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Huang L, Wu W, Hu G. Prognostic value of platelet-to-lymphocyte ratio in patients with oral squamous cell carcinoma: a systematic review and meta-analysis. BMC Oral Health 2024; 24:1262. [PMID: 39438883 PMCID: PMC11494754 DOI: 10.1186/s12903-024-05026-7] [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: 03/01/2024] [Accepted: 10/07/2024] [Indexed: 10/25/2024] Open
Abstract
OBJECTIVES Numerous studies have investigated the predictive significance of the platelet-to-lymphocyte ratio (PLR) in oral squamous cell carcinoma(OSCC). However, the results of studies on its prognostic value remain controversial. This study aims to evaluate the prognostic significance of the PLR in patients with OSCC. MATERIALS AND METHODS We conducted a comprehensive search of PubMed, Embase, the Cochrane Library, and Web of Science databases for all studies investigating the association between PLR and prognosis in OSCC, from the inception of each database up to November 2023. The outcome measures included overall survival (OS), disease-free survival (DFS) and disease-specific survival (DSS). To identify potential sources of heterogeneity, sensitivity and subgroup analyses were performed, alongside an assessment of publication bias. The analyses in this study were conducted using RevMan and Stata software. RESULTS According to the inclusion criteria, 20 articles were included, including 5,714 patients.The meta-analysis revealed that an elevated PLR adversely affects OS (HR = 1.58; 95% CI: 1.29-1.94; p < 0.0001), DFS (HR = 1.71; 95% CI: 1.20-2.42; p < 0.003), and DSS (HR = 2.41; 95% CI: 1.79-3.25; p < 0.00001). The results of the subgroup analysis showed that a preoperative high PLR was associated with reduced OS when the PLR threshold was ≤ 150 (HR = 1.49, P = 0.0003).When the PLR threshold was > 150, Preoperative PLR was not significantly associated with the prediction of overall survival (OS) in OSCC. (P > 0.05). CONCLUSION The prognostic significance of PLR in patients with oral cancer is evident in terms of OS, DSS, and DFS. Nonetheless, it is crucial to note that the predictive value of PLR might depend on specific threshold values.
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Affiliation(s)
- Li Huang
- First Traditional Chinese Medicine Clinical College of Hunan University of Chinese Medicine, Changsha, China
- Graduate School of Traditional Chinese Medicine, Changsha, China
| | - Wenke Wu
- Otorhinolaryngology and Head Neck Surgery, The First Hospital of Hunan University of Chinese Medicine, Changsha, China
| | - Ge Hu
- Otorhinolaryngology and Head Neck Surgery, The First Hospital of Hunan University of Chinese Medicine, Changsha, China.
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Zhang YY, Liu FH, Wang YL, Liu JX, Wu L, Qin Y, Zheng WR, Xing WY, Xu J, Chen X, Xu HL, Bao Q, Wang JY, Wang R, Chen XY, Wei YF, Zou BJ, Liu JC, Yin JL, Jia MQ, Gao S, Luan M, Wang HH, Gong TT, Wu QJ. Associations between peripheral whole blood cell counts derived indexes and cancer prognosis: An umbrella review of meta-analyses of cohort studies. Crit Rev Oncol Hematol 2024; 204:104525. [PMID: 39370059 DOI: 10.1016/j.critrevonc.2024.104525] [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: 07/22/2024] [Revised: 09/15/2024] [Accepted: 09/24/2024] [Indexed: 10/08/2024] Open
Abstract
Meta-analyses have reported conflicting data on the whole blood cell count (WBCC) derived indexes (neutrophil-to-lymphocyte ratio [NLR], platelet-to-lymphocyte ratio [PLR], and lymphocyte-to-monocyte ratio [LMR]) and cancer prognosis. However, the strength and quality of this evidence has not been quantified in aggregate. To grade the evidence from published meta-analyses of cohort studies that investigated the associations between NLR, PLR, and LMR and cancer prognosis. A total of 694 associations from 224 articles were included. And 219 (97.8%) articles rated as moderate-to-high quality according to AMSTAR. There were four associations supported by convincing evidence. Meanwhile, 165 and 164 associations were supported by highly suggestive and suggestive evidence, respectively. In this umbrella review, we summarized the existing evidence on the WBCC-derived indexes and cancer prognosis. Due to the direction of effect sizes is not completely consistent between studies, further research is needed to assess causality and provide firm evidence.
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Affiliation(s)
- Ying-Ying Zhang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China; Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Fang-Hua Liu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China; Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ya-Li Wang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Department of Information Center, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Jia-Xin Liu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China; Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Lang Wu
- Cancer Epidemiology Division, Population Sciences in the Pacific Program, University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Ying Qin
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China; Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Wen-Rui Zheng
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China; Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Wei-Yi Xing
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China; Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jin Xu
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xing Chen
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China; Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - He-Li Xu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China; Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qi Bao
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jia-Yi Wang
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ran Wang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China; Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xi-Yang Chen
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China; Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yi-Fan Wei
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China; Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Bing-Jie Zou
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China; Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jia-Cheng Liu
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jia-Li Yin
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China; Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ming-Qian Jia
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China; Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Song Gao
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Meng Luan
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China.
| | - Hui-Han Wang
- Department of Hematology, Shengjing Hospital of China Medical University, Shenyang, China.
| | - Ting-Ting Gong
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China.
| | - Qi-Jun Wu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China; Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China; Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China; NHC Key Laboratory of Advanced Reproductive Medicine and Fertility (China Medical University), National Health Commission, Shenyang, China.
