per the investigators' preference. Rh-endostatin (105 mg/m2) was administered with continuous infusion for 168 h (Civ 168 h). RESULTS Of the 43 patients, 72.1% had metastatic disease, and the most common primary site was the gastrointestinal tract (51.2%). The most commonly observed mutations were NRAS (23.1%), BRAF (7.7%) and CKIT mutations (5.1%). An objective response was observed in 12 (30.0%) of the 40 evaluable patients, and disease control was achieved in 31 (77.5%) patients. With a median follow-up of 17.6 months, the median progression-free survival (PFS) and overall survival (OS) were 4.9 and 15.3 months, respectively. Additionally, high lymphocyte-to-monocyte ratio (LMR) (p = 0.023, HR 0.29, 95% CI: 0.10-0.84) and BRAF/KIT/RAS mutation (p = 0.028, HR 0.24, 95% CI: 0.07-0.86) were independently correlated with prolonged OS. Toxicity was manageable overall. CONCLUSION Continuous Rh-endostatin infusion plus chemotherapy was effective and safe for the treatment of advanced or recurrent mucosal melanoma. High LMR was correlated with favorable PFS and OS in this patient population.
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Affiliation(s)
- Xiaowei Zhang
- Department of Medical Oncology, Department of Oncology, Fudan University Shanghai Cancer Center, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Feng Jin
- Department of Digestive Disease, 900Th Hospital of Joint Logistics Support Force, Fuzhou, 350002, China
| | - Shiyu Jiang
- Department of Medical Oncology, Department of Oncology, Fudan University Shanghai Cancer Center, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Jun Cao
- Department of Medical Oncology, Department of Oncology, Fudan University Shanghai Cancer Center, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Yanchun Meng
- Department of Medical Oncology, Department of Oncology, Fudan University Shanghai Cancer Center, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Yu Xu
- Department of Bone and Soft Tissue Sarcomas, Department of Oncology, Fudan University Shanghai Cancer Center, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - ChunmengWang
- Department of Bone and Soft Tissue Sarcomas, Department of Oncology, Fudan University Shanghai Cancer Center, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Yong Chen
- Department of Bone and Soft Tissue Sarcomas, Department of Oncology, Fudan University Shanghai Cancer Center, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Huijuan Yang
- Department of Gynecological Oncology, Department of Oncology, Fudan University Shanghai Cancer Center, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Yunyi Kong
- Department of Pathology, Department of Oncology, Fudan University Shanghai Cancer Center, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Xin Liu
- Department of Medical Oncology, Department of Oncology, Fudan University Shanghai Cancer Center, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
| | - Zhiguo Luo
- Department of Medical Oncology, Department of Oncology, Fudan University Shanghai Cancer Center, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
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Yang B, Eliot M, McClean MD, Waterboer T, Pawlita M, Butler R, Nelson HH, Langevin SM, Christensen BC, Kelsey KT. DNA methylation-derived systemic inflammation indices and their association with oropharyngeal cancer risk and survival. Head Neck 2022; 44:904-913. [PMID: 35048488 DOI: 10.1002/hed.26981] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 12/14/2021] [Accepted: 01/10/2022] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Head and neck squamous cell carcinomas are associated with systemic inflammation (SI). We evaluated whether DNA methylation-derived SI (mdSI) indices are associated with oropharyngeal cancer risk and survival. METHODS Ninety-four oropharyngeal squamous cell carcinoma (OPSCC) cases and 57 controls with DNA methylation data were included. Logistic regression analysis and survival analysis were performed to test the association of mdSI indices with OPSCC risk and survival. RESULTS Higher methylation-derived neutrophil-to-lymphocyte ratio (mdNLR) was associated with increased risk of OPSCC (OR = 1.21, 95%CI: 1.11-1.40) while no association was found with methylation-derived lymphocyte-to-monocyte ratio (mdLMR). For 5-year overall survival, higher mdLMR was significantly associated with decreased risk of death (HR = 0.25, 95%CI: 0.10-0.64) while the converse was observed for mdNLR (HR = 2.48, 95%CI: 1.04-5.92). CONCLUSION We observed an association between mdSI indices and OPSCC risk and 5-year overall survival. It is possible to use mdLMR as an independent prognostic factor for OPSCC.
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Affiliation(s)
- Bo Yang
- Department of Epidemiology, Brown University, Providence, Rhode Island, USA
| | - Melissa Eliot
- Department of Epidemiology, Brown University, Providence, Rhode Island, USA
| | - Michael D McClean
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Tim Waterboer
- Division of Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Michael Pawlita
- Division of Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Rondi Butler
- Department of Epidemiology, Brown University, Providence, Rhode Island, USA
| | - Heather H Nelson
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA.,Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Scott M Langevin
- Department of Environmental & Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Brock C Christensen
- Department of Epidemiology, Molecular and Systems Biology, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA.,Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
| | - Karl T Kelsey
- Department of Epidemiology, Brown University, Providence, Rhode Island, USA.,Department of Pathology and Laboratory Medicine, Brown University, Providence, Rhode Island, USA
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Cantero-Cid R, Montalbán-Hernández KM, Guevara J, Pascual-Iglesias A, Pulido E, Casalvilla JC, Marcano C, Serrano CB, Valentín J, Bonel-Pérez GC, Avendaño-Ortiz J, Terrón V, Lozano-Rodríguez R, Martín-Quirós A, Marín E, Pena E, Guerra-Pastrián L, López-Collazo E, Aguirre LA. Intertwined leukocyte balances in tumours and peripheral blood as robust predictors of right and left colorectal cancer survival. World J Gastrointest Oncol 2022; 14:295-318. [PMID: 35116118 PMCID: PMC8790415 DOI: 10.4251/wjgo.v14.i1.295] [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: 05/16/2021] [Revised: 07/07/2021] [Accepted: 11/30/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Colorectal cancer (CRC) accounts for 9.4% of overall cancer deaths, ranking second after lung cancer. Despite the large number of factors tested to predict their outcome, most patients with similar variables show big differences in survival. Moreover, right-sided CRC (RCRC) and left-sided CRC (LCRC) patients exhibit large differences in outcome after surgical intervention as assessed by preoperative blood leukocyte status. We hypothesised that stronger indexes than circulating (blood) leukocyte ratios to predict RCRC and LCRC patient outcomes will result from combining both circulating and infiltrated (tumour/peritumour fixed tissues) concentrations of leukocytes.
AIM To seek variables involving leukocyte balances in peripheral blood and tumour tissues and to predict the outcome of CRC patients.
METHODS Sixty-five patients diagnosed with colon adenocarcinoma by the Digestive Surgery Service of the La Paz University Hospital (Madrid, Spain) were enrolled in this study: 43 with RCRC and 22 with LCRC. Patients were followed-up from January 2017 to March 2021 to record overall survival (OS) and recurrence-free survival (RFS) after surgical interventions. Leukocyte concentrations in peripheral blood were determined by routine laboratory protocols. Paraffin-fixed samples of tumour and peritumoural tissues were assessed for leukocyte concentrations by immunohistochemical detection of CD4, CD8, and CD14 marker expression. Ratios of leukocyte concentration in blood and tissues were calculated and evaluated for their predictor values for OS and RFS with Spearman correlations and Cox univariate and multivariate proportional hazards regression, followed by the calculation of the receiver-operating characteristic and area under the curve (AUC) and the determination of Youden’s optimal cutoff values for those variables that significantly correlated with either RCRC or LCRC patient outcomes. RCRC patients from the cohort were randomly assigned to modelling and validation sets, and clinician-friendly nomograms were developed to predict OS and RFS from the respective significant indexes. The accuracy of the model was evaluated using calibration and validation plots.
