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Menyhart O, Fekete JT, Győrffy B. Inflammation and Colorectal Cancer: A Meta-Analysis of the Prognostic Significance of the Systemic Immune-Inflammation Index (SII) and the Systemic Inflammation Response Index (SIRI). Int J Mol Sci 2024; 25:8441. [PMID: 39126008 PMCID: PMC11312822 DOI: 10.3390/ijms25158441] [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: 06/06/2024] [Revised: 07/10/2024] [Accepted: 07/12/2024] [Indexed: 08/12/2024] Open
Abstract
The overall prognosis for colorectal cancer (CRC) remains challenging as the survival time varies widely, even in patients with the same stage of disease. Recent studies suggest prognostic relevance of the novel markers of systemic inflammation, the systemic immune-inflammation index (SII), and the systemic inflammation response index (SIRI). We conducted a comprehensive meta-analysis to assess the prognostic significance of the SII and the SIRI in CRC. We searched the relevant literature for observational studies, and random effects models were employed to conduct a statistical analysis using the metaanalysisonline.com platform. Pooled effect sizes were reported with hazard ratios (HRs) and corresponding 95% confidence intervals (CI). Data from 29 studies published between 2016 and 2024, comprising 10,091 participants, were included in our meta-analysis on SII. CRC patients with high SII levels had worse disease outcomes, which were associated with poor OS (HR: 1.75; 95% CI: 1.4-2.19) and poor PFS/DFS/RFS (HR: 1.25; 95% CI: 1.18-1.33). This increased risk of worse OS was present irrespective of the treatment strategy, sample size (<220 and ≥220), and cutoff used to define high and low SII (<550 and ≥550) groups. Based on data from five studies comprising 2362 participants, we found a strong association between the high SIRI and worse OS (HR: 2.65; 95% CI: 1.6-4.38) and DFS/RFS (HR: 2.04; 95% CI: 1.42-2.93). According to our results, both the SII and SIRI hold great promise as prognostic markers in CRC. Further validations are needed for their age- and stage-specific utility in the clinical routine.
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Affiliation(s)
- Otilia Menyhart
- Cancer Biomarker Research Group, Institute of Molecular Life Sciences, Hungarian Research Network, 1117 Budapest, Hungary; (O.M.); (J.T.F.)
- Department of Bioinformatics, Semmelweis University, 1094 Budapest, Hungary
| | - János Tibor Fekete
- Cancer Biomarker Research Group, Institute of Molecular Life Sciences, Hungarian Research Network, 1117 Budapest, Hungary; (O.M.); (J.T.F.)
- Department of Bioinformatics, Semmelweis University, 1094 Budapest, Hungary
| | - Balázs Győrffy
- Cancer Biomarker Research Group, Institute of Molecular Life Sciences, Hungarian Research Network, 1117 Budapest, Hungary; (O.M.); (J.T.F.)
- Department of Bioinformatics, Semmelweis University, 1094 Budapest, Hungary
- Department of Biophysics, Medical School, University of Pecs, 7624 Pecs, Hungary
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Zhang T, Zhu L, Wang X, Zhang X, Wang Z, Xu S, Jiao W. Machine learning models to predict systemic inflammatory response syndrome after percutaneous nephrolithotomy. BMC Urol 2024; 24:140. [PMID: 38972999 PMCID: PMC11229268 DOI: 10.1186/s12894-024-01529-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 07/01/2024] [Indexed: 07/09/2024] Open
Abstract
OBJECTIVE The objective of this study was to develop and evaluate the performance of machine learning models for predicting the possibility of systemic inflammatory response syndrome (SIRS) following percutaneous nephrolithotomy (PCNL). METHODS We retrospectively reviewed the clinical data of 337 patients who received PCNL between May 2020 and June 2022. In our study, 80% of the data were used as the training set, and the remaining data were used as the testing set. Separate prediction models based on the six machine learning algorithms were created using the training set. The predictive performance of each machine learning model was determined by the area under the receiver operating characteristic curve (AUC), accuracy, sensitivity and specificity using the testing set. We used coefficients to interpret the contribution of each variable to the predictive performance. RESULTS Among the six machine learning algorithms, the support vector machine (SVM) delivered the best performance with accuracy of 0.868, AUC of 0.942 (95% CI 0.890-0.994) in the testing set. Further analysis using the SVM model showed that prealbumin contributed the most to the prediction of the outcome, followed by preoperative urine culture, systemic immune-inflammation (SII), neutrophil to lymphocyte ratio (NLR), staghorn stones, fibrinogen, operation time, preoperative urine white blood cell (WBC), preoperative urea nitrogen, hydronephrosis, stone burden, sex and preoperative lymphocyte count. CONCLUSION Machine learning-based prediction models can accurately predict the possibility of SIRS after PCNL in advance by learning patient clinical data, and should be used to guide surgeons in clinical decision-making.
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Affiliation(s)
- Tianwei Zhang
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Ling Zhu
- Shandong Key Laboratory of Digital Medicine and Computer Assisted Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xinning Wang
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xiaofei Zhang
- Department of Education and Training, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Zijie Wang
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Shang Xu
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Wei Jiao
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, China.
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Yoshida S, Kawai H, Soe Y, Eain HS, Sanou S, Takabatake K, Takeshita Y, Hisatomi M, Nagatsuka H, Asaumi J, Yanagi Y. Efficacy of Cisplatin-CXCR4 Antagonist Combination Therapy in Oral Cancer. Cancers (Basel) 2024; 16:2326. [PMID: 39001388 PMCID: PMC11240506 DOI: 10.3390/cancers16132326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 06/13/2024] [Accepted: 06/20/2024] [Indexed: 07/16/2024] Open
Abstract
Cisplatin is a platinum-based compound that is widely used for treating inoperable oral squamous cell carcinoma (OSCC) in Japan; however, resistance to cisplatin presents a challenge and innovative approaches are required. We aimed to investigate the therapeutic potential of targeting the chemokine receptor CXCR4, which is involved in angiogenesis and tumor progression, using the CXCR4 inhibitor AMD3100, in combination with cisplatin. AMD3100 induced necrosis and bleeding in OSCC xenografts by inhibiting angiogenesis. We investigated the combined ability of AMD3100 plus cisplatin to enhance the antitumor effect in cisplatin-resistant OSCC. An MTS assay identified HSC-2 cells as cisplatin-resistant cells in vitro. Mice treated with the cisplatin-AMD combination exhibited the most significant reduction in tumor volume, accompanied by extensive hemorrhage and necrosis. Histological examination indicated thin and short tumor vessels in the AMD and cisplatin-AMD groups. These results indicated that cisplatin and AMD3100 had synergistic antitumor effects, highlighting their potential for vascular therapy of refractory OSCC. Antitumor vascular therapy using cisplatin combined with a CXCR4 inhibitor provides a novel strategy for addressing cisplatin-resistant OSCC.
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Affiliation(s)
- Saori Yoshida
- Preliminary Examination Room, Okayama University Hospital, Okayama 700-8558, Japan; (S.Y.); (Y.Y.)
| | - Hotaka Kawai
- Department of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8525, Japan; (Y.S.); (H.S.E.); (H.N.)
| | - Yamin Soe
- Department of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8525, Japan; (Y.S.); (H.S.E.); (H.N.)
| | - Htoo Shwe Eain
- Department of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8525, Japan; (Y.S.); (H.S.E.); (H.N.)
| | - Sho Sanou
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8525, Japan;
| | - Kiyofumi Takabatake
- Department of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8525, Japan; (Y.S.); (H.S.E.); (H.N.)
| | - Yohei Takeshita
- Department of Oral and Maxillofacial Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8525, Japan; (Y.T.); (J.A.)
| | - Miki Hisatomi
- Department of Oral and Maxillofacial Radiology, Okayama University Hospital, Okayama 700-8558, Japan;
| | - Hitoshi Nagatsuka
- Department of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8525, Japan; (Y.S.); (H.S.E.); (H.N.)
| | - Junichi Asaumi
- Department of Oral and Maxillofacial Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8525, Japan; (Y.T.); (J.A.)
| | - Yoshinobu Yanagi
- Preliminary Examination Room, Okayama University Hospital, Okayama 700-8558, Japan; (S.Y.); (Y.Y.)
- Department of Dental Informatics, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8525, Japan
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Gölen MK, Işık ŞM, Arıkan V. Is there a relationship between the severity of obstructive sleep apnea syndrome and the systemic immune inflammation index? Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08729-3. [PMID: 38761219 DOI: 10.1007/s00405-024-08729-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 05/06/2024] [Indexed: 05/20/2024]
Abstract
AIM Vascular dysfunction, oxidative stress and systemic inflammation are considered responsible for the pathophysiology of Obstructive sleep apnea syndrome (OSAS). It is thought that desaturation due to apnea-hypopnea attacks in OSAS patients activates inflammatory pathways. In this study, we aimed to reveal the relationship between inflammation parameters Systemic immune inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratios (PLR) severity of OSAS in patients who underwent polysomnography in our hospital's sleep laboratory. METHODS We grouped our 171 patients who were followed up in our sleep laboratory with the diagnosis of OSAS according to their AHI values. We evaluated the correlation of SII, NLR, and PLR values obtained from the complete blood tests of our patients with OSAS diagnosis and OSAS severity. RESULTS The mean NLR, PLR and SII values of patients with OSAS were statistically significantly higher than those without OSAS (p < 0.05). A positive correlation of 18% was found between the presence of OSAS and the SII value (p = 0.016). No statistically significant difference was found when comparing OSAS severity and NLR, PLR and SII values (p > 0.05). CONCLUSION We observed that SII, NLR and PLR parameters, which are rapidly assessable systemic inflammation markers of this process, were independently associated in patients diagnosed with OSAS and that there was no change in SII, NLR, and PLR parameters with OSAS severity.
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Affiliation(s)
- Meltem Karacan Gölen
- Department of Neurology, Baskent University Hospital Konya, Selcuklu, Konya, Turkey, 9042080.
| | - Şaziye Melike Işık
- Department of Neurology, Konya Numune State Hospital, Selcuklu, Konya, Turkey, 9042060
| | - Veysel Arıkan
- Department of Pulmoner Disease, Konya Numune State Hospital, Selcuklu, Konya, Turkey, 9042060
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Tang Y, Feng X, Liu N, Zhou Y, Wang Y, Chen Z, Liu Y. Relationship between systemic immune inflammation index and mortality among US adults with different diabetic status: Evidence from NHANES 1999-2018. Exp Gerontol 2024; 185:112350. [PMID: 38128848 DOI: 10.1016/j.exger.2023.112350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 12/16/2023] [Accepted: 12/18/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE To investigate the association between systemic immune inflammation index (SII) and all-cause or cardiovascular diseases (CVDs) mortality in US adults with different diabetic status based on the National Health and Nutrition Examination Survey (NHANES) database. STUDY DESIGN AND SETTING Adults with follow-up data in the NHANES 1999-2018 cycles were included in this study. The SII was calculated based on blood cells counts (including neutrophils, lymphocytes, and platelets) measured in the laboratory data. According to the quartiles of SII, population were divided into four groups (Q1-Q4). Mortality data was determined by linking NHANES survey participants to the National Death Index records, which collect mortality data and determine their vital status. Cox regression models were also performed to explore the hazard ratio (HR) and the corresponding 95 % confidence interval (95 % CI) of SII related with all-cause and CVDs mortality. In addition, restricted cubic spline was used to explore the nonlinear relationship between SII and mortality. Subgroup analysis and sensitivity analysis were performed to confirm the robustness of our results. RESULTS In this study, there were 45,454 participants were enrolled (50.43 % females), with a mean age of 47.35 ± 0.19 years. Among of which, 7971 were diabetes patients and 3281 were pre-diabetes. With the mean 9.89 ± 0.08 follow-up years, there were 6935 (15.26 %) deaths occurred. Of which, 1795 deaths were caused by CVDs. The age-adjusted death rates were higher in participants with high SII levels compared to those with low SII levels. Cox regression analysis, after adjusting for covariates, revealed that SII levels were associated with an increased risk of all-cause mortality (HR, 1.02; 95 % CI, 1.02-1.03, P < 0.0001) and CVDs mortality (HR, 1.05; 95 % CI, 1.02-1.08, P = 0.002) in the fully adjusted Model. Moreover, there was a slight increase in HR values with the progression of diabetes status. Restricted cubic spline analysis demonstrated a "U-shaped" relationship between SII and all-cause mortality in diabetic, pre-diabetic and non-diabetic populations (all the P for nonlinear < 0.001). In addition, the relationship between SII and CVDs mortality was also nonlinear in both the pre-diabetic and non-diabetic populations (both P < 0.001). However, there was a linear relationship between SII and cardiovascular mortality in individuals with diabetes (P = 0.528). CONCLUSION The SII is closely associated with the risk of all-cause and cardiovascular mortality. These associations vary among individuals with different diabetic states. Therefore, monitoring systemic inflammation and SII values is crucial in mitigating the risk of mortality.
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Affiliation(s)
- Yujie Tang
- Affiliated Hospital of Weifang Medical University, Weifang, China; School of Clinical Medicine, Weifang Medical University, Weifang, China
| | - Xiaojin Feng
- Department of Endocrinology and Metabolism, Affiliated Hospital of Weifang Medical University, Weifang, China; Department of Clinical Research Center, Affiliated Hospital of Weifang Medical University, Weifang, China
| | - Na Liu
- Department of Endocrinology and Metabolism, Affiliated Hospital of Weifang Medical University, Weifang, China
| | - Yuan Zhou
- Department of Endocrinology and Metabolism, Affiliated Hospital of Weifang Medical University, Weifang, China; Department of Clinical Research Center, Affiliated Hospital of Weifang Medical University, Weifang, China
| | - Yadi Wang
- Affiliated Hospital of Weifang Medical University, Weifang, China; School of Clinical Medicine, Weifang Medical University, Weifang, China
| | - Zhenna Chen
- Department of Ophthalmology, Affiliated Hospital of Weifang Medical University, Weifang, Shandong, China.
| | - Yongping Liu
- Department of Endocrinology and Metabolism, Affiliated Hospital of Weifang Medical University, Weifang, China; Department of Clinical Research Center, Affiliated Hospital of Weifang Medical University, Weifang, China.
