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Associations of Complete Blood Count Parameters with Disease-Free Survival in Right- and Left-Sided Colorectal Cancer Patients. J Pers Med 2022; 12:jpm12050816. [PMID: 35629238 PMCID: PMC9146340 DOI: 10.3390/jpm12050816] [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: 04/10/2022] [Revised: 05/12/2022] [Accepted: 05/13/2022] [Indexed: 02/01/2023] Open
Abstract
Colorectal cancer (CRC) is a leading cause of cancer-related deaths worldwide. Some complete blood count (CBC) parameters are found to be associated with CRC prognosis. In this study, ninety-seven pretreated CRC patients were included, and the patients were divided into two groups: left-sided and right-sided, depending on the anatomical location of the tumor. Based on clinicopathologic features including tumor budding, disease stages, and tumor anatomical location, levels of CBC parameters were compared, and disease-free survivals (DFS) were determined. There were differences between patients with different tumor budding scores for only three parameters, including red cell distribution width (RDW), numbers of platelets, and mean platelet volume (MPV). Furthermore, numbers of WBCs, monocytes, and MPV in CRC patients with early disease stages were higher than those with advanced stages. However, levels of eosinophil in CRC patients with advanced stages were higher than those with early stages. Depending on the tumor anatomical location, we observed that numbers of red blood cells (RBCs), hemoglobin (Hgb), and hematocrit (Hct) in CRC patients with left-sided tumors were higher than those with right-sided tumors. We found that low levels of MPV were associated with shorter DFS. However, high levels of eosinophils were associated with shorter DFS in all CRC patients. When patients were divided based on the tumor anatomical location, higher levels of MPV, MCHC, and Hgb were associated with better DFS in the left-sided but not right-sided CRC patients. However, left-sided, but not right-sided, CRC patients with high levels of eosinophil and RDW had shorter DFS. Furthermore, right-sided, but not left-sided, CRC patients with high levels of platelets tended to have a shorter DFS. Our data show that MPV and eosinophils could serve as potential prognostic biomarkers in pre-treatment CRC patients, regardless of the tumor anatomical location. Additionally, lower levels of MPV, MCHC, and Hgb, and high levels of eosinophils and RDW could be negative predictive biomarkers in left-sided CRC patients.
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Long Y, Zhang Y, Ni L, Yuan X, Liu Y, Tao J, Zhang Y. Prognostic value of platelet-to-lymphocyte ratio in neoadjuvant chemotherapy for solid tumors: A PRISMA-compliant meta-analysis. Medicine (Baltimore) 2021; 100:e26202. [PMID: 34397999 PMCID: PMC8294933 DOI: 10.1097/md.0000000000026202] [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: 05/20/2020] [Accepted: 05/11/2021] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION Previous research indicates that the platelet-to-lymphocyte ratio (PLR) may be an indicator of poor prognosis in many tumor types. However, the PLR is rarely described in patients undergoing neoadjuvant chemotherapy (NAC) for solid tumors. Thus, we performed a meta-analysis to investigate the prognostic value of this ratio for patients with solid tumors treated by NAC. METHODS A comprehensive search of the literature was conducted using the PubMed, EMBASE, Cochrane Library, and Web of Science databases, followed by a manual search of references from the retrieved articles. Pooled hazard ratios (HRs) with 95% confidence interval (CIs) were used to evaluate the association between PLR and 3 outcomes, namely, overall survival, disease-free survival, and pathological complete response rate after NAC. RESULTS Eighteen studies published no earlier than 2014 were included in our study. A lower PLR was associated with better overall survival (HR = 1.46, 95% CI, 1.11-1.92) and favorable disease-free survival (HR = 1.81, 95% CI, 1.27-2.59). A PLR that was higher than a certain cutoff was associated with a lower pathological complete response rate in patients with cancer who received NAC (Odds ratio = 1.93, 95% CI, 1.40-2.87). CONCLUSION Elevated PLR is associated with poor prognosis in various solid tumors. PLR may be a useful biomarker in delineating those patients with poorer prognoses who may benefit from neoadjuvant therapies.
