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Feier CVI, Muntean C, Faur AM, Gaborean V, Petrache IA, Cozma GV. Exploring Inflammatory Parameters in Lung Cancer Patients: A Retrospective Analysis. J Pers Med 2024; 14:552. [PMID: 38929773 PMCID: PMC11204880 DOI: 10.3390/jpm14060552] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Revised: 05/17/2024] [Accepted: 05/21/2024] [Indexed: 06/28/2024] Open
Abstract
Inflammation-related parameters serve as pivotal indicators in the prognosis and management of lung cancer. This retrospective investigation aimed to explore the relationship between inflammatory markers and diverse clinical variables in non-small-cell lung cancer patients. A cohort of 187 individuals undergoing elective lobectomy for lung cancer was retrospectively analyzed, spanning an 11-year data collection period. Six inflammation ratios derived from complete peripheral blood counts were assessed. Significantly elevated levels of neutrophil-to-lymphocyte ratio (NLR) (p = 0.005), platelet-to-lymphocyte ratio (PLR) (p = 0.001), Aggregate Index of Systemic Inflammation (AISI) (p = 0.015), Systemic Inflammation Response Index (SIRI) (p = 0.004), and Systemic Immune Inflammation Index (SII) (p = 0.004) were observed in patients with advanced T stages. Significantly, elevated values (p < 0.05) of these parameters were observed in the study's smoker patients compared to non-smokers. A statistically significant correlation was identified between the NLR parameter and tumor size (p = 0.07, r = 0.204), alongside a significant elevation in SIRI (p = 0.041) among patients experiencing postoperative complications. Inflammatory biomarkers emerge as invaluable prognostic indicators for patients with non-small-cell lung cancer, offering potential utility in forecasting their prognosis.
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Affiliation(s)
- Catalin Vladut Ionut Feier
- First Discipline of Surgery, Department X-Surgery, “Victor Babes” University of Medicine and Pharmacy, 2 E. Murgu Sq., 300041 Timisoara, Romania;
- First Surgery Clinic, “Pius Brinzeu” Clinical Emergency Hospital, 300723 Timisoara, Romania
| | - Calin Muntean
- Medical Informatics and Biostatistics, Department III-Functional Sciences, “Victor Babes” University of Medicine and Pharmacy, 2 E. Murgu Sq., 300041 Timisoara, Romania
| | - Alaviana Monique Faur
- Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Vasile Gaborean
- Thoracic Surgery Research Center, “Victor Babeş” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania; (V.G.); (I.A.P.); (G.V.C.)
- Department of Surgical Semiology, Faculty of Medicine, “Victor Babeş” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
| | - Ioan Adrian Petrache
- Thoracic Surgery Research Center, “Victor Babeş” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania; (V.G.); (I.A.P.); (G.V.C.)
- Department of Surgical Semiology, Faculty of Medicine, “Victor Babeş” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
| | - Gabriel Veniamin Cozma
- Thoracic Surgery Research Center, “Victor Babeş” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania; (V.G.); (I.A.P.); (G.V.C.)
- Department of Surgical Semiology, Faculty of Medicine, “Victor Babeş” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
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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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de Fréminville A, Saad M, Sage E, Pricopi C, Fischler M, Trillat B, Salze B, Pascreau T, Vasse M, Vallée A, Guen ML, Fessler J. Relationship Between Preoperative Inflammation Ratios Derived From Preoperative Blood Cell Count and Postoperative Pulmonary Complications in Patients Undergoing Lobectomy: A Single-Center Observational Study. J Cardiothorac Vasc Anesth 2024; 38:482-489. [PMID: 38016820 DOI: 10.1053/j.jvca.2023.11.001] [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: 09/18/2023] [Revised: 10/19/2023] [Accepted: 11/01/2023] [Indexed: 11/30/2023]
Abstract
OBJECTIVE Evaluation of the association of inflammatory cell ratios, especially neutrophil-to-lymphocyte ratio (NLR), based on preoperative complete blood counts, with postoperative complications in lobectomy surgery. DESIGN This was a retrospective monocentric cohort study. SETTING The study was conducted at Foch University Hospital in Suresnes, France. PARTICIPANTS Patients having undergone a scheduled lobectomy from January 2018 to September 2021. INTERVENTIONS There were no interventions. MEASUREMENTS AND MAIN RESULTS The authors studied 208 consecutive patients. Preoperative NLR, monocyte-to-lymphocyte ratio, platelet-to-lymphocyte ratio, systemic inflammation index, systemic inflammation response index, and aggregate inflammation systemic index were calculated. Median and (IQR) of NLR was 2.67 (1.92-3.69). No statistically significant association was observed between any index and the occurrence of at least one major postoperative complication, which occurred in 37% of the patients. Median postoperative length of stay was 7 (5-10) days. None of the ratios was associated with prolonged length of stay (LOS), defined as a LOS above the 75th percentile. CONCLUSIONS The results suggested that simple available inflammatory ratios are not useful for the preoperative identification of patients at risk of postoperative major complications in elective lobectomy surgery.
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Affiliation(s)
- Amaury de Fréminville
- Department of Anesthesiology, Hôpital Foch, Suresnes, France, and Université Versailles-Saint-Quentin-en-Yvelines, Versailles, France
| | - Mary Saad
- Department of Anesthesia, Institut Curie, PSL Research University, Saint Cloud, France, and PSL Research University, INSERM, Institut Curies, Saint Cloud, France
| | - Edouard Sage
- Department of Thoracic Surgery and Lung Transplantation, Hôpital Foch, Suresnes, France, and Université Versailles-Saint-Quentin-en-Yvelines, Versailles, France
| | - Ciprian Pricopi
- Department of Thoracic Surgery and Lung Transplantation, Hôpital Foch, Suresnes, France, and Université Versailles-Saint-Quentin-en-Yvelines, Versailles, France
| | - Marc Fischler
- Department of Anesthesiology, Hôpital Foch, Suresnes, France, and Université Versailles-Saint-Quentin-en-Yvelines, Versailles, France.
| | - Bernard Trillat
- Department of Information Systems, Hôpital Foch, Suresnes, France
| | - Benjamin Salze
- Department of Anesthesiology, Hôpital Foch, Suresnes, France, and Université Versailles-Saint-Quentin-en-Yvelines, Versailles, France
| | - Tiffany Pascreau
- Department of Clinical Biology, Hôpital Foch, Suresnes, France, and Department of Epidemiology-Data-Biostatistics, Delegation of Clinical Research and Innovation, Hôpital Foch, Suresnes, France
| | - Marc Vasse
- Department of Clinical Biology, Hôpital Foch, Suresnes, France, and Department of Epidemiology-Data-Biostatistics, Delegation of Clinical Research and Innovation, Hôpital Foch, Suresnes, France
| | - Alexandre Vallée
- Department of Epidemiology and Public Health, Hôpital Foch, Suresnes, France
| | - Morgan Le Guen
- Department of Anesthesiology, Hôpital Foch, Suresnes, France, and Université Versailles-Saint-Quentin-en-Yvelines, Versailles, France
| | - Julien Fessler
- Department of Anesthesiology, Hôpital Foch, Suresnes, France, and Université Versailles-Saint-Quentin-en-Yvelines, Versailles, France
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Heshmat-Ghahdarijani K, Sarmadi V, Heidari A, Falahati Marvasti A, Neshat S, Raeisi S. The neutrophil-to-lymphocyte ratio as a new prognostic factor in cancers: a narrative review. Front Oncol 2023; 13:1228076. [PMID: 37860198 PMCID: PMC10583548 DOI: 10.3389/fonc.2023.1228076] [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: 06/06/2023] [Accepted: 09/18/2023] [Indexed: 10/21/2023] Open
Abstract
The increasing incidence of cancer globally has highlighted the significance of early diagnosis and improvement of treatment strategies. In the 19th century, a connection was made between inflammation and cancer, with inflammation recognized as a malignancy hallmark. The neutrophil-to-lymphocyte ratio (NLR), calculated from a complete blood count, is a simple and accessible biomarker of inflammation status. NLR has also been proven to be a prognostic factor for various medical conditions, including mortality classification in cardiac patients, infectious diseases, postoperative complications, and inflammatory states. In this narrative review, we aim to assess the prognostic potential of NLR in cancer. We will review recent studies that have evaluated the association between NLR and various malignancies. The results of this review will help to further understand the role of NLR in cancer prognosis and inform future research directions. With the increasing incidence of cancer, it is important to identify reliable and accessible prognostic markers to improve patient outcomes. The study of NLR in cancer may provide valuable insights into the development and progression of cancer and inform clinical decision-making.