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Zhang M, Hao J, Wu Y, Gao Z, Wang M. Value of the lung immune prognostic index in patients with advanced small cell lung cancer treated with programmed death-ligand 1 and programmed death-1 inhibitors in the Chinese alpine region. Front Oncol 2024; 14:1411548. [PMID: 39391237 PMCID: PMC11464291 DOI: 10.3389/fonc.2024.1411548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 06/21/2024] [Indexed: 10/12/2024] Open
Abstract
Purpose To assess the potential added value of the lung immune prognostic index (LIPI) in patients with small cell lung cancer (SCLC), treated with programmed death-ligand 1 (PD-L1)/programmed death-1 (PD-1) inhibitors, who lived in the Chinese alpine region. Methods 120 SCLC patients treated with PD-L1/PD-1 inhibitors were divided into three LIPI groups, from July 2018 to April 2021. Cox regression models were used to evaluate the prognostic effect of three LIPI groups on overall survival (OS) and progression-free survival (PFS). Logistic regression analysis was conducted to explore the association between immune-related adverse events (irAEs) and the pretreatment of neutrophil-to-lymphocyte ratio (dNLR), lactate dehydrogenase (LDH), and LIPI. Results The median OS was 4.5, 6.3, and 10.0 months (p=0.001) and the median PFS was 2.5, 4.3, and 5.3 months (p=0.049) for Poor, Intermediate, and Good LIPI, respectively. The disease control rate (DCR) was also higher in the Good LIPI group (p=0.003). Moreover, multivariate analysis confirmed that worse LIPI was correlated with shorter OS and PFS. dNLR was associated with the onset of irAEs, not LIPI. Conclusion: The LIPI might be a promising predictive and prognostic biomarker in SCLC patients treated with PD-L1/PD-1 inhibitors in the Chinese Alpine region.
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Affiliation(s)
| | | | | | | | - Meng Wang
- Department of Respiratory Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, China
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Zhang C, Wang SF, Zhang YL, Teng CX. Peripheral hemoglobin to albumin ratio predicts prognosis in patients with nasopharyngeal carcinoma underwent concurrent chemoradiotherapy. BMC Cancer 2024; 24:1012. [PMID: 39148032 PMCID: PMC11325836 DOI: 10.1186/s12885-024-12763-z] [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: 02/06/2024] [Accepted: 08/05/2024] [Indexed: 08/17/2024] Open
Abstract
BACKGROUND Recently, the hemoglobin to albumin ratio (HAR) has been shown to be closely associated with the survival of certain malignancies. However, its prognostic value in nasopharyngeal carcinoma (NPC) remained to be elucidated. Herein, we aimed to explore the correlation between HAR and overall survival (OS) in NPC patients treated with concurrent chemoradiotherapy (CCRT). METHODS This retrospective study included a total of 858 patients with NPC receiving CCRT between January 2010 and December 2014 in Sun Yat-sen University Cancer Center. We randomly divided them into the training cohort (N = 602) and the validation cohort (N = 206). We performed univariate and multivariate Cox regression analyses to identify variables associated with OS, based on which, a predictive nomogram was constructed and assessed. RESULTS In both the training and validation cohorts, patients were classified into low- and high-HAR groups according to the cutoff value determined by the maximally selected rank statistics. This HAR cutoff value effectively divided patients into two distinct prognostic groups with significant differences. Multivariable Cox analysis revealed that higher T-stage, N-stage, and HAR values were significantly related to poorer prognosis in NPC patients and served as independent prognostic factors for NPC. Based on these, a predictive model was constructed and graphically presented as a nomogram, whose predictive performance is satisfactory with a C-index of 0.744 [95%CI: 0.679-0.809] and superior to traditional TNM staging system [C-index = 0.609, 95%CI: 0.448-0.770]. CONCLUSION The HAR value was an independent predictor for NPC patients treated with CCRT, the predictive model based on HAR with superior predictive performance than traditional TNM staging system might improve individualized survival predictions.
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Affiliation(s)
- Chao Zhang
- State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, 510060, People's Republic of China
- Department of Breast Oncology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China
| | - Si-Fen Wang
- State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, 510060, People's Republic of China
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China
| | - Yu-Ling Zhang
- Department of Endocrinology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, China
| | - Cha-Xiang Teng
- Department of Medical Oncology, Shenzhen Qianhai Taikang Hospital, Shenzhen, 518054, People's Republic of China.
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Yan C, Yang G, Zhang C, Chen K, Sun Y, Liang Z, Lai L, Li L, Qu S, Zhu XD. A nomogram based on circulating CD8 + T cell and platelet-to-lymphocyte ratio to predict overall survival of patients with locally advanced nasopharyngeal carcinoma. Radiat Oncol 2024; 19:108. [PMID: 39138513 PMCID: PMC11323451 DOI: 10.1186/s13014-024-02500-y] [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: 05/07/2024] [Accepted: 07/31/2024] [Indexed: 08/15/2024] Open
Abstract
PURPOSE To explore the influence of circulating lymphocyte subsets, serum markers, clinical factors, and their impact on overall survival (OS) in locally advanced nasopharyngeal carcinoma (LA-NPC). Additionally, to construct a nomogram predicting OS for LA-NPC patients using independent prognostic factors. METHODS A total of 530 patients with LA-NPC were included in this study. In the training cohort, Cox regression analysis was utilized to identify independent prognostic factors, which were then integrated into the nomogram. The concordance index (C-index) was calculated for both training and validation cohorts. Schoenfeld residual analysis, calibration curves, and decision curve analysis (DCA) were employed to evaluate the nomogram. Kaplan-Meier methods was performed based on risk stratification using the nomogram. RESULTS A total of 530 LA-NPC patients were included. Multivariate Cox regression analysis revealed that the circulating CD8+T cell, platelet-to-lymphocyte ratio (PLR), lactate dehydrogenase (LDH), albumin (ALB), gender, and clinical stage were independent prognostic factors for LA-NPC (p < 0.05). Schoenfeld residual analysis indicated overall satisfaction of the proportional hazards assumption for the Cox regression model. The C-index of the nomogram was 0.724 (95% CI: 0.669-0.779) for the training cohort and 0.718 (95% CI: 0.636-0.800) for the validation cohort. Calibration curves demonstrated good correlation between the model and actual survival outcomes. DCA confirmed the clinical utility enhancement of the nomogram over the TNM staging system. Significant differences were observed in OS among different risk stratifications. CONCLUSION Circulating CD8+ T cell, PLR, LDH, ALB, gender and clinical stage are independent prognostic factors for LA-NPC. The nomogram and risk stratification constructed in this study effectively predict OS in LA-NPC.