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Zhao W, Jiang J. Advances in Predictive Biomarkers for Anti-Angiogenic Therapy in Non-Small Cell Lung Cancer. Cancer Control 2024; 31:10732748241270589. [PMID: 39192835 PMCID: PMC11363049 DOI: 10.1177/10732748241270589] [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: 04/15/2024] [Revised: 05/23/2024] [Accepted: 06/26/2024] [Indexed: 08/29/2024] Open
Abstract
This study aimed to explore advances in biomarkers related to anti-angiogenic therapy in patients with non-small cell lung cancer (NSCLC), thereby enhancing treatment selection, advancing personalized and precision medicine to improve treatment outcomes and patient survival rates. This article reviews key discoveries in predictive biomarkers for anti-angiogenic therapy in NSCLC in recent years, such as (1) liquid biopsy predictive biomarkers: studies have identified activated circulating endothelial cells (aCECs) via liquid biopsy as potential predictive biomarkers for the efficacy of anti-angiogenic therapy; (2) imaging biomarkers: advanced imaging technologies, such as dynamic contrast-enhanced integrated magnetic resonance positron emission tomography (MR-PET), are used to assess tumor angiogenesis in patients with NSCLC and evaluate the clinical efficacy of anti-angiogenic drugs; (3) genetic predictive biomarkers: research has explored polymorphisms of Vascular Endothelial Growth Factor Receptor-1 (VEGFR-1) and vascular endothelial growth factor-A (VEGF-A), as well as how plasma levels of VEGF-A can predict the outcomes and prognosis of patients with non-squamous NSCLC undergoing chemotherapy combined with bevacizumab. Despite progress in identifying biomarkers related to anti-angiogenic therapy, several challenges remain, including limitations in clinical trials, heterogeneity in NSCLC, and technical hurdles. Future research will require extensive clinical validation and in-depth mechanistic studies to fully exploit the potential of these biomarkers for personalized treatment.
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Affiliation(s)
- Weixing Zhao
- Department of Oncology, Graduate School of Qinghai University, Qinghai, China
| | - Jun Jiang
- Division III, Department of Medical Oncology, Affiliated Hospital of Qinghai University, Qinghai, China
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Petracci E, Passardi A, Biggeri A, Valgiusti M, Monti M, Frassineti GL, Nanni O, Scarpi E. Baseline and Longitudinal Neutrophil-to-Lymphocyte Ratio as Prognostic Factor for Metastatic Colorectal Cancer: A Secondary Analysis of the ITACa Randomized Trial. JCO Precis Oncol 2024; 8:e2300256. [PMID: 38295317 PMCID: PMC10843252 DOI: 10.1200/po.23.00256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 10/16/2023] [Accepted: 11/16/2023] [Indexed: 02/02/2024] Open
Abstract
PURPOSE We aimed to investigate the prognostic role of baseline and longitudinal levels of neutrophil-to-lymphocyte ratio (NLR) in patients with metastatic colorectal cancer (mCRC) treated with chemotherapy + bevacizumab (CT + B) or chemotherapy only. Additionally, we investigated whether treatment outcomes were mediated by the longitudinal biomarker. METHODS Data from an Italian randomized phase III trial were used. The main end point was progression-free survival (PFS). To address research questions, a series of joint models of longitudinal and survival data were specified, and the direct and indirect treatment effects were quantified. RESULTS Data for 239 patients, 113 (47.3%) treated with CT + B and 126 (52.7%) with CT only, were included in the analyses. The effect of NLR seemed to be mediated by the longitudinal trajectory of the biomarker. Only in the patient subgroup treated with CT + B, the baseline NLR retained a direct effect on PFS. Regarding the effect of treatment on PFS, two scenarios were observed. In the subgroup of patients with low baseline, NLR bevacizumab showed a direct protective effect only (hazard ratio [HR], 0.66 [95% CI, 0.45 to 0.98]), whereas in the subgroup with high baseline NLR, there was evidence for an adverse direct effect (HR, 1.63 [95% CI, 1.03 to 2.57]) and a protective indirect-which is mediated by the longitudinal biomarker-effect (HR, 0.71 [95% CI, 0.55 to 0.90]). CONCLUSION In our study, inflammatory indexes collected longitudinally showed a significant adverse prognostic role, thus suggesting the collection and use of such data for better clinical decision making. In the specific setting, we considered this is particularly important as the treatment effect seemed to be modified by both the baseline and longitudinal inflammation statuses. However, further research is needed to understand the possible factors underlying these results.
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Affiliation(s)
- Elisabetta Petracci
- Unit of Biostatistics and Clinical Trials, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Alessandro Passardi
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Annibale Biggeri
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Martina Valgiusti
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Manlio Monti
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Giovanni Luca Frassineti
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Oriana Nanni
- Unit of Biostatistics and Clinical Trials, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Emanuela Scarpi
- Unit of Biostatistics and Clinical Trials, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
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Passardi A, Azzali I, Bittoni A, Marisi G, Rebuzzi F, Molinari C, Bartolini G, Matteucci L, Sullo FG, Debonis SA, Gallio C, Monti M, Valgiusti M, Muratore M, Rapposelli IG, Ulivi P, Frassineti GL. Inflammatory indices as prognostic markers in metastatic colorectal cancer patients treated with chemotherapy plus Bevacizumab. Ther Adv Med Oncol 2023; 15:17588359231212184. [PMID: 38107830 PMCID: PMC10722949 DOI: 10.1177/17588359231212184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 10/19/2023] [Indexed: 12/19/2023] Open
Abstract
Background Validated predictors of sensitivity or resistance to Bevacizumab (Bev) are not available, and Inflammatory Indexes (IIs) has been reported to be useful prognostic factors in various malignant solid tumours, including metastatic colorectal cancer (mCRC). Objectives To explore the prognostic value of IIs in mCRC patients treated with first-line chemotherapy plus Bev. Design One hundred and eighty-two patients diagnosed with mCRC and treated with first line chemotherapy plus Bev were considered for this prospective non-pharmacological study. Neutrophil, lymphocyte, platelet, aspartate transaminase (AST) and lactate dehydrogenase (LDH) tests were carried out at baseline and before each treatment cycle, according to clinical practice. Methods Pre-treatment Systemic Immune-inflammation Index (SII), Colon Inflammatory Index (CII) and Aspartate aminotransferase-Lymphocyte Ratio Index (ALRI) were evaluated to assess a correlation with progression-free survival (PFS) and overall survival (OS). Results In the overall population, PFS and OS were lower in patients with high SII (HR 1.64, p = 0.006 and HR 1.75, p = 0.004, respectively) and high ALRI (HR 2.13, p = 0.001 and HR 1.76, p = 0.02, respectively), but no difference was detected according to CII value. The multivariate analysis confirmed both SII and ALRI as independent prognostic factors for PFS (HR 1.64 and 2.82, respectively) and OS (HR 1.65 and 2.12, respectively). Conclusion Our results demonstrate and confirm that IIs, and in particular SII and ALRI, are easy to measure prognostic markers for patient candidates to first line chemotherapy plus Bev for mCRC.
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Affiliation(s)
- Alessandro Passardi
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) ‘Dino Amadori’, Meldola, Italy
| | - Irene Azzali
- Unit of Biostatistics and Clinical Trials, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) ‘Dino Amadori’, Meldola, Italy
| | - Alessandro Bittoni
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) ‘Dino Amadori’, Via P. Maroncelli 40, Meldola 47014, Italy
| | - Giorgia Marisi
- Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) ‘Dino Amadori’, Meldola, Italy
| | - Francesca Rebuzzi
- Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) ‘Dino Amadori’, Meldola, Italy
| | - Chiara Molinari
- Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) ‘Dino Amadori’, Meldola, Italy
| | - Giulia Bartolini
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) ‘Dino Amadori’, Meldola, Italy
| | - Laura Matteucci
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) ‘Dino Amadori’, Meldola, Italy
| | - Francesco Giulio Sullo
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) ‘Dino Amadori’, Meldola, Italy
| | - Silvia Angela Debonis
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) ‘Dino Amadori’, Meldola, Italy
| | - Chiara Gallio
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) ‘Dino Amadori’, Meldola, Italy
| | - Manlio Monti
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) ‘Dino Amadori’, Meldola, Italy
| | - Martina Valgiusti
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) ‘Dino Amadori’, Meldola, Italy
| | - Margherita Muratore
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) ‘Dino Amadori’, Meldola, Italy
| | - Ilario Giovanni Rapposelli
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) ‘Dino Amadori’, Meldola, Italy
| | - Paola Ulivi
- Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) ‘Dino Amadori’, Meldola, Italy
| | - Giovanni Luca Frassineti
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) ‘Dino Amadori’, Meldola, Italy
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Yao S, Han Y, Yang M, Jin K, Lan H. Integration of liquid biopsy and immunotherapy: opening a new era in colorectal cancer treatment. Front Immunol 2023; 14:1292861. [PMID: 38077354 PMCID: PMC10702507 DOI: 10.3389/fimmu.2023.1292861] [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: 09/12/2023] [Accepted: 11/03/2023] [Indexed: 12/18/2023] Open
Abstract
Immunotherapy has revolutionized the conventional treatment approaches for colorectal cancer (CRC), offering new therapeutic prospects for patients. Liquid biopsy has shown significant potential in early screening, diagnosis, and postoperative monitoring by analyzing circulating tumor cells (CTC) and circulating tumor DNA (ctDNA). In the era of immunotherapy, liquid biopsy provides additional possibilities for guiding immune-based treatments. Emerging technologies such as mass spectrometry-based detection of neoantigens and flow cytometry-based T cell sorting offer new tools for liquid biopsy, aiming to optimize immune therapy strategies. The integration of liquid biopsy with immunotherapy holds promise for improving treatment outcomes in colorectal cancer patients, enabling breakthroughs in early diagnosis and treatment, and providing patients with more personalized, precise, and effective treatment strategies.
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Affiliation(s)
- Shiya Yao
- Department of Colorectal Surgery, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, Zhejiang, China
| | - Yuejun Han
- Department of Colorectal Surgery, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, Zhejiang, China
| | - Mengxiang Yang
- Department of Colorectal Surgery, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, Zhejiang, China
| | - Ketao Jin
- Department of Colorectal Surgery, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, Zhejiang, China
| | - Huanrong Lan
- Department of Surgical Oncology, Hangzhou Cancer Hospital, Hangzhou, Zhejiang, China
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Xiao Y, Jiang C, Li H, Xu D, Liu J, Huili Y, Nie S, Guan X, Cao F. Genes associated with inflammation for prognosis prediction for clear cell renal cell carcinoma: a multi-database analysis. Transl Cancer Res 2023; 12:2629-2645. [PMID: 37969384 PMCID: PMC10643973 DOI: 10.21037/tcr-23-1183] [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: 07/10/2023] [Accepted: 09/19/2023] [Indexed: 11/17/2023]
Abstract
Background Clear cell renal cell carcinoma (ccRCC) is the largest subtype of kidney tumour, with inflammatory responses characterising all stages of the tumour. Establishing the relationship between the genes related to inflammatory responses and ccRCC may help the diagnosis and treatment of patients with ccRCC. Methods First, we obtained the data for this study from a public database. After differential analysis and Cox regression analysis, we obtained the genes for the establishment of a prognostic model for ccRCC. As we used data from multiple databases, we standardized all the data using the surrogate variable analysis (SVA) package to make the data from different sources comparable. Next, we used a least absolute shrinkage and selection operator (LASSO) regression to construct a prognostic model of genes related to inflammation. The data used for modelling and internal validation came from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) series (GSE29609) databases. ccRCC data from the International Cancer Genome Consortium (ICGC) database were used for external validation. Tumour data from the E-MTAB-1980 cohort were used for external validation. The GSE40453 and GSE53757 datasets were used to verify the differential expression of inflammation-related gene model signatures (IRGMS). The immunohistochemistry of IRGMS was queried through the Human Protein Atlas (HPA) database. After the adequate validation of the IRGM, we further explored its application by constructing nomograms, pathway enrichment analysis, immunocorrelation analysis, drug susceptibility analysis, and subtype identification. Results The IRGM can robustly predict the prognosis of samples from patients with ccRCC from different databases. The verification results show that nomogram can accurately predict the survival rate of patients. Pathway enrichment analysis showed that patients in the high-risk (HR) group were associated with a variety of tumorigenesis biological processes. Immune-related analysis and drug susceptibility analysis suggested that patients with higher IRGM scores had more treatment options. Conclusions The IRGMS can effectively predict the prognosis of ccRCC. Patients with higher IRGM scores may be better candidates for treatment with immune checkpoint inhibitors and have more chemotherapy options.
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Affiliation(s)
- Yonggui Xiao
- School of Clinical Medicine, Affiliated Hospital, North China University of Science and Technology, Tangshan, China
| | - Chonghao Jiang
- Department of Urology, Affiliated Hospital of North China University of Science and Technology, Tangshan, China
| | - Hubo Li
- School of Clinical Medicine, Affiliated Hospital, North China University of Science and Technology, Tangshan, China
| | - Danping Xu
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Jinzheng Liu
- School of Clinical Medicine, Affiliated Hospital, North China University of Science and Technology, Tangshan, China
| | - Youlong Huili
- School of Clinical Medicine, Affiliated Hospital, North China University of Science and Technology, Tangshan, China
| | - Shiwen Nie
- School of Clinical Medicine, Affiliated Hospital, North China University of Science and Technology, Tangshan, China
| | - Xiaohai Guan
- Department of Urology, Affiliated Hospital of North China University of Science and Technology, Tangshan, China
| | - Fenghong Cao
- Department of Urology, Affiliated Hospital of North China University of Science and Technology, Tangshan, China
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11
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Balbaloglu H, Tasdoven I, Karadeniz Cakmak G. Can inflammatory indices predict sentinel lymph node status in patients with early-stage breast cancer? Medicine (Baltimore) 2023; 102:e34808. [PMID: 37603529 PMCID: PMC10443763 DOI: 10.1097/md.0000000000034808] [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: 06/19/2023] [Accepted: 07/27/2023] [Indexed: 08/23/2023] Open
Abstract
Breast cancer research has focused on the early detection and treatment of breast cancer. Axillary lymph node status is essential for primary breast cancer staging, recurrence, and survival. The current quest for precision medicine is to identify predictive markers that offer the advantage of individualized treatment options. This study aimed to investigate the value of inflammatory indices in predicting positive sentinel nodes in breast cancer. We studied 602 patients with early-stage breast cancer who underwent sentinel lymph node biopsies (SLNB) at the Bülent Ecevit University General Surgery Clinic. We obtained data, including the clinical and demographic characteristics of the patients, such as age, histological type, and sentinel lymph nodes. Neutrophil, lymphocyte, platelet, and monocyte counts were obtained from preoperative complete blood count test data from the patient registry. The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), systemic inflammatory index (SII), and sentinel lymph node biopsy were analyzed. Sentinel LAP was negative in 391 (65%) patients and positive in 211 (35%). In the receiver operating characteristic curve analysis, no significant difference was found between SLNB positivity and negativity in terms of NLR, PLR, LMR, or SII. In contrast to previous research, NLR, PLR, LMR, or SII did not affect SLNB positivity prediction in our study.