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Affiliation(s)
- Kian Heshmat-Ghahdarijani
- Cardiac Rehabilitation, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Vida Sarmadi
- School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Afshin Heidari
- School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Sina Neshat
- School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Biostatistics and Epidemiology, University of California, San Francisco, San Francisco, CA, United States
| | - Sina Raeisi
- School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Kao DD, Ferrandino RM, Roof SA, Marshall DC, Khan MN, Chai RL, Park YHA, Sigel KM. Neutrophil-to-lymphocyte ratio as a predictor of surgical outcomes in head and neck cancer. Head Neck 2023; 45:1903-1912. [PMID: 37204760 PMCID: PMC10349925 DOI: 10.1002/hed.27402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 02/17/2023] [Accepted: 04/30/2023] [Indexed: 05/20/2023] Open
Abstract
BACKGROUND Neutrophil-to-lymphocyte ratio (NLR) is a biomarker of systemic inflammation that is associated with adverse oncologic and surgical outcomes. We investigated the use of NLR as a prognostic indicator of complications of head and neck cancer (HNC) surgeries. METHODS We conducted a retrospective study of 11 187 Veterans who underwent HNC surgery between 2000 and 2020. We calculated preoperative NLR values and fit logistic regression models adjusting for potential confounding factors, comparing high-NLR patients to low-NLR patients. RESULTS The cohort had a median age of 63 and was 98% men. High-NLR patients had increased odds of 30-day mortality (p < 0.001), having 1+ perioperative complications (p < 0.001), sepsis (p = 0.03), failure to wean from mechanical ventilation (p = 0.04), pneumonia (p < 0.001), and pulmonary embolism (p = 0.02) compared with low-NLR patients. CONCLUSION NLR was a robust, independent predictor of 30-day mortality, having 1+ surgical complications, sepsis, failure to wean from mechanical ventilation, pneumonia, and pulmonary embolism.
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Affiliation(s)
- Derek D. Kao
- Department of Medicine, Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rocco M. Ferrandino
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Scott A. Roof
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Deborah C. Marshall
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Mohemmed Nazir Khan
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Raymond L. Chai
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Yeun-Hee A. Park
- Department of Medicine, Division of Hematology/Oncology, James J. Peters VA Medical Center, Bronx, New York, USA
- Department of Medicine, Division of Hematology/Oncology, The College of Physicians and Surgeons at Columbia University, New York, New York, USA
| | - Keith M. Sigel
- Department of Medicine, Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Yang J, Wan Y, Ni Q, Zuo J, Wang J, Zhang X, Zhou L. Quantifying causal effects from observed data using quasi-intervention. BMC Med Inform Decis Mak 2022; 22:337. [PMID: 36544217 PMCID: PMC9773512 DOI: 10.1186/s12911-022-02086-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 12/15/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Causal inference is a crucial element within medical decision-making. There have been many methods for investigating potential causal relationships between disease and treatment options developed in recent years, which can be categorized into two main types: observational studies and experimental studies. However, due to the nature of experimental studies, financial resources, human resources, and patients' ethical considerations, researchers cannot fully control the exposure of the research participants. Furthermore, most existing observational research designs are limited to determining causal relationships and cannot handle observational data, let alone determine the dosages needed for medical research. RESULTS This paper presents a new experimental strategy called quasi-intervention for quantifying the causal effect between disease and treatment options in observed data by using a causal inference method, which converts the potential effect of different treatment options on disease into computing differences in the conditional probability. We evaluated the accuracy of the quasi-intervention by quantifying the impact of adjusting Chinese patients' neutrophil-to-lymphocyte ratio (NLR) on their overall survival (OS) (169 lung cancer patients and 79 controls).The results agree with the literature in this study, consisting of nine papers on cohort studies on the NLR and the prognosis of lung cancer patients, proving that our method is correct. CONCLUSION Taken together, the results imply that quasi-intervention is a promising method for quantifying the causal effect between disease and treatment options without clinical trials, and it could improve confidence about treatment options' efficacy and safety.
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Affiliation(s)
- Jinghua Yang
- grid.412017.10000 0001 0266 8918School of Computer Science, University of South China, Hengyang, China ,grid.412017.10000 0001 0266 8918School of Nuclear Science and Technology, University of South China, Hengyang, China
| | - Yaping Wan
- grid.412017.10000 0001 0266 8918School of Computer Science, University of South China, Hengyang, China ,Hunan Provincial Base for Scientific and Technological Innovation Cooperation, Hengyang, China
| | - Qianxi Ni
- grid.410622.30000 0004 1758 2377Hunan Cancer Hospital, Changsha, China ,grid.412017.10000 0001 0266 8918School of Nuclear Science and Technology, University of South China, Hengyang, China
| | - Jianhong Zuo
- The Third Affiliated Hospital of South China University, Hengyang, China
| | - Jin Wang
- grid.412017.10000 0001 0266 8918School of Computer Science, University of South China, Hengyang, China
| | - Xiapeng Zhang
- grid.412017.10000 0001 0266 8918School of Computer Science, University of South China, Hengyang, China
| | - Lifang Zhou
- grid.412017.10000 0001 0266 8918School of Computer Science, University of South China, Hengyang, China
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Wu HL, Liu HY, Liu WC, Hou MC, Tai YH. A predictive model incorporating inflammation markers for high-grade surgical complications following liver resection for hepatocellular carcinoma. J Chin Med Assoc 2022; 85:845-852. [PMID: 35316229 DOI: 10.1097/jcma.0000000000000713] [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: 11/25/2022] Open
Abstract
BACKGROUND Systemic inflammation and immune deficiency predispose surgical patients to infection and adversely affect postoperative recovery. We aimed to evaluate the prognostic ability of inflammation and immune-nutritional markers and to develop a predictive model for high-grade complications after resection of hepatocellular carcinoma (HCC). METHODS This study enrolled 1431 patients undergoing liver resection for primary HCC at a medical center. Preoperative neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio, prognostic nutritional index, Model for End-Stage Liver Disease score, Albumin-Bilirubin score, Fibrosis-4 score, and Aspartate Aminotransferase to Platelet Ratio Index score were assessed. Stepwise backward variable elimination was conducted to determine the factors associated with Clavien-Dindo grade III to V complications within 30-day postoperative period. The predictive model was internally validated for discrimination performance using area under the receiver operating characteristic curve (AUC). RESULTS A total of 106 (7.4%) patients developed high-grade complications. Four factors independently predicted a high-grade postoperative complication and were integrated into the predictive model, including NLR (adjusted odds ratio: 1.10, 95% confidence interval [CI], 1.02-1.19), diabetes mellitus, extent of hepatectomy, and intraoperative blood loss. The AUC of the model was 0.755 (95% CI, 0.678-0.832) in the validation dataset. Using the cutoff value based on Youden's index, the sensitivity and specificity of the risk score were 59.0% and 76.3%, respectively. CONCLUSION Preoperative NLR independently predicted a high-grade complication after resection of HCC. The predictive model allows for identification of high-risk patients and appropriate modifications of perioperative care to improve postoperative outcomes.
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Affiliation(s)
- Hsiang-Ling Wu
- Department of Anesthesiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Hsin-Yi Liu
- Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan, ROC
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC
| | - Wan-Chi Liu
- Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan, ROC
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC
| | - Ming-Chih Hou
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Ying-Hsuan Tai
- Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan, ROC
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC
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Ülger G, Baldemir R, Zengin M, Sazak H, Alagöz A. Is there a correlation between preoperative neutrophil-to-lymphocyte, platelet-to-lymphocyte, and lymphocyte-to-monocyte ratios and postoperative pain in video-assisted thoracoscopic surgery? Medicine (Baltimore) 2022; 101:e29472. [PMID: 35623082 PMCID: PMC9276095 DOI: 10.1097/md.0000000000029472] [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] [Received: 10/22/2021] [Accepted: 04/28/2022] [Indexed: 01/04/2023] Open
Abstract
Many thoracic surgery procedures are now performed with video-assisted thoracoscopic surgery (VATS). Postoperative pain is a common condition in patients undergoing VATS. In this study, we aimed to investigate whether neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) are effective in evaluating postoperative pain in patients undergoing VATS.This prospective observational study was performed between March 2021 and September 2021 at a tertiary thoracic surgery center. The study included patients who had undergone elective VATS. Preoperative and postoperative NLR, PLR, LMR, hemogram values and postoperative visual analog scale (VAS) were recorded.A total of 105 patients were analyzed. A positive correlation was observed between postoperative monocyte, neutrophils and VAS resting and VAS cough levels in the early postoperative period. No significant correlation was found between preoperative and postoperative NLR, PLR, and LMR values and VAS rest and VAS cough values. When compared to the preoperative period, a negative correlation was found between the change in the postoperative LMR value and the VAS rest and VAS cough values in the early postoperative period.When compared to the preoperative period, the change in postoperative neutrophil, postoperative monocytes, and postoperative LMR values in patients undergoing VATS in thoracic surgery can be used as a guide in the objective evaluation of postoperative acute pain. It is the belief of the researchers that comprehensive new studies on this subject will contribute significantly to the determination of objective criteria in postoperative pain evaluation.