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Affiliation(s)
- Chang Yan
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, 530021, People's Republic of China
| | - Guohai Yang
- Department of Gastrointestinal Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, 530021, People's Republic of China
| | - Chaojun Zhang
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, 530021, People's Republic of China
| | - KaiHua Chen
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, 530021, People's Republic of China
| | - Yongchu Sun
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, 530021, People's Republic of China
| | - Zhongguo Liang
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, 530021, People's Republic of China
| | - Lin Lai
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, 530021, People's Republic of China
| | - Ling Li
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, 530021, People's Republic of China
| | - Song Qu
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, 530021, People's Republic of China
| | - Xiao-Dong Zhu
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, 530021, People's Republic of China.
- Department of Oncology, Wuming Hospital of Guangxi Medical University, Nanning, Guangxi, 530199, People's Republic of China.
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Wang J, Wang G, Cheng L, Zhu H, Wang J, Ding X, Niu H, Zhao K, Shu K. Preoperative peripheral inflammatory markers are predictors of postoperative central diabetes insipidus in craniopharyngioma patients: a retrospective study. BMC Cancer 2024; 24:572. [PMID: 38720306 PMCID: PMC11080258 DOI: 10.1186/s12885-024-12324-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 04/30/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Postoperative central diabetes insipidus (CDI) is commonly observed in craniopharyngioma (CP) patients, and the inflammatory response plays an important role in CPs. We aimed to evaluate the predictive value of preoperative peripheral inflammatory markers and their combinations regarding CDI occurrence in CPs. METHODS The clinical data including preoperative peripheral inflammatory markers of 208 CP patients who underwent surgical treatment were retrospectively collected and analyzed. The preoperative peripheral white blood cells (WBC), neutrophils, lymphocytes, monocytes, platelet (PLT), neutrophil-to-lymphocyte ratio (NLR), derived-NLR (dNLR), monocyte-to-lymphocyte ratio (MLR) and PLT-to-lymphocyte ratio (PLR) were assessed in total 208 CP patients and different age and surgical approach CP patient subgroups. Their predictive values were evaluated by the receiver operator characteristic curve analysis. RESULTS Preoperative peripheral WBC, neutrophils, NLR, dNLR, MLR, and PLR were positively correlated and lymphocyte was negatively associated with postoperative CDI occurrence in CP patients, especially when WBC ≥ 6.66 × 109/L or lymphocyte ≤ 1.86 × 109/L. Meanwhile, multiple logistic regression analysis showed that WBC > 6.39 × 109/L in the > 18 yrs age patients, WBC > 6.88 × 109/L or lymphocytes ≤ 1.85 × 109/L in the transcranial approach patients were closely associated with the elevated incidence of postoperative CDI. Furthermore, the area under the curve obtained from the receiver operator characteristic curve analysis showed that the best predictors of inflammatory markers were the NLR in total CP patients, the MLR in the ≤ 18 yrs age group and the transsphenoidal group, the NLR in the > 18 yrs age group and the dNLR in the transcranial group. Notably, the combination index NLR + dNLR demonstrated the most valuable predictor in all groups. CONCLUSIONS Preoperative peripheral inflammatory markers, especially WBC, lymphocytes and NLR + dNLR, are promising predictors of postoperative CDI in CPs.
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Affiliation(s)
- Jing Wang
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Department of Neurosurgery, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China
| | - Guanghui Wang
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Lidong Cheng
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Hongtao Zhu
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Junwen Wang
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xinmin Ding
- Department of Neurosurgery, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China
| | - Hongquan Niu
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Kai Zhao
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
| | - Kai Shu
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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Yuan Y, Liang X, He M, Wu Y, Jiang X. Haemoglobin, albumin, lymphocyte, and platelet score as an independent predictor for renal prognosis in IgA nephropathy. Front Endocrinol (Lausanne) 2024; 15:1339921. [PMID: 38737556 PMCID: PMC11088234 DOI: 10.3389/fendo.2024.1339921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 04/15/2024] [Indexed: 05/14/2024] Open
Abstract
Objective The haemoglobin, albumin, lymphocyte, and platelet (HALP) score, a convenient and composite laboratory biomarker, can reflect inflammation and systemic nutritional status. This study was performed to investigate the effect of the HALP score on the prognosis of patients with IgA nephropathy (IgAN). Methods This is a retrospective single centre study that enrolled 895 biopsy-confirmed IgAN patients from June 2019 to June 2022 who were followed for more than 1 year. Kaplan-Meier curves and Cox regression analyses were performed to determine the relationship between HALP and adverse outcomes. The restricted cubic splines was used to identify the possible associations. The optimal cut-off value of HALP for renal poor outcome was identified by the area under the receiver operating characteristic curve (AUC). Results A total of 895 patients finally participated in the study and were divided into three groups (tertial 1-3) according to the baseline HALP score. More severe clinicopathologic features were observed in the lower HALP group, and Kaplan-Meier analysis showed patients in tertial 1 had a higher risk of kidney failure than the other groups (log-rank=11.02, P= 0.004). Multivariate Cox regression revealed that HALP score was an independent risk factor for renal prognosis in IgAN (adjusted HR: 0.967, 95% CI: 0.945-0.990, P = 0.006). The results of subgroup analysis suggested that HALP was more important in patients under the age of 50, BMI ≤ 23.9 and eGFR ≤ 90 mL/min/1.73 m2. The best cut-off HALP for renal survival was 38.83, sensitivity 72.1%, and specificity 55.9% (AUC: 0.662). Patients were further grouped according to HALP cut-off values and propensity matched. Multivariate Cox regression analysis revealed that HALP remained an independent predictor of IgAN in the matched cohort (HR 0.222, CI: 0.084-0.588, P=0.002). Conclusion HALP is a novel and potent composite parameter to predict kidney outcome in patients with IgAN.