RESULTS The relationship of leukocyte ratios in blood and peritumour resulted in six robust predictors of worse OS in RCRC: CD8+ lymphocyte content in peritumour (CD8pt, AUC = 0.585, cutoff < 8.250, P = 0.0077); total lymphocyte content in peritumour (CD4CD8pt, AUC = 0.550, cutoff < 10.160, P = 0.0188); lymphocyte-to-monocyte ratio in peritumour (LMRpt, AUC = 0.807, cutoff < 3.185, P = 0.0028); CD8+ LMR in peritumour (CD8MRpt, AUC = 0.757, cutoff < 1.650, P = 0.0007); the ratio of blood LMR to LMR in peritumour (LMRb/LMRpt, AUC = 0.672, cutoff > 0.985, P = 0.0244); and the ratio of blood LMR to CD8+ LMR in peritumour (LMRb/CD8MRpt, AUC = 0.601, cutoff > 1.485, P = 0.0101). In addition, three robust predictors of worse RFS in RCRC were found: LMRpt (AUC = 0.737, cutoff < 3.185, P = 0.0046); LMRb/LMRpt (AUC = 0.678, cutoff > 0.985, P = 0.0155) and LMRb/CD8MRpt (AUC = 0.615, cutoff > 1.485, P = 0.0141). Furthermore, the ratio of blood LMR to CD4+ LMR in peritumour (LMRb/CD4MRpt, AUC = 0.786, cutoff > 10.570, P = 0.0416) was found to robustly predict poorer OS in LCRC patients. The nomograms showed moderate accuracy in predicting OS and RFS in RCRC patients, with concordance index of 0.600 and 0.605, respectively.
CONCLUSION Easily obtainable variables at preoperative consultation, defining the status of leukocyte balances between peripheral blood and peritumoural tissues, are robust predictors for OS and RFS of both RCRC and LCRC patients.
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Affiliation(s)
- Ramón Cantero-Cid
- Tumor Immunology Laboratory, The Innate Immune Response Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid 28046, Spain
| | - Karla Marina Montalbán-Hernández
- Tumor Immunology Laboratory, The Innate Immune Response Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid 28046, Spain
| | - Jenny Guevara
- Digestive Surgery Service, La Paz University Hospital, Madrid 28046, Spain
| | - Alejandro Pascual-Iglesias
- Tumor Immunology Laboratory, The Innate Immune Response Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid 28046, Spain
| | - Elisa Pulido
- Tumor Immunology Laboratory, The Innate Immune Response Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid 28046, Spain
| | - José Carlos Casalvilla
- Tumor Immunology Laboratory, The Innate Immune Response Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid 28046, Spain
| | - Cristóbal Marcano
- Digestive Surgery Service, La Paz University Hospital, Madrid 28046, Spain
| | | | - Jaime Valentín
- Tumor Immunology Laboratory, The Innate Immune Response Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid 28046, Spain
| | - Gloria Cristina Bonel-Pérez
- Tumor Immunology Laboratory, The Innate Immune Response Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid 28046, Spain
| | - José Avendaño-Ortiz
- Tumor Immunology Laboratory, The Innate Immune Response Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid 28046, Spain
| | - Verónica Terrón
- Tumor Immunology Laboratory, The Innate Immune Response Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid 28046, Spain
| | - Roberto Lozano-Rodríguez
- Tumor Immunology Laboratory, The Innate Immune Response Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid 28046, Spain
| | - Alejandro Martín-Quirós
- Emergency Department and Emergent Pathology Research Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid 28046, Spain
| | - Elvira Marín
- Tumor Immunology Laboratory, The Innate Immune Response Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid 28046, Spain
| | - Eva Pena
- Pathologic Anatomy Service, Hospital La Paz, Madrid 28046, Spain
| | | | - Eduardo López-Collazo
- Tumor Immunology Laboratory, The Innate Immune Response Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid 28046, Spain
| | - Luis Augusto Aguirre
- Tumor Immunology Laboratory, The Innate Immune Response Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid 28046, Spain
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Lin YW, Kang WP, Huang BL, Qiu ZH, Wei LF, Zhang B, Ding TY, Luo Y, Liu CT, Chu LY, Guo HP, Xu YW, Peng YH. Nomogram based on clinical characteristics and serological inflammation markers to predict overall survival of oral tongue squamous cell carcinoma patient after surgery. BMC Oral Health 2021; 21:667. [PMID: 34961504 PMCID: PMC8711158 DOI: 10.1186/s12903-021-02028-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 12/14/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Oral tongue squamous cell carcinoma (OTSCC) is a prevalent malignant disease that is characterized by high rates of metastasis and postoperative recurrence. The aim of this study was to establish a nomogram to predict the outcome of OTSCC patients after surgery. METHODS We retrospectively analyzed 169 OTSCC patients who underwent treatments in the Cancer Hospital of Shantou University Medical College from 2008 to 2019. The Cox regression analysis was performed to determine the independent prognostic factors associated with patient's overall survival (OS). A nomogram based on these prognostic factors was established and internally validated using a bootstrap resampling method. RESULTS Multivariate Cox regression analysis revealed the independent prognostic factors for OS were TNM stage, age, lymphocyte-to-monocyte ratio and immunoglobulin G, all of which were identified to create the nomogram. The Akaike Information Criterion and Bayesian Information Criterion of the nomogram were lower than those of TNM stage (292.222 vs. 305.480; 298.444 vs. 307.036, respectively), indicating a better goodness-of-fit of the nomogram for predicting OS. The bootstrap-corrected of concordance index (C-index) of nomogram was 0.784 (95% CI 0.708-0.860), which was higher than that of TNM stage (0.685, 95% CI 0.603-0.767, P = 0.017). The results of time-dependent C-index for OS also showed that the nomogram had a better discriminative ability than that of TNM stage. The calibration curves of the nomogram showed good consistency between the probabilities and observed values. The decision curve analysis also revealed the potential clinical usefulness of the nomogram. Based on the cutoff value obtained from the nomogram, the proposed high-risk group had poorer OS than low-risk group (P < 0.0001). CONCLUSIONS The nomogram based on clinical characteristics and serological inflammation markers might be useful for outcome prediction of OTSCC patient.
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Affiliation(s)
- Yi-Wei Lin
- Department of Clinical Laboratory Medicine, The Cancer Hospital of Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China
- Precision Medicine Research Center, Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China
| | - Wei-Piao Kang
- Department of Otolaryngology, The Second Affiliated Hospital of Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China
| | - Bin-Liang Huang
- Department of Clinical Laboratory Medicine, The Cancer Hospital of Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China
- Precision Medicine Research Center, Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China
| | - Zi-Han Qiu
- Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China
| | - Lai-Feng Wei
- Department of Clinical Laboratory Medicine, The Cancer Hospital of Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China
- Precision Medicine Research Center, Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China
| | - Biao Zhang
- Department of Clinical Laboratory Medicine, The Cancer Hospital of Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China
- Precision Medicine Research Center, Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China
| | - Tian-Yan Ding
- Department of Clinical Laboratory Medicine, The Cancer Hospital of Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China
- Precision Medicine Research Center, Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China
| | - Yun Luo
- Department of Clinical Laboratory Medicine, The Cancer Hospital of Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China
- Precision Medicine Research Center, Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China
| | - Can-Tong Liu
- Department of Clinical Laboratory Medicine, The Cancer Hospital of Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China
- Precision Medicine Research Center, Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China
| | - Ling-Yu Chu
- Department of Clinical Laboratory Medicine, The Cancer Hospital of Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China
- Precision Medicine Research Center, Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China
| | - Hai-Peng Guo
- Department of Head and Neck Surgery, The Cancer Hospital of Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China.
| | - Yi-Wei Xu
- Department of Clinical Laboratory Medicine, The Cancer Hospital of Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China.
- Precision Medicine Research Center, Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China.