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Inflammatory Indexes as Predictive Biomarkers of Postoperative Complications in Oncological Thoracic Surgery. Curr Oncol 2022; 29:3425-3432. [PMID: 35621666 PMCID: PMC9139720 DOI: 10.3390/curroncol29050276] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/24/2022] [Accepted: 05/06/2022] [Indexed: 02/05/2023] Open
Abstract
The role of inflammatory responses in predicting outcomes in oncological thoracic surgery is still unclear. The aim of this study was to evaluate a series of blood count inflammation indexes as predicting factors for postoperative complications. We retrospectively studied 249 patients undergoing elective thoracic surgery in our institution between 2008 and 2020. A total of 184 patients underwent open surgery, and 65 underwent VATS. The neutrophil-to-lymphocyte (NLR), monocyte-to-lymphocyte (MLR), and platelet-to-lymphocyte (PLR) ratios, Systemic Inflammation Response Index (SIRI) were calculated preoperatively and on the first and fourth postoperative days, as well as a new derivative index, the Aggregate Inflammation Systemic Index (AISI). Univariate correlations evidenced a statistically significant association between the NLR at the fourth postoperative day and the occurrence of surgical complications in the global cohort (rho = 0.15, p = 0.03). A similar significant association with MLR on the fourth postoperative day is found in the open group (rho = −0.15, p = 0.048). NLR and LMR on the fourth postoperative day are associated with postoperative complications in the whole and open groups, respectively. Simple, easy-to-perform and inexpensive, blood cell count indexes may be useful in predicting complications in oncological thoracic surgery. A greater number of broader, prospective, randomized studies are necessary to confirm these findings.
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Mori M, Narushima K, Hirano A, Kano Y, Chiba F, Edamoto Y, Yoshida M. Preoperative neutrophil-to-lymphocyte ratio may contribute to the prediction of postoperative infectious complications in patients with acute appendicitis: a retrospective study. BMC Surg 2022; 22:78. [PMID: 35241053 PMCID: PMC8892689 DOI: 10.1186/s12893-022-01529-8] [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: 12/15/2021] [Accepted: 02/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Several studies have assessed various clinical variables to identify risk factors for postoperative complications in patients with acute appendicitis. However, few studies have focused on the relationships between systemic inflammatory variables and postoperative complications in patients with acute appendicitis. We investigated the relationships between postoperative complications and systemic inflammatory variables, and assessed the clinical utility of these variables as predictors of postoperative complications in patients with acute appendicitis. METHODS We retrospectively reviewed 181 patients who underwent immediate appendectomy for acute appendicitis. All postoperative complications were classified as infectious or noninfectious, and we evaluated the relationships between postoperative complications and clinical factors including the preoperative neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio. RESULTS In total, 28 patients (15.5%) had postoperative Clavien-Dindo grade II-IV complications; 17 patients (9.4%) and 11 patients (6.1%) were categorized as the infectious and noninfectious complication groups, respectively. The cutoff value of the preoperative neutrophil-to-lymphocyte ratio for all complications was 11.3, and multivariate analysis revealed that the preoperative neutrophil-to-lymphocyte ratio was an independent predictor of any postoperative complication (odds ratio: 4.223, 95% confidence interval: 1.335-13.352; P = 0.014). The cutoff value of the preoperative neutrophil-to-lymphocyte ratio for infectious complications was 11.4, and multivariate analysis revealed that the preoperative neutrophil-to-lymphocyte ratio was an independent predictor of infectious complications (odds ratio: 4.235, 95% confidence interval: 1.137-15.776; P = 0.031). CONCLUSIONS In patients with acute appendicitis, the preoperative neutrophil-to-lymphocyte ratio may be a useful predictor of all postoperative complications, especially infectious complications.
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Affiliation(s)
- Mikito Mori
- Department of Surgery, Secomedic Hospital, 696-1 Toyotomi-cho, Funabashi, Chiba, 274-0053, Japan.
| | - Kazuo Narushima
- Department of Surgery, Secomedic Hospital, 696-1 Toyotomi-cho, Funabashi, Chiba, 274-0053, Japan
| | - Atsushi Hirano
- Department of Surgery, Secomedic Hospital, 696-1 Toyotomi-cho, Funabashi, Chiba, 274-0053, Japan
| | - Yoshihiko Kano
- Department of Surgery, Secomedic Hospital, 696-1 Toyotomi-cho, Funabashi, Chiba, 274-0053, Japan
| | - Fumihiro Chiba
- Department of Surgery, Secomedic Hospital, 696-1 Toyotomi-cho, Funabashi, Chiba, 274-0053, Japan
| | - Yoshihiro Edamoto
- Department of Surgery, Secomedic Hospital, 696-1 Toyotomi-cho, Funabashi, Chiba, 274-0053, Japan
| | - Masahiro Yoshida
- Department of Hepato-Biliary-Pancreatic and Gastrointestinal Surgery, International University of Health and Welfare Ichikawa Hospital, 6-1-14 Kounodai, Ichikawa, Chiba, 272-0827, Japan
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Zhang T, Wang J, Wang D, Xu K, Wu L, Wang X, Wang W, Deng L, Liang J, Lv J, Hui Z, Zhou Z, Feng Q, Xiao Z, Chen D, Wang J, Wang L, Bi N. The time-series behavior of systemic inflammation-immune status in predicting survival of locally advanced non-small cell lung cancer treated with chemoradiotherapy. JOURNAL OF THE NATIONAL CANCER CENTER 2022; 2:33-40. [PMID: 39035216 PMCID: PMC11256537 DOI: 10.1016/j.jncc.2021.11.003] [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: 04/05/2021] [Revised: 10/26/2021] [Accepted: 11/03/2021] [Indexed: 11/24/2022] Open
Abstract
Background Systematic inflammation is believed to play a crucial role in tumorigenesis and metastasis. This study aims at evaluating the prognostic value of time-series behavior of systematic inflammation-immune status before and after definitive chemoradiotherapy (dCRT) in patients with locally advanced non-small cell lung cancer (LA-NSCLC). Methods The relationship between systematic inflammation-immune score (SIS, defined as pretreatment peripheral platelet count × neutrophil count/lymphocyte count) and the prognosis was tested in a retrospective study of 386 consecutive LA-NSCLC patients (Group A) with pretreatment SIS and 161 patients (Group B) with SIS before and one month after the dCRT. Results SIS of 1400 × 109 was found to be an optimal cutoff point to stratify the patients into high (>1400 × 109) and low (≤1400 × 109) SIS groups. Univariate and multivariate analyses revealed that the SIS, whether before or after dCRT, was an independent predictor for overall survival (OS), progress-free survival (PFS), and distant metastasis-free survival (DMFS). High SIS (>1400 × 109) was shown to predict poor 3-year OS (P=0.006, hazard ratio [HR]=2.427), PFS (P=0.001, HR=2.442) and DMFS (P=0.015, HR=2.119). However, SIS was not related to local regional recurrence-free survival in either Group A (P=0.346) or Group B (P=0.486). Further, the area under the receiver operating characteristic curve of the SIS for OS was higher than the neutrophil count/lymphocyte count ratio, platelet count/lymphocyte count ratio, and other conventional clinic-pathological indices. Conclusions The SIS is a stable and more sensitive survival predictor than other inflammation-based factors and conventional clinical indices, which may aid in more accurately stratifying patients for risk assessment and treatment decisions.
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Affiliation(s)
- Tao Zhang
- 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, Beijing, China
| | - Jianyang Wang
- 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, Beijing, China
| | - Daquan Wang
- 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, Beijing, China
| | - Kunpeng Xu
- 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, Beijing, China
| | - Linfang Wu
- 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, Beijing, China
| | - Xin Wang
- 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, Beijing, China
| | - Wenqing Wang
- 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, Beijing, China
| | - Lei Deng
- 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, Beijing, China
| | - Jun Liang
- 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, Beijing, China
| | - Jima Lv
- 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, Beijing, China
| | - Zhouguang Hui
- 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, Beijing, China
| | - Zongmei Zhou
- 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, Beijing, China
| | - Qinfu Feng
- 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, Beijing, China
| | - Zefen Xiao
- 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, Beijing, China
| | - Dongfu Chen
- 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, Beijing, China
| | - Jie Wang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Luhua Wang
- 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, Beijing, China
| | - Nan Bi
- 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, Beijing, China
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Xiaowei M, Wei Z, Qiang W, Yiqian N, Yanjie N, Liyan J. Assessment of systemic immune-inflammation index in predicting postoperative pulmonary complications in patients undergoing lung cancer resection. Surgery 2022; 172:365-370. [DOI: 10.1016/j.surg.2021.12.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 12/17/2021] [Accepted: 12/19/2021] [Indexed: 12/14/2022]
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Xue Q, Zhu Y, Wang Y, Yang JJ, Zhou CM. Using Nomograms to Predict the PPCs of Patients With Diffuse Peritonitis Undergoing Emergency Gastrointestinal Surgery. Front Med (Lausanne) 2021; 8:705713. [PMID: 35004710 PMCID: PMC8732989 DOI: 10.3389/fmed.2021.705713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 11/24/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: To develop and validate a nomogram model for predicting postoperative pulmonary complications (PPCs) in patients with diffuse peritonitis undergoing emergency gastrointestinal surgery.Methods: We used the least absolute shrinkage and selection operator (LASSO) regression model to analyze the independent risk factors for PPCs in patients with diffuse peritonitis who underwent emergency gastrointestinal surgery. Using R, we developed and validated a nomogram model for predicting PPCs in patients with diffuse peritonitis undergoing emergency gastrointestinal surgery.Results: The LASSO regression analysis showed that AGE, American Society of Anesthesiologists physical status classification (ASA), DIAGNOSIS, platelets (on the 3rd day after surgery), cholesterol (on the 3rd day after surgery), ALBUMIN (on the first day after surgery), and preoperative ALBUMIN were independent risk factors for PPCs in patients with diffuse peritonitis undergoing emergency gastrointestinal surgery. The area under the curve (AUC) value of the nomogram model in the training group was 0.8240; its accuracy was 0.7000, and its sensitivity was 0.8658. This demonstrates that the nomogram has a high prediction value. Also in the test group, the AUC value of the model established by the variables AGE, ASA, and platelets (on the 3rd day after surgery), cholesterol (on the 3rd day after surgery), ALBUMIN (on the first day after surgery), and preoperative ALBUMIN was 0.8240; its accuracy was 0.8000; and its specificity was 0.8986. In the validation group, the same results were obtained. The results of the clinical decision curve show that the benefit rate was also high.Conclusion: Based on the risk factors AGE, ASA, DIAGNOSIS, platelets (on the 3rd day after surgery), cholesterol (on the 3rd day after surgery), ALBUMIN (on the first day after surgery), and preoperative ALBUMIN, the nomogram model established in this study for predicting PPCs in patients with diffuse peritonitis undergoing emergency gastrointestinal surgery has high accuracy and discrimination.