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Affiliation(s)
- Yuan Yuan
- Department of Nephrology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China
- Key Laboratory of Zhejiang Province, Management of Kidney Disease, Hangzhou, China
- Key Laboratory of Precise Prevention and Treatment of Rheumatism Syndrome of Renal Wind Disease, Hangzhou, China
| | - Xiaoli Liang
- Department of Nephrology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China
| | - Minhui He
- Department of Nephrology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China
| | - Yufan Wu
- Department of Nephrology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China
| | - Xue Jiang
- Department of Nephrology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China
- Key Laboratory of Zhejiang Province, Management of Kidney Disease, Hangzhou, China
- Key Laboratory of Precise Prevention and Treatment of Rheumatism Syndrome of Renal Wind Disease, Hangzhou, China
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Li J, Ye Y, Cai Y, Ji H, Qin W, Luo Y, Zhou X, Zhang Z, Xiao X, Zhang B. Triglyceride-inflammation score established on account of random survival forest for predicting survival in patients with nasopharyngeal carcinoma: a retrospective study. Front Immunol 2024; 15:1375931. [PMID: 38736892 PMCID: PMC11082337 DOI: 10.3389/fimmu.2024.1375931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 04/12/2024] [Indexed: 05/14/2024] Open
Abstract
Objective This study aimed to establish an effective prognostic model based on triglyceride and inflammatory markers, including neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR), to predict overall survival (OS) in patients with nasopharyngeal carcinoma (NPC). Additionally, we aimed to explore the interaction and mediation between these biomarkers in their association with OS. Methods A retrospective review was conducted on 259 NPC patients who had blood lipid markers, including triglyceride and total cholesterol, as well as parameters of peripheral blood cells measured before treatment. These patients were followed up for over 5 years, and randomly divided into a training set (n=155) and a validation set (n=104). The triglyceride-inflammation (TI) score was developed using the random survival forest (RSF) algorithm. Subsequently, a nomogram was created. The performance of the prognostic model was measured by the concordance index (C-index), time-dependent receiver operating characteristic (ROC) curve, and decision curve analysis (DCA). The interaction and mediation between the biomarkers were further analyzed. Bioinformatics analysis based on the GEO dataset was used to investigate the association between triglyceride metabolism and immune cell infiltration. Results The C-index of the TI score was 0.806 in the training set, 0.759 in the validation set, and 0.808 in the entire set. The area under the curve of time-dependent ROC of TI score in predicting survival at 1, 3, and 5 years were 0.741, 0.847, and 0.871 respectively in the training set, and 0.811, 0.837, and 0.758 in the validation set, then 0.771, 0.848, and 0.862 in the entire set, suggesting that TI score had excellent performance in predicting OS in NPC patients. Patients with stage T1-T2 or M0 had significantly lower TI scores, NLR, and PLR, and higher LMR compared to those with stage T3-T3 or M1, respectively. The nomogram, which integrated age, sex, clinical stage, and TI score, demonstrated good clinical usefulness and predictive ability, as evaluated by the DCA. Significant interactions were found between triglyceride and NLR and platelet, but triglyceride did not exhibit any medicating effects in the inflammatory markers. Additionally, NPC tissues with active triglyceride synthesis exhibited high immune cell infiltration. Conclusion The TI score based on RSF represents a potential prognostic factor for NPC patients, offering convenience and economic advantages. The interaction between triglyceride and NLR may be attributed to the effect of triglyceride metabolism on immune response.
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Affiliation(s)
- Jun Li
- Department of Clinical Laboratory, Wuzhou Red Cross Hospital, Wuzhou, Guangxi, China
- Guangxi Health Commission Key Laboratory of Molecular Epidemiology of Nasopharyngeal Carcinoma, Wuzhou Red Cross Hospital, Wuzhou, Guangxi, China
| | - Yinxin Ye
- Department of Clinical Laboratory, Wuzhou Red Cross Hospital, Wuzhou, Guangxi, China
- Guangxi Health Commission Key Laboratory of Molecular Epidemiology of Nasopharyngeal Carcinoma, Wuzhou Red Cross Hospital, Wuzhou, Guangxi, China
| | - Yonglin Cai
- Guangxi Health Commission Key Laboratory of Molecular Epidemiology of Nasopharyngeal Carcinoma, Wuzhou Red Cross Hospital, Wuzhou, Guangxi, China
| | - Huojin Ji
- Department of Clinical Laboratory, Wuzhou Red Cross Hospital, Wuzhou, Guangxi, China
- Guangxi Health Commission Key Laboratory of Molecular Epidemiology of Nasopharyngeal Carcinoma, Wuzhou Red Cross Hospital, Wuzhou, Guangxi, China
| | - Weiling Qin
- Department of Clinical Laboratory, Wuzhou Red Cross Hospital, Wuzhou, Guangxi, China
- Guangxi Health Commission Key Laboratory of Molecular Epidemiology of Nasopharyngeal Carcinoma, Wuzhou Red Cross Hospital, Wuzhou, Guangxi, China
| | - Yonglin Luo
- Department of Clinical Laboratory, Wuzhou Red Cross Hospital, Wuzhou, Guangxi, China
- Guangxi Health Commission Key Laboratory of Molecular Epidemiology of Nasopharyngeal Carcinoma, Wuzhou Red Cross Hospital, Wuzhou, Guangxi, China
| | - Xiaoying Zhou
- Key Laboratory of High-Incidence-Tumor Prevention & Treatment (Guangxi Medical University), Ministry of Education, Nanning, Guangxi, China
| | - Zhe Zhang
- Department of Otolaryngology-Head and Neck Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Xue Xiao
- Department of Otolaryngology-Head and Neck Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Bin Zhang
- Department of Radiation Oncology, Wuzhou Red Cross Hospital, Wuzhou, Guangxi, China
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Juesas Iglesias L, Sánchez-Canteli M, Pedregal Mallo D, Otero-Rosales M, López F, García-Pedrero JM, Rodrigo JP. Prognostic value of preoperative inflammatory ratios in early glottic cancer treated with transoral laser surgery. Head Neck 2024; 46:819-830. [PMID: 38196290 DOI: 10.1002/hed.27631] [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: 05/18/2023] [Revised: 11/29/2023] [Accepted: 12/24/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND There is growing evidence regarding the prognostic utility of ratios such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammatory index (SIII) in head and neck squamous cell carcinoma (HNSCC). However, most studies to date include heterogeneous series with different treatments or tumor subsites. METHODS We collected data from 201 patients with stage I-II glottic squamous cell carcinoma treated with transoral laser surgery. NLR, PLR, and SIII were calculated from preoperative cell blood count, cut-off points were obtained by ROC curve analysis, and survival rates were calculated. RESULTS High NLR (p = 0.012) and SIII (p = 0.037), but not PLR (p = 0.48), were associated with worse disease-specific survival (DSS). A similar trend was observed with overall survival (OS), although it did not reach statistical significance. On multivariable analyses, both high NLR (HR = 3.8, 95% CI = 1.5-9.9, p = 0.006) and high SIII (HR = 2.77, 95% CI = 1.1-6.9, p = 0.03) were significantly associated with shortened DSS. CONCLUSIONS Preoperative NLR and SIII emerge as independent prognostic biomarkers for early-stage surgically treated glottic tumors and could guide individualized follow-up.