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Ma Y, Zhang J, Chen X. Lymphocyte-to-Monocyte Ratio is Associated with the Poor Prognosis of Breast Cancer Patients Receiving Neoadjuvant Chemotherapy. Cancer Manag Res 2021; 13:1571-1580. [PMID: 33623436 PMCID: PMC7896736 DOI: 10.2147/cmar.s292048] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 01/31/2021] [Indexed: 12/11/2022] Open
Abstract
Purpose Systemic inflammatory cell ratio, neutrophil–lymphocyte ratio (NLR), platelet–lymphocyte ratio (PLR), and lymphocyte–monocyte ratio (LMR) are used as prognostic indicators for several types of tumors. The purpose of this study was to evaluate the predictive value of inflammatory markers for pathological response and prognosis in breast cancer patients receiving neoadjuvant chemotherapy (NAC). Methods In this study, we collected data of 203 breast cancer patients who underwent surgery after receiving standard neoadjuvant therapy. The effects of NLR, PLR, and LMR on the disease-free survival (DFS) of patients with breast cancer were analyzed by χ2 test and Cox regression analyses. Results We found that 27 of the 203 patients (13.3%) had local or distant metastases. The peripheral blood NLR, PLR, and LMR areas under the curve (AUC) were 0.674 (0.555–0.793), 0.630 (0.508–0.753), and 0.773 (0.673–0.874), respectively. The optimal cutoff values were 3.0, 135, and 6.2, respectively. Univariate and multivariate analyses revealed that LMR was related to the pathological complete response (pCR) rates and breast cancer DFS (P < 0.05). Among all patients, those with low LMR, HER-2 positive, and lymph node status (N2–3) demonstrated poor DFS. Conclusion Our study thus demonstrated that LMR can act as a potential marker for predicting the efficacy and prognosis of patients with breast cancer.
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Affiliation(s)
- Youzhao Ma
- Department of Breast Disease, Henan Breast Cancer Center, Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, 450008, People's Republic of China
| | - Jingyang Zhang
- Department of Breast Disease, Henan Breast Cancer Center, Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, 450008, People's Republic of China
| | - Xiuchun Chen
- Department of Breast Disease, Henan Breast Cancer Center, Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, 450008, People's Republic of China
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Mungan İ, Bostancı EB, Türksal E, Tezcan B, Aktaş MN, Can M, Kazancı D, Turan S. The predictive power of C-reactive protein- lymphocyte ratio for in-hospital mortality after colorectal cancer surgery. Cancer Rep (Hoboken) 2021; 4:e1330. [PMID: 33586918 PMCID: PMC8222561 DOI: 10.1002/cnr2.1330] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 12/07/2020] [Accepted: 12/09/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The relation between immunity, inflammation, and tumor development and progression has been emphasized in colorectal cancer widely and the prognosis is linked to the inflammatory reaction of the host as well as the biological behavior of the tumor. AIM In this study, we aimed to find out the predictive power of C-reactive protein- lymphocyte ratio (CLR) for in-hospital mortality after colorectal surgery. METHODS AND RESULTS A series of 388 CRC patients were enrolled in the present retrospective study which was conducted in a tertiary state Hospital in Ankara, Turkey. In-hospital mortality was the main outcome to evaluate the predictive power of inflammatory markers, while the other outcomes that would be evaluated as separate variables were LOS in hospital and LOS in ICU. In this study, there were 260 males and 128 females, and the mean age was 60.9. The in-hospital mortality rate was 3.4% (n = 13) and age, APACHE II score and Charlson comorbidity index score were related to in-hospital mortality statistically. The mean LOS in the hospital was 13.9 days and LOS in ICU was 4.5 days. The CRP levels and the CLR levels were higher both in the preoperative and postoperative periods in the mortality (+) group and the difference was significant statistically (P = .008/ .002 and .004/ <.001, respectively). CLR in the postoperative period had the best predictive power with AUC: 0.876. CONCLUSION In conclusion, within the context of our study there appears to be a relationship between CLR, as measured on day 2 postoperatively, and in-hospital mortality. It is observed to be more effective than NLR, ALC, and CRP.