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Affiliation(s)
- Qiong Xue
- Department of Anesthesiology, Pain and Perioperative Medicine, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yu Zhu
- Department of Anesthesiology, Pain and Perioperative Medicine, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Department of Scientific Research, Zhaoqing Medical College, Zhaoqing, China
| | - Ying Wang
- Department of Anesthesiology, Pain and Perioperative Medicine, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jian-Jun Yang
- Department of Anesthesiology, Pain and Perioperative Medicine, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- *Correspondence: Jian-Jun Yang
| | - Cheng-Mao Zhou
- Department of Anesthesiology, Pain and Perioperative Medicine, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Cheng-Mao Zhou
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Łochowski M, Chałubińska-Fendler J, Zawadzka I, Łochowska B, Rębowski M, Brzeziński D, Kozak J. The Prognostic Significance of Preoperative Platelet-to-Lymphocyte and Neutrophil-to-Lymphocyte Ratios in Patients Operated for Non-Small Cell Lung Cancer. Cancer Manag Res 2021; 13:7795-7802. [PMID: 34675674 PMCID: PMC8517424 DOI: 10.2147/cmar.s317705] [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: 06/16/2021] [Accepted: 09/09/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction The aim of the study was to determine the prognostic significance of PLR and NLR ratios in patients operated due to non-small cell lung cancer. Material The study group consisted of 532 (174 women, 358 men) patients with non-small cell lung cancer (NSCLC) staged IA-IIIA. The mean age was 63.6 years (range 36 to 84 years). Together with platelet/lymphocyte ratio (PLR) and neutrophil/lymphocyte ratio (NLR), the following factors were included in the statistical analysis: age, sex, smoking history, the number of leukocytes, neutrophils, and platelets, histopathology, T-stage, N-stage, concomitant diseases according to the Charlson Comorbidity Index (CCI), type of operation, adjuvant chemotherapy, and overall survival. Results Univariate analysis showed an association between the value of PLR and NLR and the length of survival. Multivariate analysis found that the stage of advancement of the neoplastic disease (p=0.00003), adjuvant chemotherapy (p=0.009), CCI > 4 (0.00008), and PLR > 144 (p=0.001) were negative prognostic factors for survival > 2 years; however, this effect diminishes in patients surviving more than 5 years. Conclusion PLR might serve as a prognostic factor in patients affected by NSCLC with expected two-year overall survival.
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Affiliation(s)
- Mariusz Łochowski
- Clinic of Thoracic Surgery and Respiratory Rehabilitation, Medical University of Lodz, Lodz, Poland
| | | | - Izabela Zawadzka
- "Synevo" Medical Laboratory, Regional Multi-Specialist Center for Oncology and Traumatology of the Nicolaus Copernicus Memorial Hospital in Lodz, Lodz, Poland
| | - Barbara Łochowska
- Department of Radiotherapy and General Oncology, Regional Multi-Specialist Center for Oncology and Traumatology of the Nicolaus Copernicus Memorial Hospital in Lodz, Lodz, Poland
| | - Marek Rębowski
- Clinic of Thoracic Surgery and Respiratory Rehabilitation, Medical University of Lodz, Lodz, Poland
| | - Daniel Brzeziński
- Clinic of Thoracic Surgery and Respiratory Rehabilitation, Medical University of Lodz, Lodz, Poland
| | - Józef Kozak
- Clinic of Thoracic Surgery and Respiratory Rehabilitation, Medical University of Lodz, Lodz, Poland
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Tacconi F, Carlea F, La Rocca E, Vanni G, Ambrogi V. Systemic Inflammation after Uniport, Multiport, or Hybrid VATS Lobectomy for Lung Cancer. Thorac Cardiovasc Surg 2021; 70:258-264. [PMID: 34404095 DOI: 10.1055/s-0041-1731824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Different video-assisted thoracic surgery (VATS) approaches can be adopted to perform lobectomy for non-small cell lung cancer. Given the hypothetical link existing between postoperative inflammation and long-term outcomes, we compared the dynamics of systemic inflammation markers after VATS lobectomy performed with uniportal access (UNIVATS), multiportal access (MVATS), or hybrid approach (minimally invasive hybrid open surgery, MIHOS). METHODS Peripheral blood-derived inflammation markers (neutrophil-to-lymphocyte [NTL] ratio, platelet-to-lymphocyte [PTL] ratio, and systemic immune-inflammation index [SII]) were measured preoperatively and until postoperative day 5 in 109 patients undergoing UNIVATS, MVATS, or MIHOS lobectomy. Differences were compared through repeated-measure analysis of variance, before and after 1:1:1 propensity score matching. Time-to-event analysis was also done by measuring time to NTL normalization, based on the reliability change index for each patient. RESULTS After UNIVATS, there was a faster decrease in NTL ratio (p = 0.015) and SII (p = 0.019) compared with other approaches. MVATS exhibited more pronounced PTL rebound (p = 0.011). However, all these differences disappeared in matched analysis. After MIHOS, NTL ratio normalization took longer (mean difference: 0.7 ± 0.2 days, p = 0.047), yet MIHOS was not independently associated with slower normalization at Cox's regression analysis (p = 0.255, odds ratio: 1.6, confidence interval: 0.7-4.0). Furthermore, surgical access was not associated with cumulative postoperative morbidity, nor was it with incidence of postoperative pneumonia. CONCLUSION In this study, different VATS approaches resulted into unsubstantial differences in postoperative systemic inflammatory response, after adjusting for confounders. The majority of patients returned back to preoperative values by postoperative day 5 independently on the adopted surgical access. Further studies are needed to elaborate whether these small differences may still be relevant to patient management.
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Affiliation(s)
- Federico Tacconi
- Department of Surgery, Unit of Thoracic Surgery, Tor Vergata University Polyclinic, Rome, Italy
| | - Federica Carlea
- Department of Surgery, Unit of Thoracic Surgery, Tor Vergata University Polyclinic, Rome, Italy
| | - Eleonora La Rocca
- Department of Surgery, Unit of Thoracic Surgery, Tor Vergata University Polyclinic, Rome, Italy
| | - Gianluca Vanni
- Department of Surgery, Unit of Thoracic Surgery, Tor Vergata University Polyclinic, Rome, Italy
| | - Vincenzo Ambrogi
- Department of Surgery, Unit of Thoracic Surgery, Tor Vergata University Polyclinic, Rome, Italy
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Mori M, Shuto K, Hirano A, Narushima K, Kosugi C, Yamazaki M, Koda K, Yoshida M. Preoperative Neutrophil-to-Lymphocyte Ratio may Predict Postoperative Pneumonia in Stage I-III Gastric Cancer Patients After Curative Gastrectomy: A Retrospective Study. World J Surg 2021; 45:3359-3369. [PMID: 34333681 DOI: 10.1007/s00268-021-06264-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Several studies have demonstrated that diverse systemic inflammatory-based prognostic parameters predict a poor prognosis in patients with gastric cancer. However, few studies have focused on the relationships between postoperative complications and systemic inflammatory-based prognostic parameters after curative gastrectomy. We investigated the relationships between postoperative complications and these parameters and assessed the clinical utility of the parameters as predictors of postoperative complications in patients with stage I-III gastric cancer. METHODS We retrospectively reviewed 300 patients who underwent curative gastrectomy for stage I-III gastric cancer. All postoperative complications were classified as infectious or noninfectious. We evaluated the relationships between postoperative complications and clinical factors, including systemic inflammatory-based prognostic parameters. RESULTS In total, 101 patients (33.7%) had postoperative Clavien-Dindo grade II-IV complications, and 54 (18.0%) patients developed infectious complications including pancreatic fistula, pneumonia, anastomotic leak, intra-abdominal abscess, and cholecystitis. The relationships between postoperative complications and systemic inflammatory-based prognostic parameters were evaluated by the areas under the receiver operating characteristic curves. Postoperative pneumonia was identified as the most sensitive complication to the systemic inflammatory-based prognostic parameters. Multivariate analysis revealed that preoperative neutrophil-to-lymphocyte ratio (odds ratio, 14.621; 95% confidence interval, 1.160-184.348; p = 0.038) was an independent predictor of pneumonia. CONCLUSIONS Preoperative neutrophil-to-lymphocyte ratio may be a useful predictor of postoperative pneumonia in patients with stage I-III gastric cancer after curative gastrectomy.
