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Wu N, Cai J, Jiang J, Lin Y, Wang X, Zhang W, Kang M, Zhang P. Biomarkers of lymph node metastasis in esophageal cancer. Front Immunol 2024; 15:1457612. [PMID: 39399490 PMCID: PMC11466839 DOI: 10.3389/fimmu.2024.1457612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2024] [Accepted: 09/12/2024] [Indexed: 10/15/2024] Open
Abstract
Esophageal cancer (EC) is among the most aggressive malignancies, ranking as the seventh most prevalent malignant tumor worldwide. Lymph node metastasis (LNM) indicates localized spread of cancer and often correlates with a poorer prognosis, emphasizing the necessity for neoadjuvant systemic therapy before surgery. However, accurate identification of LNM in EC presents challenges due to the lack of satisfactory diagnostic techniques. Imaging techniques, including ultrasound and computerized tomography scans, have low sensitivity and accuracy in assessing LNM. Additionally, the existing serological detection lacks precise biomarkers. The intricate and not fully understood molecular processes involved in LNM of EC contribute to current detective limitations. Recent research has shown potential in using various molecules, circulating tumor cells (CTCs), and changes in the microbiota to identify LNM in individuals with EC. Through summarizing potential biomarkers associated with LNM in EC and organizing the underlying mechanisms involved, this review aims to provide insights that facilitate biomarker development, enhance our understanding of the underlying mechanisms, and ultimately address the diagnostic challenges of LNM in clinical practice.
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Affiliation(s)
| | | | | | | | | | | | - Mingqiang Kang
- Department of Thoracic Surgery, Fujian Medical University Union Hospital,
Fuzhou, China
| | - Peipei Zhang
- Department of Thoracic Surgery, Fujian Medical University Union Hospital,
Fuzhou, China
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2
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Hashimoto I, Tanabe M, Onuma S, Morita J, Nagasawa S, Maezawa Y, Kanematsu K, Aoyama T, Yamada T, Ogata T, Yukawa N, Rino Y, Saito A, Oshima T. A propensity‑matched analysis of the prognostic value of advanced lung cancer inflammation index in patients with gastric cancer after curative resection. Oncol Lett 2024; 27:285. [PMID: 38736744 PMCID: PMC11083996 DOI: 10.3892/ol.2024.14418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 04/04/2024] [Indexed: 05/14/2024] Open
Abstract
The prognostic significance of inflammation, immune response and nutritional status in patients with cancer is well-documented. The advanced lung cancer inflammation index (ALI) has emerged as a novel prognostic indicator, reflecting both inflammation and nutritional status. This study aimed to assess the prognostic relevance of preoperative ALI in patients with gastric cancer (GC). Data of 459 patients who underwent curative gastrectomy for GC between December 2013 and November 2017 at the Kanagawa Cancer Center (Yokohama, Japan) were retrospectively analyzed. Preoperative ALI was calculated from blood tests. Patients were divided into the high- and low-ALI groups. This study investigated the association between preoperative ALI, clinicopathological features, overall survival (OS) and relapse-free survival (RFS) after propensity-matched analysis. Comparative analysis revealed that patients in the low-ALI group tended to be older, were predominantly female, had lower body mass index and had a higher incidence of lymphatic invasion compared with those in the high-ALI group before propensity-matched analysis. Notably, the low-ALI group exhibited significantly reduced OS and RFS post-gastrectomy (85.5% vs. 93.8%, P=0.01; and 82.1% vs. 91.8%, P=0.02, respectively). Multivariate analysis identified low ALI as an independent prognostic factor for both OS and RFS. In conclusion, preoperative ALI could provide a valuable prognostic tool for patients with GC undergoing curative resection, offering insights into patient survival outcomes based on their inflammatory and nutritional status.