- Guangdong Esophageal Cancer Institute, The Cancer Hospital of Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China.
| | - Yu-Hui Peng
- Department of Clinical Laboratory Medicine, The Cancer Hospital of Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China.
- Precision Medicine Research Center, Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China.
- Guangdong Esophageal Cancer Institute, The Cancer Hospital of Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China.
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Lymphocyte-to-Monocyte Ratio as a Marker for Endoscopic Activity in Ulcerative Colitis. IMMUNO 2021. [DOI: 10.3390/immuno1040024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Leukocyte subtypes can be used to evaluate the severity of ulcerative colitis (UC). In this study, we examined the relationship between the lymphocyte-to-monocyte ratio (LMR) and the Mayo endoscopic score (MES) in assessing endoscopic activity in UC. Eighty-nine samples of leukocyte subtypes and biomarkers, including fecal calprotectin (FC), the fecal immunochemical occult blood test (FIT), and C-reactive protein (CRP), from 71 patients with UC were retrospectively investigated, along with the MES. The MES was significantly correlated with the LMR, FC, the FIT, and CRP. There were significant differences in the LMR, FC, the FIT, and CRP between groups with an MES < 1 and >2 (p = 0.001, p = 0.003, p < 0.001, and p < 0.001, respectively). In the receiver operating characteristic (ROC) analysis for predicting mucosal healing (MES 0 or 1), the areas under the curve (AUCs) for the LMR, FC, the FIT, and CRP, were 0.712, 0.860, 0.908, and 0.796, respectively. In the analysis of patients without immunomodulators, the correlation of the MES with the LMR and CRP was significant. The LMR can be used to assess endoscopic activity in UC, particularly in patients without immunomodulators.
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Nouri-Vaskeh M, Mirza-Aghazadeh-Attari M, Pashazadeh F, Azami-Aghdash S, Alizadeh H, Pouya P, Halimi M, Jadideslam G, Zarei M. Prognostic Impact of Monocyte to Lymphocyte Ratio in Clinical Outcome of Patients with Hepatocellular Carcinoma: A Systematic Review and Meta-analysis. Galen Med J 2021; 9:e1948. [PMID: 34466618 PMCID: PMC8344106 DOI: 10.31661/gmj.v9i0.1948] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 06/23/2020] [Accepted: 06/30/2020] [Indexed: 01/14/2023] Open
Abstract
Background: Lymphocyte to monocyte ratio (LMR) is a surrogate marker of systemic inflammation which is shown to be related to the patient’s survival in multiple malignancies. An important implication of this marker potentially is neoplasms in which there is no correlation between prognosis and histopathological staging and also has no reliable chemical markers associated with prognosis. Herein, this meta-analysis aimed to investigate the prognostic role of LMR in patients with hepatocellular carcinoma (HCC). Materials and Methods: In the current systemic review and meta-analysis, we conducted a systemic search of databases and indexing sources, including PubMed, EMBASE, Cochrane, Scopus, and ProQuest up to May 2019 toinclude studies on the prognostic significance of LMR on patients with HCC. Overall survival (OS), disease-free survival (DFS) and recurrence-free survival (RFS) values were extracted from the studies and analyzed. The pooled hazard ratio with a 95% confidence interval was explored to identify the prognostic value of the LMR in the survival of the patients with HCC. Results: A total of 12 studies with a total sample size of 3750 cases were included. There was significant heterogeneity among the studies; therefore, subgroup analysis was also performed. Overall analysis regarding OS showed an insignificant relationship between LMR and patient’s prognosis, dividing to subgroups based on LMR cut-offs did not yield any significant result, subgroup analysis for RFS founded statistically significant results and LMR was significantly related to DFS. Conclusion: High LMR was associated with increased DFS and RFS, in return this association was not observed for OS.
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Affiliation(s)
- Masoud Nouri-Vaskeh
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Network of Immunity in Infection, Malignancy and Autoimmunity, Universal Scientific Education and Research Network, Tehran, Iran
| | | | - Fariba Pashazadeh
- Iranian EBM Centre: A Joanna Briggs Institute Affiliated Group
- Research Center for Evidence-Based Medicine, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saber Azami-Aghdash
- Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hadi Alizadeh
- Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Parnia Pouya
- Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Monireh Halimi
- Department of Pathology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
- Correspondence to: Monireh Halimi, Associate Professor of Pathology, Department of Pathology, Tabriz University of Medical Sciences, Tabriz, Iran Telephone Number: +984133376923 Email Address:
| | - Golamreza Jadideslam
- Department of Molecular Medicine, Faculty of Advanced Medical Sciences, Tabriz university of Medical Sciences, Tabriz, Iran
| | - Mohammad Zarei
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Center for Mitochondrial and Epigenomic Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
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9
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Aoyama J, Kuwahara T, Sano D, Fujisawa T, Tokuhisa M, Shimizu M, Sakagami T, Ichikawa Y, Iwai H, Oridate N. Combination of Performance Status and Lymphocyte-monocyte Ratio as a Novel Prognostic Marker for Patients With Recurrent/Metastatic Squamous Cell Carcinoma of the Head and Neck. CANCER DIAGNOSIS & PROGNOSIS 2021; 1:353-361. [PMID: 35403150 PMCID: PMC8988961 DOI: 10.21873/cdp.10047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 07/16/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND/AIM We previously presented the real-world treatment outcomes of the EXTREME regimen as a first-line therapy for recurrent/metastatic squamous cell carcinoma of the head and neck (R/M SCCHN). This study aimed to evaluate the prognostic significance of pretreatment inflammatory biomarkers in patients with R/M-SCCHN treated with the EXTREME regimen as first-line therapy as a supplementary study of our previous retrospective cohort study. PATIENTS AND METHODS The treatment outcomes of 100 patients with R/M-SCCHN treated with the EXTREME regimen as first-line therapy were compared according to patient characteristics and pretreatment inflammatory biomarkers using a Cox proportional hazards regression model. Survival was evaluated using the Kaplan-Meier method. RESULTS In multivariate analysis, a lymphocyte-to-monocyte ratio (LMR) of <1.944 and Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 1 were independent risk factors for poor overall and progression-free survival. Furthermore, we found that the PS-LMR score based on the ECOG PS and LMR could stratify patients to extract the poor prognostic characteristics of R/M-SCCHN patients treated with the EXTREME regimen as first-line therapy. CONCLUSION Further evaluation is warranted to study the reliability and applicability of this novel scoring system in predicting the prognosis of R/M-SCCHN patients in the future.