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Affiliation(s)
- Mikito Mori
- Department of Hepato-Biliary-Pancreatic and Gastrointestinal Surgery, International University of Health and Welfare Ichikawa Hospital, 6-1-14 Kounodai, Ichikawa, Chiba, 272-0827, Japan. .,Department of Surgery, Teikyo University Chiba Medical Center, 3426-3 Anesaki, Ichihara, Chiba, 299-0111, Japan.
| | - Kiyohiko Shuto
- Department of Surgery, Teikyo University Chiba Medical Center, 3426-3 Anesaki, Ichihara, Chiba, 299-0111, Japan
| | - Atsushi Hirano
- Department of Hepato-Biliary-Pancreatic and Gastrointestinal Surgery, International University of Health and Welfare Ichikawa Hospital, 6-1-14 Kounodai, Ichikawa, Chiba, 272-0827, Japan
| | - Kazuo Narushima
- Department of Hepato-Biliary-Pancreatic and Gastrointestinal Surgery, International University of Health and Welfare Ichikawa Hospital, 6-1-14 Kounodai, Ichikawa, Chiba, 272-0827, Japan
| | - Chihiro Kosugi
- Department of Surgery, Teikyo University Chiba Medical Center, 3426-3 Anesaki, Ichihara, Chiba, 299-0111, Japan
| | - Masato Yamazaki
- Department of Surgery, Teikyo University Chiba Medical Center, 3426-3 Anesaki, Ichihara, Chiba, 299-0111, Japan
| | - Keiji Koda
- Department of Surgery, Teikyo University Chiba Medical Center, 3426-3 Anesaki, Ichihara, Chiba, 299-0111, Japan
| | - Masahiro Yoshida
- Department of Hepato-Biliary-Pancreatic and Gastrointestinal Surgery, International University of Health and Welfare Ichikawa Hospital, 6-1-14 Kounodai, Ichikawa, Chiba, 272-0827, Japan
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Preoperative Platelet-to-Lymphocyte Ratio (PLR) for Predicting the Survival of Stage I-III Gastric Cancer Patients with a MGC Component. BIOMED RESEARCH INTERNATIONAL 2021; 2021:9678363. [PMID: 33997045 PMCID: PMC8112911 DOI: 10.1155/2021/9678363] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 04/23/2021] [Indexed: 12/17/2022]
Abstract
Background The preoperative platelet-to-lymphocyte ratio (PLR) evaluates the prognosis of gastric cancer patients. However, whether preoperative PLR may be used to evaluate the prognosis of mucinous gastric carcinoma (MGC) patients is poorly investigated. The present study evaluated the effect of preoperative PLR on overall survival in gastric cancer patients with a mucinous component. Methods A total of 336 MGC were enrolled in this study, and the characteristics of the tumor, including pathological features and clinical data, were retrospectively analyzed. Results A high PLR was associated with larger tumor size, advanced tumor invasion, lymph node metastasis, advanced TNM stage, tumor location, total gastrectomy, low hemoglobin level, low albumin level, high fibrinogen level, high platelet level, and high neutrophil-to-lymphocyte ratio (NLR, all P's < 0.05). Multivariate analysis identified age (HR = 1.876; 95% CI 1.361-2.585, P < 0.001), TNM stage (HR = 2.350; 95% CI 1.216-4.542, P = 0.011), globulin (HR = 1.520; 95% CI 1.067-2.165, P = 0.020), total gastrectomy (HR = 0.537; 95% CI 0.373-0.772, P = 0.001), and PLR (HR = 1.582; 95% CI 1.066-2.348, P = 0.023) as independent prognostic factors for OS. Conclusion Preoperative PLR is related to pathological features and may independently evaluate the survival of MGC. Therefore, preoperative PLR may help physicians develop treatment plans and evaluate survival in these patients.
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Jokic V, Savic-Vujovic K, Spasic J, Stanic N, Marinkovic M, Radosavljevic D, Cavic M. Hematological parameters in EGFR-mutated advanced NSCLC patients treated with TKIs: predicting survival and toxicity. Expert Rev Anticancer Ther 2021; 21:673-679. [PMID: 33606592 DOI: 10.1080/14737140.2021.1893694] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Background: The aim of this study was to analyze the prognostic value of pre-treatment hematological parameters in EGFR-mutated non-small cell lung cancer patients treated with tyrosine-kinase inhibitors (TKIs).Patients and methods: Patients with EGFR mutations were treated with EGFR-TKIs in the first line until progression/unacceptable toxicity. Hematological parameters were derived from the absolute baseline differential counts of a complete blood count. The associations between the patients' and tumor characteristics were analyzed using Pearson Chi-Square, Fisher's exact, t-test, and Mann-Whitney tests. Cutoff values were determined using ROC curves, and correlation with survival was examined by Kaplan-Meier method and Cox regression.Results: Patients with NMR<12.62 had a longer PFS compared to patients with higher NMR values (12.0 vs. 10.0 months, p = 0.054) and a significantly longer OS (20.0 vs. 11.0 months, p = 0.010). The same parameter was confirmed as a predictors of favorable response in the patient subgroup with activating EGFR mutations. Patients with NLR>2.9 and LMR<2.5 more often presented with paronichia and diarrhea, and patients with PLR>190 more often had paronichia, diarrhea and hyperbilirubinemia.Conclusion: Low baseline value of the hematological parameter NMR has shown potential as a routine, low-cost, and minimally invasive predictor of survival in EGFR-TKI-treated NSCLC patients.
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Affiliation(s)
- Vera Jokic
- Clinic for Medical Oncology, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | - Katarina Savic-Vujovic
- Department of Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Jelena Spasic
- Clinic for Medical Oncology, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | - Nemanja Stanic
- Clinic for Medical Oncology, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | - Mladen Marinkovic
- Clinic for Radiation Oncology and Diagnostics, Department of Radiation Oncology, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | - Davorin Radosavljevic
- Clinic for Medical Oncology, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | - Milena Cavic
- Department of Experimental Oncology, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
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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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Gao K, Cheng H, Bhushan S, Li N, Xiao Z. Preoperative neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio are correlated with tumor–node–metastasis stages in patients with non-small cell lung cancer. J Cancer Res Ther 2021; 18:1666-1673. [DOI: 10.4103/jcrt.jcrt_473_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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21
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Guo M, Sun T, Zhao Z, Ming L. Preoperative Platelet to Albumin Ratio Predicts Outcome of Patients with Non-Small-Cell Lung Cancer. Ann Thorac Cardiovasc Surg 2020; 27:84-90. [PMID: 33162436 PMCID: PMC8058543 DOI: 10.5761/atcs.oa.20-00090] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Objective: The purpose of this study was to evaluate the predictive power of the platelet to albumin ratio (PAR) on survival outcomes of patients with non-small-cell lung cancer (NSCLC). Patients and Methods: In all, 198 patients with NSCLC were recruited. The X-tile software was performed to identify the optimal cutoff values for PAR, platelet to lymphocyte ratio (PLR), and neutrophil to lymphocyte ratio (NLR). The Kaplan–Meier method, univariate and multivariate analyses Cox regression were used to analyze the prognostic factors for overall survival (OS). Results: In all, 198 patients were enrolled, containing 146 (73.7%) men and 52 (26.3%) women. The optimal cutoff values for PAR, PLR, and NLR were 8.8×109, 147.7, and 3.9, respectively. Patients with PAR > 8.8 × 109 (P <0.001), PLR > 147.7 (P <0.001), and NLR >3.9 (P = 0.007) were associated with poor OS. Multivariate analyses found that PAR was an independent predictor in NSCLC patients (hazard ratio [HR]: 4.604, 95% confidence interval [CI]: 2.557–8.290, P <0.001). Conclusion: Preoperative PAR is a useful and potential prognostic biomarker in NSCLC patients who have received primary resection.
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Affiliation(s)
- Manman Guo
- Department of Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University, Key Clinical Laboratory of Henan Province, Zhengzhou, China
| | - Ting Sun
- Department of Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University, Key Clinical Laboratory of Henan Province, Zhengzhou, China
| | - Zhuochen Zhao
- Department of Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University, Key Clinical Laboratory of Henan Province, Zhengzhou, China
| | - Liang Ming
- Department of Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University, Key Clinical Laboratory of Henan Province, Zhengzhou, China
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Paliogiannis P, Deidda S, Maslyankov S, Paycheva T, Farag A, Mashhour A, Misiakos E, Papakonstantinou D, Mik M, Losinska J, Scognamillo F, Sanna F, Feo CF, Cherchi G, Xidas A, Zinellu A, Restivo A, Zorcolo L. Blood cell count indexes as predictors of anastomotic leakage in elective colorectal surgery: a multicenter study on 1432 patients. World J Surg Oncol 2020; 18:89. [PMID: 32375770 PMCID: PMC7204308 DOI: 10.1186/s12957-020-01856-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 04/17/2020] [Indexed: 02/07/2023] Open
Abstract
Background The aim of this study was to evaluate a series of blood count inflammation indexes in predicting anastomotic leakage (AL) in elective colorectal surgery. Methods Demographic, pathologic, and clinical data of 1432 consecutive patients submitted to colorectal surgery in eight surgical centers were retrospectively evaluated. The neutrophil to lymphocyte (NLR), derived neutrophil to lymphocyte (dNLR), lymphocyte to monocyte (LMR), and platelet to lymphocyte (PLR) ratios were calculated before surgery and on the 1st and 4th postoperative days, in patients with or without AL. Results There were 106 patients with AL (65 males, mean age 67.4 years). The NLR, dNLR, and PLR were significantly higher in patients with AL in comparison to those without, on both the 1st and 4th postoperative days, but significance was greater on the 4th postoperative day. An NLR cutoff value of 7.1 on this day showed the best area under the curve (AUC 0.744; 95% CI 0.719–0.768) in predicting AL. Conclusions Among the blood cell indexes of inflammation evaluated, NLR on the 4th postoperative day showed the best ability to predict AL. NLR is a low cost, easy to perform, and widely available index, which might be potentially used in clinical practice as a predictor of AL in patients undergoing elective colorectal surgery.