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Affiliation(s)
- Itaru Hashimoto
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Kanagawa 241-8515, Japan
- Department of Surgery, Yokohama City University, Yokohama, Kanagawa 236-0004, Japan
| | - Mie Tanabe
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Kanagawa 241-8515, Japan
- Department of Surgery, Yokohama City University, Yokohama, Kanagawa 236-0004, Japan
| | - Shizune Onuma
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Kanagawa 241-8515, Japan
- Department of Surgery, Yokohama City University, Yokohama, Kanagawa 236-0004, Japan
| | - Junya Morita
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Kanagawa 241-8515, Japan
- Department of Surgery, Yokohama City University, Yokohama, Kanagawa 236-0004, Japan
| | - Shinsuke Nagasawa
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Kanagawa 241-8515, Japan
- Department of Surgery, Yokohama City University, Yokohama, Kanagawa 236-0004, Japan
| | - Yukio Maezawa
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Kanagawa 241-8515, Japan
- Department of Surgery, Yokohama City University, Yokohama, Kanagawa 236-0004, Japan
| | - Kyohei Kanematsu
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Kanagawa 241-8515, Japan
| | - Toru Aoyama
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Kanagawa 241-8515, Japan
- Department of Surgery, Yokohama City University, Yokohama, Kanagawa 236-0004, Japan
| | - Takanobu Yamada
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Kanagawa 241-8515, Japan
- Department of Surgery, Yokohama City University, Yokohama, Kanagawa 236-0004, Japan
| | - Takashi Ogata
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Kanagawa 241-8515, Japan
| | - Norio Yukawa
- Department of Surgery, Yokohama City University, Yokohama, Kanagawa 236-0004, Japan
| | - Yasushi Rino
- Department of Surgery, Yokohama City University, Yokohama, Kanagawa 236-0004, Japan
| | - Aya Saito
- Department of Surgery, Yokohama City University, Yokohama, Kanagawa 236-0004, Japan
| | - Takashi Oshima
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Kanagawa 241-8515, Japan
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Hori T, Aihara KI, Ishida K, Inaba K, Inaba K, Kaneko Y, Kawahito K, Bekku S, Hosoki M, Mori K, Itami K, Katsuse M, Hanaoka Y, Kageji T, Uraoka H, Nakamura S. Usefulness of Palliative Prognostic Index, Objective Prognostic Score, and Neutrophil-Lymphocyte Ratio/Albumin Ratio As Prognostic Indicators for Patients Without Cancer Receiving Home-Visit Palliative Care: A Pilot Study at a Community General Hospital. Palliat Med Rep 2024; 5:142-149. [PMID: 38596695 PMCID: PMC11002559 DOI: 10.1089/pmr.2023.0096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2024] [Indexed: 04/11/2024] Open
Abstract
Background Although the palliative prognostic index (PPI), objective prognostic score (OPS), and neutrophil-lymphocyte ratio/albumin ratio (NLR/Alb) are well-known prognostic indicators for cancer patients, they do not provide clarity when it comes to predicting prognosis in patients without cancer who receive home-visit palliative care. Objective The aim of this study was to determine whether PPI, OPS, and NLR/Alb can predict prognosis for patients without cancer who received home-visit palliative care. Design This is a retrospective study. Setting/Subjects We recruited 58 patients without cancer who received home-visit palliative care from Tokushima Prefectural Kaifu Hospital, Japan, and died at home or at the hospital within seven days of admission between January 2009 and March 2023. Measurements The PPI, OPS, and NLR/Alb of the study patients were evaluated at regular intervals, and statistical analysis was performed on the relationship between these indices and the time to death. Results Simple regression analysis showed that PPI, OPS, and NLR/Alb were negatively correlated with the period until death (p < 0.001). The survival curves of the groups classified according to PPI, OPS, and NLR/Alb were significantly stratified. The predictive capacities of PPI, OPS, and NLR/Alb for death within 21 days were as follows: PPI (area under the curve [AUC]: 0.71; sensitivity: 59%; specificity: 68%), OPS (AUC: 0.73; sensitivity: 88%; specificity: 47%), and NLR/Alb (AUC: 0.72; sensitivity: 72%; specificity: 73%). Conclusions PPI, OPS, and NLR/Alb were useful in predicting the survival period and short-term prognosis within 21 days for patients without cancer who received home-visit palliative care.