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Affiliation(s)
- Jun Aoyama
- Department of Otorhinolaryngology, Head and Neck Surgery,Yokohama City University, School of Medicine, Yokohama, Japan
| | - Tatsu Kuwahara
- Department of Otorhinolaryngology, Head and Neck Surgery,Yokohama City University, School of Medicine, Yokohama, Japan
| | - Daisuke Sano
- Department of Otorhinolaryngology, Head and Neck Surgery,Yokohama City University, School of Medicine, Yokohama, Japan
| | - Takuo Fujisawa
- Department of Otorhinolaryngology, Head and Neck Surgery, Kansai Medical University, Osaka, Japan
| | - Motohiko Tokuhisa
- Department of Oncology, Yokohama City University,Yokohama City University, School of Medicine, Yokohama, Japan
| | - Minaki Shimizu
- Department of Otorhinolaryngology, Head and Neck Surgery, Kansai Medical University, Osaka, Japan
| | - Tomofumi Sakagami
- Department of Otorhinolaryngology, Head and Neck Surgery, Kansai Medical University, Osaka, Japan
| | - Yasushi Ichikawa
- Department of Oncology, Yokohama City University,Yokohama City University, School of Medicine, Yokohama, Japan
| | - Hiroshi Iwai
- Department of Otorhinolaryngology, Head and Neck Surgery, Kansai Medical University, Osaka, Japan
| | - Nobuhiko Oridate
- Department of Otorhinolaryngology, Head and Neck Surgery,Yokohama City University, School of Medicine, Yokohama, Japan
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10
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Jia W, Yuan L, Ni H, Xu B, Zhao P. Prognostic Value of Platelet-to-Lymphocyte Ratio, Neutrophil-to-Lymphocyte Ratio, and Lymphocyte-to-White Blood Cell Ratio in Colorectal Cancer Patients Who Received Neoadjuvant Chemotherapy. Technol Cancer Res Treat 2021; 20:15330338211034291. [PMID: 34308689 PMCID: PMC8317245 DOI: 10.1177/15330338211034291] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background: The objective of this study was to assess the prognostic value of pretreatment platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), and lymphocyte-to-white blood cell ratio (LWR) of CRC patients who received neoadjuvant chemotherapy. Methods: We analyzed the peripheral blood routine parameters and other clinical data of 145 patients with colorectal cancer who had undergone neoadjuvant chemotherapy between January 2011 and February 2014. Pretreatment blood parameters of 145 patients were collected, and PLR, NLR, and LWR were calculated. The utility of PLR, NLR, and LWR in predicting treatment efficacy and patient survival was statistically evaluated using the chi-square test, log-rank test, Kaplan-Meier curves and logistic regression models, and Cox regression models. Results: Receiver operating characteristic curve showed that the best cutoff values of PLR, NLR, and LWR were 154.31, 3.01, and 0.22, respectively. In univariate analysis, tumor location (P = 0.044), differentiation degree (P = 0.001), lymph node metastasis (P = 0.020), and high PLR (P = 0.042) were significantly correlated with a lower overall response rate (ORR). In addition, clinical stage, lymph node metastasis, and high PLR were correlated with short OS (P < 0.01) and DFS (P < 0.01). Moreover, WBC count was correlated with a short OS. Multivariate analysis showed that tumor location (P = 0.013), differentiation degree (P = 0.001), and lymph node metastasis (P = 0.033) were independent predictors of ORR. In addition, lymph node metastasis independently predicted a shorter OS (P = 0.011). Lymph node metastasis (P = 0.013) and high PLR (P = 0.022) were independent prognostic factors for short DFS. Conclusions: For CRC patients who received NAC, clinical pathological stage and lymph node metastasis were correlated with lower ORR and survival, while a high PLR that may be of prognostic relevance in CRC patients receiving NAC.
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Affiliation(s)
- Wangqiang Jia
- Department of General Surgery, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan, People's Republic of China
| | - Long Yuan
- Department of General Surgery, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan, People's Republic of China
| | - Hongyan Ni
- Department of General Surgery, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan, People's Republic of China
| | - Benling Xu
- Department of Immunotherapy, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Peng Zhao
- Department of General Surgery, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan, People's Republic of China
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11
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Descriptive statistics of dataset from the meta-analysis and meta-regression analysis on prognostic significance of pre-treatment systemic hemato-immunological indices of cervical cancer patients. Data Brief 2021; 35:106925. [PMID: 33850979 PMCID: PMC8039823 DOI: 10.1016/j.dib.2021.106925] [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: 01/27/2021] [Revised: 02/23/2021] [Accepted: 02/23/2021] [Indexed: 11/30/2022] Open
Abstract
In this study, we perform a meta-analysis and meta-regression analysis for the article entitled “Prognostic value of systemic hemato-immunological indices in uterine cervical cancer: A systemic review, meta-analysis, and meta-regression of observational studies.” [1] We implemented quantitative meta-analyses and time series meta-regression analysis to determine whether systemic hemato-immunological indices, such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), thrombocyte-to-lymphocyte ratio (TLR), and C-reactive protein/albumin ratio (CAR) are associated with an increased risk of cervical collision cancer. In all, 9558 patients from 22 studies were included after a systematic data search, performed comprehensively using the following databases: MEDLINE, Web of Science, Embase, and Cochrane. The meta-analysis was conducted with a random-effects model using the Review Manager software (Revman version 5.3). The overall survival (OS), disease-free survival (DFS), and progression-free survival (PFS) data were compared among each observational study. All data are expressed as hazard ratios (HRs) and 95% confidence intervals (CIs), and were calculated using the generic inverse of variance method. Statistical heterogeneity was quantified using Cochrane's Q statistic and Higgins I2 statistic. Subgroup analysis was performed to investigate the sources of heterogeneity. Furthermore, quality assessment of the included datasets was presented according to the Newcastle-Ottawa Scale method. Additionally, sensitivity analysis was conducted to explore the sources of heterogeneity and analyze whether the results were stable and reliable. Meta-analysis random-effect approach was used for the regression to evaluate the effect of age, presence of squamous cell carcinoma patients, and number of evaluated NLR and PLR parameters on patient survival.
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12
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Hopkins R, Xiang W, Marlier D, Au VB, Ching Q, Wu LX, Guan R, Lee B, Chia WK, Wang WW, Wee J, Ng J, Cheong R, Han S, Chu A, Chee CL, Shuen T, Podinger M, Lezhava A, Toh HC, Connolly JE. Monocytic Myeloid-Derived Suppressor Cells Underpin Resistance to Adoptive T Cell Therapy in Nasopharyngeal Carcinoma. Mol Ther 2021; 29:734-743. [PMID: 33038324 PMCID: PMC7854281 DOI: 10.1016/j.ymthe.2020.09.040] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 08/28/2020] [Accepted: 09/28/2020] [Indexed: 12/18/2022] Open
Abstract
Advanced, late-stage Epstein-Barr virus (EBV)-positive nasopharyngeal carcinoma (NPC) is incurable, and its treatment remains a clinical and therapeutic challenge. Results from a phase II clinical trial in advanced NPC patients employing a combined chemotherapy and EBV-specific T cell (EBVST) immunotherapy regimen showed a response rate of 71.4%. Longitudinal analysis of patient samples showed that an increase in EBV DNA plasma concentrations and the peripheral monocyte-to-lymphocyte ratio negatively correlated with overall survival. These parameters were combined into a multivariate analysis to stratify patients according to risk of death. Immunophenotyping at serial time points showed that low-risk individuals displayed significantly decreased amounts of monocytic myeloid-derived suppressor cells postchemotherapy, which subsequently influenced successful cytotoxic T-lymphocyte (CTL) immunotherapy. Examination of the low-risk group, 2 weeks post-EBVST infusion, showed that individuals with a greater overall survival possessed an increased frequency of CD8 central and effector memory T cells, together with higher levels of plasma interferon (IFN)-γ, and cytotoxic lymphocyte-associated transcripts. These results highlight the importance of the rational selection of chemotherapeutic agents and consideration of their impact on both systemic immune responses and downstream cellular immunotherapy outcomes.