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Affiliation(s)
- Panagiotis Paliogiannis
- Experimental Pathology and Oncology, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Viale San Pietro 43, 07100, Sassari, Italy.
| | - Simona Deidda
- Colorectal Surgery Unit, Department of Surgical Sciences, University of Cagliari, Monserrato, 09042, Cagliari, Italy
| | - Svilen Maslyankov
- Second Surgery Clinic, Department of Surgery, Medical University of Sofia, G.Sofijski str. 1, 1404, Sofia, Bulgaria
| | - Tsvetelina Paycheva
- Second Surgery Clinic, Department of Surgery, Medical University of Sofia, G.Sofijski str. 1, 1404, Sofia, Bulgaria
| | - Ahmed Farag
- Colorectal Surgery Unit, General Surgery Department, Faculty of Medicine, Cairo University, Kaser Alainy Hospital, 89 Almanial, Cairo, Egypt
| | - Abdrabou Mashhour
- Colorectal Surgery Unit, General Surgery Department, Faculty of Medicine, Cairo University, Kaser Alainy Hospital, 89 Almanial, Cairo, Egypt
| | - Evangelos Misiakos
- Third Department of Surgery, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, 12462, Athens, Greece
| | - Dimitrios Papakonstantinou
- Third Department of Surgery, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, 12462, Athens, Greece
| | - Michal Mik
- Department of General and Colorectal Surgery, Medical University of Lodz, Plac Hallera 1, 90-647, Lodz, Poland
| | - Joanna Losinska
- Department of General and Colorectal Surgery, Medical University of Lodz, Plac Hallera 1, 90-647, Lodz, Poland
| | - Fabrizio Scognamillo
- First Surgery Clinic, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Viale San Pietro 43, 07100, Sassari, Italy
| | - Fabio Sanna
- First Surgery Clinic, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Viale San Pietro 43, 07100, Sassari, Italy
| | - Claudio Francesco Feo
- Second Surgery Clinic, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Viale San Pietro 43, 07100, Sassari, Italy
| | - Giuseppe Cherchi
- Second Surgery Clinic, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Viale San Pietro 43, 07100, Sassari, Italy
| | - Andreas Xidas
- Unit of Surgery, Nostra Signora della Mercede Hospital of Lanusei, Via Ospedale, 08045, Lanusei, Italy
| | - Angelo Zinellu
- Clinical Biochemistry and Clinical Molecular Biology, Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43, 07100, Sassari, Italy
| | - Angelo Restivo
- Colorectal Surgery Unit, Department of Surgical Sciences, University of Cagliari, Monserrato, 09042, Cagliari, Italy
| | - Luigi Zorcolo
- Colorectal Surgery Unit, Department of Surgical Sciences, University of Cagliari, Monserrato, 09042, Cagliari, Italy
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Wang Y, Hu X, Su MC, Wang YW, Che GW. Postoperative Elevations of Neutrophil-to-lymphocyte and Platelet-to-lymphocyte Ratios Predict Postoperative Pulmonary Complications in Non-small Cell Lung Cancer Patients: A Retrospective Cohort Study. Curr Med Sci 2020; 40:339-347. [PMID: 32337695 DOI: 10.1007/s11596-020-2189-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 12/06/2019] [Indexed: 02/05/2023]
Abstract
The neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) are found to increase in patients who develop postoperative complications (PCs). The aim of the present study was to explore the association of the perioperative changes of NLR (ΔNLR) and PLR (ΔPLR) with PCs in non-small cell lung cancer (NSCLC). Clinical data of 509 patients, who were diagnosed with NSCLC and underwent thoracoscopic radical resection between January 1, 2014 and July 31, 2016 at the Department of Thoracic Surgery, West China Hospital, were reviewed. Patients were divided into PC and non-PC groups, and clinical characteristics including ΔNLR and ΔPLR were compared between them. The optimal cut-off values of ΔNLR and ΔPLR were determined by receiver operating characteristics (ROC) curves and patients were assigned to high ΔNLR/ΔPLR and low ΔNLR/ΔPLR groups in terms of the cut-off values. Clinicopathologic characteristics and the incidence of different PCs were compared between the dichotomized groups. Univariate and multivariate logistic regression analyses were performed to identify the independent risk factors for PCs. The results showed that the ΔNLR and ΔPLR in the PC group were signifcantly higher than those in the non-PC group (P<0.001 for both). The optimal cutoff values of ΔNLR and ΔPLR were 6.6 and 49, respectively. Patients with ΔNLR>6.6 or ΔPLR>49 were more likely to experience postoperative pulmonary complications (PPCs) (P<0.001 for both). Multivariate logistic regression analysis demonstrated that smoking [odds ratio (OR): 2.450, 95% confdence interval (95% CI): 1.084-5.535, P=0.031)], tumor size (OR: 1.225, 95% CI: 1.047-1.433, P=0.011), ΔNLR>6.6 (OR: 2.453, 95% CI: 1.224-4.914, P=0.011) and ΔPLR>49 (OR: 2.231, 95% CI: 1.182-4.212, P=0.013) were predictive of PPCs. In conclusion, the ΔNLR and ΔPLR may act as novel predictors for PPCs in NSCLC patients undergoing thoracoscopic radical lung resection, and patients with ΔNLR>6.6 or ΔPLR>49 should be treated more actively to prevent or reduce PPCs.
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Affiliation(s)
- Yan Wang
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Xu Hu
- West China School of Medicine, Sichuan University, Chengdu, 610041, China
| | - Meng-Chan Su
- West China School of Medicine, Sichuan University, Chengdu, 610041, China
| | - Yan-Wen Wang
- West China School of Medicine, Sichuan University, Chengdu, 610041, China
| | - Guo-Wei Che
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, China.
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Huang Q, Diao P, Li CL, Peng Q, Xie T, Tan Y, Lang JY. Preoperative platelet-lymphocyte ratio is a superior prognostic biomarker to other systemic inflammatory response markers in non-small cell lung cancer. Medicine (Baltimore) 2020; 99:e18607. [PMID: 31977852 PMCID: PMC7004654 DOI: 10.1097/md.0000000000018607] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Systemic inflammatory response markers are associated with poor survival in many types of malignances. This study aimed to evaluate the prognostic value of preoperative neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), lymphocyte-monocyte ratio (LMR), and C-reactive protein (CRP) in patients with non-small cell lung cancer (NSCLC).We retrospectively evaluated 254 NSCLC patients who underwent radical surgery between January 2012 and April 2014 in the Sichuan Provincial Cancer Hospital. The cut-off values of NLR, PLR, LMR, and CRP were determined according to the receiver operating characteristic curve, and the correlation of NLR, PLR, LMR, and CRP with prognosis was analyzed based on the cut-off value.The cut-off value for NLR, PLR, LMR, and CRP were 3.18, 122, 4.04, and 8.8, respectively. Univariate analysis showed that age (P = .022), tumor-node-metastasis (TNM) stage (P < .001), T stage (P = .001), and N stage (P < .001) were significantly correlated with disease-free survival (DFS), while age (P = .011), TNM stage (P < .001), T stage (P = .008), N stage (P < .001), and PLR (P = .001) were significantly correlated with overall survival (OS). In multivariate analysis, age (hazard ratio [HR]: 1.564, 95% confidence interval [CI]: 1.087-2.252, P = .016) and TNM stage (HR: 1.704, 95% CI: 1.061-2.735, P = .027) remained independent risk factors affecting DFS, while age (HR: 1.721, 95% CI: 1.153-2.567, P = .008), TNM stage (HR: 2.198, 95% CI: 1.263-3.824, P = .005), and PLR (HR: 1.850, 95% CI: 1.246-2.746, P = .002) were independent risk factors affecting OS.The preoperative PLR is superior to NLR, LMR, and CRP as a biomarker for evaluating the prognosis of patients undergoing curative surgery for NSCLC.