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Affiliation(s)
- İbrahim Mungan
- Department of Intensive Care Unit, Ankara Eğitim ve Araştırma Şehir Hastanesi, Ankara, Turkey
| | - Erdal Birol Bostancı
- Department of Gastrointestinal Surgery, Ankara Eğitim ve Araştırma Şehir Hastanesi, Ankara, Turkey
| | - Erbil Türksal
- Department of Anesthesiology, Ankara Keçiören Eğitim Ve Araştırma Hastanesi, Ankara, Turkey
| | - Büşra Tezcan
- Department of Intensive Care Unit, Ankara Eğitim ve Araştırma Şehir Hastanesi, Ankara, Turkey
| | - Mehmet Nesim Aktaş
- Department of Intensive Care Unit, Ankara Eğitim ve Araştırma Şehir Hastanesi, Ankara, Turkey
| | - Müçteba Can
- Department of Intensive Care Unit, Ankara Eğitim ve Araştırma Şehir Hastanesi, Ankara, Turkey
| | - Dilek Kazancı
- Department of Intensive Care Unit, Ankara Eğitim ve Araştırma Şehir Hastanesi, Ankara, Turkey
| | - Sema Turan
- Department of Intensive Care Unit, Ankara Eğitim ve Araştırma Şehir Hastanesi, Ankara, Turkey
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Ali Khan M, Maken RN, Nisar H, Fatima I, Khan IU, Masood M, Shahid AB. THE Role of Preoperative carcinoembryonic antigen in recurrence of resectable colorectal carcinoma. Acta Clin Croat 2020; 59:216-222. [PMID: 33456107 PMCID: PMC7808221 DOI: 10.20471/acc.2020.59.02.03] [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] [Indexed: 12/24/2022] Open
Abstract
In colorectal carcinoma, carcinoembryonic antigen (CEA) is a recommended marker for surveillance after curative resection. The aim of the present study was to determine the association of preoperative CEA with recurrence of colorectal carcinoma in our population. The study included 55 patients with all operable stages of colorectal adenocarcinoma treated during the 2012-2014 period, evaluated retrospectively and followed-up for recurrence for 2 years. Data on the baseline (preoperative) CEA levels were retrieved from patient files. On data analysis, SPSS 16.0 was used. In patients with normal preoperative CEA, the rate of recurrence was significantly low (p=0.008) and the likelihood of no recurrence 1.55-fold greater as compared to patients with raised initial CEA levels (p=0.028). In patients with raised preoperative CEA, the risk of recurrence was 5.26-fold greater as compared to those with normal CEA levels (p=0.028). A significant weak positive correlation (rs=0.297) was found between raised CEA and recurrence. A highly significant (p=0.002) moderate positive correlation was recorded in patients aged <50 and moderate positive correlation of borderline significance in males (rs=0.324, p=0.058). Sensitivity was 94.4% and specificity 32.4% in predicting recurrence. Accordingly, preoperative elevated CEA showed a significant weak positive correlation with recurrence while normal preoperative CEA moderately decreased the likelihood of recurrence.
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Affiliation(s)
| | - Rab Nawaz Maken
- 1Institute of Nuclear Medicine and Oncology (INMOL), Lahore, Pakistan; 2Pakistan Institute of Engineering and Applied Sciences (PIEAS), Islamabad, Pakistan
| | - Hasan Nisar
- 1Institute of Nuclear Medicine and Oncology (INMOL), Lahore, Pakistan; 2Pakistan Institute of Engineering and Applied Sciences (PIEAS), Islamabad, Pakistan
| | - Ismat Fatima
- 1Institute of Nuclear Medicine and Oncology (INMOL), Lahore, Pakistan; 2Pakistan Institute of Engineering and Applied Sciences (PIEAS), Islamabad, Pakistan
| | - Irfan Ullah Khan
- 1Institute of Nuclear Medicine and Oncology (INMOL), Lahore, Pakistan; 2Pakistan Institute of Engineering and Applied Sciences (PIEAS), Islamabad, Pakistan
| | - Misbah Masood
- 1Institute of Nuclear Medicine and Oncology (INMOL), Lahore, Pakistan; 2Pakistan Institute of Engineering and Applied Sciences (PIEAS), Islamabad, Pakistan
| | - Abu Baker Shahid
- 1Institute of Nuclear Medicine and Oncology (INMOL), Lahore, Pakistan; 2Pakistan Institute of Engineering and Applied Sciences (PIEAS), Islamabad, Pakistan
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Zhang YY, Li WQ, Li ZF, Guo XH, Zhou SK, Lin A, Yan WH. Higher Levels of Pre-operative Peripheral Lymphocyte Count Is a Favorable Prognostic Factor for Patients With Stage I and II Rectal Cancer. Front Oncol 2019; 9:960. [PMID: 31612109 PMCID: PMC6769073 DOI: 10.3389/fonc.2019.00960] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 09/10/2019] [Indexed: 12/13/2022] Open
Abstract