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Affiliation(s)
- Richard Hopkins
- Institute of Molecular and Cell Biology, A∗STAR, Singapore 138673, Singapore; Tessa Therapeutics, Singapore 038982, Singapore
| | | | | | - Veonice Bijin Au
- Institute of Molecular and Cell Biology, A∗STAR, Singapore 138673, Singapore
| | - Qianting Ching
- Institute of Molecular and Cell Biology, A∗STAR, Singapore 138673, Singapore
| | - Lynn Xue Wu
- Institute of Molecular and Cell Biology, A∗STAR, Singapore 138673, Singapore
| | - Rujun Guan
- Tessa Therapeutics, Singapore 038982, Singapore
| | - Bernett Lee
- Singapore Immunology Network, Singapore 138648, Singapore
| | - Whay-Kuang Chia
- National Cancer Centre Singapore, Singapore 169610, Singapore
| | - Who-Whong Wang
- Tessa Therapeutics, Singapore 038982, Singapore; National Cancer Centre Singapore, Singapore 169610, Singapore
| | - Joseph Wee
- National Cancer Centre Singapore, Singapore 169610, Singapore
| | - Joanna Ng
- Tessa Therapeutics, Singapore 038982, Singapore; National Cancer Centre Singapore, Singapore 169610, Singapore
| | - Rachael Cheong
- National Cancer Centre Singapore, Singapore 169610, Singapore
| | - Shuting Han
- National Cancer Centre Singapore, Singapore 169610, Singapore
| | - Axel Chu
- National Cancer Centre Singapore, Singapore 169610, Singapore
| | - Chit Lai Chee
- National Cancer Centre Singapore, Singapore 169610, Singapore
| | - Timothy Shuen
- National Cancer Centre Singapore, Singapore 169610, Singapore
| | | | | | - Han Chong Toh
- Institute of Molecular and Cell Biology, A∗STAR, Singapore 138673, Singapore; Tessa Therapeutics, Singapore 038982, Singapore; National Cancer Centre Singapore, Singapore 169610, Singapore.
| | - John E Connolly
- Institute of Molecular and Cell Biology, A∗STAR, Singapore 138673, Singapore; Tessa Therapeutics, Singapore 038982, Singapore; Institute of Biomedical Studies, Baylor University, Waco, TX 76712, USA.
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13
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Simple Peripheral Blood Cell Parameters to Predict Prognosis in Non-Small Cell Lung Cancer. Indian J Surg 2021. [DOI: 10.1007/s12262-020-02237-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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14
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Xu L, Chen J, Guo H, Huang R, Guo L, Yu Y, Zhai T, Wu F, Chen Z, Li D, Chen C. Distribution of Peripheral Blood Cells in Esophageal Cancer Patients During Concurrent Chemoradiotherapy Predicts Long-Term Locoregional Progression Hazard After Treatment (GASTO1072). Cancer Manag Res 2021; 13:4203-4215. [PMID: 34079373 PMCID: PMC8164679 DOI: 10.2147/cmar.s307695] [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: 02/25/2021] [Accepted: 05/04/2021] [Indexed: 02/05/2023] Open
Abstract
PURPOSE Predicting the response to chemoradiotherapy is critical for the optimal management of esophageal cancer; however, it remains an unmet clinical need. This study aimed to evaluate the predictive potential of peri-treatment peripheral blood cells (PBC) in disease progression hazard in esophageal cancer following chemoradiotherapy. PATIENTS AND METHODS A total of 87 patients with primary esophageal squamous cell carcinoma were subjected to definitive concurrent chemoradiotherapy in a Phase II trial. PBC parameters (hemoglobin, neutrophils, platelets, lymphocytes, and monocytes) were collected at seven time points throughout the course of radiotherapy. The potential of peri-treatment PBC parameters to predict the 3-year cumulative hazard of tumor progression was evaluated. RESULTS Patients with disease progression displayed distinct distribution patterns of peri-treatment PBC compared to that in patients without disease progression. Greater prediction capabilities for risk of locoregional disease progression were found in PBC collected after the start of radiotherapy compared to those in their pretreatment counterparts, and in individual parameters rather than cell-to-cell ratios. The most predictive PBC parameters were integrated by summation and designated as a PBC score (PBCS), which further augmented their predictive power. Patients classified according to their PBCS (high vs medium v. low) had significantly different 3-year cumulative hazards of locoregional progression (58% vs 29% vs 7%, P = 0.0017). Multivariate analysis confirmed that high PBCS (HR, 12.2; 95% CI, 2.0-76.3; P = 0.007) and medium (HR, 5.8; 95% CI 1.2-27.7; P = 0.028) were independent indicators of locoregional progression. CONCLUSION Systematic analysis of PBC distribution in esophageal cancer patients undergoing definitive chemoradiotherapy could help predict long-term locoregional progression hazard after treatment.
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Affiliation(s)
- Liangyu Xu
- Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, Shantou, 515031, People’s Republic of China
- Department of Radiation Oncology, Dongguan Tungwah Hospital, Dongguan, 523110, People’s Republic of China
| | - Jianzhou Chen
- Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, Shantou, 515031, People’s Republic of China
| | - Hong Guo
- Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, Shantou, 515031, People’s Republic of China
| | - Ruihong Huang
- Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, Shantou, 515031, People’s Republic of China
| | - Longjia Guo
- Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, Shantou, 515031, People’s Republic of China
| | - Yuanxiang Yu
- Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, Shantou, 515031, People’s Republic of China
| | - Tiantian Zhai
- Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, Shantou, 515031, People’s Republic of China
| | - Fangcai Wu
- Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, Shantou, 515031, People’s Republic of China
| | - Zhijian Chen
- Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, Shantou, 515031, People’s Republic of China
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, 518116, People’s Republic of China
| | - Derui Li
- Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, Shantou, 515031, People’s Republic of China
| | - Chuangzhen Chen
- Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, Shantou, 515031, People’s Republic of China
- Correspondence: Chuangzhen Chen Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, 7 Raoping Road, Shantou, Guangdong, 515031, People’s Republic of ChinaTel/Fax +86 754 88555844 Email
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15
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Jin J, Yang L, Liu D, Li WM. Prognostic Value of Pretreatment Lymphocyte-to-Monocyte Ratio in Lung Cancer: A Systematic Review and Meta-Analysis. Technol Cancer Res Treat 2021; 20:1533033820983085. [PMID: 33576324 PMCID: PMC7887688 DOI: 10.1177/1533033820983085] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 11/11/2020] [Accepted: 11/30/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The overall prognosis of lung cancer remains unfavorable and novel prognostic biomarkers of lung cancer are needed warranted. Accumulating evidence indicate that systemic inflammation plays a vital role in lung cancer. The lymphocyte-to-monocyte ratio (LMR) is biomarker that reflects the level of systemic inflammation. OBJECTIVE To perform a comprehensive meta-analysis exploring the correlation of pretreatment LMR with the overall survival (OS) and progression-free survival (PFS) of lung cancer patients. METHODS We conducted searches of the PubMed, Embase, Cochrane Library, and Web of Science databases to May 2020 to identify relevant studies and calculated combined hazard ratios (HRs) to evaluate the association between pretreatment LMR and survival time in patients with lung cancer. RESULTS A total of 23 studies comprising 8361 lung cancer patients were included. Among the patients, 5702 (68%) were males, 4548 were current smokers and 2212 were diagnosed with squamous carcinoma. The pooled analysis revealed that decreased pretreatment LMR was significantly correlated with reduced of PFS (HR = 1.49, 95% CI: 1.34-1.67, p < 0.01) and reduced OS (HR = 1.61, 95% CI: 1.45-1.79, p < 0.01) among lung cancer patients. Furthermore, in the subgroup analyses according to histologic type, a lower level of pretreatment LMR seemed to be unrelated to the poorer OS of small cell lung cancer (SCLC) patients (HR = 1.21, 95%CI: 0.87-1.67, P = 0.25). CONCLUSIONS Decreased pretreatment LMR in peripheral blood was associated with shorter OS and PFS in lung cancer patients, suggesting its potential prognostic value.