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Affiliation(s)
- Hakan Balbaloglu
- Bulent Ecevit University, School of Medicine, Department of General Surgery, Zonguldak, Turkey
| | - Ilhan Tasdoven
- Bulent Ecevit University, School of Medicine, Department of General Surgery, Zonguldak, Turkey
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Miyamoto Y, Akiyama T, Kato R, Sawayama H, Ogawa K, Yoshida N, Baba H. Prognostic Significance of Systemic Inflammation Indices by K-ras Status in Patients With Metastatic Colorectal Cancer. Dis Colon Rectum 2023; 66:e809-e817. [PMID: 35195557 DOI: 10.1097/dcr.0000000000002392] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Systemic inflammation markers are useful prognostic indicators for metastatic colorectal cancer. However, the influence of K-ras genotypes on these markers in patients with metastatic colorectal cancer is unclear. OBJECTIVE This study aimed to evaluate the associations between systems of evaluating pretreatment systemic inflammation and outcomes according to K-ras genotypes in patients with metastatic colorectal cancer. DESIGN This was a retrospective study. SETTINGS This study was conducted at a university hospital. PATIENTS This study included a total of 272 patients ( K-ras wild type: K-ras mutant = 169:103) who received first-line systemic chemotherapy for metastatic colorectal cancer. MAIN OUTCOME MEASURES We retrospectively calculated 8 systemic inflammation indices: neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, lymphocyte/monocyte ratio, prognostic nutritional index, Glasgow prognostic score, Naples prognostic score, systemic inflammation score, and systemic immune-inflammation index. Patients were categorized into high or low groups for each index. The prognostic relevance of these indices for overall survival was evaluated according to the K-ras genotype. RESULTS Kaplan-Meier survival analyses showed that median overall survival significantly differed between the high and low groups for all indices in the K-ras wild-type group but not in the K-ras mutant group, except for Glasgow prognostic score and lymphocyte/monocyte ratio. Multivariate Cox regression analyses identified all indices as independent prognostic factors. In the K-ras wild-type group, all indices except platelet/lymphocyte ratio had strong prognostic effects, but not in the K-ras mutant group. Interaction tests indicated that K-ras genotype significantly influenced the prognostic impacts of the neutrophil/lymphocyte ratio ( p = 0.042), prognostic nutritional index ( p = 0.048), Naples prognostic score ( p < 0.001), and systemic immune-inflammation index ( p = 0.004). LIMITATIONS A major limitation of this study is the lack of external validation. CONCLUSIONS The prognostic significance of systemic inflammation indices is more useful in patients with K-ras wild-type metastatic colorectal cancer than those with K-ras mutant cancer. See Video Abstract at http://links.lww.com/DCR/B921 . IMPORTANCIA PRONSTICA DE LOS NDICES DE INFLAMACIN SISTMICA POR ESTADO DE KRAS EN PACIENTES CON CNCER COLORRECTAL METASTSICO ANTECEDENTES:Los marcadores de inflamación sistémica son indicadores de pronósticos útiles para el cáncer colorrectal metastásico. Sin embargo, la influencia de los genotipos KRAS en estos marcadores en pacientes con cáncer colorrectal metastásico no está clara.OBJETIVO:Evaluamos las asociaciones entre los sistemas de evaluación de la inflamación sistémica previa al tratamiento y los resultados según los genotipos K-ras en pacientes con cáncer colorrectal metastásico.AJUSTE:Este estudio se realizó en un hospital universitario.DISEÑO:Este fue un estudio retrospectivo.PACIENTES:Un total de 272 pacientes (K-ras wildtype [K-raswt]:mutant [K-rasMut] = 169:103) que recibieron quimioterapia sistémica de primera línea para el cáncer colorrectal metastásico.PRINCIPALES MEDIDAS DE RESULTADO:Calculamos retrospectivamente 8 índices de inflamación sistémica: proporción de neutrófilos/linfocitos, proporción de plaquetas/linfocitos, proporción de linfocitos/monocitos, índice nutricional pronóstico, puntuación de pronóstico de Glasgow, puntuación de pronóstico de Nápoles, puntuación de inflamación sistémica e índice de inmunoinflamación sistémica. Los pacientes se clasificaron en grupos altos o bajos para cada índice. La relevancia pronóstica de estos índices para la supervivencia global se evaluó según el genotipo K-ras.RESULTADOS:Los análisis de supervivencia de Kaplan-Meier mostraron que la mediana de la supervivencia general difería significativamente entre los grupos alto y bajo para todos los índices en el grupo K-raswt pero no en el grupo K-rasMut, excepto para la puntuación de pronóstico de Glasgow y la proporción de linfocitos/monocitos. Los análisis de regresión multivariable de Cox identificaron todos los índices como factores pronósticos independientes. En el grupo K-raswt, todos los índices, excepto el cociente plaquetas/linfocitos, tuvieron fuertes efectos pronósticos, pero no en el grupo K-rasMut. Las pruebas de interacción indicaron que el genotipo K-ras influyó significativamente en los impactos pronósticos de la proporción de neutrófilos/linfocitos (p = 0,042), el índice nutricional pronóstico (p = 0,048), la puntuación pronóstica de Nápoles (p < 0,001) y el índice de inflamación inmunológica sistémica (p = 0,004).LIMITACIÓN:Una limitación importante de este estudio es la falta de validación externa.CONCLUSIÓNES:La importancia pronóstica de los índices de inflamación sistémica es más útil en pacientes con cáncer colorrectal metastásico K-raswt. Consulte Video Resumen en http://links.lww.com/DCR/B921 . (Traducción-Dr. Yolanda Colorado ).
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Affiliation(s)
- Yuji Miyamoto
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Takahiko Akiyama
- Department of Gastrointestinal Cancer Biology, International Research Centre for Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Rikako Kato
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Hiroshi Sawayama
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Katsuhiro Ogawa
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Naoya Yoshida
- Division of Translational Research and Advanced Treatment Against Gastrointestinal Cancer, Kumamoto University, Kumamoto, Japan
| | - Hideo Baba
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
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Fu Z, Cheng P, Jian Q, Wang H, Ma Y. High Systemic Immune-Inflammation Index, Predicting Early Allograft Dysfunction, Indicates High 90-Day Mortality for Acute-On-Chronic Liver Failure after Liver Transplantation. Dig Dis 2023; 41:938-945. [PMID: 37494918 DOI: 10.1159/000532110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 07/12/2023] [Indexed: 07/28/2023]
Abstract
INTRODUCTION The aim of the study was to investigate the relationship between systemic immune-inflammation index (SII) and early allograft dysfunction (EAD) and 90-day mortality after liver transplantation (LT) in acute-on-chronic liver failure (ACLF). METHODS Retrospective record analysis was done on 114 patients who had LT for ACLF. To identify the ideal SII, the receiver operating characteristic curve was used. The incidence of EAD and 90-day mortality following LT were calculated. The prognostic value of SII was assessed using the Kaplan-Meier technique and the Cox proportional hazards model. RESULTS The cut-off for SII was 201.5 (AUC = 0.728, p < 0.001). EAD occurred in 40 (35.1%) patients of the high SII group and 5 (4.4%) patients of the normal SII group, p < 0.001. 18 (15.8%) deaths occurred in the high SII group and 2 (1.8%) deaths occurred in the normal SII group, p = 0.008. The multivariate analysis demonstrated that SII ≥201.5, MELD ≥27 were independent prognostic factors for 90-day mortality after LT. CONCLUSION SII predicts the occurrence of EAD and is an independent risk factor for 90-day mortality after LT.
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Affiliation(s)
- Zongli Fu
- Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial International Cooperation Base of Science and Technology (Organ Transplantation), The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Pengrui Cheng
- Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial International Cooperation Base of Science and Technology (Organ Transplantation), The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Qian Jian
- Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial International Cooperation Base of Science and Technology (Organ Transplantation), The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Hanyu Wang
- Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial International Cooperation Base of Science and Technology (Organ Transplantation), The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yi Ma
- Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial International Cooperation Base of Science and Technology (Organ Transplantation), The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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Akpınar CK, Kocaturk O, Aykac O, Acar BA, Dogan H, Onalan A, Acar T, Uysal Kocabas Z, Topaktas B, Gurkas E, Ozdemir AO. Can C-reactive protein/albumin ratio be a prognostic factor in acute stroke patients undergoing mechanical thrombectomy? Clin Neurol Neurosurg 2023; 231:107856. [PMID: 37413825 DOI: 10.1016/j.clineuro.2023.107856] [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: 04/05/2023] [Revised: 06/12/2023] [Accepted: 06/24/2023] [Indexed: 07/08/2023]
Abstract
INTRODUCTION C-reactive protein (CRP) and albumin are markers synthesized by the liver and may reflect inflammatory responses. CRP/Albumin ratio (CAR) serves better to reflect the inflammatory state and therefore the prognosis. Worse prognosis is reported in previous studies when CAR rate on admission is high in patients with stroke, aneurysmal subarachnoid hemorrhage, malignancy or patients followed in intensive care units. We aimed to investigate the relation of CAR with prognosis in mechanical thrombectomy performed acute stroke patients. MATERIALS AND METHODS Stroke patients admitted to five different stroke centers between January 2021 and August 2022 undergoing mechanical thrombectomy were included and retrospectively analyzed. The CAR ratio was calculated as the ratio of CRP to albumin level in the venous blood samples. Primary outcome was the relation between CAR and functional outcome at 90 days determined by modified Rankin Scale (mRS). RESULTS This study included 558 patients with a mean age of 66,5 ± 12.5 years (age range:18-89 years) best cutoff value of the CAR was 3.36, with 74.2 % sensitivity and 60.7 % specificity (Area under the curve: 0.774; 95 %CI: 0.693-0.794). There was no significant correlation between CAR rate and age, CAR rate and NIHSS on admission, and also between CAR rate and symptom recanalization (p > 0.05). CAR ratio in the mRS 3-6 group was statistically significantly higher (p < 0.001). In the multivariate analyses, CAR showed an association with 90-day mortality (odds ratio, 1.049; 95 % CI, 1.032-1.066) CONCLUSION: In acute ischemic stroke patients treated with mechanical thrombectomy, CAR may be one of the factors affecting poor clinical outcome and/or mortality in patients undergoing mechanical thrombectomy. Upcoming similar studies in this patient group may better clarify the prognostic role of CAR.
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Affiliation(s)
- Cetin Kursad Akpınar
- Samsun University, Samsun Training and Research Hospital, Department of Neurology, Interventional Neurology, Samsun, Turkey
| | - Ozcan Kocaturk
- Balıkesir Atatürk City Hospital, Department of Neurology, Interventional Neurology, Balıkesir, Turkey
| | - Ozlem Aykac
- Eskisehir Osmangazi University, Medical Faculty, Department of Neurology, Neurocritical Care, Interventional Neurology, Eskisehir, Turkey
| | | | - Hasan Dogan
- Samsun University, Samsun Training and Research Hospital, Department of Neurology, Interventional Neurology, Samsun, Turkey.
| | - Aysenur Onalan
- Health Sciences University, Dr. Lutfi Kirdar City Hospital, Department of Neurology, Interventional Neurology, İstanbul, Turkey
| | - Turkan Acar
- Sakarya University, Faculty of Medicine, Department of Neurology, Sakarya, Turkey
| | - Zehra Uysal Kocabas
- Eskisehir Osmangazi University, Medical Faculty, Department of Neurology, Neurocritical Care, Interventional Neurology, Eskisehir, Turkey
| | | | - Erdem Gurkas
- Health Sciences University, Dr. Lutfi Kirdar City Hospital, Department of Neurology, Interventional Neurology, İstanbul, Turkey
| | - Atilla Ozcan Ozdemir
- Eskisehir Osmangazi University, Medical Faculty, Department of Neurology, Neurocritical Care, Interventional Neurology, Eskisehir, Turkey
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Hasirci I, Şahin A. Importance of the neutrophil-lymphocyte ratio and systemic immune-inflammation index in predicting colorectal pathologies in fecal occult blood-positive patients. J Clin Lab Anal 2023; 37:e24878. [PMID: 37096941 DOI: 10.1002/jcla.24878] [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: 02/06/2023] [Revised: 03/07/2023] [Accepted: 03/26/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND The fecal occult blood (FOB) test is one of the primary screening methods for colorectal cancer (CRC). In this study, we aimed to investigate the effect of the neutrophil/lymphocyte ratio (NLR) and systemic immune-inflammation index (SII) in predicting CRC and other colorectal pathologies in patients with a positive FOB test. METHODS This retrospective study included patients with a positive FOB test who underwent colonoscopy for the investigation of the etiology. The optimal cutoff levels of NLR and SII for predicting colorectal pathologies were determined using the receiver operating characteristic analysis. RESULTS Of the 157 FOB+ patients, 35% were male and 65% were female, with a median age of 59 years. There were 96 patients in Group 1 and 61 patients in Group 2. The mean age of the patients in Group 2 was significantly higher (p < 0.001). The rate of male patients was significantly higher in Group 2. NLR and SII were significantly higher in Group 2 than in Group 1 (p < 0.001). The area under the curve values of NLR and SII in predicting colorectal pathologies in FOB+ patients were 0.817 and 0.825, respectively. At the cutoff values of 0.689 and 0.795, NLR and SII had a sensitivity of 60.66% and 95.83%, respectively, and a specificity of 95.83% and 100%, respectively. CONCLUSION Neutrophil/lymphocyte ratio and SII can be used as important biomarkers in the early diagnosis of CRC and other colorectal lesions in patients with a positive FOB test.
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Affiliation(s)
- Ismail Hasirci
- Department of General Surgery, Konya City Hospital, Konya, Turkey
| | - Alpaslan Şahin
- Department of General Surgery, Konya City Hospital, Konya, Turkey
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Guo G, Hu X, Gao T, Zhou H, Li B, Zhou C, Yu B, Wang G. Potential impact of platelet-to-lymphocyte ratio on prognosis in patients with colorectal cancer: A systematic review and meta-analysis. Front Surg 2023; 10:1139503. [PMID: 37051571 PMCID: PMC10083474 DOI: 10.3389/fsurg.2023.1139503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 03/06/2023] [Indexed: 03/29/2023] Open
Abstract
BackgroundNumerous studies have confirmed that inflammation promotes the occurrence, development and prognosis of colorectal cancer (CRC).ObjectiveThis study focuses on the potentially prognostic value of the platelet-to-lymphocyte ratio (PLR) in CRC patients.Data SourcesThis study was registered at PROSPERO (ID: CRD42020219215). Relative studies were searched on PubMed, Cochrane Library, Embase, Web of Science, and clinical trial databases by two back-to-back reviewers. Study Selection and Intervention: Studies were screened according to the predetermined inclusion and exclusion criteria, comparing prognosis differences between low PLR levels and high PLR levels for CRC patients. Main Outcome Measures: Studies were integrated and compared to analyze the value of PLR in predicting overall survival (OS), progression-free survival (PFS), cancer-specific survival (CSS), disease-free survival (DFS) and recurrence-free survival (RFS) of CRC. Results: Outcomes were compared using Review Manager (version 5.4) software from Cochrane Collaboration. A total of 27 literary works, including 13,330 patients, were incorporated into our study. The final results showed that higher PLR levels had worse OS (hazard ratio [HR] = 1.40, 95% confidence interval [CI] = 1.21–1.62, P < 0.00001), DFS (HR = 1.44, 95% CI = 1.09–1.90, P = 0.01) and RFS (HR = 1.48, 95% CI = 1.13–1.94, P = 0.005) than lower PLR levels, respectively. However, there was no evidence of significance for PFS (HR = 1.14, 95% CI = 0.84–1.54, P = 0.40) and CSS (HR = 1.16, 95% CI = 0.88–1.53, P = 0.28) in the final meta-analysis.LimitationsOur study has the following limitations. First of all, we only included literature published in English, which means that some publication bias may be inevitable. In addition, our study used aggregate data, not individual data; furthermore, we did not define the exact cut-off value representing the PLR level.ConclusionAn elevated PLR seems to be an adverse prognostic factor affecting survival outcomes in patients with CRC. Meanwhile, more prospective studies are required to confirm our conclusion.PROSPERO ID: CRD42020219215.