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Affiliation(s)
- Luis Juesas Iglesias
- Department of Otolaryngology-Head and Neck Surgery. Hospital Universitario Central de Asturias, Instituto de Investigación Sanitaria del Principado de Asturias, Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, Oviedo, Spain
| | - Mario Sánchez-Canteli
- Department of Otolaryngology-Head and Neck Surgery. Hospital Universitario Central de Asturias, Instituto de Investigación Sanitaria del Principado de Asturias, Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, Oviedo, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto de Salud Carlos III, Madrid, Spain
| | - Daniel Pedregal Mallo
- Department of Otolaryngology-Head and Neck Surgery. Hospital Universitario Central de Asturias, Instituto de Investigación Sanitaria del Principado de Asturias, Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, Oviedo, Spain
| | - María Otero-Rosales
- Department of Otolaryngology-Head and Neck Surgery. Hospital Universitario Central de Asturias, Instituto de Investigación Sanitaria del Principado de Asturias, Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, Oviedo, Spain
| | - Fernando López
- Department of Otolaryngology-Head and Neck Surgery. Hospital Universitario Central de Asturias, Instituto de Investigación Sanitaria del Principado de Asturias, Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, Oviedo, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto de Salud Carlos III, Madrid, Spain
| | - Juana M García-Pedrero
- Department of Otolaryngology-Head and Neck Surgery. Hospital Universitario Central de Asturias, Instituto de Investigación Sanitaria del Principado de Asturias, Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, Oviedo, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto de Salud Carlos III, Madrid, Spain
| | - Juan P Rodrigo
- Department of Otolaryngology-Head and Neck Surgery. Hospital Universitario Central de Asturias, Instituto de Investigación Sanitaria del Principado de Asturias, Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, Oviedo, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto de Salud Carlos III, Madrid, Spain
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10
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Wu C, Yan X, Xie F, Lai X, Wang L, Jiang Y. Development of a nomogram for predicting pharyngocutaneous fistula based on skeletal muscle mass and systemic inflammation indices. Head Neck 2024; 46:571-580. [PMID: 38124665 DOI: 10.1002/hed.27614] [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: 06/27/2023] [Revised: 11/16/2023] [Accepted: 12/12/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Laryngeal and hypopharyngeal cancers often require surgical treatment, which can lead to the development of pharyngocutaneous fistula (PCF). Our research aimed to assess the predictive value of skeletal muscle mass (SMM) and systemic inflammation indices for PCF and construct a clinically effective nomogram. METHODS A nested case-control study of 244 patients matched from 1171 patients with laryngeal or hypopharyngeal cancer was conducted. SMM was measured at the third cervical level based on CT scans. A PCF nomogram was developed based on the univariate and multivariate analyses. RESULTS Glucose, white blood cell count, platelet-to-lymphocyte ratio, and skeletal muscle index were independent risk factors for PCF. The area under the curve for the PCF nomogram was 0.841 (95% CI 0.786-0.897). The calibration and decision curves indicated that the nomogram was well-calibrated with good clinical utility. CONCLUSIONS The nomogram we constructed may help clinicians predict PCF risk early in the postoperative period, pending external validation.
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Affiliation(s)
- Ce Wu
- Department of Otolaryngology - Head and Neck Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xudong Yan
- Department of Otolaryngology - Head and Neck Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Feng Xie
- Department of Otolaryngology - Head and Neck Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xiaolong Lai
- Department of Otolaryngology - Head and Neck Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Lin Wang
- Department of Otolaryngology - Head and Neck Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yan Jiang
- Department of Otolaryngology - Head and Neck Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
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苏 俊, 王 晓, 孙 志. [Establishment and verification of a prognostic nomogram for survival of tongue squamous cell carcinoma patients who underwent cervical dissection]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2024; 56:120-130. [PMID: 38318906 PMCID: PMC10845181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Indexed: 02/07/2024]
Abstract
OBJECTIVE To evaluate the prognostic significance of inflammatory biomarkers, prognostic nutritional index and clinicopathological characteristics in tongue squamous cell carcinoma (TSCC) patients who underwent cervical dissection. METHODS The retrospective cohort study consisted of 297 patients undergoing tumor resection for TSCC between January 2017 and July 2018. The study population was divided into the training set and validation set by 7 :3 randomly. The peripheral blood indices of interest were preoperative neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), systemic inflammation score (SIS) and prognostic nutritional index (PNI). Kaplan-Meier survival analysis and multivariable Cox regression analysis were used to evaluate independent prognostic factors for overall survival (OS) and disease-specific survival (DSS). The nomogram's accuracy was internally validated using concordance index, receiver operating characteristic (ROC) curve, area under the curve (AUC), calibration plot and decision curve analysis. RESULTS According to the univariate Cox regression analysis, clinical TNM stage, clinical T category, clinical N category, differentiation grade, depth of invasion (DOI), tumor size and pre-treatment PNI were the prognostic factors of TSCC. Multivariate Cox regression analysis revealed that pre-treatment PNI, clinical N category, DOI and tumor size were independent prognostic factors for OS or DSS (P < 0.05). Positive neck nodal status (N≥1), PNI≤50.65 and DOI > 2.4 cm were associated with the poorer 5-year OS, while a positive neck nodal status (N≥1), PNI≤50.65 and tumor size > 3.4 cm were associated with poorer 5-year DSS. The concordance index of the nomograms based on independent prognostic factors was 0.708 (95%CI, 0.625-0.791) for OS and 0.717 (95%CI, 0.600-0.834) for DSS. The C-indexes for external validation of OS and DSS were 0.659 (95%CI, 0.550-0.767) and 0.780 (95%CI, 0.669-0.890), respectively. The 1-, 3- and 5-year time-dependent ROC analyses (AUC = 0.66, 0.71 and 0.72, and AUC = 0.68, 0.77 and 0.79, respectively) of the nomogram for the OS and DSS pronounced robust discriminative ability of the model. The calibration curves showed good agreement between the predicted and actual observations of OS and DSS, while the decision curve confirmed its pronounced application value. CONCLUSION Pre-treatment PNI, clinical N category, DOI and tumor size can potentially be used to predict OS and DSS of patients with TSCC. The prognostic nomogram based on these variables exhibited good accurary in predicting OS and DSS in patients with TSCC who underwent cervical dissection. They are effective tools for predicting survival and helps to choose appropriate treatment strategies to improve the prognosis.