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Affiliation(s)
- Jing Jin
- Department of Pulmonary & Critical Care, West China Hospital, Sichuan University, Chengdu, China
| | - Lan Yang
- Department of Pulmonary & Critical Care, West China Hospital, Sichuan University, Chengdu, China
| | - Dan Liu
- Department of Pulmonary & Critical Care, West China Hospital, Sichuan University, Chengdu, China
| | - Wei Min Li
- Department of Pulmonary & Critical Care, West China Hospital, Sichuan University, Chengdu, China
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Bauckneht M, Rebuzzi SE, Signori A, Donegani MI, Murianni V, Miceli A, Borea R, Raffa S, Damassi A, Ponzano M, Catalano F, Martelli V, Marini C, Boccardo F, Morbelli S, Sambuceti G, Fornarini G. The Prognostic Role of Baseline Metabolic Tumor Burden and Systemic Inflammation Biomarkers in Metastatic Castration-Resistant Prostate Cancer Patients Treated with Radium-223: A Proof of Concept Study. Cancers (Basel) 2020; 12:E3213. [PMID: 33142739 PMCID: PMC7693606 DOI: 10.3390/cancers12113213] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 10/26/2020] [Accepted: 10/29/2020] [Indexed: 12/13/2022] Open
Abstract
Over the last years has emerged the urgent need for the identification of reliable prognostic biomarkers able to potentially identify metastatic castration-resistant prostate cancer (mCRPC) patients most likely to benefit from Radium-223 (Ra-223) since baseline. In the present monocentric retrospective study, we analyzed the prognostic power of systemic inflammation biomarkers and 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG-PET)-derived parameters and their potential interplay in this clinical setting. The following baseline laboratory parameters were collected in 59 mCRPC patients treated with Ra-223: neutrophil-to-lymphocyte ratio (NLR), derived NLR (dNLR), lymphocyte-to-monocyte ratio (LMR), platelets-to-lymphocyte ratio (PLR), and systemic inflammation index (SII), while maximum Standardized Uptake Value, Metabolic Tumor Volume (MTV), and Total Lesion Glycolysis (TLG) were calculated in the 48 of them submitted to baseline FDG-PET. At the univariate analysis, NLR, dNLR, MTV, and TLG were able to predict the overall survival (OS). However, only NLR and MTV were independent predictors of OS at the multivariate analysis. Additionally, the occurrence of both increased NLR and MTV at baseline identified mCRPC patients at higher risk for lower long-term survival after treatment with Ra-223. In conclusion, the degree of systemic inflammation, the quantification of the metabolically active tumor burden and their combination might represent potentially valuable tools for identifying mCRPC patients who are most likely to benefit from Ra-223. However, further studies are needed to reproduce these findings in larger settings.
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Affiliation(s)
- Matteo Bauckneht
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (C.M.); (S.M.); (G.S.)
| | - Sara Elena Rebuzzi
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (S.E.R.); (V.M.); (R.B.); (A.D.); (F.C.); (V.M.); (G.F.)
| | - Alessio Signori
- Department of Health Sciences (DISSAL), University of Genova, Largo R. Benzi 10, 16132 Genova, Italy; (A.S.); (M.I.D.); (A.M.); (S.R.); (M.P.)
| | - Maria Isabella Donegani
- Department of Health Sciences (DISSAL), University of Genova, Largo R. Benzi 10, 16132 Genova, Italy; (A.S.); (M.I.D.); (A.M.); (S.R.); (M.P.)
| | - Veronica Murianni
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (S.E.R.); (V.M.); (R.B.); (A.D.); (F.C.); (V.M.); (G.F.)
| | - Alberto Miceli
- Department of Health Sciences (DISSAL), University of Genova, Largo R. Benzi 10, 16132 Genova, Italy; (A.S.); (M.I.D.); (A.M.); (S.R.); (M.P.)
| | - Roberto Borea
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (S.E.R.); (V.M.); (R.B.); (A.D.); (F.C.); (V.M.); (G.F.)
| | - Stefano Raffa
- Department of Health Sciences (DISSAL), University of Genova, Largo R. Benzi 10, 16132 Genova, Italy; (A.S.); (M.I.D.); (A.M.); (S.R.); (M.P.)
| | - Alessandra Damassi
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (S.E.R.); (V.M.); (R.B.); (A.D.); (F.C.); (V.M.); (G.F.)
| | - Marta Ponzano
- Department of Health Sciences (DISSAL), University of Genova, Largo R. Benzi 10, 16132 Genova, Italy; (A.S.); (M.I.D.); (A.M.); (S.R.); (M.P.)
| | - Fabio Catalano
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (S.E.R.); (V.M.); (R.B.); (A.D.); (F.C.); (V.M.); (G.F.)
| | - Valentino Martelli
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (S.E.R.); (V.M.); (R.B.); (A.D.); (F.C.); (V.M.); (G.F.)
| | - Cecilia Marini
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (C.M.); (S.M.); (G.S.)
- CNR Institute of Molecular Bioimaging and Physiology (IBFM), 20090 Segrate (MI), Italy
| | - Francesco Boccardo
- Academic Unit of Medical Oncology, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy;
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, 16132 Genova, Italy
| | - Silvia Morbelli
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (C.M.); (S.M.); (G.S.)
- Department of Health Sciences (DISSAL), University of Genova, Largo R. Benzi 10, 16132 Genova, Italy; (A.S.); (M.I.D.); (A.M.); (S.R.); (M.P.)
| | - Gianmario Sambuceti
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (C.M.); (S.M.); (G.S.)
- Department of Health Sciences (DISSAL), University of Genova, Largo R. Benzi 10, 16132 Genova, Italy; (A.S.); (M.I.D.); (A.M.); (S.R.); (M.P.)
| | - Giuseppe Fornarini
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (S.E.R.); (V.M.); (R.B.); (A.D.); (F.C.); (V.M.); (G.F.)
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Han X, Liu S, Yang G, Hosseinifard H, Imani S, Yang L, Maghsoudloo M, Fu S, Wen Q, Liu Q. Prognostic value of systemic hemato-immunological indices in uterine cervical cancer: A systemic review, meta-analysis, and meta-regression of observational studies. Gynecol Oncol 2020; 160:351-360. [PMID: 33092868 DOI: 10.1016/j.ygyno.2020.10.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 10/10/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To estimate the prognostic efficacy of several systemic hemato-immunological indices for the treatment of cervical cancer as well as to determine whether the systemic hemato-immunological indices are associated with an increased risk of cervical collision cancer. METHODS A systematic search was conducted to identify studies that evaluated the prognostic impact of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), thrombocyte-to-lymphocyte ratio (TLR), C-reactive protein/albumin ratio (CAR), and systemic immune-inflammation index (SII) in cervical cancer patients. The endpoints were overall survival (OS) or progression-free survival (PFS) and clinicopathologic parameters. A meta-analysis using random-effect models was performed to calculate hazard ratios (HRs) or odds ratios with 95% confidence intervals. RESULTS Twenty-two retrospective cohort studies involving 9558 patients were included. Our results show that high NLR, PLR, TLR, and CAR indicated poor prognosis for patients with cervical cancer (HRs = 2.46, 1.88, 3.70, and 3.94, respectively; all P ≤ 0.001). Subgroup analysis suggested that the highest NLR and PLR were more precise biomarkers in patients who were diagnosed with FIGO stage I-III cervical cancer after treatment with chemo-radiotherapy. High TLR and high LMR displayed significant prognostic value in late-FIGO stage III-IV cervical cancer (HRs = 4.33 and 2.032, respectively). Additionally, CAR was associated with poor survival in patients with advanced-FIGO stage cervical cancer and larger tumor size. According to the difference of NLR, the younger (43-51 years old) cervical cancer patients had a tendency of increased collision risk. However, cervical cancer patients in the 52-61 years age group were more vulnerable than their respective counterparts using the pooled estimate for PLR. CONCLUSION Our findings support a prognostic role for elevated CAR and TLR besides that of NLR and PLR in advanced-FIGO stage cervical cancer.