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Affiliation(s)
- Ganlin Guo
- The Second Hospital of Hebei Medical University, Shijiazhuang, China
- The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xuhua Hu
- The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Tianyi Gao
- The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Huixian Zhou
- The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Baokun Li
- The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Chaoxi Zhou
- The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Bin Yu
- The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Guiying Wang
- The Second Hospital of Hebei Medical University, Shijiazhuang, China
- The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
- Correspondence: Guiying Wang
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Tzikos G, Alexiou I, Tsagkaropoulos S, Menni AE, Chatziantoniou G, Doutsini S, Papavramidis T, Grosomanidis V, Stavrou G, Kotzampassi K. Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio as Predictive Factors for Mortality and Length of Hospital Stay after Cardiac Surgery. J Pers Med 2023; 13:jpm13030473. [PMID: 36983655 PMCID: PMC10054765 DOI: 10.3390/jpm13030473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 02/18/2023] [Accepted: 03/03/2023] [Indexed: 03/08/2023] Open
Abstract
Background: Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are widely accepted indices positively correlated with disease severity, progression, and mortality. In this study, we tested whether NLR and PLR could predict mortality and length of hospital stay (LOS) after cardiac surgery. Methods: NLR and PLR were calculated on days 0, 3, 5, and 7 postoperatively. A ROC curve was generated to assess their prognostic value; multivariate logistic analysis identified independent risk factors for 90-day mortality. Results: Analysis was performed on 179 patients’ data, 11 of whom (6.15%) died within 90 days. The discriminatory performance for predicting 90-day mortality was better for NLR7 (AUC = 0.925, 95% CI:0.865–0.984) with the optimal cut-off point being 7.10. NLR5 and PLR3 also exhibited a significant strong discriminative performance. Similarly, a significant discriminative performance was prominent for PLR3, NLR5, and NLR7 with respect to LOS. Moreover, NLR7 (OR: 2.143, 95% CI: 1.076–4.267, p = 0.030) and ICU LOS (OR:1.361, 95% CI: 1.045–1.774, p = 0.022) were significant independent risk factors for 90-day mortality. Conclusions: NLR and PLR are efficient predictive factors for 90-day mortality and LOS in cardiac surgery patients. Owing to the simplicity of determining NLR and PLR, their postoperative monitoring may offer a reliable predictor of patients’ outcomes in terms of LOS and mortality.
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Affiliation(s)
- Georgios Tzikos
- Department of Surgery, Aristotle University of Thessaloniki, 546 36 Thessaloniki, Greece
- Correspondence:
| | - Ioannis Alexiou
- Department of Cardiothoracic Surgery, Aristotle University of Thessaloniki, 546 36 Thessaloniki, Greece
| | - Sokratis Tsagkaropoulos
- Department of Cardiothoracic Surgery, Aristotle University of Thessaloniki, 546 36 Thessaloniki, Greece
| | | | | | - Soultana Doutsini
- Department of Surgery, Aristotle University of Thessaloniki, 546 36 Thessaloniki, Greece
| | | | - Vasilios Grosomanidis
- Department of Surgery, Aristotle University of Thessaloniki, 546 36 Thessaloniki, Greece
| | - George Stavrou
- Department of Surgery, Aristotle University of Thessaloniki, 546 36 Thessaloniki, Greece
| | - Katerina Kotzampassi
- Department of Surgery, Aristotle University of Thessaloniki, 546 36 Thessaloniki, Greece
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Biomarkers for Outcome in Metastatic Melanoma in First Line Treatment with Immune Checkpoint Inhibitors. Biomedicines 2023; 11:biomedicines11030749. [PMID: 36979727 PMCID: PMC10044937 DOI: 10.3390/biomedicines11030749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 02/26/2023] [Accepted: 02/27/2023] [Indexed: 03/06/2023] Open
Abstract
Introduction: A high proportion of metastatic melanoma patients do not respond to immune checkpoint inhibitors (ICI), and until now, no validated biomarkers for response and survival have been known. Methods: We performed a retrospective analysis of outcomes in patients with metastatic melanoma treated with first-line ICI at the Institute of Oncology Ljubljana from January 2018 to December 2020. The immune-related adverse events (irAEs) and serum immune-inflammation parameters (neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (LR), systemic immune-inflammation index (SII) and pan-immune-inflammation value (PIV)) were analyzed as potential biomarkers for response and survival. Survival rates were calculated using the Kaplan–Meier method and then compared with the log-rank test. Multivariate regression Cox analysis was used to determine independent prognostic factors for progression-free survival (PFS) and overall survival (OS). Results: Median follow-up was 22.5 months. The estimated median progression-free survival (PFS) was 15 months (95% CI 3.3–26.2). The two-year survival rate (OS) was 66.6%. Among 129 treated patients, 24 (18.6%) achieved complete response, 28 (21.7%) achieved partial response, 26 (20.2%) had stable disease and 51 (39.5%) patients experienced a progressive disease. There was a higher response rate in patients with irAEs (p < 0.001) and high NLR before the second cycle of ICI (p = 0.052). Independent prognostic factors for PFS were irAE (HR 0.41 (95% CI 0.23–0.71)), SII before the first cycle of ICI (HR 1.94 (95% CI 1.09–3.45)) and PLR before the second cycle of ICI (HR 1.71 (95% CI 1.03–2.83)). The only independent prognostic factor for OS was SII before the first cycle of ICI (HR 2.60 (95% CI 0.91–7.50)). Conclusions: Patients with high pre-treatment levels of SII had a higher risk of progression and death; however, patients with irAEs in the high-SII group might respond well to ICI. Patients who develop irAEs and have high NLRs before the second ICI application have higher rates of CR and PR, which implicates their use as early biomarkers for responsiveness to ICI.
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Taieb J, Price T, Vidot L, Chevallier B, Wyrwicz L, Bachet JB. Safety and efficacy of trifluridine/tipiracil in previously treated metastatic colorectal cancer: final results from the phase IIIb single-arm PRECONNECT study by duration of therapy. BMC Cancer 2023; 23:94. [PMID: 36707808 PMCID: PMC9881327 DOI: 10.1186/s12885-022-10489-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 12/26/2022] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND PRECONNECT was an international, phase IIIb trial evaluating the safety and efficacy of trifluridine/tipiracil (FTD/TPI) for metastatic colorectal cancer (mCRC). METHODS Patients with mCRC received FTD/TPI 35 mg/m2 twice-daily on days 1-5 and 8-12 of each 28-day cycle for third- or later-line treatment. PRIMARY ENDPOINT safety and time to deterioration of Eastern Cooperative Oncology Group performance status [ECOG PS] to ≥2). Secondary endpoints included progression-free survival (PFS). Potential prognostic factors for PFS were explored. RESULTS Of 914 patients, 69% completed 0-3, 24% completed 4-7, and 7% completed ≥8 cycles of FTD/TPI. Drug-related grade ≥ 3 adverse events included neutropenia (38.1%), anaemia (7.2%) and asthenia (3.4%). Median [95% CI] time to ECOG PS deterioration was 8.7 [8.1-not calculable] months and increased with duration of treatment (DoT). Median PFS was 2.8 [2.7-3.0] months and increased with duration of treatment DoT. Prognostic factors associated with longer PFS included time since diagnosis of first metastasis, number of metastatic sites, baseline ECOG PS, presence/absence of liver metastasis or previous regorafenib treatment, and laboratory variables. CONCLUSIONS No new safety concerns for FTD/TPI were identified and PFS increased with DoT. These data provide confidence for the use of FTD/TPI, including the use of multiple cycles, in routine practice. TRIAL REGISTRATION EudraCT Number: 2016-002311-18; registered 19/09/2016. https://clinicaltrials.gov/ct2/show/NCT03306394 ; registered 11/10/2017.
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Affiliation(s)
- Julien Taieb
- Department of Gastroenterology and Digestive Oncology, European Hospital Group Georges-Pompidou, Paris, France
| | - Timothy Price
- grid.278859.90000 0004 0486 659XDepartment of Medical Oncology, The Queen Elizabeth Hospital and University of Adelaide, Woodville South, South Australia Australia
| | - Loïck Vidot
- grid.418301.f0000 0001 2163 3905Servier, Suresnes, Paris, France
| | | | - Lucjan Wyrwicz
- grid.418165.f0000 0004 0540 2543Department of Oncology and Radiotherapy, Maria Skłodowska Curie Memorial Cancer Centre and Institute of Oncology, Warsaw National Cancer Research Institute, Warsaw, Poland
| | - Jean-Baptiste Bachet
- grid.411439.a0000 0001 2150 9058Department of Hepatogastroenterology, University Hospital Pitie Salpetriere, Paris, France ,grid.462844.80000 0001 2308 1657Sorbonne University, Paris, France
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Wang S, Ji Y, Ma J, Du P, Cao Y, Yang X, Yu Z, Yang Y. Role of inflammatory factors in prediction of Gleason score and its upgrading in localized prostate cancer patients after radical prostatectomy. Front Oncol 2023; 12:1079622. [PMID: 36713540 PMCID: PMC9878388 DOI: 10.3389/fonc.2022.1079622] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 12/22/2022] [Indexed: 01/15/2023] Open
Abstract
Purpose To investigate the role of inflammatory factors including systemic immune-inflammation index (SII) and neutrophil to lymphocyte ratio (NLR) in predicting Gleason Score (GS) and Gleason Score upgrading (GSU) in localized prostate cancer (PCa) after radical prostatectomy (RP). Methods The data of 297 patients who underwent prostate biopsy and RP in our center from January 2014 to March 2020 were retrospectively analyzed. Preoperative clinical characteristics including age, values of tPSA, total prostate volume (TPV), f/t PSA ratio, body mass index (BMI), biopsy GS and inflammatory factors including SII, NLR, lymphocyte to monocyte (LMR), neutrophil ratio (NR), platelet to lymphocyte ratio (PLR), lymphocyte ratio (LR), mean platelet volume (MPV) and red cell distribution (RDW) as well as pathological T (pT) stage were collected and compared according to the grades of RP GS (GS ≤ 6 and GS≥7), respectively. ROC curve analysis was used to confirm the discriminative ability of inflammatory factors including SII, NLR and their combination with tPSA for predicting GS and GSU. By using univariate and multivariate logistic regression analysis, the association between significant inflammatory markers and grades of GS were evaluated. Results Patients enrolled were divided into low (GS ≤ 6) and high (GS≥7) groups by the grades of GS. The median values of clinical factors were 66.08 ± 6.04 years for age, 36.62 ± 23.15 mL for TPV, 26.16 ± 33.59 ng/mL for tPSA and 0.15 ± 0.25 for f/t PSA ratio, 22.34 ± 3.14 kg/m2 for BMI, 15 (5.1%) were pT1, 116 (39.1%) were pT2 and 166 (55.9%) were pT3. According to the student's t test, patients in high GS group had a greater proportion of patients with pT3 (P<0.001), and higher NLR (P=0.04), SII (P=0.037) and tPSA (P=0.015) compared with low GS group, the distribution of age, TPV, f/t PSA ratio, BMI, LMR, NR, PLR, LR, MPV and RDW did not show any significantly statistical differences. The AUC for SII, NLR and tPSA was 0.732 (P=0.007), 0.649 (P=0.045) and 0.711 (P=0.015), with threshold values of 51l.08, 2.3 and 10.31ng/mL, respectively. According to the multivariable logistic regression models, NLR ≥ 2.3 (OR, 2.463; 95% CI, 0.679-10.469, P=0.042), SII ≥ 511.08 (OR, 3.519; 95% CI 0.891-12.488; P=0.003) and tPSA ≥ 10.31 ng/mL (OR, 4.146; 95% CI, 1.12-15.35; P=0.033) were all independent risk factors associated with higher GS. The AUC for combination of SII, NLR with tPSA was 0.758 (P=0.003) and 0.756 (P=0.003), respectively. GSU was observed in a total of 48 patients with GS ≤ 6 (55.17%). Then patients were divided into 2 groups (high and low) according to the threshold value of SII, NLR, tPSA, SII+tPSA and NLR+tPSA, respectively, when the GSU rates were compared with regard to these factors, GSU rate in high level group was significantly higher than that in low level group, P=0.001, 0.044, 0.017, <0.001 and <0.001, respectively. Conclusion High SII, NLR and tPSA were associated with higher GS and higher GSU rate. SII was likely to be a more favorable biomarker for it had the largest AUC area compared with tPSA and NLR; the combination of SII or NLR with tPSA had greater values for predicting GS and GSU compared with NLR, SII or tPSA alone, since the AUC area of combination was much higher. SII, NLR were all useful inflammatory biomarkers for predicting GS and detecting GSU among localized PCa patients with biopsy GS ≤ 6.
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Quantitative Metabolomics to Explore the Role of Plasma Polyamines in Colorectal Cancer. Int J Mol Sci 2022; 24:ijms24010101. [PMID: 36613539 PMCID: PMC9820724 DOI: 10.3390/ijms24010101] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/14/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022] Open
Abstract
Colorectal cancer (CRC) is one of the major public health and socio-economic problems, which management demands the development of non-invasive screening tests. Assessment of circulating polyamines could be a valuable tool, although analytical problems still preclude its clinical practice. We exploited ultra-high-resolution liquid chromatography and mass spectrometry, as a highly sensitive and innovative method, to profile eleven polyamines, including spermine and spermidine with their acetylated forms. These data together with an evaluation of the inflammatory indexes might represent suitable biomarkers for the identification of CRC patients. The statistical models revealed good discrimination in distinguishing CRC patients from healthy subjects. The plasma assessment of ornithine and acetylspermine, as well as lymphocyte/platelet ratio, revealed helpful information on the progression of CRC. The combined profiles of circulating polyamines and inflammatory indexes, together with the application of an innovative technology, could represent a valuable tool for discriminating patients from different clinical groups.
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22
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Bir Yucel K, Karabork Kilic AC, Sutcuoglu O, Yazıcı O, Aydos U, Kilic K, Özdemir N. Effects of Sarcopenia, Myosteatosis, and the Prognostic Nutritional Index on Survival in Stage 2 and 3 Gastric Cancer Patients. Nutr Cancer 2022; 75:368-375. [PMID: 36093734 DOI: 10.1080/01635581.2022.2121845] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND We aimed to evaluate the relationship between sarcopenia, myosteatosis, and systemic inflammatory response biomarkers and their prognostic role in stage 2 and 3 gastric cancer patients. METHODS This study included 84 patients with stage 2 or 3 gastric cancer who underwent a gastrectomy. Computed tomography scans were used to determine the skeletal muscle index (SMI) at the third lumbar vertebra level for sarcopenia and myosteatosis. RESULTS Based on the Asian Working Group of Sarcopenia (AWGS2019) criteria, the sarcopenia incidence was 36.9% and that of myosteatosis 46.4%. Univariate analysis showed that sarcopenia (48 vs. 14 mo, p < 0.001), myosteatosis (45 vs. 16 mo, p = 0.016), a low prognostic nutritional index (60 vs. 15 mo, p = 0.003), stage 3 (104 vs. 21 mo, p = 0.013), and old age (45 vs. 16 mo, p = 0.015) were poor prognostic markers. Multivariate analysis revealed that sarcopenia (AWGS2019), age, and stage significantly affected overall survival (hazard ratio: 3.31, 95% CI: 1.85-5.1; 1.96, 95% CI: 1.06-6.63; 2.5, 95% CI: 1.2-5.1, respectively). CONCLUSION We showed that sarcopenia directly affects overall gastric cancer survival.