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Affiliation(s)
- Taiki Hori
- Department of Internal Medicine, Tokushima Prefectural Kaifu Hospital, Tokushima, Japan
- Department of Hematology, Endocrinology and Metabolism, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Ken-ichi Aihara
- Department of Community Medicine and Medical Science, and Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Koki Ishida
- Department of Internal Medicine, Tokushima Prefectural Kaifu Hospital, Tokushima, Japan
| | - Kaori Inaba
- Department of General Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Keisuke Inaba
- Department of General Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Yousuke Kaneko
- Department of Internal Medicine, Tokushima Prefectural Kaifu Hospital, Tokushima, Japan
| | - Keisuke Kawahito
- Department of Internal Medicine, Tokushima Prefectural Kaifu Hospital, Tokushima, Japan
| | - Shoki Bekku
- Department of Internal Medicine, Tokushima Prefectural Kaifu Hospital, Tokushima, Japan
| | - Minae Hosoki
- Department of Internal Medicine, Tokushima Prefectural Kaifu Hospital, Tokushima, Japan
| | - Kensuke Mori
- Department of Internal Medicine, Tokushima Prefectural Kaifu Hospital, Tokushima, Japan
| | - Kanako Itami
- Department of Nursing, Tokushima Prefectural Kaifu Hospital, Tokushima, Japan
| | - Masayo Katsuse
- Department of Nursing, Tokushima Prefectural Kaifu Hospital, Tokushima, Japan
| | - Yoshimi Hanaoka
- Department of Nursing, Tokushima Prefectural Kaifu Hospital, Tokushima, Japan
| | - Teruyoshi Kageji
- Department of Neurosurgery, and Tokushima Prefectural Kaifu Hospital, Tokushima, Japan
| | - Hideyuki Uraoka
- Department of Orthopedic Surgery, Tokushima Prefectural Kaifu Hospital, Tokushima, Japan
| | - Shingen Nakamura
- Department of Community Medicine and Medical Science, and Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
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Tian X, Hou Y, Guo J, Wu H, Nie L, Wang H, Zhang Y, Lv Y. Effect of intensity modulated radiotherapy on lymphocytes in patients with esophageal squamous cell carcinoma and its clinical significance. Front Oncol 2023; 13:1096386. [PMID: 36959779 PMCID: PMC10028288 DOI: 10.3389/fonc.2023.1096386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 02/24/2023] [Indexed: 03/09/2023] Open
Abstract
Background Radiotherapy usually leads to a decrease in the total number of lymphocytes in patients with esophageal cancer. The factors that causing lymphopenia and the clinical significance of lymphopenia are studied in this article. Patients and methods 110 patients with esophageal squamous cell carcinoma who had undergo intensity-modulated radiation therapy were enrolled. Statistical methods were used to analyze the correlation between lymphopenia and total survival in patients with esophageal cancer during radiotherapy, and analyze the correlations between nutritional factors and lymphopenia. Results There were 11 patients with the lowest lymphocyte value with level 1-2 during radiotherapy, accounting for 10% of all the patients, and 110 patients with level 3-4, accounting for 90% of all the patient. In all the enrolled patients, the incidence of lymphocyte nadir G1, G2, G3 and G4 MinALC during radiotherapy accounted for 0.91%, 9.09%, 62.73% and 27.27%, respectively.KM survival analysis showed that the overall survival of patients in the group (MinALC ≤ 0.41×109/L) was significantly lower than that of the patients in the other group (MinALC>0.43×109/L). Nutritional indicators were positively correlated with the decline degree of lymphocytes. The minimal value of lymphocyte can predict the occurrence of grade 3-4 radiation pneumonitis. Conclusion Lymphopenia induced by radiotherapy can predict survival and radiation pneumonitis. Nutritional factors such as hemoglobin and albumin were positively correlated with total lymphocytes numbers induced by radiotherapy.