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Affiliation(s)
- 俊琪 苏
- 北京大学口腔医学院·口腔医院检验科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心,北京 100081Department of Clinical Laboratory, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China
| | - 晓颖 王
- 北京大学口腔医学院·口腔医院病案管理科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心,北京 100081Department of Medical Record, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China
| | - 志强 孙
- 北京大学口腔医学院·口腔医院检验科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心,北京 100081Department of Clinical Laboratory, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China
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12
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Sági B, Vas T, Csiky B, Nagy J, Kovács TJ. Are Platelet-Related Parameters Prognostic Predictors of Renal and Cardiovascular Outcomes in IgA Nephropathy? J Clin Med 2024; 13:991. [PMID: 38398303 PMCID: PMC10889748 DOI: 10.3390/jcm13040991] [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: 01/02/2024] [Revised: 02/03/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
Background: IgA nephropathy (IgAN) is associated with chronic inflammation. Platelet-related parameters, such as the platelet (PLT) count, platelet-to-albumin ratio (PAR), and platelet-to-lymphocyte ratio (PLR), were examined as potential prognostic indicators for renal and cardiovascular (CV) outcomes in IgAN. We were interested in whether platelet-related parameters are risk factors for ESKD and CV events in IgAN patients. Methods: In a monocentric retrospective study, 124 IgAN patients were divided into two groups based on the cut-off value of the PAR. All-cause mortality, major CV events, and end-stage renal disease were the primary combined endpoints. Secondary endpoints, such as CV or renal endpoints, were also analyzed separately. Results: The patients' mean age was 43.7 ± 13.5 years, and the follow-up time was 124 ± 67 months. The K-M curve showed that the PLR, PAR, and PLT were strongly associated with primary combined (p = 0.002, p = 0.004, p = 0.001) and renal outcomes (p < 0.001, p < 0.001, p < 0.001), but not with CV outcomes in IgAN. However, when combined with left ventricular hypertrophy (LVH) or metabolic syndrome (MetS), the PAR was found to be a significant predictor of both primary (p < 0.001, p < 0.001) and secondary outcomes (p = 0.001 and p = 0.038; p = 0.001 and p = 0.015). Additionally, the PLR correlated with albuminuria (r = -0.165, p = 0.033) and LVH (r = -0.178, p = 0.025), while PLT correlated with eGFR (r = 0.158, p = 0.040). Conclusions. Elevated PARs and PLRs may predict progression to end-stage kidney disease, but in combination with LVH and MetS, they were related to CV events in IgAN. The determination of PARs and PLRs can be useful and cost-effective parameters for assessing both cardiovascular and renal risks in IgAN.
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Affiliation(s)
- Balázs Sági
- 2nd Department of Internal Medicine and Nephrology, Diabetes Center, Clinical Center, Medical School, University of Pécs, 7624 Pécs, Hungary; (B.S.); (B.C.); (J.N.)
- Triton Life Dialysis Center, 7624 Pécs, Hungary
| | - Tibor Vas
- 2nd Department of Internal Medicine and Nephrology, Diabetes Center, Clinical Center, Medical School, University of Pécs, 7624 Pécs, Hungary; (B.S.); (B.C.); (J.N.)
| | - Botond Csiky
- 2nd Department of Internal Medicine and Nephrology, Diabetes Center, Clinical Center, Medical School, University of Pécs, 7624 Pécs, Hungary; (B.S.); (B.C.); (J.N.)
- Triton Life Dialysis Center, 7624 Pécs, Hungary
| | - Judit Nagy
- 2nd Department of Internal Medicine and Nephrology, Diabetes Center, Clinical Center, Medical School, University of Pécs, 7624 Pécs, Hungary; (B.S.); (B.C.); (J.N.)
| | - Tibor József Kovács
- 2nd Department of Internal Medicine and Nephrology, Diabetes Center, Clinical Center, Medical School, University of Pécs, 7624 Pécs, Hungary; (B.S.); (B.C.); (J.N.)