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Affiliation(s)
| | | | - Osman Sutcuoglu
- Department of Medical Oncology, Gazi University, Ankara, Turkey
| | - Ozan Yazıcı
- Department of Medical Oncology, Gazi University, Ankara, Turkey
| | - Uguray Aydos
- Department of Nuclear Medicine, Gazi University, Ankara, Turkey
| | - Koray Kilic
- Department of Radiology, Gazi University, Ankara, Turkey
| | - Nuriye Özdemir
- Department of Medical Oncology, Gazi University, Ankara, Turkey
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Wu J, Zhu H, Zhang Q, Sun Y, He X, Liao J, Liu Y, Huang L. Nomogram based on the systemic immune-inflammation index for predicting the prognosis of diffuse large B-cell lymphoma. Asia Pac J Clin Oncol 2022; 19:e138-e148. [PMID: 35754170 DOI: 10.1111/ajco.13806] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 02/21/2022] [Accepted: 05/25/2022] [Indexed: 11/26/2022]
Abstract
AIM To investigate systemic immune-inflammation index (SII) as prognostic factors and establish a nomogram based on SII for the prediction of survival in diffuse large B-cell lymphoma (DLBCL). METHODS One hundred and fifty-five DLBCL patients were randomized into primary (N = 100) and validation (N = 55) cohorts. Kaplan-Meier survival curves and Cox regression models were used to evaluate the impact of SII on survival. The nomogram based on SII was analyzed by using R software. RESULTS Univariate and multivariate analyses revealed that high SII (>1684.), C-reactive protein-to-albumin ratio (CAR > 0.21), and age-adjusted International Prognostic Index (aaIPI) score were independent predictors of overall survival (OS). High SII and aaIPI were independent predictors of progression-free survival. The nomogram had better accuracy and discrimination than the International Prognostic Index, National Comprehensive Cancer Network-International Prognostic Index, and aaIPI systems. The concordance index values of the nomogram for OS were 0.885 in the primary cohort and 0.821 in the validation cohort. CONCLUSIONS Our results suggested that SII, CAR, and aaIPI could be used to judge the prognosis of DLBCL patients. The nomogram was a reliable model for predicting the OS of DLBCL patients.
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Affiliation(s)
- Jing Wu
- Department of Oncology, Guizhou Provincial People's Hospital, Guizhou Cancer Center, Guiyang, China
| | - Haizhen Zhu
- Department of Oncology, Guizhou Provincial People's Hospital, Guizhou Cancer Center, Guiyang, China
| | - Qi Zhang
- Department of Oncology, Guizhou Provincial People's Hospital, Guizhou Cancer Center, Guiyang, China
| | - Yi Sun
- Department of Oncology, Guizhou Provincial People's Hospital, Guizhou Cancer Center, Guiyang, China
| | - XinYun He
- Department of Oncology, Guizhou Provincial People's Hospital, Guizhou Cancer Center, Guiyang, China
| | - Jiaqun Liao
- Department of Oncology, Guizhou Provincial People's Hospital, Guizhou Cancer Center, Guiyang, China
| | - Yuncong Liu
- Department of Oncology, Guizhou Provincial People's Hospital, Guizhou Cancer Center, Guiyang, China
| | - Limin Huang
- Department of Oncology, Guizhou Provincial People's Hospital, Guizhou Cancer Center, Guiyang, China
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Wang S, Yang X, Yu Z, Du P, Sheng X, Cao Y, Yan X, Ma J, Yang Y. The Values of Systemic Immune-Inflammation Index and Neutrophil-Lymphocyte Ratio in Predicting Biochemical Recurrence in Patients With Localized Prostate Cancer After Radical Prostatectomy. Front Oncol 2022; 12:907625. [PMID: 35719913 PMCID: PMC9200963 DOI: 10.3389/fonc.2022.907625] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 05/04/2022] [Indexed: 12/24/2022] Open
Abstract
Purpose To investigate the association between preoperative systemic immune-inflammation index (SII) and neutrophil-lymphocyte ratio (NLR) and oncological outcomes in localized prostate cancer (PCa) patients after radical prostatectomy (RP). Methods Between January 2014 and December 2019, 291 patients with pathologically confirmed localized PCa who underwent RP were included in this study. The threshold values of SII and NLR for biochemical recurrence (BCR) were calculated according to Youden's index based on the receiver operating characteristic (ROC) curve, then the patients were divided into two groups by the threshold values of SII and NLR, and the clinicopathological outcomes were analyzed and compared between groups, respectively. The binary logistic regression model was used to evaluate the association between SII, NLR, and pathological outcomes including Gleason score (GS) and pathological T (pT) stage. Kaplan-Meier curves and univariable and multivariable Cox regression models were used to determine the association between high SII, high NLR, and BCR-free survival, respectively. Results The median follow-up time was 48 months (IQR 36-62), and 114 (39.18%) patients developed BCR. The AUC of SII for BCR was 0.813 (P < 0.001), with a threshold value of 528.54, a sensitivity of 72.9%, and a specificity of 76.3%; the AUC of NLR for BCR was 0.824 (P < 0.001), with a threshold value of 2.62, a sensitivity of 71.2%, and a specificity of 81.6%. Patients were divided into two groups according to the threshold values of SII and NLR, respectively. Patients in the high SII group had higher tPSA, GS, pT stage, and BCR rate than patients in the low SII group (P = 0.004, 0.04, 0.007, and <0.001, respectively), and patients in the high NLR group had higher tPSA, GS, pT stage, and BCR rate than patients in the low NLR group (P = 0.04, 0.02, 0.006, and <0.001, respectively). Multivariable logistic regression analysis revealed that high SII was significantly correlated with adverse pathological outcomes of GS (HR, 1.656; 95% CI, 1.00-2.742, P = 0.042) and pT stage (HR, 1.478; 95% CI, 0.972-3.64, P = 0.028); there was no association between high NLR and pathological events. Kaplan-Meier analysis showed significantly poorer BCR-free survival in patients with high SII or high NLR (P < 0.001 and <0.001, respectively). By using the multivariable Cox regression model, high SII (HR, 4.521; 95% CI, 2.262-9.037, P < 0.001) and high NLR (HR, 4.787; 95% CI, 2.339-9.798, P < 0.001) were both significant predictors of BCR after RP. Conclusion High SII was significantly related to unfavorable clinicopathological outcomes. High preoperative SII and NLR were related to higher BCR rate in localized PCa after RP, and they were all independent risk factors associated with shorter BCR-free survival. These two factors might provide promising and inexpensive methods for predicting clinical outcomes in patients with RP.
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Affiliation(s)
- Shuo Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Urological Department, Peking University Cancer Hospital & Institute, Beijing, China
| | - Xiao Yang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Urological Department, Peking University Cancer Hospital & Institute, Beijing, China
| | - Ziyi Yu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Urological Department, Peking University Cancer Hospital & Institute, Beijing, China
| | - Peng Du
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Urological Department, Peking University Cancer Hospital & Institute, Beijing, China
| | - Xinan Sheng
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Renal Cancer and Melanoma, Peking University Cancer Hospital & Institute, Beijing, China
| | - Yudong Cao
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Urological Department, Peking University Cancer Hospital & Institute, Beijing, China
| | - Xieqiao Yan
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Renal Cancer and Melanoma, Peking University Cancer Hospital & Institute, Beijing, China
| | - Jinchao Ma
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Urological Department, Peking University Cancer Hospital & Institute, Beijing, China
| | - Yong Yang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Urological Department, Peking University Cancer Hospital & Institute, Beijing, China
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Schiffmann LM, Bruns CJ, Schmidt T. Resistance Mechanisms of the Metastatic Tumor Microenvironment to Anti-Angiogenic Therapy. Front Oncol 2022; 12:897927. [PMID: 35664794 PMCID: PMC9162757 DOI: 10.3389/fonc.2022.897927] [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: 03/16/2022] [Accepted: 04/21/2022] [Indexed: 11/23/2022] Open
Abstract
Angiogenesis describes the formation of blood vessels from an existing vascular network. Anti-angiogenic drugs that target tumor blood vessels have become standard of care in many cancer entities. Though very promising results in preclinical evaluation, anti-angiogenic treatments fell short of expectations in clinical trials. Patients develop resistance over time or are primarily refractory to anti-angiogenic therapies similar to conventional chemotherapy. To further improve efficacy and outcome to these therapies, a deeper understanding of mechanisms that mediate resistance to anti-angiogenic therapies is needed. The field has done tremendous efforts to gain knowledge about how tumors engage tumor cell and microenvironmental mechanisms to do so. This review highlights the current state of knowledge with special focus on the metastatic tumor site and potential therapeutic relevance of this understanding from a translational and clinical perspective.
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Affiliation(s)
- Lars M. Schiffmann
- Department of General, Visceral, Cancer and Transplantation Surgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | | | - Thomas Schmidt
- Department of General, Visceral, Cancer and Transplantation Surgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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Clinical significance of baseline Pan-Immune-Inflammation Value and its dynamics in metastatic colorectal cancer patients under first-line chemotherapy. Sci Rep 2022; 12:6893. [PMID: 35477740 PMCID: PMC9046216 DOI: 10.1038/s41598-022-10884-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 03/18/2022] [Indexed: 11/17/2022] Open
Abstract
Pan-Immune-Inflammation Value (PIV) has been recently proposed as a new blood-based prognostic biomarker in metastatic colorectal cancer (mCRC). Herein we aimed to validate its prognostic significance and to evaluate its utility for disease monitoring in patients with mCRC receiving first-line chemotherapy. We conducted a single-centre retrospective study involving 130 previously untreated mCRC patients under first-line standard chemotherapy in a real-world scenario. PIV was calculated as (neutrophil count × platelet count × monocyte count)/lymphocyte count at three different time-points: baseline, week 4 after therapy initiation, and at disease progression. We analyzed the influence of baseline PIV on overall survival (OS), progression-free survival (PFS), disease control rate (DCR), and overall response rate (ORR). We also explored the utility of PIV dynamics for disease monitoring. Baseline PIV high was significantly associated with worse OS in univariate [hazard ratio (HR) = 2.10, 95% CI, 1.41–3.15; p = 0.000299] and multivariate (HR = 1.82, 95% CI, 1.15–2.90; p = 0.011) analyses. Baseline PIV was also associated with worse PFS in univariate (HR = 2.04, 95% CI, 1.40–2.97; p = 0.000187) and multivariate (HR = 1.56, 95% CI, 1.05–2.31; p = 0.026) analyses. Baseline PIV was not correlated either with DCR or ORR. Regarding PIV dynamics, there was a statistically significant increase from week 4 to disease progression (p = 0.0003), which was at the expense of cases with disease control as best response (p < 0.0001). In conclusion, this study validates the prognostic significance of baseline PIV in patients with mCRC receiving first-line standard chemotherapy in a real-world scenario. Moreover, it suggests the potential utility of PIV monitoring to anticipate the disease progression among those patients who achieve initial disease control.
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Yang J, Deng M, Bi M, Wang Y, Qiao X, Zhang S. Prognostic values of inflammatory indexes in bevacizumab-treated patients with advanced non-small-cell lung cancer. Future Sci OA 2022; 8:FSO798. [PMID: 35662746 PMCID: PMC9136631 DOI: 10.2144/fsoa-2021-0162] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 03/23/2022] [Indexed: 11/24/2022] Open
Abstract
Purpose: Inflammatory indexes, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII) and lymphocyte-to-monocyte ratio (LMR), have been confirmed as prognostic factors in multiple manigances. However, the prognostic value of these parameters in bevacizumab-treated non-small-cell lung cancer (NSCLC) is still not clear. Methods: We retrospectively studied 119 patients with advanced NSCLC who received bevacizumab treatment. The associations of pretreatment NLR, PLR, SII and LMR with progression-free survival (PFS) and overall survival (OS) were analyzed. Results & Conclusion: The median PFS and OS of patients with high baseline NLR, PLR and SII and low LMR were significantly decreased than those of patients with low baseline NLR, PLR and SII and high LMR. Multivariable analysis indicated that high baseline SII was independently related with inferior prognosis, and baseline LMR was an independent predictor for OS. In this study we retrospectively studied 119 patients with advanced non-small-cell lung cancer receiving bevacizumab treatment. We found that the prognosis of the patients with high baseline neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and systemic immune-inflammation index (SII) and low lymphocyte-to-monocyte ratio (LMR) were significantly poorer than those in patients with low baseline NLR, PLR and SII and high LMR. Multivariable analysis indicated that high baseline SII was independently related with inferior progression-free survival and overall survival, and that baseline LMR was an independent predictor for overall survival. This study suggests that we can predict the efficacy of bevacizumab by analyzing several blood cell count indexes.
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Affiliation(s)
- Jingru Yang
- Department of Medical Oncology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui Province, China
| | - Mingliang Deng
- Department of Neurosurgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui Province, China
| | - Minghong Bi
- Department of Medical Oncology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui Province, China
| | - Yaping Wang
- Department of Medical Oncology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui Province, China
| | - Xuxu Qiao
- Department of Medical Oncology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui Province, China
| | - Shanshan Zhang
- Department of Medical Oncology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui Province, China
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Li Q, Chen L, Jin H, Zhao Y, Hao Z, Ma X. Pretreatment Inflammatory Markers Predict Outcomes and Prognosis in Colorectal Cancer Patients With Synchronous Liver Metastasis. Clin Med Insights Oncol 2022; 16:11795549221084851. [PMID: 35355514 PMCID: PMC8958682 DOI: 10.1177/11795549221084851] [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: 10/06/2021] [Accepted: 02/13/2022] [Indexed: 02/05/2023] Open
Abstract
Introduction Pretreatment inflammatory markers were applied to predict the prognosis of colorectal cancer. However, the role of these markers in predicting survival in patients with synchronous colorectal liver metastasis (CLM) is rarely reported. Notably, lymphocyte-to-monocyte ratio (LMR) was mainly reported in hematologic malignancies and is worth to be further explored to predict the survival of synchronous CLM. Methods Totally, 196 patients who were diagnosed with synchronous CLM were enrolled. Their clinical and laboratory data before treatment were collected, retrospectively. Univariate and multivariate analyses were performed to analyze the inflammatory biomarkers. Results LMR (P = .002) and lactate dehydrogenase (LDH) (P = .017) were significantly related to the progression-free survival (PFS). More factors such as neutrophil-to-lymphocyte ratio (NLR) (P = .011), carbohydrate antigen 19-9 (CA19-9) (P = .001), number of metastatic foci (P = .006), and adjuvant chemotherapy (P = .027) were correlated with overall survival (OS). In multivariate analysis, LMR remained statistically associated with PFS (P = .003). Regarding OS, LMR (P = .016) and LDH (P = .013) were significantly independent predictive factors. Conclusions The higher LMR and lower LDH were strongly correlated with better survival in synchronous CLM patients. In addition, the result also indicated that enhanced LMR was related to better PFS. The LMR and LDH can be used to predict prognosis of the synchronous CLM.