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Affiliation(s)
- Xiufang Tian
- Department of Oncology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Key Laboratory of Rheumatic Disease and Translational Medicine, Shandong Lung Cancer Institute, Jinan, Shandong, China
| | - Yong Hou
- Department of Oncology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Key Laboratory of Rheumatic Disease and Translational Medicine, Shandong Lung Cancer Institute, Jinan, Shandong, China
| | - Jianping Guo
- Department of Oncology, Maternal and Child Health Care Hospital of Zibo, Zibo, Shandong, China
| | - Haiyan Wu
- Department of Pharmacy, Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Limin Nie
- Department of Pathology, Caoxian People's Hospital, Shandong, Heze, China
| | - Hang Wang
- Department of Graduate, Shandong First Medical University, Jinan, Shandong, China
| | - Yan Zhang
- Department of Clinical Medicine, Shandong University, Jinan, Shandong, China
| | - Yajuan Lv
- Department of Oncology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Key Laboratory of Rheumatic Disease and Translational Medicine, Shandong Lung Cancer Institute, Jinan, Shandong, China
- *Correspondence: Yajuan Lv,
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5
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Yang Q, Shen A, Chen X, Guo L, Peng H, Gao M. Clinical Significance of Nutrition and Inflammation in Esophageal Cancer Patients with Surgery: A Meta-Analysis. Nutr Cancer 2022; 74:3128-3139. [PMID: 35341393 DOI: 10.1080/01635581.2022.2056620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Many studies have reported that the geriatric nutritional risk index (GNRI) and C-reactive protein to albumin ratio (CAR) may be associated with prognosis of esophageal cancer (EC); however, the results are inconsistent. Therefore, we performed a meta-analysis to evaluate the effect of preoperative GNRI and CAR on the prognosis of EC. PubMed, Embase, Cochrane Library, and Web of Science databases were searched. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were used to analyze the relationship between GNRI/CAR and prognosis. Publication bias was estimated using Begg's funnel plot asymmetry test and Egger's test. A total of 21 studies comprising 5,018 patients were included in the meta-analysis. A decreased GNRI was significantly associated with poorer overall survival (OS) (HR = 1.808, 95% CI: 1.489-2.196, P < 0.001) and cancer-specific survival (CSS) (HR = 1.769, 95% CI: 1.193-2.624, P = 0.005), and an increased CAR was significantly associated with lower OS (HR = 2.179, 95% CI: 1.587-2.992, P < 0.001), CSS (HR = 1.733, 95% CI: 1.333-2.253, P < 0.001), and recurrence-free survival (HR = 2.178, 95% CI: 1.328-3.573, P = 0.002). Thus, preoperative GNRI and CAR may be noninvasive and powerful tools for predicting survival outcomes in patients with EC.
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Affiliation(s)
- Qiuxing Yang
- Cancer Research Center Nantong, Nantong Tumor Hospital, Affiliated Tumor Hospital of Nantong University, Nantong, China
| | - Aiguo Shen
- Cancer Research Center Nantong, Nantong Tumor Hospital, Affiliated Tumor Hospital of Nantong University, Nantong, China
| | - Xudong Chen
- Department of Pathology, Nantong Tumor Hospital, Affiliated Tumor Hospital of Nantong University, Nantong, China
| | - Liyuan Guo
- Department of Laboratory, Nantong Tumor Hospital, Affiliated Tumor Hospital of Nantong University, Nantong, China
| | - Hui Peng
- Department of Radiology, Nantong Tumor Hospital, Affiliated Tumor Hospital of Nantong University, Nantong, China
| | - Mingde Gao
- Department of Urology, Nantong Tumor Hospital, Affiliated Tumor Hospital of Nantong University, Nantong, China
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Shen X, Wang W, Niu X. Neutrophil Lymphocyte Ratio to Albumin Ratio and White Blood Cell to Hemoglobin Ratio as Prognostic Markers for Hepatocellular Carcinoma Patients Who Underwent Curative Hepatectomy. Int J Gen Med 2021; 14:5029-5038. [PMID: 34511986 PMCID: PMC8414077 DOI: 10.2147/ijgm.s329911] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 08/19/2021] [Indexed: 12/24/2022] Open
Abstract
Purpose Inflammation factors affect the prognosis of hepatocellular carcinoma (HCC). However, it is not clear if the preoperative neutrophil lymphocyte ratio to albumin ratio (NLRAR) and white blood cell to hemoglobin ratio (WHR) affect the prognosis of HCC post curative hepatectomy. We assessed the prognostic values of NLRAR and WHR in patients suffering from HCC who underwent curative resection. Materials and Methods A total of 169 eligible HCC cases were reviewed. The optimal cut-off values for NLRAR and WHR were selected using the X-tile software. The overall survival (OS) rate was assessed following the Kaplan–Meier analysis method. The Log rank test and Cox proportional hazard regression model were also used to analyze the data. The prognostic values of NLRAR and WHR were calculated by analyzing the area under the receiver operating characteristic curve (AUC). The decision curve analysis (DCA) was performed for clinical benefits. Results The OS rate recorded for the high NLRAR group was poorer than the OS rate recorded for the low NLRAR group. Similar trends were observed for WHR. The NLRAR and WHR were the independent predictors of OS. The results were based on the multivariate Cox analyses method. Results obtained by analyzing the subgroups revealed that NLRAR and WHR could be used for the prognosis of HCC in tumor stage I-patients. The NLRAR–WHR scoring system (NWS) could be used to classify HCC patients into two cohorts with different prognoses. This scoring system was more efficient than NLRAR or WHR in predicting OS. Conclusion The preoperative NLRAR and WHR are effective prognostic indicators for HCC in patients who underwent curative hepatectomy.