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Affiliation(s)
- Qing Huang
- Department of Oncology, Chengdu First Peoples’ Hospital
| | | | - Chang-Lin Li
- Department of Oncology, Chengdu First Peoples’ Hospital
| | | | - Tianpeng Xie
- Department of Thoracic Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
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Wang Y, Hu X, Xu W, Wang H, Huang Y, Che G. Prognostic value of a novel scoring system using inflammatory response biomarkers in non-small cell lung cancer: A retrospective study. Thorac Cancer 2019; 10:1402-1411. [PMID: 31104359 PMCID: PMC6558461 DOI: 10.1111/1759-7714.13085] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 04/14/2019] [Accepted: 04/19/2019] [Indexed: 02/05/2023] Open
Abstract
Background The neutrophil‐to‐lymphocyte ratio (NLR), platelet‐to‐lymphocyte ratio (PLR), and lymphocyte‐to‐monocyte ratio (LMR) are reported to show a strong correlation with prognosis in patients with non‐small cell lung cancer (NSCLC). We aimed to describe a novel scoring system combining these ratios, termed the inflammatory response biomarker (IRB) score, and test its prognostic value in NSCLC. Methods The data of 261 NSCLC patients who underwent thoracoscopic radical resection in a single center were retrospectively reviewed. The IRB score was defined as follows: a high NLR (> 2.12), a high PLR (92.9), and a low LMR (< 4.57) were each scored as 1; the opposite values were scored as 0. The individual scores were added to produce the IRB score (range: 0–3). Results Multivariate analyses indicated that high tumor node metastasis (TNM) stage (hazard ratio [HR] 2.721, 95% confidence interval [CI] 1.597–4.989; P < 0.001) and an IRB score ≥ 2 (HR 2.696, 95% CI 1.506–4.826; P = 0.001) were independent prognostic factors for poor overall survival. Furthermore, smoking history (HR 2.953, 95% CI 1.086–8.026; P = 0.034), high TNM stage (HR 3.108, 95% CI 1.911–5.056; P < 0.001), and IRB score ≥ 2 (HR = 2.316, 95% CI: 1.389–3.861; P = 0.001) were demonstrated to be independent prognostic factors for poor disease‐free survival. Conclusion The novel scoring system combining NLR, PLR, and LMR was an independent prognostic factor in NSCLC patients undergoing thoracoscopic radical resection and was superior to these ratios alone for predicting prognosis.
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Affiliation(s)
- Yan Wang
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Xu Hu
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Wenying Xu
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Haoyuan Wang
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Yu Huang
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Guowei Che
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China
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Toyokawa T, Muguruma K, Tamura T, Sakurai K, Amano R, Kubo N, Tanaka H, Yashiro M, Hirakawa K, Ohira M. Comparison of the prognostic impact and combination of preoperative inflammation-based and/or nutritional markers in patients with stage II gastric cancer. Oncotarget 2018; 9:29351-29364. [PMID: 30034622 PMCID: PMC6047670 DOI: 10.18632/oncotarget.25486] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 05/07/2018] [Indexed: 12/11/2022] Open
Abstract
Background The aim of this study was to evaluate and compare the prognostic value of preoperative established inflammation-based and/or nutritional markers, C-reactive protein-to-albumin ratio (CAR), neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, Prognostic Nutritional Index (PNI), Glasgow Prognostic Score, and prognostic index in patients with stage II gastric cancer. We then developed a new prognostic index based on the results of our investigation. Methods This study retrospectively reviewed 240 consecutive patients who underwent R0 resection for stage II gastric cancer. Time-dependent receiver operating characteristic curve analyses were performed to assess discrimination ability and to determine optimal cut-off values. Prognostic factors predicting overall survival (OS) were analyzed using Cox proportional hazards models. Results Among inflammation-based and/or nutritional markers, multivariate analyses demonstrated CAR and PNI as independent prognostic factors for OS (hazard ratio (HR) 1.707, 95% confidence interval (CI) 1.016-2.867, p=0.044 and HR 0.415, 95%CI 0.234-0.736, p=0.003, respectively). CAR-PNI score, constructed as the combination of CAR and PNI, was significantly associated with OS, relapse-free survival and cancer-specific survival (p<0.001 each). Multivariate analysis revealed CAR-PNI score as an independent prognostic factor for OS (HR for CAR-PNI score 1: 2.432, 95%CI 1.155-5.118; HR for CAR-PNI score 2: 4.099, 95%CI 1.835-9.157; p=0.002). Conclusions CAR and PNI are independent prognostic factors providing superior prediction of survival compared to other inflammation-based and/or nutritional markers. CAR-PNI score offers a novel and promising prognostic indicator for patients with stage II gastric cancer.
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Affiliation(s)
- Takahiro Toyokawa
- Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Abeno-ku, Osaka 545-8585, Japan
| | - Kazuya Muguruma
- Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Abeno-ku, Osaka 545-8585, Japan
| | - Tatsuro Tamura
- Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Abeno-ku, Osaka 545-8585, Japan
| | - Katsunobu Sakurai
- Department of Gastroenterological Surgery, Osaka City General Hospital, Miyakojima-ku, Osaka 534-0021, Japan
| | - Ryosuke Amano
- Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Abeno-ku, Osaka 545-8585, Japan
| | - Naoshi Kubo
- Department of Gastroenterological Surgery, Osaka City General Hospital, Miyakojima-ku, Osaka 534-0021, Japan
| | - Hiroaki Tanaka
- Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Abeno-ku, Osaka 545-8585, Japan
| | - Masakazu Yashiro
- Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Abeno-ku, Osaka 545-8585, Japan
| | - Kosei Hirakawa
- Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Abeno-ku, Osaka 545-8585, Japan
| | - Masaichi Ohira
- Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Abeno-ku, Osaka 545-8585, Japan
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Prognostic value of C-reactive protein levels in patients with bone neoplasms: A meta-analysis. PLoS One 2018; 13:e0195769. [PMID: 29668751 PMCID: PMC5906001 DOI: 10.1371/journal.pone.0195769] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 03/29/2018] [Indexed: 12/19/2022] Open
Abstract
Objective The aim of this study was to conduct a meta-analysis of retrospective studies that investigated the association of preoperative C-reactive protein (CRP) levels with the overall survival (OS) of patients with bone neoplasms. Methods A detailed literature search was performed in the Cochrane Library, Web of Science, Embase and PubMed databases up to August 28, 2017, for related research publications written in English. We extracted the data from these studies and combined the hazard ratios (HR) and 95% confidence intervals (CIs) to assess the correlation between CRP levels and OS in patients with bone neoplasms. Results Five studies with a total of 816 participants from several countries were enrolled in this current meta-analysis. In a pooled analysis of all the publications, increased serum CRP levels had an adverse prognostic effect on the overall survival of patients with bone neoplasms. However, the combined data showed no significant relationship between the level of CRP and OS in Asian patients (HR = 1.73; 95% CI: 0.86–3.49; P = 0.125). Similar trends were observed in patients with bone neoplasms when stratified by ethnicity, histology, metastasis and study sample size. Conclusions The results of this meta-analysis suggest that increased CRP expression indicates a poorer prognosis in patients with bone neoplasms. More prospective studies are needed to confirm the prognostic significance of CRP levels in patients with bone neoplasms.
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Liu C, Wu S, Meng X, Liu G, Chen D, Cong Y, Shen G, Sun B, Wang W, Wang Q, Gao H, Liu X. Predictive value of peripheral regulatory T cells in non-small cell lung cancer patients undergoing radiotherapy. Oncotarget 2018. [PMID: 28624781 PMCID: PMC5522158 DOI: 10.18632/oncotarget.15238] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background Studies increasingly focus on the impact of radiotherapy on immunity; however, the role of peripheral cellular immunity prior to radiotherapy in cancer patients remains largely unknown. In this study, we investigated the predictive roles of lymphocyte subsets on tumor progression in non-small cell lung cancer (NSCLC) patients undergoing radiotherapy, and their expression in NSCLC patients at first relapse. Methods We enrolled 70 NSCLC patients and 14 age- and sex-matched healthy donors and tested the lymphocyte subsets in their peripheral blood by flow cytometry. Among them, 40 newly diagnosed patients received radiotherapy and were enrolled to investigate the predictive value of lymphocyte subsets on tumor progression after radiotherapy by uni- and multivariate analyses; 30 patients at first relapse were included to evaluate the differences of lymphocyte subsets between them and first diagnosed patients and healthy volunteers. Results Increased proportions of regulatory T cells, CD8+ T cells, and CD8+CD28- T cells and decreased CD4+ T cells and CD4/CD8 ratios were observed in NSCLC patients at first relapse compared to newly diagnosed patients. In the 40 first diagnosed patients undergoing radiotherapy, uni- and multivariate analyses showed that increased level of regulatory T cells correlated with poor progression-free survival (hazard ratio = 2.55 and 3.76, P = 0.022 and 0.010, respectively). Conclusions Peripheral regulatory T cells were increased and independently predict tumor progression in NSCLC patients undergoing radiotherapy, suggesting the promising combination of radiotherapy and immunotherapy.