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Affiliation(s)
| | | | | | | | | | - Xuelei Ma
- Xuelei Ma, Department of Biotherapy, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu 610041, Sichuan, China.
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Zhou H, Zhu L, Song J, Wang G, Li P, Li W, Luo P, Sun X, Wu J, Liu Y, Zhu S, Zhang Y. Liquid biopsy at the frontier of detection, prognosis and progression monitoring in colorectal cancer. Mol Cancer 2022; 21:86. [PMID: 35337361 PMCID: PMC8951719 DOI: 10.1186/s12943-022-01556-2] [Citation(s) in RCA: 79] [Impact Index Per Article: 39.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 03/02/2022] [Indexed: 02/07/2023] Open
Abstract
Colorectal cancer (CRC) is one of the most common cancers worldwide and a leading cause of carcinogenic death. To date, surgical resection is regarded as the gold standard by the operator for clinical decisions. Because conventional tissue biopsy is invasive and only a small sample can sometimes be obtained, it is unable to represent the heterogeneity of tumor or dynamically monitor tumor progression. Therefore, there is an urgent need to find a new minimally invasive or noninvasive diagnostic strategy to detect CRC at an early stage and monitor CRC recurrence. Over the past years, a new diagnostic concept called “liquid biopsy” has gained much attention. Liquid biopsy is noninvasive, allowing repeated analysis and real-time monitoring of tumor recurrence, metastasis or therapeutic responses. With the advanced development of new molecular techniques in CRC, circulating tumor cells (CTCs), circulating tumor DNA (ctDNA), exosomes, and tumor-educated platelet (TEP) detection have achieved interesting and inspiring results as the most prominent liquid biopsy markers. In this review, we focused on some clinical applications of CTCs, ctDNA, exosomes and TEPs and discuss promising future applications to solve unmet clinical needs in CRC patients.
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Affiliation(s)
- Hui Zhou
- Department of General Surgery, Third Xiangya Hospital, Central South University, Changsha, 410013, China.,Department of General Surgery, Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, China
| | - Liyong Zhu
- Department of General Surgery, Third Xiangya Hospital, Central South University, Changsha, 410013, China
| | - Jun Song
- Department of General Surgery, Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, China
| | - Guohui Wang
- Department of General Surgery, Third Xiangya Hospital, Central South University, Changsha, 410013, China
| | - Pengzhou Li
- Department of General Surgery, Third Xiangya Hospital, Central South University, Changsha, 410013, China
| | - Weizheng Li
- Department of General Surgery, Third Xiangya Hospital, Central South University, Changsha, 410013, China
| | - Ping Luo
- Department of General Surgery, Third Xiangya Hospital, Central South University, Changsha, 410013, China
| | - Xulong Sun
- Department of General Surgery, Third Xiangya Hospital, Central South University, Changsha, 410013, China
| | - Jin Wu
- Department of General Surgery, Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, China
| | - Yunze Liu
- Department of General Surgery, Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, China
| | - Shaihong Zhu
- Department of General Surgery, Third Xiangya Hospital, Central South University, Changsha, 410013, China.
| | - Yi Zhang
- Department of General Surgery, Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, China.
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KARACAN GÖLEN M, YILMAZ OKUYAN D. Is the systemic immune-inflammation index a predictive marker of carotid artery stenosis? JOURNAL OF HEALTH SCIENCES AND MEDICINE 2022. [DOI: 10.32322/jhsm.1052129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Kalavska K, Sestakova Z, Mlcakova A, Gronesova P, Miskovska V, Rejlekova K, Svetlovska D, Sycova-Mila Z, Obertova J, Palacka P, Mardiak J, Chovanec M, Chovanec M, Mego M. Comprehensive Assessment of Selected Immune Cell Subpopulations Changes in Chemotherapy-Naïve Germ Cell Tumor Patients. Front Oncol 2022; 12:858797. [PMID: 35359385 PMCID: PMC8963339 DOI: 10.3389/fonc.2022.858797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 02/10/2022] [Indexed: 12/14/2022] Open
Abstract
The pattern of immune cell distribution in testicular germ cell tumors (GCT) significantly differs from the immune environment in normal testicular tissues. The present study aimed to evaluate the role of different leukocyte subpopulation in GCTs. A cohort of 84 chemotherapy-naïve GCT patients was analyzed. Immunophenotyping of peripheral blood leukocyte subpopulations was carried out by flow cytometry. In addition, the data assessing the immunophenotypes and the baseline clinicopathological characteristics of the included subjects were statistically evaluated. Their prognostic value for the assessment of progression-free survival (PFS) and overall survival (OS) was estimated. The percentage of different innate/adaptive immune cell subpopulations was significantly associated with poor risk-related clinical features, including the number of metastatic sites, presence of retroperitoneal, mediastinal, lung, brain and non-pulmonary visceral metastases as well as with the S-stage and International Germ Cell Consensus Classification Group (IGCCCG) risk groups. In univariate analysis, the percentages of neutrophils, eosinophils, dendritic cells type 2, lymphocytes and T cytotoxic cells were significantly associated with PFS, while the neutrophil, non-classical monocyte and lymphocyte percentage were associated with OS. However, all these outcome correlations were not independent of IGCCCG in multivariate analysis. The data indicated a link among different innate/adaptive peripheral immune cell subpopulations in GCT patients. In addition, the association between these subpopulations and tumor characteristics was also investigated. The findings of the present study may contribute to a deeper understanding of the interactions between cancer and innate/adaptive immune response in GCT patients.
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Affiliation(s)
- Katarina Kalavska
- Translational Research Unit, Faculty of Medicine, National Cancer Institute, Comenius University, Bratislava, Slovakia
- Department of Molecular Oncology, Cancer Research Institute, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Zuzana Sestakova
- Department of Genetics, Cancer Research Institute, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia
- Department of Laboratory Medicine, National Institute of Children's Diseases, Bratislava, Slovakia
| | - Andrea Mlcakova
- Department of Hematology, National Cancer Institute, Bratislava, Slovakia
| | - Paulina Gronesova
- Department of Tumor Immunology, Cancer Research Institute, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Viera Miskovska
- 1Department of Oncology, Faculty of Medicine, St. Elisabeth Cancer Institute, Comenius University, Bratislava, Slovakia
| | - Katarina Rejlekova
- 2Department of Oncology, Faculty of Medicine, National Cancer Institute, Comenius University, Bratislava, Slovakia
- Department of Oncology, National Cancer Institute, Bratislava, Slovakia
| | - Daniela Svetlovska
- Translational Research Unit, Faculty of Medicine, National Cancer Institute, Comenius University, Bratislava, Slovakia
| | | | - Jana Obertova
- 2Department of Oncology, Faculty of Medicine, National Cancer Institute, Comenius University, Bratislava, Slovakia
- Department of Oncology, National Cancer Institute, Bratislava, Slovakia
| | - Patrik Palacka
- 2Department of Oncology, Faculty of Medicine, National Cancer Institute, Comenius University, Bratislava, Slovakia
- Department of Oncology, National Cancer Institute, Bratislava, Slovakia
| | - Jozef Mardiak
- 2Department of Oncology, Faculty of Medicine, National Cancer Institute, Comenius University, Bratislava, Slovakia
- Department of Oncology, National Cancer Institute, Bratislava, Slovakia
| | - Miroslav Chovanec
- Department of Genetics, Cancer Research Institute, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Michal Chovanec
- 2Department of Oncology, Faculty of Medicine, National Cancer Institute, Comenius University, Bratislava, Slovakia
- Department of Oncology, National Cancer Institute, Bratislava, Slovakia
| | - Michal Mego
- Translational Research Unit, Faculty of Medicine, National Cancer Institute, Comenius University, Bratislava, Slovakia
- Department of Genetics, Cancer Research Institute, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia
- 2Department of Oncology, Faculty of Medicine, National Cancer Institute, Comenius University, Bratislava, Slovakia
- Department of Oncology, National Cancer Institute, Bratislava, Slovakia
- *Correspondence: Michal Mego,
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Wang S, Ji Y, Chen Y, Du P, Cao Y, Yang X, Ma J, Yu Z, Yang Y. The Values of Systemic Immune-Inflammation Index and Neutrophil-Lymphocyte Ratio in the Localized Prostate Cancer and Benign Prostate Hyperplasia: A Retrospective Clinical Study. Front Oncol 2022; 11:812319. [PMID: 35047413 PMCID: PMC8763322 DOI: 10.3389/fonc.2021.812319] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 12/06/2021] [Indexed: 12/27/2022] Open
Abstract
PURPOSE To evaluate the diagnostic values of systemic immune-inflammation index (SII) and neutrophil-lymphocyte ratio (NLR) in patients with localized prostate cancer (PCa). METHODS Between January 2014 and December 2019, 117 patients with benign prostate hyperplasia (BPH) and 278 patients with localized PCa who underwent radical prostatectomy (RP) were included in this study. The inflammatory markers including SII, NLR, platelet-lymphocyte ratio (PLR), lymphocyte-monocyte ratio (LMR), lymphocyte ratio (LR), neutrophil ratio (NR), mean platelet volume (MPV), and red cell distribution (RDW) of these two groups were examined and analyzed. ROC curve analysis was performed to assess the discriminative ability of inflammatory markers and their combination with tPSA for PCa. The binary logistic regression model was used to evaluate the association between significant inflammatory markers and risk of PCa. RESULTS The pathological results from RP specimen comprised 72 (25.90%) patients with pT1, 168 (60.43%) patients with pT2, and 38 (13.67%) patients with pT3. According to Student's t test, patients with PCa had higher NLR (p = 0.034), SII (p = 0.008), and NR (p = 0.004), and lower LR (p = 0.025), MPV (p = 0.003), and TPV (p = 0.022) compared with patients with BPH; the distribution of age, PLR, LMR, RDW, f/t PSA ratio, and BMI did not show any significant differences. The AUC for NLR, SII, NR, and tPSA was 0.697 (p = 0.015), 0.719 (p < 0.001), 0.647 (p = 0.009), and 0.708 (p < 0.001), with threshold values of 1.6, 471.86, 65.15%, and 12.89 ng/ml, respectively. Patients were divided into two groups according to the threshold values, respectively. By using the multivariable logistic regression models, NLR ≥ 1.6 (OR, 2.731; 95% CI, 0.937-7.961, p = 0.042), SII ≥ 471.86 (OR, 1.274; 95% CI 0.473-3.433; p = 0.033), and PSA ≥ 12.89 ng/ml (OR, 1.443; 95% CI, 0.628-3.944; p = 0.014) were independent risk factors associated with PCa. The AUC for combination of NLR, SII, and NR with tPSA was 0.705 (p < 0.001), 0.725 (p < 0.001), and 0.704 (p < 0.001), respectively. CONCLUSION This study demonstrated that SII, NLR, and NR were all independent risk factors of PCa. These factors alone could provide better screen methods for PCa before biopsy. In addition, SII is a more powerful tool among these three inflammatory markers associated with PCa. Besides, combination of SII and NLR with tPSA had not much advantage compared with themselves alone.
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Affiliation(s)
- Shuo Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Urological Department, Peking University Cancer Hospital and Institute, Beijing, China
| | - Yongpeng Ji
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Urological Department, Peking University Cancer Hospital and Institute, Beijing, China
| | - Yanyun Chen
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Anesthesiology Department, Peking University Cancer Hospital and Institute, Beijing, China
| | - Peng Du
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Urological Department, Peking University Cancer Hospital and Institute, Beijing, China
| | - Yudong Cao
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Urological Department, Peking University Cancer Hospital and Institute, Beijing, China
| | - Xiao Yang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Urological Department, Peking University Cancer Hospital and Institute, Beijing, China
| | - Jinchao Ma
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Urological Department, Peking University Cancer Hospital and Institute, Beijing, China
| | - Ziyi Yu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Urological Department, Peking University Cancer Hospital and Institute, Beijing, China
| | - Yong Yang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Urological Department, Peking University Cancer Hospital and Institute, Beijing, China
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Gultekin A, Sahin A, Akgul M, Yildirim I, Altinoz K, Baran O, Arar C. The effect of epidural analgesia added to general anesthesia on systemic immune-inflammation index in radical prostatectomy surgery: A retrospective study. Niger J Clin Pract 2022; 25:855-860. [DOI: 10.4103/njcp.njcp_1858_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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Di Nunno V, Franceschi E, Tosoni A, Gatto L, Maggio I, Lodi R, Bartolini S, Brandes AA. Immune-checkpoint inhibitors in pituitary malignancies. Anticancer Drugs 2022; 33:e28-e35. [PMID: 34348358 DOI: 10.1097/cad.0000000000001157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
To date, there are no standardized systemic treatment options for patients with metastatic pituitary carcinoma progressed to chemo and radiation therapy. Immune-checkpoint inhibitors (ICIs) have been successfully assessed in other solid malignancies and could be a concrete hope for these patients. We performed a critical review of the literature aimed to evaluate studies assessing ICIs in pituitary malignancies. We also conducted research about published translational data assessing immune-contexture in these malignancies. Some preliminary reports reported a successful administration of pembrolizumab or the combination between nivolumab and ipilimumab in patients with metastatic ACTH-secreting pituitary carcinomas. Translational data suggest that adenomas secreting growth hormone and ACTH have a suppressed immune-microenvironment, which could be more likely to benefit from ICIs. Immune-checkpoint inhibitors can be an effective treatment in patients with pituitary carcinoma and maybe also recurrent adenoma. Tumors secreting growth hormone and ACTH are more likely to benefit from ICIs due to a different immune-microenvironment.