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Affiliation(s)
- Xueqin Shen
- Department of Gastroenterology, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui Province, People's Republic of China
| | - Wei Wang
- Department of Gastroenterology, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui Province, People's Republic of China
| | - Xiaoping Niu
- Department of Gastroenterology, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui Province, People's Republic of China
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Karahan I, Yalçin S. Is C-Reactive Protein/Albumin Ratio of Advanced-Stage Non-small Cell Lung Cancer Patients Able to Predict Mortality in the Admission for Palliative Care? Indian J Palliat Care 2020; 26:365-368. [PMID: 33311881 PMCID: PMC7725176 DOI: 10.4103/ijpc.ijpc_218_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 03/26/2020] [Indexed: 11/04/2022] Open
Abstract
Context: Lung cancer is frequent and mortal cancer. The predicting mortality may be helpful for cancer management. Aim: The purpose of the study was to evaluate the role of baseline C-reactive protein (CRP)/albumin ratio (CAR) in relation to hospital mortality, the setting of advanced stage non-small cell lung cancer (NSCLC). Materials and Methods: The present study is a retrospective analysis and included 77 adult patients with Stage IV NSCLC who were hospitalized for supportive care. All patients are divided into two groups as survivors and nonsurvivors. CAR on the admission was compared between groups. The correlation between CAR and the death time was investigated. The cutoff level of CAR was calculated, and patients with a high level were described in two groups. Results: For all participants, the mean age was 63.0 ± 9.9 years, and the median values of CRP and albumin levels were 15.3 mg/dl (1–51.5) and 5.7 g/dl (0.02–22.7), respectively. CAR was significantly lower in the survivor group. By receiver operation curve analysis, the cutoff levels of CRP and CAR were determined as 10.8 and 3.5, respectively. The odds ratio of mortality was 3.85 (1.49–9.94 95% confidence interval [CI], P = 0.006) for higher than cutoff levels of CAR. The odds ratio was 3.38 (1.32–8.65 95% CI, P = 0.01) for higher CRP levels. There was a significant but weak negative correlation between the time of death and both CRP and CAR in the nonsurvivor group (r = −0.46, P = 0.002; r = −0.48, P = 0.001, respectively). Conclusion: The present study showed that CAR was significantly increased in nonsurvivors. CAR may be a cheap, easy, and effective tool for predicting the death and its time of hospitalized NSCLC patients.
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Affiliation(s)
- Irfan Karahan
- Department of Internal Medicine, School of Medicine, Kirikkale University, Kirikkale, Turkey
| | - Selim Yalçin
- Department of Medical Oncology, School of Medicine, Kirikkale University, Kirikkale, Turkey
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Matsunaga T, Miyata H, Sugimura K, Motoori M, Asukai K, Yanagimoto Y, Yamamoto K, Akita H, Nishimura J, Wada H, Takahashi H, Yasui M, Omori T, Ohue M, Fujiwara Y, Yano M. Prognostic Significance of C-reactive Protein-to-prealbumin Ratio in Patients with Esophageal Cancer. Yonago Acta Med 2019; 63:8-19. [PMID: 32158328 DOI: 10.33160/yam.2020.02.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 11/25/2019] [Indexed: 01/27/2023]
Abstract
Background The prognostic value of combination of C-reactive protein and prealbumin (CRP/PAlb) in esophageal cancer remains unclear. Methods We enrolled 167 esophageal cancer patients who underwent curative esophagectomy. Univariate and multivariate analyses were performed to determine the prognostic significance of various markers, including CRP-to-albumin (CRP/Alb) ratio, modified Glasgow prognostic score, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and prognostic nutritional index. Results Receiver operating characteristic analysis revealed the optimal cut-off value of each inflammatory factor, and CRP/PAlb ratio had the greatest discriminative power in predicting recurrence-free survival (RFS) among the examined measures (AUC 0.668). The 5-year overall survival and RFS rates were significantly lower in patients with high CRP/PAlb ratio than in those with low CRP/PAlb ratio (P < 0.001, P = 0.001, respectively). In the univariate analysis, RFS was significantly worse in patients with low BMI, T2 or deeper tumor invasion, positive lymph node metastasis, positive venous invasion, high CRP/PAlb ratio, high CRP/Alb ratio, high NLR, and high LMR. Multivariate analysis revealed that CRP/PAlb, but not CRP/Alb, was an independent prognostic factor along with lymph node metastasis. Conclusion CRP/PAlb ratio was useful for predicting the prognosis of esophageal cancer patients.