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Affiliation(s)
- Xingping Han
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, People's republic of China; Clinical Nursing Research Institute, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, People's republic of China
| | - Shuya Liu
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, People's republic of China
| | - Gang Yang
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, People's republic of China; Department of Oncology, Anyue Hospital of Traditional Chinese Medicine, Second Ziyang Hospital of Traditional Chinese Medicine, Ziyang, Sichuan, People's republic of China
| | - Hossein Hosseinifard
- Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saber Imani
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, People's republic of China
| | - Lisha Yang
- Department of Obstetrics, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, People's republic of China
| | - Mazaher Maghsoudloo
- Laboratory of Systems Biology and Bioinformatics, Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran
| | - ShaoZhi Fu
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, People's republic of China
| | - QingLian Wen
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, People's republic of China.
| | - Qiang Liu
- Department of Obstetrics and Gynecology, Army Medical Center of PLA (Daping Hospital), Army Medical University (Third Military Medical University), Chongqing 400038, People's Republic of China.
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Wang Y, Zhong X, Zhou L, Lu J, Jiang B, Liu C, Guo J. Prognostic Biomarkers for Pancreatic Ductal Adenocarcinoma: An Umbrella Review. Front Oncol 2020; 10:1466. [PMID: 33042793 PMCID: PMC7527774 DOI: 10.3389/fonc.2020.01466] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 07/09/2020] [Indexed: 12/11/2022] Open
Abstract
Background: Pancreatic ductal adenocarcinoma (PDAC) leads to the majority of cancer-related deaths due to its morbidity with similar mortality. Lack of effective prognostic biomarkers are the main reason for belated post-operative intervention of recurrence which causes high mortality. Numerous systematic reviews and meta-analyses have explored the prognostic value of biomarkers in PDAC so far. In this article, we performed an umbrella review analyzing these studies to provide an overview of associations between prognostic biomarkers and PDAC survival outcome and synthesized these results to guide better clinical practice. Methods: Systematic reviews and meta-analyses investigating the associations between PDAC survival outcomes and prognostic biomarkers were acquired via the PubMed and Embase databases from inception till February 1, 2020. Associations supported by nominally statistically significant results were classified into strong, highly suggestive, suggestive, and weak based on several critical factors such as the statistical significance of summary estimates, the number of events, the estimate of the largest study included, interstudy heterogeneity, small-study effects, 95% predictive interval (PI), excess significance bias, and the results of credibility ceiling sensitivity analyses. Results: We included 41 meta-analyses containing 63 associations between PDAC survival outcomes and prognostic biomarkers. Although, none was supported by strong evidence among these associations, an association between C-reactive protein to albumin ratio (CAR) and PDAC overall survival (OS) and an association between neutrophil-lymphocyte ratio (NLR) and PDAC OS were supported by highly suggestive evidence. Otherwise, the association between lactate dehydrogenase (LDH) and PDAC OS was supported by suggestive evidence. The remaining 60 associations were supported by weak or not suggestive evidence. Conclusion: Associations between CAR or NLR and PDAC OS were supported by highly suggestive evidence. And the association between LDH and PDAC OS was supported by suggestive evidence. Although the methodological quality of the included systematic reviews and meta-analyses which were evaluated by AMSTAR2.0 is generally poor, the identification of the relatively robust prognostic biomarkers of PDAC may guide better post-operative intervention and follow-up to prolong patients' survival.
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Affiliation(s)
- Yizhi Wang
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China
| | - Xi Zhong
- Key Laboratory of Precision Diagnosis and Treatment of Gastrointestinal Tumors, Department of Surgical Oncology and General Surgery, Ministry of Education, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Li Zhou
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China
| | - Jun Lu
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China
| | - Bolun Jiang
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China
| | - Chengxi Liu
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China
| | - Junchao Guo
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China
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Ha Y, Mohamed Ali MA, Petersen MM, Harmsen WS, Therneau TM, Lee HC, Ryoo BY, Bampoh S, Valles KA, Mady M, Missula VR, Prasai K, Roberts LR, Kim KM. Lymphocyte to monocyte ratio-based nomogram for predicting outcomes of hepatocellular carcinoma treated with sorafenib. Hepatol Int 2020; 14:776-787. [PMID: 32740886 DOI: 10.1007/s12072-020-10076-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 07/15/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND The ability of the pretreatment lymphocyte to monocyte ratio (LMR) to predict outcomes of patients with hepatocellular carcinoma (HCC) receiving sorafenib is not conclusively determined. METHODS We retrospectively studied patients treated with sorafenib for HCC in two tertiary referral centres in Asia and North America. Primary endpoints were overall survival (OS) and progression-free survival (PFS). Predictive factors for the outcomes were determined by Cox proportional hazards models. A risk assessment tool was developed. RESULTS Compared to the North America cohort, the Asia cohort was more heavily pretreated (72.1% vs. 35.2%; p < 0.001), had higher hepatitis B virus infection (87.6% vs. 5.6%; p < 0.001), and more distant metastases (83.2% vs. 25.4%; p < 0.001). Lower monocyte count in the Asia cohort (median 462.7 vs. 600.0/μL; p = 0.023) resulted in a higher LMR (median 2.6 vs. 1.8; p < 0.001). High LMR was associated with a significantly higher OS [hazard ratio (HR) 0.88; 95% confidence interval (CI) 0.81‒0.97; p = 0.007]. This was confirmed in a sensitivity analysis including patients treated in Asia only (HR 0.89; 95% CI 0.81‒0.97; p = 0.010). An OS nomogram was constructed with the following variables selected in the multivariate Cox model: LMR, treatment location, previous treatment, performance status, alpha-fetoprotein, lymph node metastasis, and Child‒Pugh score. The concordance score was 0.71 (95% CI, 0.67‒0.75). LMR did not predict PFS. CONCLUSION LMR measured before sorafenib administration predicts OS in advanced HCC patients. Our OS nomogram, incorporating LMR, can be offered to clinicians to improve their ability to assess prognosis, strengthen the prognosis-based decision-making, and inform patients in the clinic.
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Affiliation(s)
- Yeonjung Ha
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA.,Department of Gastroenterology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.,Department of Gastroenterology, CHA Bundang Medical Center, CHA University, 59 Yatap-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 13496, South Korea
| | - Mohamed A Mohamed Ali
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA
| | - Molly M Petersen
- Division of Biomedical Statistics and Informatics, Mayo Clinic Health Sciences Research, 205 Third Street SW, Rochester, MN, 55905, USA
| | - William S Harmsen
- Division of Biomedical Statistics and Informatics, Mayo Clinic Health Sciences Research, 205 Third Street SW, Rochester, MN, 55905, USA
| | - Terry M Therneau
- Division of Biomedical Statistics and Informatics, Mayo Clinic Health Sciences Research, 205 Third Street SW, Rochester, MN, 55905, USA
| | - Han Chu Lee
- Department of Gastroenterology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - Baek-Yeol Ryoo
- Department of Oncology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - Sally Bampoh
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA
| | - Kenneth A Valles
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA
| | - Mohamad Mady
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA
| | - Venkata R Missula
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA
| | - Kritika Prasai
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA
| | - Lewis R Roberts
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA.
| | - Kang Mo Kim
- Department of Gastroenterology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.
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Inflammation-Based Scores Increase the Prognostic Value of Circulating Tumor Cells in Primary Breast Cancer. Cancers (Basel) 2020; 12:cancers12051134. [PMID: 32369910 PMCID: PMC7281016 DOI: 10.3390/cancers12051134] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 04/16/2020] [Accepted: 04/29/2020] [Indexed: 12/26/2022] Open
Abstract
A correlation between circulating tumor cells (CTCs) and monocytes in metastatic breast cancer (BC), where CTCs and monocyte-to-lymphocyte ratio (MLR) were predictors of overall survival (OS), was recently shown. Herein, we aimed to assess the association between CTCs and the complete blood count (CBC)-derived inflammation-based scores in 284 primary BC patients. CTCs were determined in CD45-depleted peripheral blood mononuclear cells by real time-PCR. This method allowed us to detect a subset of CTCs with an epithelial-to-mesenchymal transition phenotype (CTC EMT), previously associated with inferior outcomes in primary BC. In the present study, CTC EMT positivity (hazard ratio (HR) = 2.4; 95% CI 1.20–4.66, p = 0.013) and elevated neutrophil-to-lymphocyte ratio (NLR) (HR = 2.20; 95% CI 1.07–4.55; p = 0.033) were associated with shorter progression-free survival (PFS) in primary BC patients. Multivariate analysis showed that CTC EMT-positive patients with NLR ≥ 3 had 8.6 times increased risk of disease recurrence (95% CI 2.35–31.48, p = 0.001) compared with CTC EMT-negative patients with NLR < 3. Similarly, disease recurrence was 13.14 times more likely in CTC EMT-positive patients with MLR ≥ 0.34 (95% CI 4.35–39.67, p < 0.001). Given its low methodological and financial demands, the CBC-derived inflammation-based score determination could, after broader validation, significantly improve the prognostication of BC patients.