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Affiliation(s)
| | | | | | | | | | - Raffaele Lodi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
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Acikgoz O, Cakan B, Demir T, Bilici A, Oven BB, Hamdard J, Olmuscelik O, Olmez OF, Seker M, Yildiz O. Platelet to lymphocyte ratio is associated with tumor localization and outcomes in metastatic colorectal cancer. Medicine (Baltimore) 2021; 100:e27712. [PMID: 34871263 PMCID: PMC8568374 DOI: 10.1097/md.0000000000027712] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 10/19/2021] [Indexed: 01/05/2023] Open
Abstract
The aim of this study was to investigate the predictive and prognostic value of PLR, and the relationship between PLR and tumor localization.A total of 229 patients with de-novo metastatic CRC were retrospectively analyzed. The cutoff value for PLR was defined by the receiver operating characteristic (ROC) curve analysis and threshold value of 196.5 as best cut-off value was found.The higher rate of BRAF mutation was significantly detected for patients with PLRhigh (> 196.5) compared to those with PLRlow (≤196.5) (P = .001). PLR was significantly higher in tumors located on the right colon (P = .012). PLR, tumor localization, the presence of surgery for primary tumor, the presence of curative surgery, the presence of metastasectomy for progression-free survival (PFS) and PLR, gender, BRAF mutation, tumor localization, the presence of surgery for primary tumor, the presence of metastasectomy for overall survival (OS) were found to be prognostic factors by univariate analysis. Multivariate analysis showed that PLR, the presence of curative surgery and the presence of metastasectomy for both PFS and OS were found to be independent prognostic factors. Moreover, a logistic regression analysis indicated that PLR and tumor localization were found to be an independent factors for predicting response to systemic treatment (P < .001 and P = .023 respectively).Our results showed that pretreatment PLR was readily feasible and simple biomarker predicting response to treatment and survival, in addition it was significantly associated with tumor localization.
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Affiliation(s)
- Ozgur Acikgoz
- Department of Medical Oncology, Istanbul Medipol University School of Medicine, Istanbul, Turkey
| | - Burcin Cakan
- Department of Medical Oncology, Denizli Pamukkale University School of Medicine, Denizli, Turkey
| | - Tarik Demir
- Department of Medical Oncology, Istanbul Bezmialem Vakif University School of Medicine, Istanbul, Turkey
| | - Ahmet Bilici
- Department of Medical Oncology, Istanbul Medipol University School of Medicine, Istanbul, Turkey
| | - Bala Basak Oven
- Department of Medical Oncology, Istanbul Bahcesehir University School of Medicine, Istanbul, Turkey
| | - Jamshid Hamdard
- Department of Medical Oncology, Istanbul Medipol University School of Medicine, Istanbul, Turkey
| | - Oktay Olmuscelik
- Department of Medical Oncology, Istanbul Medipol University School of Medicine, Istanbul, Turkey
| | - Omer Fatih Olmez
- Department of Medical Oncology, Istanbul Medipol University School of Medicine, Istanbul, Turkey
| | - Mesut Seker
- Department of Medical Oncology, Istanbul Bezmialem Vakif University School of Medicine, Istanbul, Turkey
| | - Ozcan Yildiz
- Department of Medical Oncology, Istanbul Medipol University School of Medicine, Istanbul, Turkey
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Gatto L, Franceschi E, Tosoni A, Di Nunno V, Maggio I, Tonon C, Lodi R, Agati R, Bartolini S, Brandes AA. Distinct MRI pattern of "pseudoresponse" in recurrent glioblastoma multiforme treated with regorafenib: Case report and literature review. Clin Case Rep 2021; 9:e04604. [PMID: 34457284 PMCID: PMC8380081 DOI: 10.1002/ccr3.4604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 06/13/2021] [Accepted: 06/20/2021] [Indexed: 12/31/2022] Open
Abstract
Antiangiogenic agents can induce a distinct MRI pattern in glioblastoma, characterized by a decrease in the contrast enhancement on T1-weighted images and a simultaneous hyperintensity on T2-weighted or fluid-attenuated inversion recovery images.
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Affiliation(s)
- Lidia Gatto
- Department of Medical OncologyAzienda USL of BolognaBolognaItaly
| | | | - Alicia Tosoni
- Department of Medical OncologyAzienda USL of BolognaBolognaItaly
| | | | - Ilaria Maggio
- Department of Medical OncologyAzienda USL of BolognaBolognaItaly
| | - Caterina Tonon
- IRCCS Istituto delle Scienze Neurologiche di BolognaBolognaItaly
| | - Raffaele Lodi
- IRCCS Istituto delle Scienze Neurologiche di BolognaBolognaItaly
| | - Raffaele Agati
- IRCCS Istituto delle Scienze Neurologiche di BolognaBolognaItaly
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Jia W, Yuan L, Ni H, Xu B, Zhao P. Prognostic Value of Platelet-to-Lymphocyte Ratio, Neutrophil-to-Lymphocyte Ratio, and Lymphocyte-to-White Blood Cell Ratio in Colorectal Cancer Patients Who Received Neoadjuvant Chemotherapy. Technol Cancer Res Treat 2021; 20:15330338211034291. [PMID: 34308689 PMCID: PMC8317245 DOI: 10.1177/15330338211034291] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background: The objective of this study was to assess the prognostic value of pretreatment platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), and lymphocyte-to-white blood cell ratio (LWR) of CRC patients who received neoadjuvant chemotherapy. Methods: We analyzed the peripheral blood routine parameters and other clinical data of 145 patients with colorectal cancer who had undergone neoadjuvant chemotherapy between January 2011 and February 2014. Pretreatment blood parameters of 145 patients were collected, and PLR, NLR, and LWR were calculated. The utility of PLR, NLR, and LWR in predicting treatment efficacy and patient survival was statistically evaluated using the chi-square test, log-rank test, Kaplan-Meier curves and logistic regression models, and Cox regression models. Results: Receiver operating characteristic curve showed that the best cutoff values of PLR, NLR, and LWR were 154.31, 3.01, and 0.22, respectively. In univariate analysis, tumor location (P = 0.044), differentiation degree (P = 0.001), lymph node metastasis (P = 0.020), and high PLR (P = 0.042) were significantly correlated with a lower overall response rate (ORR). In addition, clinical stage, lymph node metastasis, and high PLR were correlated with short OS (P < 0.01) and DFS (P < 0.01). Moreover, WBC count was correlated with a short OS. Multivariate analysis showed that tumor location (P = 0.013), differentiation degree (P = 0.001), and lymph node metastasis (P = 0.033) were independent predictors of ORR. In addition, lymph node metastasis independently predicted a shorter OS (P = 0.011). Lymph node metastasis (P = 0.013) and high PLR (P = 0.022) were independent prognostic factors for short DFS. Conclusions: For CRC patients who received NAC, clinical pathological stage and lymph node metastasis were correlated with lower ORR and survival, while a high PLR that may be of prognostic relevance in CRC patients receiving NAC.
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Affiliation(s)
- Wangqiang Jia
- Department of General Surgery, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan, People's Republic of China
| | - Long Yuan
- Department of General Surgery, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan, People's Republic of China
| | - Hongyan Ni
- Department of General Surgery, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan, People's Republic of China
| | - Benling Xu
- Department of Immunotherapy, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Peng Zhao
- Department of General Surgery, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan, People's Republic of China
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Naszai M, Kurjan A, Maughan TS. The prognostic utility of pre-treatment neutrophil-to-lymphocyte-ratio (NLR) in colorectal cancer: A systematic review and meta-analysis. Cancer Med 2021; 10:5983-5997. [PMID: 34308567 PMCID: PMC8419761 DOI: 10.1002/cam4.4143] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/03/2021] [Accepted: 07/03/2021] [Indexed: 12/24/2022] Open
Abstract
Background Inflammation is a hallmark of cancer, and systemic markers of inflammation are increasingly recognised as negative prognostic factors for clinical outcome. Neutrophil‐to‐lymphocyte ratio (NLR) is readily available from routine blood testing of patients diagnosed with cancer. Methods Peer‐reviewed publications from PubMed/MEDLINE, Web of Science and EMBASE were identified according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis (PRISMA) guidelines. Hazard ratios (HR) for overall survival (OS) and surrogate endpoints (SE; comprising disease‐, recurrence‐ and progression‐free survival) were pooled using a random effects model. Additional analysis was carried out to further investigate NLR as an independent prognostic factor and account for heterogeneity. Results Seventy‐one eligible papers comprising 32,788 patients were identified. High NLR was associated with poor clinical outcomes. Significant publication bias was observed, and larger studies also adjusted for more covariates. Correcting for publication bias in multivariate studies brought our best estimate for true effect size to HR = 1.57 (95% CI 1.39–1.78; p < 0.0001) for OS and to HR = 1.38 (95% CI 1.16–1.64; p = 0.0003) for SE. Conclusions NLR is confirmed as an easily available prognostic biomarker in colorectal cancer, despite the limitations of some studies previously reporting this finding. As such, it should be routinely collected in prospective clinical trials. While more standardised and rigorous large‐scale studies are needed before high NLR can be fully assessed as an independent predictor of CRC progression and outcome, the data suggest that it may be used to highlight individuals with tumour‐promoting inflammatory context.
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Affiliation(s)
- Mate Naszai
- Medical Sciences Division, University of Oxford, Oxford, UK
| | - Alina Kurjan
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, UK
| | - Timothy S Maughan
- MRC Oxford Institute for Radiation Oncology, University of Oxford, Oxford, UK
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Prognostic significance of the systemic immune-inflammation index in pancreatic carcinoma patients: A meta-analysis. Biosci Rep 2021; 41:229290. [PMID: 34286342 PMCID: PMC8329648 DOI: 10.1042/bsr20204401] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 06/29/2021] [Accepted: 07/19/2021] [Indexed: 12/18/2022] Open
Abstract
Background: Systemic immune-inflammation index (SII) is a prognostic indicator for several malignancies, including pancreatic carcinoma; however, there is no consensus on its significance. In the current study, a systematic meta-analysis was used to explore the correlation between SII and prognosis in pancreatic carcinoma patients. Methods: PubMed, Embase and Cochrane Library databases were screened from inception to May 2020. Studies describing the prognostic role of SII in pancreatic carcinoma were then retrieved. The pooled hazard ratio (HR) and 95% confidence interval (CI) was calculated using random- or fixed-effects models to determine the correlation between SII and prognosis. Results: A total of four studies, comprising 1749 patients, met the inclusion criteria of the study and were therefore included in this meta-analysis. The meta-analysis showed that high SII indicated was correlated with worse overall survival (OS) in patients with pancreatic carcinoma (HR: 1.43, 95% CI: 1.24–1.65, P<0.001). These findings were validated through subgroup analyses, stratified by the American Joint Committee on Cancer (AJCC) stage. In addition, patients with high SII showed poorer cancer-specific survival (HR: 2.32, 95% CI: 1.55–3.48, P<0.001). However, analysis showed no significant correlations between SII and disease-free and relapse-free survival (RFS). Conclusion: These findings indicate that SII is a potential non-invasive and a promising tool for predicting clinical outcomes of pancreatic carcinoma patients. However, the current research did not explore whether neoadjuvant therapy has an effect on the prognostic value of SII. Further studies using adequate designs and larger sample sizes are required to validate these findings.
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Marchetti C, D'Indinosante M, Bottoni C, Di Ilio C, Di Berardino S, Costantini B, Minucci A, Vertechy L, Scambia G, Fagotti A. NLR and BRCA mutational status in patients with high grade serous advanced ovarian cancer. Sci Rep 2021; 11:11125. [PMID: 34045513 PMCID: PMC8159985 DOI: 10.1038/s41598-021-90361-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 05/05/2021] [Indexed: 12/21/2022] Open
Abstract
Laboratory-markers of the systemic inflammatory-response, such as neutrophil/lymphocyte-ratio (NLR) have been studied as prognostic factors in several tumors but in OC-patients their role is still controversial and no data about the possible correlation with the BRCA-status has been ever reported. We consecutively enrolled a series of 397 newly diagnosed high-grade serous-advanced OC-patients. All patients were tested for BRCA-mutational-status and blood-parameters have been collected 48 h before staging-surgery. A significant correlation of NLR with disease distribution (p < 0.005) was found and patients with NLR < 4 underwent primary-debulking-surgery more frequently (p-value 0.001), with a lower surgical-complexity-score (p-value 0.002). Regarding survival-data, patients with NLR < 4 had a significant 7-month increase in mPFS (26 vs 19 months, p = 0.009); focusing on the BRCA-status, among both BRCA-mutated and BRCA-wild type patients, those with lower NLR had a significantly prolonged mPFS compared to patients with NLR > 4 (BRCA-mutated: 35 vs 23 months, p = 0.03; BRCA-wt: 19 vs 16 months, p = 0.05). At multivariate-analysis, independent factors of prolonged PFS were BRCA mutational status, having received complete cytoreduction and NLR < 4. Also, the strongest predictors of longer OS were BRCA-mutational status, having received complete cytoreductive surgery, NLR < 4 and age. NLR is confirmed to be a prognostic marker in OC-patients and it seems unrelated with BRCA-mutational status.
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Affiliation(s)
- Claudia Marchetti
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Marco D'Indinosante
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Catholic University of the Sacred Heart, Rome, Italy
| | - Carolina Bottoni
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Chiara Di Ilio
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Catholic University of the Sacred Heart, Rome, Italy
| | - Stefano Di Berardino
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Catholic University of the Sacred Heart, Rome, Italy
| | - Barbara Costantini
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Angelo Minucci
- Molecular and Genomic Diagnostics Laboratory, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Laura Vertechy
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giovanni Scambia
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. .,Catholic University of the Sacred Heart, Rome, Italy. .,Department of Women's and Children's Health, Fondazione "Policlinico Universitario A.Gemelli"-IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy.
| | - Anna Fagotti
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Catholic University of the Sacred Heart, Rome, Italy
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Sonmez G, Demirtas T, Tombul ST, Akgun H, Demirtas A. Diagnostic efficiency of systemic immune-inflammation index in fusion prostate biopsy. Actas Urol Esp 2021; 45:359-365. [PMID: 34088435 DOI: 10.1016/j.acuroe.2021.04.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 08/11/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To investigate the diagnostic efficiency of systemic immune response (SII) in prostate cancer (PCa) in patients with PSA < 10 ng/mL undergoing fusion prostate biopsy. METHODS The prospective study included patients who were planned for fusion prostate biopsy and had PSA < 10 ng/mL and a PI-RADS ≥ 3. All the patients underwent 12-core standard transrectal prostate biopsy followed targeted biopsy (combined biopsy). Based on preoperative complete blood count parameters, SII was calculated using the following formula: SII = platelet × neutrophil-to-lymphocyte ratio. Correlations between PI-RADS score, platelet, neutrophil-to-lymphocyte ratio, PSA, PSA density, SII and PCa were determined using ROC curve analysis. Optimal cut-off values were determined using the maximum Youden Index (defined as: sensitivity + specificity - 1). RESULTS The study included 508 patients with a mean age of 62.49 ± 6.86 years and a median PSA level of 7.28 (5.69-8.70) ng/mL. The overall clinically significant PCa rate was 39.4%. Although SII had no significant diagnostic value in PCa patients with low ISUP grades (grade 1 and 2) (AUC = 0.487, P = 0.622), it was revealed as a significant marker in PCa patients with an ISUP grade ≥ 3 (AUC = 0.811, P < 0.001). The cut-off value of SII was 533.0. While the combination of SII with PI-RADS score is the most effective marker, neutrophil-to-lymphocyte ratio and platelet were also revealed as effective markers in predicting ISUP grade 3-5 PCa, though not as effective as SII. CONCLUSION SII and SII combination with PI-RADS score appear to be a significant diagnostic marker in patients with high-grade PCa (ISUP grade 3-5). These values were found to be higher compared to those of patients with a benign pathology and patients with lower ISUP scores.