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Affiliation(s)
- Tomoyuki Matsunaga
- Department of Digestive Surgery, Osaka International Cancer Institute, Osaka 541-8567, Japan.,Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan
| | - Hiroshi Miyata
- Department of Digestive Surgery, Osaka International Cancer Institute, Osaka 541-8567, Japan
| | - Keijiro Sugimura
- Department of Digestive Surgery, Osaka International Cancer Institute, Osaka 541-8567, Japan
| | - Masaaki Motoori
- Department of Surgery, Osaka General Medical Center, Osaka 558-8558, Japan
| | - Kei Asukai
- Department of Digestive Surgery, Osaka International Cancer Institute, Osaka 541-8567, Japan
| | - Yoshitomo Yanagimoto
- Department of Digestive Surgery, Osaka International Cancer Institute, Osaka 541-8567, Japan
| | - Kazuyoshi Yamamoto
- Department of Digestive Surgery, Osaka International Cancer Institute, Osaka 541-8567, Japan
| | - Hirofumi Akita
- Department of Digestive Surgery, Osaka International Cancer Institute, Osaka 541-8567, Japan
| | - Junichi Nishimura
- Department of Digestive Surgery, Osaka International Cancer Institute, Osaka 541-8567, Japan
| | - Hiroshi Wada
- Department of Digestive Surgery, Osaka International Cancer Institute, Osaka 541-8567, Japan
| | - Hidenori Takahashi
- Department of Digestive Surgery, Osaka International Cancer Institute, Osaka 541-8567, Japan
| | - Masayoshi Yasui
- Department of Digestive Surgery, Osaka International Cancer Institute, Osaka 541-8567, Japan
| | - Takeshi Omori
- Department of Digestive Surgery, Osaka International Cancer Institute, Osaka 541-8567, Japan
| | - Masayuki Ohue
- Department of Digestive Surgery, Osaka International Cancer Institute, Osaka 541-8567, Japan
| | - Yoshiyuki Fujiwara
- Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan
| | - Masahiko Yano
- Department of Digestive Surgery, Osaka International Cancer Institute, Osaka 541-8567, Japan
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9
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Wang Y, Hu X, Huang Y, Xu WY, Wu YM, Li PF, Che GW. Prognostic value of the C-reactive protein to albumin ratio in esophageal cancer: A systematic review and meta-analysis. Kaohsiung J Med Sci 2019; 36:54-61. [PMID: 31512813 DOI: 10.1002/kjm2.12129] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Accepted: 08/21/2019] [Indexed: 02/05/2023] Open
Abstract
In recent years, some studies suggested that the pretreatment C-reactive protein to albumin ratio (CAR) may be predictive for prognosis of esophageal cancer (EC), but their results were inconsistent. Therefore, the current meta-analysis was preformed to better determine the prognostic value of pretreatment CAR in EC. The PubMed, EMBASE, Web of Science, Cochrane Library, and PubMed Central databases were searched up to January 10, 2019 to identify studies evaluating the correlation between CAR and prognosis of EC. The primary outcome was the overall survival (OS) and secondary outcomes were disease-free survival (DFS) and cancer-specific survival (CSS). Pooled hazard ratios (HRs) and corresponding 95% confidence intervals (95% CIs) were used to estimate the predictive role of CAR for prognosis in EC. Based on the results of this research, a total of 11 studies with 2930 patients diagnosed as EC were included. Pooled results suggested that elevated pretreatment CAR was significantly associated with poor OS (HR = 1.80, 95% CI: 1.31-2.47, P < .001) with high heterogeneity (I2 = 86.5%, P < .001) and poor CSS (HR = 1.72, 95% CI: 1.33-2.22, P < .001) without heterogeneity (I2 = 0.0%, P < .323); however, no significant association was observed between pretreatment CAR and DFS (HR = 1.41, 95% CI: 0.60-3.34, P = .429) with high heterogeneity (I2 = 76.7%, P < .038). Subgroup analyses further manifested that EC patients with higher CAR had worse OS. An elevated pretreatment CAR may indicate poor survival in patients with EC. Thus, pretreatment CAR may serve as a promising biomarker in EC and could be used to predict prognosis and help decision-making in clinical work.