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Emir KN, Demirel B, Atasoy BM. An Investigation of the Role of Phase Angle in Malnutrition Risk Evaluation and Clinical Outcomes in Patients with Head and Neck or Brain Tumors Undergoing Radiotherapy. Nutr Cancer 2024; 76:252-261. [PMID: 38185865 DOI: 10.1080/01635581.2023.2300496] [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: 07/21/2023] [Revised: 11/23/2023] [Accepted: 12/18/2023] [Indexed: 01/09/2024]
Abstract
This cross-sectional study aimed to investigate the role of bioelectrical impedance analysis (BIA) and phase angle measurement in assessing malnutrition in head and neck (n = 37) and brain (n = 63) tumor patients received radiotherapy. Common nutritional screening and assessment tests were used to identify malnutrition in the patients. Each patient underwent these tests once, along with phase angle measurement. Additionally, inflammation parameters, including neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), and systemic inflammatory index (SII), were calculated. All study results were correlated with the phase angle cutoff point of 5.72°. The phase angle demonstrated significant correlations with subjective global assessment (SGA), mini nutritional assessment (MNA) scores, BIA parameters, nutritional index, NLR, and SII (p < 0.05). Moreover, in head and neck tumor patients, those with higher standardized phase angle values exhibited significantly better two-year overall survival (32.1% vs. 87.5%, p = 0.006). The phase angle measurement is a convenient, noninvasive, and reproducible method that can complement existing tools for assessing malnutrition risk in radiotherapy patients. The significant correlations observed between the phase angle and various nutritional, inflammation markers and prognosis highlight its potential utility. Further studies incorporating a larger patient cohort will be beneficial in establishing a standard phase angle reference value for cancer patients.
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Affiliation(s)
- Kubra Nur Emir
- Faculty of Health Science, Department of Nutrition and Dietetics, Istanbul Bilgi University, Istanbul, Turkey
| | - Birsen Demirel
- Faculty of Health Science, Department of Nutrition and Dietetics, Istanbul Bilgi University, Istanbul, Turkey
| | - Beste M Atasoy
- Department of Radiation Oncology, Marmara University School of Medicine, Istanbul, Turkey
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Ng M, Lu M, Chen VC, Ting H, Huang C, Gossop M. Lymphocyte-related ratios in methamphetamine-induced psychotic disorder in Taiwan, comparing with patients with schizophrenia. Addict Biol 2024; 29:e13363. [PMID: 38380726 PMCID: PMC10898829 DOI: 10.1111/adb.13363] [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: 06/05/2023] [Revised: 08/14/2023] [Accepted: 11/17/2023] [Indexed: 02/22/2024]
Abstract
The lymphocyte-related ratios, neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR) and platelet-to-lymphocyte ratio (PLR) are new measures of inflammation within the body. Few studies have investigated the inflammatory response of patients with methamphetamine-induced psychotic disorder. Clinically, the psychotic symptoms and behavioural manifestation of methamphetamine-induced psychotic disorder are often indistinguishable from paranoid schizophrenia. We aimed to determine the differences in these inflammatory markers between patients with methamphetamine-induced psychotic disorder, patients with schizophrenia and healthy individuals. A total of 905 individuals were recruited. The NLR and MLR were found to be higher in both patients with methamphetamine-induced psychotic disorders and patients with schizophrenia compared with healthy controls. There was no significant difference between the three groups in PLR. When compared with the control group, the methamphetamine-induced psychotic disorder group was significantly higher in NLR 27% (95%CI = 11 to 46%, p = 0.001), MLR 16% (95%CI = 3% to 31%, p = 0.013) and PLR 16% (95%CI = 5% to 28%, p = 0.005). NLR of the group with methamphetamine-induced psychotic disorder was 17% (95%CI = 73% to 94%, p = 0.004) less than the group with schizophrenia, while MLR and PLR did not differ significantly between the two groups. This is the first study that investigated the lymphocyte-related ratios in methamphetamine-induced psychotic disorder when compared with patients with schizophrenia and healthy individuals. The results showed that both patients with methamphetamine-induced psychotic disorder and patients with schizophrenia had stronger inflammatory responses than the healthy control. Our finding also indicated that the inflammatory response of methamphetamine-induced psychotic disorder was between those of patients with schizophrenia and healthy individuals.
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Affiliation(s)
- Mei‐Hing Ng
- Institute of MedicineChung Shan Medical UniversityTaichungTaiwan
- Tsaotun Psychiatric CenterMinistry of Health and WelfareNantou CountyTaiwan
| | - Mong‐Liang Lu
- Department of PsychiatryWan‐Fang Hospital & School of MedicineCollege of MedicineTaipei Medical UniversityTaipeiTaiwan
| | - Vincent Chin‐Hung Chen
- Department of PsychiatryChang Gung Medical FoundationChiayi Chang Gung Memorial HospitalChiayi CountyTaiwan
- Department of PsychiatrySchool of MedicineChang Gung UniversityTaiwan
| | - Hua Ting
- Institute of MedicineChung Shan Medical UniversityTaichungTaiwan
- Department of Physical Medicine and RehabilitationChung‐Shan Medical, University HospitalChung‐Shan Medical UniversityTaichungTaiwan
| | - Chieh‐Liang Huang
- Tsaotun Psychiatric CenterMinistry of Health and WelfareNantou CountyTaiwan
| | - Michael Gossop
- National Addiction CentreInstitute of PsychiatryKing's College LondonLondonUK
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Lien MY, Hwang TZ, Wang CC, Hsieh CY, Yang CC, Wang CC, Lien CF, Shih YC, Yeh SA, Hsieh MC. A Novel Prognostic Model Using Pan-Immune-Inflammation Value and Programmed Death Ligand 1 in Patients with Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma Receiving Immune Checkpoint Inhibitors: A Retrospective Multicenter Analysis. Target Oncol 2024; 19:71-79. [PMID: 38041732 DOI: 10.1007/s11523-023-01018-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2023] [Indexed: 12/03/2023]
Abstract
BACKGROUND Little is known regarding the prognostication of the Pan-Immune-Inflammation Value (PIV) in patients with recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC). OBJECTIVES This study aimed to investigate the prognostic role of PIV in patients with R/M HNSCC receiving immune checkpoint inhibitors (ICI). PATIENTS AND METHODS Patients who were diagnosed to have R/M HNSCC and treated with ICI were reviewed retrospectively. The cutoff value of PIV was set at the median. Patients were stratified into high PIV and low PIV. Kaplan-Meier curves were estimated for progression-free survival (PFS) and overall survival (OS). RESULTS A total of 192 patients were included in our study for oncologic outcomes evaluation. For the total population, the median PFS was 5.5 months and OS was 18.2 months. After stratification by PIV, median PFS was 11.7 months in the low PIV and 2.8 months in the high PIV groups (p < 0.001). The median OS was 21.8 months in the low PIV and 11.5 months in the high PIV groups (p < 0.001). Multivariate analysis demonstrated that PIV and PD-L1 were independent predictors associated with survival. A prognostic model using both PIV and PD-L1 was constructed. The median PFS was 12.2, 6.4, and 3.0 months for patients with risk scores of 0, 1, and 2, respectively (p < 0.001). The median OS was 23.7, 18.1, and 11.4 months for patients with risk scores of 0, 1, and 2, respectively (p < 0.001). CONCLUSIONS PIV is a prognostic biomarker in patients with R/M HNSCC treated with ICI. A prognostic model using PIV and PD-L1 could provide outcome prediction and risk stratification.