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Affiliation(s)
- G Sonmez
- Assistant Prof., MD, Department of Urology, Erciyes University, Kayseri, Turkey
| | - T Demirtas
- MD, Department of Medical History and Ethics, Erciyes University, Kayseri, Turkey
| | - S T Tombul
- MD, Department of Urology, Erciyes University, Kayseri, Turkey
| | - H Akgun
- Prof., MD, Department of Pathology, Erciyes University, Kayseri, Turkey
| | - A Demirtas
- Prof., MD, Department of Urology, Erciyes University, Kayseri, Turkey.
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Matsubara S, Mabuchi S, Takeda Y, Kawahara N, Kobayashi H. Prognostic value of pre-treatment systemic immune-inflammation index in patients with endometrial cancer. PLoS One 2021; 16:e0248871. [PMID: 33989285 PMCID: PMC8121307 DOI: 10.1371/journal.pone.0248871] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 03/08/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The systemic immune-inflammation index (SII), which is calculated using absolute platelet, neutrophil, and lymphocyte counts, has recently attracted attentions as a prognostic indicator in patients with solid malignancies. In the current study, we retrospectively investigated the prognostic significance of pre-treatment SII among patients with endometrial cancer. METHOD Endometrial cancer patients treated at Nara medical university hospital between 2008 and 2018 were included in the current study. Receiver operating characteristic (ROC) curve was used to find the optimal SII cut-off values for 3-years progression free survival (PFS) and overall survival (OS). Then, the predictive abilities of SII and its superiority over neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) were investigated. Kaplan-Meier method was used to calculate the OS and PFS rates, and log-rank test was used to compare the survival rate between two groups. Univariate and multivariate Cox regression analysis were performed to identify risk factors for PFS and OS. RESULT A total of 442 patients were included in the current study. The cut-off value of SII for predicting PFS and OS were defined by ROC analysis as 931 and 910, respectively. Univariate analyses showed that elevated SII was associated with significantly shorter survival (p <0.001 for both PFS and OS). Cox regression analyses revealed that an advanced FIGO stage (p <0.001 for both PFS and OS) and an elevated SII (p = 0.014 for PFS, p = 0.011 for OS) are the independent prognostic factors for survival. When SII was compared with NLR and PLR, SII showed greater area under curve for predicting survival. CONCLUSION The SII is an independent prognostic factor in endometrial cancer patients, allowing more precise survival estimation than PLR or NLR.
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Affiliation(s)
- Sho Matsubara
- Department of Obstetrics and Gynecology, Nara Medical University, Kashihara, Nara, Japan
| | - Seiji Mabuchi
- Department of Obstetrics and Gynecology, Nara Medical University, Kashihara, Nara, Japan
| | - Yoshinori Takeda
- Department of Obstetrics and Gynecology, Nara Medical University, Kashihara, Nara, Japan
| | - Naoki Kawahara
- Department of Obstetrics and Gynecology, Nara Medical University, Kashihara, Nara, Japan
| | - Hiroshi Kobayashi
- Department of Obstetrics and Gynecology, Nara Medical University, Kashihara, Nara, Japan
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Franceschi E, De Biase D, Di Nunno V, Pession A, Tosoni A, Gatto L, Tallini G, Visani M, Lodi R, Bartolini S, Brandes AA. The clinical and prognostic role of ALK in glioblastoma. Pathol Res Pract 2021; 221:153447. [PMID: 33887544 DOI: 10.1016/j.prp.2021.153447] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 04/08/2021] [Accepted: 04/09/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND anaplastic lymphoma kinase (ALK) overexpression and gene alterations have been detected in several malignancies, with prognostic and therapeutic implications. However, few studies investigated the correlation between ALK altered expression and prognosis in patients with glioblastoma (GBM). METHODS We performed an evaluation of ALK overexpression and structural/quantitative chromosome alterations through immune-histochemical assay (IHC with D5F3 antibody) and fluorescent in situ hybridization (FISH) in patients with isocitrate dehydrogenase (IDH) wild type (wt) GBM. Assuming an ALK overexpression in 20 % of patients we planned a sample of 44 patients to achieve a probability of 90 % to include from 10 % to 30 % of patients with ALK alterations. RESULTS We evaluated 44 patients with IDH wt GBM, treated in our institution and dead due to GBM progression in 2017. ALK overexpression obtained by a composed score (the product of IHC intensity staining and rate of positive cells) was observed in 19 (43 %) patients. FISH analysis showed that 11 patients (25 %) had gene deletion, 2 patients (4.5 %) had monosomy and one patient (2.3 %) presented polysomy. Only one patient (2.3 %) demonstrated ALK rearrangement. There was no statistical difference in median OS between patients with ALK-positive (mOS = 18.9 months) and ALK-negative IHC (mOS = 18.0 months). CONCLUSION We identified some rare previously unreported alterations of ALK gene in patients with IDH wt GBM. In these patients, the ALK overexpression does not influences survival.
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Affiliation(s)
| | - Dario De Biase
- Department of Pharmacy and Biotechnology (FaBIT) - Molecular Pathology Laboratory, University of Bologna, Bologna, Italy
| | | | - Annalisa Pession
- Department of Pharmacy and Biotechnology (FaBIT) - Molecular Pathology Laboratory, University of Bologna, Bologna, Italy
| | - Alicia Tosoni
- Department of Oncology, AUSL Bologna, Bologna, Italy
| | - Lidia Gatto
- Department of Oncology, AUSL Bologna, Bologna, Italy
| | - Giovanni Tallini
- Molecular Diagnostic Unit, University of Bologna School of Medicine and Surgery, Bologna, Italy
| | - Michela Visani
- Molecular Diagnostic Unit, University of Bologna School of Medicine and Surgery, Bologna, Italy
| | - Raffaele Lodi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Italy
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Beal EW, Cloyd JM. Neutrophil-to-Lymphocyte Ratio in Colorectal Liver Metastases: Simply Prognostic or Clinically Relevant? Ann Surg Oncol 2021; 28:4072-4073. [PMID: 33881655 DOI: 10.1245/s10434-021-10054-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 04/09/2021] [Indexed: 01/13/2023]
Affiliation(s)
- Eliza W Beal
- The Ohio State University Wexner Medical Center and James Cancer Hospital, Columbus, OH, USA.
| | - Jordan M Cloyd
- The Ohio State University Wexner Medical Center and James Cancer Hospital, Columbus, OH, USA
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Significance of preoperative systemic immune-inflammation (SII) in predicting postoperative systemic inflammatory response syndrome after percutaneous nephrolithotomy. Urolithiasis 2021; 49:513-519. [PMID: 33835228 DOI: 10.1007/s00240-021-01266-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 03/27/2021] [Indexed: 12/19/2022]
Abstract
There is evidence that inflammation response biomarkers are positivity associated with bacteremia and urosepsis. The objective of this study was to investigate the value of preoperative systemic immune-inflammation (SII) in predicting systemic inflammatory response syndrome (SIRS) after percutaneous nephrolithotomy (PCNL). Records from 365 consecutive patients who previously received standard PCNL for kidney stones were retrospectively reviewed. Exactly 108 (29.6%) of the 365 patients who underwent PCNL developed SIRS postoperatively. The association of SIRS with the preoperative risk factors of infectious complications was evaluated. Female gender, operating time, SII, neutrophil to lymphocyte ratio (NLR), and lymphocyte to monocyte ratio (LMR) were found to be independent predictors for post-PCNL SIRS. Female patients with SIRS were more likely to have positive urine culture, a higher level of serum leukocyte, and serum hs-CRP than male patients with SIRS. Receiver operating characteristic curve analysis indicated SII for predicting the occurrence of SIRS with a higher AUC (0.782) than other systemic inflammation biomarkers such as LMR (0.734), NLR (0.671), and PLR (0.617). As a novel integrated inflammation biomarker for predicting SIRS after PCNL, SII showed a better predictive value than other traditional inflammation indicators. To our knowledge, we present the first study to investigate the predictive value of the preoperative SII on post-PCNL SIRS.
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Systemic immunity markers associated with lymphocytes predict the survival benefit from paclitaxel plus bevacizumab in HER2 negative advanced breast cancer. Sci Rep 2021; 11:6328. [PMID: 33737682 PMCID: PMC7973794 DOI: 10.1038/s41598-021-85948-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 03/02/2021] [Indexed: 01/04/2023] Open
Abstract
Although paclitaxel plus bevacizumab (PB) therapy is an effective chemotherapeutic regimen for HER2-negative advanced breast cancer (ABC), predictive markers for its effectiveness remain undefined. We investigated the usefulness of systemic immunity markers associated with lymphocytes as predictive markers for PB therapy in patients with HER2-negative ABC. We retrospectively reviewed data from 114 patients with HER2-negative ABC who underwent PB therapy from November 2011 to December 2019. We calculated the absolute lymphocyte count (ALC), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) as representative systemic immunity markers. The time to treatment failure (TTF) and overall survival (OS) of the patients with high ALC, low NLR, and high LMR were significantly longer compared with those of the patients with low ALC, high NLR, and low LMR. A multivariable analysis revealed that high ALC, low NLR, and low PLR were independent predictors for TTF and high ALC, low NLR, and high LMR were independent predictors for OS. Systemic immunity markers were significantly associated with longer TTF and OS in patients who underwent PB therapy and may represent predictive markers for PB therapy in patients with HER2-negative ABC.
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Tumor Microenvironment in Metastatic Colorectal Cancer: The Arbitrator in Patients' Outcome. Cancers (Basel) 2021; 13:cancers13051130. [PMID: 33800796 PMCID: PMC7961499 DOI: 10.3390/cancers13051130] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/25/2021] [Accepted: 03/02/2021] [Indexed: 02/06/2023] Open
Abstract
Simple Summary Colorectal cancer accounts for approximately 10% of all annually diagnosed cancers worldwide being liver metastasis, the most common cause of death in patients with colorectal cancer. The interplay between tumor and stromal cells in the primary tumor microenvironment and at distant metastases are rising in importance as potential mechanisms of the tumor progression. In this review we discuss the new biomarkers derived from tumor microenvironment and liquid biopsy as emerging prognostic and treatments response markers for metastatic colorectal cancer. We also review the developing new clinical strategies based on tumor microenvironmental cells to tackle metastatic disease in metastatic colorectal cancer patients. Abstract Colorectal cancer (CRC) is one of the most common cancers in western countries. Its mortality rate varies greatly, depending on the stage of the disease. The main cause of CRC mortality is metastasis, which most commonly affects the liver. The role of tumor microenvironment in tumor initiation, progression and metastasis development has been widely studied. In this review we summarize the role of the tumor microenvironment in the liver pre-metastatic niche formation, paying attention to the distant cellular crosstalk mediated by exosomes. Moreover, and based on the prognostic and predictive capacity of alterations in the stromal compartment of tumors, we describe the role of tumor microenvironment cells and related liquid biopsy biomarkers in the delivery of precise medication for metastatic CRC. Finally, we evaluate the different clinical strategies to prevent and treat liver metastatic disease, based on the targeting of the tumor microenvironment. Specifically, targeting angiogenesis pathways and regulating immune response are two important research pipelines that are being widely developed and promise great benefits.
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Sonmez G, Demirtas T, Tombul S, Akgun H, Demirtas A. Diagnostic efficiency of systemic immune-inflammation index in fusion prostate biopsy. Actas Urol Esp 2021. [PMID: 33640195 DOI: 10.1016/j.acuro.2020.08.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To investigate the diagnostic efficiency of systemic immune response (SII) in prostate cancer (PCa) in patients with PSA<10ng/ml undergoing fusion prostate biopsy. METHODS The prospective study included patients who were planned for fusion prostate biopsy and had PSA<10ng/ml and a PI-RADS≥3. All the patients underwent 12-core standard transrectal prostate biopsy followed targeted biopsy (combined biopsy). Based on preoperative complete blood count parameters, SII was calculated using the following formula: SII=platelet×neutrophil-to-lymphocyte ratio. Correlations between PI-RADS score, platelet, neutrophil-to-lymphocyte ratio, PSA, PSA density, SII and PCa were determined using ROC curve analysis. Optimal cut-off values were determined using the maximum Youden Index (defined as: sensitivity+specificity-1). RESULTS The study included 508 patients with a mean age of 62.49±6.86 years and a median PSA level of 7.28 (5.69-8.70) ng/ml. The overall clinically significant PCa rate was 39.4%. Although SII had no significant diagnostic value in PCa patients with low ISUP grades (grade 1 and 2) (AUC=0.487, P=.622), it was revealed as a significant marker in PCa patients with an ISUP grade≥3 (AUC=0.811, P<.001). The cut-off value of SII was 533.0. While the combination of SII with PI-RADS score is the most effective marker, neutrophil-to-lymphocyte ratio and platelet were also revealed as effective markers in predicting ISUP grade 3-5 PCa, though not as effective as SII. CONCLUSION SII and SII combination with PI-RADS score appear to be a significant diagnostic marker in patients with high-grade PCa (ISUP grade 3-5). These values were found to be higher compared to those of patients with a benign pathology and patients with lower ISUP scores.
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Neutrophil-Lymphocyte Ratio as an Initial Screening Biomarker for Differential Diagnosis of Cushing's Syndrome from Nonfunctional Adenoma in Patients with an Adrenal Mass. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6635594. [PMID: 33628798 PMCID: PMC7899776 DOI: 10.1155/2021/6635594] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 12/25/2020] [Accepted: 02/01/2021] [Indexed: 02/07/2023]
Abstract
Objective Assessing excess adrenal hormones is important in patients with adrenal mass. Current screening tests for excess cortisol hormones are complex, so it cannot be done sometimes due to the limited medical resources. The aim of the study was to evaluate whether the neutrophil-lymphocyte ratio (NLR) can be used as an initial screening biomarker for Cushing's syndrome (CS) in patients with an adrenal mass. Methods This retrospective study included a total of 185 patients with CS and 185 patients with nonfunctional adrenal adenoma (matched 1 : 1 by sex, body mass index, and discharge date). The NLR was compared between the two groups. The association between NLR and serum and urinary cortisol concentrations was analyzed, and an NLR cut-off value for CS screening was calculated. Results NLR (3.38 (2.33, 5.45) vs. 2.13 (1.74, 3.00), P < 0.001) was significantly higher in the CS group than in the nonfunctional adenoma group. In CS patients, the NLR was positively associated with serum cortisol concentrations at 8 am, with 24-hour urine free cortisol and with serum cortisol after a 1 mg dexamethasone suppression test (P < 0.001 each). An NLR cut-off of 2.2 had a sensitivity of 80.0% and a specificity of 54.05%. The weighted Youden index for the NLR was similar to that of the 24-hour urine free cortisol and late-night serum cortisol tests, which are recommended initial tests for CS diagnosis. Conclusion The NLR may be useful for initial screening for CS among patients with an adrenal mass as an easy and convenient marker.
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Prognostic Role of a New Index Tested in European and Korean Advanced Biliary Tract Cancer Patients: the PECS Index. J Gastrointest Cancer 2021; 53:289-298. [DOI: 10.1007/s12029-021-00596-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2021] [Indexed: 12/13/2022]
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