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Affiliation(s)
- Chao Liu
- Department of Radiation Oncology, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China
| | - Shikai Wu
- Department of Radiation Oncology, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China
| | - Xiangying Meng
- Department of Radiation Oncology, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China
| | - Guangxian Liu
- Cancer Therapy Center, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China
| | - Dongmei Chen
- Department of Radiation Oncology, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China
| | - Yang Cong
- Department of Radiation Oncology, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China
| | - Ge Shen
- Department of Radiation Oncology, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China
| | - Bing Sun
- Department of Radiation Oncology, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China
| | - Wei Wang
- Cancer Therapy Center, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China
| | - Qian Wang
- Department of Radiation Oncology, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China
| | - Hongjun Gao
- Department of Lung Cancer, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China
| | - Xiaoqing Liu
- Department of Lung Cancer, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China
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Luo H, Ge H, Cui Y, Zhang J, Fan R, Zheng A, Zheng X, Sun Y. Systemic Inflammation Biomarkers Predict Survival in Patients of Early Stage Non-Small Cell Lung Cancer Treated With Stereotactic Ablative Radiotherapy - A Single Center Experience. J Cancer 2018; 9:182-188. [PMID: 29290784 PMCID: PMC5743726 DOI: 10.7150/jca.21703] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 10/24/2017] [Indexed: 12/18/2022] Open
Abstract
Background: Increasing evidence indicates a relationship between systemic inflammation and survival following treatment in various tumors. However, the correlation of systematic inflammation with survival after stereotactic ablative radiotherapy (SABR) in early stage non-small cell lung cancer (NSCLC) has not been well established. Patients and methods: We retrospectively analyzed patients with newly diagnosed early stage NSCLC treated with SABR in a single institution from 2011 to 2015. The neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and lymphocyte- monocyte ratio (LMR) were calculated as systemic inflammation biomarkers. Overall survival (OS) was the first end-point. Receiver operating characteristic (ROC) was used to determine cut-off points for OS. Univariate and multivariate Cox proportional hazards regression were used to investigate the potential factors associated with OS. Results: In the 63 patients who were eligible for analysis. The median follow up after SBRT was 29.5 months (range 8-67 months) while the 3-year OS was 74.2%. Based on ROC analysis, optimal cut-off values of NLR, PLR, and LMR were 2.06, 199.55 and 4.0, respectively. Significant survival benefit was found in the NLR ≤2.06 group (p=0.028), PLR≤199.55 group (p=0.001), and LMR˃4.0 group (p=0.046). Univariate analysis indicated that low NLR (p=0.011), low PLR (p=0.003), and high LMR (p=0.014) were correlated with improved survival. Multivariate analysis indicated that high PLR (p=0.033) and low LMR (p=0.046) were independent prognostic factors for poor survival. Conclusions: In patients of early stage NSCLC who received SABR, pretreatment NLR, PLR, and LMR could be considered useful prognostic indicators of OS. These metrics may provide reliable and convenient predictors to identify patients who would benefit from SABR.
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Affiliation(s)
- Hui Luo
- Division of Graduate, The Second Clinical Medical School and the Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Hong Ge
- Department of Radiation Oncology, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China
| | - Yingying Cui
- Department of Radiation Oncology, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China
| | - Jiangong Zhang
- Division of Scientific Research and Education, The Affiliated Cancer Hospital of Zhengzhou university, Zhengzhou, China
| | - Ruitai Fan
- Department of Radiation Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Anping Zheng
- Department of Radiation Oncology, Anyang Cancer Hospital, Anyang, China
| | - Xiaoli Zheng
- Department of Radiation Oncology, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China
| | - Yanan Sun
- Department of Radiation Oncology, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China
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Prognostic value of the Glasgow prognostic score in lung cancer: evidence from 10 studies. Int J Biol Markers 2017; 33:201-207. [PMID: 29076522 DOI: 10.5301/ijbm.5000308] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Objective: To conduct a meta-analysis of prospective and retrospective studies to reveal the relationship between the Glasgow prognostic score (GPS) and overall survival (OS) or progression-free survival (PFS) in patients with lung cancer. Methods: Correlative studies were included by searching the databases of PubMed, Web of Science, Embase, and PubMed Cochrane Library until April 16, 2017. We combined the hazard ratios (HRs) and 95% confidence intervals (CIs) to assess the correlation between GPS and OS or PFS in patients with lung cancer. Results: Ten studies involving 5,369 participants from several regions were identified through searching databases. In a pooled analysis of all studies, elevated GPS was associated with poorer OS (HR = 2.058; 95% CI, 1.51-2.80; p<0.05). However, the combined data showed no significant relationship between the GPS of 1 or 2, and PFS, respectively. Subgroup analysis showed that the patients with GPS ≥1 had poorer OS compared with those with GPS = 0 (HR = 2.01; 95% CI, 1.75-2.32; p<0.001). A similar trend was observed in patients receiving chemotherapy (HR = 1.66; 95% CI, 1.17-2.36; p<0.05) and surgery (HR = 2.88; 95% CI, 1.59-5.22; p<0.001) when stratified by treatment. Conclusions: Increased level of GPS may have a prognostic value in lung cancer. We detected a statistical difference in the association of elevated GPS and poorer OS, though the association was not significant in PFS settings. However, further studies are warranted to draw firm conclusions.
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THE RELATIONSHIP BETWEEN NEUTROPHİL / LYMPHOCYTES RATIO AND PLATELET / LYMPHOCYTES RATIO WITH PROGNOSIS IN OPERATED STAGE 1-2 OF NON- SMALL CELL LUNG CANCER DISEASE: ONE CENTRAL EXPERIENCE. ANADOLU KLINIĞI TIP BILIMLERI DERGISI 2017. [DOI: 10.21673/anadoluklin.315155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Clinical utility of the modified Glasgow prognostic score in lung cancer: A meta-analysis. PLoS One 2017; 12:e0184412. [PMID: 28886134 PMCID: PMC5590927 DOI: 10.1371/journal.pone.0184412] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 08/23/2017] [Indexed: 02/05/2023] Open
Abstract
Objective To perform a meta-analysis of prospective and retrospective studies exploring the association of the modified Glasgow prognostic score (mGPS) with overall survival (OS) in patients with lung cancer. Methods Relevant studies were identified by searching the Cochrane Library, Web of Science, Embase and PubMed until April 16, 2017. We combined hazard ratios (HRs) and 95% confidence intervals (CIs) to assess the correlation between mGPS and OS in patients with lung cancer. Results Eleven studies involving 5817 participants from several countries were included in the meta-analysis. In a pooled analysis of all studies, elevated mGPS predicted poorer OS (HR = 1.77; 95% CI: 1.35–2.31; P<0.05). Subgroup analyses stratified by mGPS showed that mGPS of 1 or 2 and mGPS≥1 were predictive of poorer OS and that the HR for mGPS of 2 (HR = 5.82; 95% CI: 1.85–18.22; P = 0.003) was significantly greater than that for mGPS of 1 (HR = 1.74; 95% CI: 1.24–2.45; P = 0.001) and mGPS≥1 (HR = 1.42; 95% CI: 1.14–1.76; P = 0.002). Among patients undergoing surgery, elevated mGPS had a non-significant correlation with reduced OS (HR = 2.48; 95% CI: 0.90–6.85; P = 0.079), whereas the correlation was significant for patients receiving chemotherapy or other palliative treatment (HR = 1.74; 95% CI: 1.31–2.30; P<0.05). Conclusions Our findings indicate that mGPS may have prognostic value in lung cancer, as we detected a significant association between elevated mGPS and poorer OS. The association between mGPS and poorer OS was non-significant among patients undergoing surgery, which may be attributable to lower tumor load. However, further studies are warranted to draw firm conclusions.
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Shi S, Chen Q, Ye L, Yin D, Li X, Dai Z, He J. Prognostic value of systemic inflammation score in patients with hepatocellular carcinoma after hepatectomy. Oncotarget 2017; 8:79366-79375. [PMID: 29108315 PMCID: PMC5668048 DOI: 10.18632/oncotarget.18121] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 04/24/2017] [Indexed: 12/18/2022] Open
Abstract
Inflammation plays an important role in cancer progression. In this study, we aimed to investigate the prognostic value of the systemic inflammatory biomarkers in hepatocellular carcinoma (HCC) patients undergoing curative resection. Data from 271 HCC patients who underwent curative resection in Zhongshan Hospital between 2008 and 2011 were included. Kaplan-Meier survival analysis showed that gamma-glutamyltransferase (GGT) and lymphocyte-to-monocyte ratio (LMR) were significantly associated with overall survival(OS) and time to recurrence(TTR). We created a systemic inflammation score (SIS) basing on preoperative serum GGT and LMR. Low SIS was also significantly associated with increased OS and TTR. Univariate and multivariate analyses revealed the LMR, GGT and SIS were independent predictors for OS and TTR. The predictive ability of the SIS, as assessed by area under the receiver operating characteristic curve, was 0.682 (95% CI, 0.618-0.746) for OS, which was higher than GGT and LMR. In conclusion, low preoperative LMR and high preoperative GGT were associated with a poor prognosis in HCC patients after hepatectomy. Our results confirmed that the SIS qualifies as a novel prognostic predictor of HCC patients after hepatectomy.
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Affiliation(s)
- Shiming Shi
- Department of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai, P.R. China
| | - Qing Chen
- Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, P.R. China.,Department of General Surgery, Zhongshan Hospital South, Fudan University, Shanghai Public Health Clinical Center, Fudan University, Shanghai, P.R. China
| | - Luxi Ye
- Department of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai, P.R. China
| | - Dan Yin
- Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, P.R. China.,Institute of Biomedical Sciences, Fudan University, Shanghai, P.R. China
| | - Xuedong Li
- Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, P.R. China
| | - Zhi Dai
- Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, P.R. China
| | - Jian He
- Department of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai, P.R. China
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