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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
| | - Yu Huang
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Wen-Ying Xu
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Yan-Ming Wu
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Peng-Fei Li
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Guo-Wei Che
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China
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Lv Y, Zhang J, Liu Z, Tian Y, Liu F. A novel inflammation-based prognostic index for patients with esophageal squamous cell carcinoma: Neutrophil lymphocyte ratio/prealbumin ratio. Medicine (Baltimore) 2019; 98:e14562. [PMID: 30762804 PMCID: PMC6407987 DOI: 10.1097/md.0000000000014562] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Revised: 01/09/2019] [Accepted: 01/23/2019] [Indexed: 01/19/2023] Open
Abstract
NLR/Alb (neutrophil lymphocyte ratio/albumin ratio), is a prognostic index for esophageal cancer has been confirmed. Prealbumin (PA) is more sensitive to malnutrition than albumin. A new prognostic index, named neutrophil lymphocyte ratio/prealbumin ratio (NLR/PA), for predicting the survival time in patients with esophageal squamous cell carcinoma (ESCC) was proposed.A retrospective study of 315 cases with ESCC was enrolled. The optimal cut-off values were evaluated by ROC curve (the receiver operating characteristics curve). Pearson correlation analyses were used to calculate the correlations among NLR, Alb, NLR/Alb and NLR/PA. The overall survival (OS) was calculated by Kaplan-Meier method. Cox regression analyses were performed to evaluate the prognostic factors.The optimal cut-off value was 0.01 for NLR/PA according to ROC curve. According to multivariate analyses, TNM stage, NLR, NLR/Alb, NLR/PA were prognostic factors for OS. The AUC area (the area under the receiver operating characteristics curves) of the NLR/PA was higher than the areas of NLR and NLR/Alb for all the patients. The index of NLR/ PA had a higher AUC area than that of the index of NLR or NLR/Alb for patients in stage I-II. But in stage III-IVA, the index of NLR had a higher AUC area than that of the index of NLR/PA or NLR/Alb.The index of NLR/PA is superior to the index of NLR as a prognostic indicator for patients with early stage (stage I-II) ESCC.
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Zhang X, Jiang Y, Wang Y, Wang Z, Zhao L, Xue X, Sang S, Zhang L. Prognostic role of neutrophil-lymphocyte ratio in esophageal cancer: A systematic review and meta-analysis. Medicine (Baltimore) 2018; 97:e13585. [PMID: 30544482 PMCID: PMC6310576 DOI: 10.1097/md.0000000000013585] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The prognostic role of neutrophil-to-lymphocyte ratio (NLR) in esophageal cancer (EC) remains controversial. METHODS The aim of this study was to evaluate the association between NLR and oncologic outcome of EC patients through a meta-analysis. A systematic search was performed in PubMed, Web of Science and Embase for relevant studies. Meta-analysis was performed using hazard ratio (HR) and95% confidence interval (CI) as effect measures. RESULTS Finally, 33 articles with 11,039patients were included in our study. The synthesized results indicated that the elevated NLR was negatively related to overall survival (OS) (HR = 1.39, 95% CI: 1.23-1.54). When the patients were stratified according to country, pathological type, treatment strategies, sample size, and different HR estimate method, high NLR was also significantly correlated with poor OS. Similarly, elevated NLR was also associated with shorter disease-free survival (DFS), progress-free survival (PFS), relapse-free survival (RFS), and cancer-specific survival (CSS). CONCLUSION The elevated pretreatment NLR is associated with poor oncological outcomes in patients with EC. NLR may be a significant predictive biomarker in EC. Further large-cohort studies are needed to confirm these findings.
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Affiliation(s)
| | | | - Yang Wang
- Department of Medical Imaging, Shandong Provincial Hospital Affiliated to Shandong University, Shandong University, Jinan
| | | | - Linping Zhao
- Department of Thoracic Surgery, Shouguang City People's Hospital, Shouguang
| | - Xianbiao Xue
- Department of Thoracic Surgery, Juye County People's Hospital, Juye
| | - Shaowei Sang
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, People's Republic of China
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