The clinical significance of peripheral blood parameters has been considered to be a potential prognostic indicator for malignancies. In this study, 224 colorectal cancer (CRC; ncolon = 103; nrectal = 121) patients who underwent resection were enrolled, and the pre- and post-operative clinical laboratory data within 1 week, before and after surgery, were collected. The prognostic value of the counts of white blood cell (WBC), neutrophil, lymphocyte and platelet, the neutrophil to lymphocyte ratio (NLR), and systemic immune-inflammation index (SII) were analyzed. Data revealed that pre-operative lymphocyte count (pre-LC) was much higher than that of post-LC (p < 0.001), and only rectal cancer patients with pre-LChigh (>median: 1.61 × 109/L) had a significantly better overall survival (OS) and 5-year survival rate (SR) than those with pre-LClow (OS: 62.3 vs. 49.5 months; SR: 74.0 vs. 43.0%; p = 0.006). Cox's proportional hazard models revealed that pre-LChigh was an independent, favorable prognostic factor for rectal cancer patients (hazard ratio = 0.348; p = 0.003). Moreover, when the disease stages were stratified, the pre-LChigh was significantly associated with better prognosis of rectal cancer patients with stage I + II rectal cancer (n = 65; OS: 67.5 vs. 54.3 months; p = 0.011). Taken together, our study revealed that pre-operative lymphocyte count is an independent prognostic factor for patients with stage I and II rectal cancer.
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Affiliation(s)
- Ying-Ying Zhang
- School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou, China
| | - Wan-Qing Li
- School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou, China
| | - Zhen-Fa Li
- School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou, China
| | - Xiao-Hua Guo
- School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou, China
| | - Shen-Kang Zhou
- Department of Gastrointestinal Surgery, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai, China
| | - Aifen Lin
- School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou, China
| | - Wei-Hua Yan
- School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou, China
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Sit M, Aktas G, Ozer B, Kocak MZ, Erkus E, Erkol H, Yaman S, Savli H. MEAN PLATELET VOLUME: AN OVERLOOKED HERALD OF MALIGNANT THYROID NODULES. Acta Clin Croat 2019; 58:417-420. [PMID: 31969752 PMCID: PMC6971808 DOI: 10.20471/acc.2019.58.03.03] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Physicians and surgeons pay much attention to evaluating thyroid nodules due to the malignant potential of these growths. Inflammation has a crucial role in the development of cancer. Increase in the mean platelet volume (MPV) has been described in various inflammatory conditions. Since some of thyroid nodules are malignant, we aimed to compare MPV values between patients with malignant and benign thyroid nodules after precise pathologic diagnosis. We retrospectively analyzed hemograms of patients having undergone thyroid surgery for thyroid nodule between January 2013 and January 2015, and compared them to those recorded in healthy subjects. MPV was higher in the malignant thyroid nodule group than in the benign nodule group (9.1±1 fL vs. 7.8±0.8 fL). The difference was statistically significant (p<0.001). Increased MPV should be considered as an assistive diagnostic tool in differentiating malignant and benign thyroid nodules. However, further prospective studies are required to confirm its usefulness in this population.
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Affiliation(s)
| | - Gulali Aktas
- Abant Izzet Baysal University Hospital, Department of Internal Medicine, Golkoy, Bolu, Turkey
| | - Bahri Ozer
- Abant Izzet Baysal University Hospital, Department of Internal Medicine, Golkoy, Bolu, Turkey
| | - Mehmet Zahid Kocak
- Abant Izzet Baysal University Hospital, Department of Internal Medicine, Golkoy, Bolu, Turkey
| | - Edip Erkus
- Abant Izzet Baysal University Hospital, Department of Internal Medicine, Golkoy, Bolu, Turkey
| | - Hayri Erkol
- Abant Izzet Baysal University Hospital, Department of Internal Medicine, Golkoy, Bolu, Turkey
| | - Semih Yaman
- Abant Izzet Baysal University Hospital, Department of Internal Medicine, Golkoy, Bolu, Turkey
| | - Haluk Savli
- Abant Izzet Baysal University Hospital, Department of Internal Medicine, Golkoy, Bolu, Turkey
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