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Preoperative lymphocyte-to-monocyte ratio predicts postoperative infectious complications after laparoscopic colorectal cancer surgery. Int J Clin Oncol 2019; 25:633-640. [PMID: 31781993 DOI: 10.1007/s10147-019-01583-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 11/19/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND AIM Postoperative infectious complications (POI), which can increase length of hospital stay, medical cost, and worsen overall survival, are a concern in minimally invasive colorectal cancer (CRC) surgeries. Recent reports showed that relatively new inflammation-based score, lymphocyte-to-monocyte ratio (LMR) is an independent predictor of long-term outcomes after CRC surgeries. In this study, LMR was evaluated as a predictor of short-term postoperative outcomes. PATIENTS AND METHODS This was a single-institutional retrospective study of 211 consecutive patients who had undergone laparoscopic CRC surgery with primary tumor resection from January 2014 to August 2015 at Nippon Medical School Chiba Hokusoh Hospital. The patients were divided into two groups (no POI; n = 176 and POI; n = 35). The associations between inflammation-based scores, namely neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and LMR, and the occurrence of POI were investigated. Receiving operator characteristic curve analysis was used to determine the cutoff point of preoperative LMR. RESULTS Low LMR (cut-off 3.46), long operative time, and smoking were found to be independent predictors of POI in a multivariate analysis (LMR: Odds ratio 5.61, 95% confidence interval 1.98-15.9, P = 0.001). Patients with low LMR also appeared to have more advanced and aggressive tumours. CONCLUSION This is the first study to report that the lower LMR is a predictive factor of POI after laparoscopic CRC surgery, and it may provide additional information for treatment decisions to prevent POI.
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Zhang S, Li M, Yuan F, Chen L, Mi R, Wei X, Song Y, Yin Q. The predictive value of dynamic monitoring of peripheral blood lymphocyte to monocyte ratio in patients with extranodal NK/T cell lymphoma. Cancer Cell Int 2019; 19:272. [PMID: 31649489 PMCID: PMC6805491 DOI: 10.1186/s12935-019-0993-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 10/14/2019] [Indexed: 12/23/2022] Open
Abstract
Background To investigate the value of dynamic monitoring peripheral blood lymphocyte-to-monocyte (LMR) ratio in evaluating the treatment response and prognosis of patients with extranodal NK/T cell lymphoma (ENKTL). Methods A total of 148 patients with ENKTL were retrospectively analyzed in the Affiliated Tumor Hospital of Zhengzhou University between March 2012 and March 2018. The optimal cut-off value of LMR was determined using the receiver operating characteristic curve (ROC) method, then patients were divided into low LMR group and high LMR group. The LMR level was dynamically measured at various time points, and the relationships between LMR and therapeutic response, and survival were analyzed. Results The complete remission rate (CR) was 85.7% in patients with high LMR at diagnosis, which was remarkably higher than that of patients with low LMR at diagnosis (64.9%) (P = 0.009). The 5-year overall survival (OS) and progression-free survival (PFS) were 49.28% and 44.89% in the low LMR group, respectively; 5-year OS and PFS in the high LMR group were 84.50% and 67.12%, respectively, significantly longer (P values were < 0.001 and 0.034, respectively). The OS and PFS of patients with elevated LMR after treatment were longer than those with decreased LMR after treatment (all P values < 0.05). The LMRs at relapse were significantly lower in both high and low LMR groups than those of the last follow-up (P values were 0.001 and 0.016, respectively). Univariate and multivariate analysis demonstrated that low LMR was an independent risk factor for poor prognosis in ENKTL patients (P values were < 0.001 and 0.009, respectively). Conclusions Lymphocyte to monocyte ratio can be used as an indicator of treatment response, prognosis and recurrence in patients with ENKTL. Low LMR before and after treatment is a poor prognostic factor.
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Affiliation(s)
- Shengnan Zhang
- Department of Hematopathy, Henan Institute of Hematology, Cancer Hospital Affiliated to Zhengzhou University, Zhengzhou, 450000 Henan China
| | - Mengjuan Li
- Department of Hematopathy, Henan Institute of Hematology, Cancer Hospital Affiliated to Zhengzhou University, Zhengzhou, 450000 Henan China
| | - Fangfang Yuan
- Department of Hematopathy, Henan Institute of Hematology, Cancer Hospital Affiliated to Zhengzhou University, Zhengzhou, 450000 Henan China
| | - Lin Chen
- Department of Hematopathy, Henan Institute of Hematology, Cancer Hospital Affiliated to Zhengzhou University, Zhengzhou, 450000 Henan China
| | - Ruihua Mi
- Department of Hematopathy, Henan Institute of Hematology, Cancer Hospital Affiliated to Zhengzhou University, Zhengzhou, 450000 Henan China
| | - Xudong Wei
- Department of Hematopathy, Henan Institute of Hematology, Cancer Hospital Affiliated to Zhengzhou University, Zhengzhou, 450000 Henan China
| | - Yongping Song
- Department of Hematopathy, Henan Institute of Hematology, Cancer Hospital Affiliated to Zhengzhou University, Zhengzhou, 450000 Henan China
| | - Qingsong Yin
- Department of Hematopathy, Henan Institute of Hematology, Cancer Hospital Affiliated to Zhengzhou University, Zhengzhou, 450000 Henan China
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Long non-coding RNA XIST predicting advanced clinical parameters in cancer: A Meta-Analysis and case series study in a single institution. Oncol Lett 2019; 18:2192-2202. [PMID: 31404342 PMCID: PMC6676735 DOI: 10.3892/ol.2019.10592] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Accepted: 06/13/2019] [Indexed: 12/11/2022] Open
Abstract
Dysregulated expression of long non-coding RNA X-inactive specific transcript (lncRNA-XIST) has been indicated in various cancer types. In the present study, a meta-analysis was conducted to evaluate the potential role of lncRNA-XIST in predicting the clinicopathological parameters of patients with cancer. Eligible studies were obtained through a systematic search of PubMed, Web of Science, Embase and the Cochrane Library, of articles published prior to January 2019. The combined odds ratio and 95% confidence interval were calculated to determine the association between lncRNA-XIST expression and patient outcome. In addition, 45 pairs of osteosarcoma (OS) tissues and adjacent healthy tissues from a single institution were analyzed for the expression of lncRNA-XIST, and its association with clinicopathological features; ultimately, a total of 1,869 cancer patients from 25 studies were assessed. The results demonstrated that high expression levels of lncRNA-XIST were significantly associated with lymphatic metastasis, larger tumor size, advanced cancer stage and distant metastasis. However, sex was not associated with lncRNA-XIST expression level. In the OS patient cohort, it was demonstrated that lncRNA-XIST was highly expressed in OS tissues, which negatively correlated with patient prognosis. The present study indicated that lncRNA-XIST may serve as a potential biomarker for advanced clinical parameters in human cancer.
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