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Affiliation(s)
- Ming-Yu Lien
- Division of Hematology and Oncology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
- School and Medicine, China Medical University, Taichung, Taiwan
| | - Tzer-Zen Hwang
- Department of Otolaryngology, E-Da Hospital, Kaohsiung, Taiwan
- College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Chih-Chun Wang
- Department of Otolaryngology, E-Da Hospital, Kaohsiung, Taiwan
- College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Ching-Yun Hsieh
- Division of Hematology and Oncology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
- School and Medicine, China Medical University, Taichung, Taiwan
| | - Chuan-Chien Yang
- Department of Otolaryngology, E-Da Hospital, Kaohsiung, Taiwan
- College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Chien-Chung Wang
- Department of Otolaryngology, E-Da Hospital, Kaohsiung, Taiwan
- College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Ching-Feng Lien
- Department of Otolaryngology, E-Da Hospital, Kaohsiung, Taiwan
- College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Yu-Chen Shih
- College of Medicine, I-Shou University, Kaohsiung, Taiwan
- Department of Otolaryngology, E-Da Cancer Hospital, Kaohsiung, Taiwan
| | - Shyh-An Yeh
- College of Medicine, I-Shou University, Kaohsiung, Taiwan
- Department of Radiation Oncology, E-Da Hospital, Kaohsiung, Taiwan
| | - Meng-Che Hsieh
- College of Medicine, I-Shou University, Kaohsiung, Taiwan.
- Department of Hematology-Oncology, College of Medicine, E-Da Cancer Hospital, Kaohsiung, Taiwan, I-Shou University, Kaohsiung, Taiwan.
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Koca T, Cetmi DA, Aksoy RA, Korcum AF. The Predictive Role of Inflammatory Biomarkers in Patients With Larynx Cancer Undergoing Definitive Radiotherapy. Technol Cancer Res Treat 2024; 23:15330338241280433. [PMID: 39196647 PMCID: PMC11363246 DOI: 10.1177/15330338241280433] [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: 06/15/2024] [Revised: 08/16/2024] [Accepted: 07/24/2024] [Indexed: 08/30/2024] Open
Abstract
Inflammation plays an important role in the process of cancer development. The number of studies evaluating the ability of inflammatory biomarkers to predict survival has increased in recent years. This study aimed to comprehensively evaluate the predictive role of inflammatory biomarkers in patients with larynx cancer undergoing definitive radiotherapy. A total of 101 patients who underwent definitive radiotherapy for larynx cancer at our center were retrospectively examined. Blood samples were taken from the patients before radiotherapy to obtain biomarkers such as C-reactive protein (CRP), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), pan-immune inflammatory value (PIV), hemo-eosinophil inflammation index (HEI), albumin, and Lactate dehydrogenase (LDH). The study examined the predictive value of parameters for progression-free survival (PFS), local recurrence-free survival (LRFS), and overall survival (OS) using both univariate and multivariate Cox regression analysis. In the univariate analysis, the biomarkers that predicted PFS were SII, PIV, CRP, and Eastern Cooperative Oncology Group Performance Status (ECOG PS). According to the multivariate analysis, only CRP was found to be a significant predictor of PFS. In the univariate analysis, the following biomarkers were found to predict OS: NLR, PLR, MLR, SII, PIV, CRP, HEI, stage, and ECOG PS. In the multivariate analysis, NLR and ECOG PS were found to be predictors of OS. A significant difference was found in MLR, PIV, and CRP values based on the presence of lymphatic metastasis. The current study is the first to comprehensively examine the relationship between larynx cancer and several inflammatory biomarkers. Many of these biomarkers have been shown to predict both PFS and OS in patients with larynx cancer undergoing definitive radiotherapy. It has been shown that PIV and CRP may predict the presence of lymphatic metastases in addition to PFS and OS.
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Affiliation(s)
- Timur Koca
- Department of Radiation Oncology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Durmus Ali Cetmi
- Department of Radiation Oncology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Rahmi Atil Aksoy
- Department of Radiation Oncology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Aylin Fidan Korcum
- Department of Radiation Oncology, Akdeniz University School of Medicine, Antalya, Turkey
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Diana R, Pierluigi M, Dardo M, Claudia A, Rosario R, Luigi L. THE PROGNOSTIC ROLE OF PRE-TREATMENT PLATELET-TO-LYMPHOCYTE RATIO IN HEAD AND NECK SQUAMOUS CELL CARCINOMA: META-ANALYSIS AND TRIAL SEQUENTIAL ANALYSIS. J Evid Based Dent Pract 2023; 23:101898. [PMID: 38035889 DOI: 10.1016/j.jebdp.2023.101898] [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: 10/31/2022] [Revised: 05/23/2023] [Accepted: 06/14/2023] [Indexed: 12/02/2023]
Abstract
BACKGROUND Evidence suggests that inflammation contributes to tumor development, from onset to progression and metastasis. Platelet-to-lymphocyte ratio (PLR) is a composite parameter that provides information from two distinct cellular elements, platelets, and lymphocytes. The purpose of this systematic review and meta-analysis is to evaluate the prognostic role of the PLR, in terms of overall survival (OS), disease-free survival (DFS), cancer-specific survival (CSS) and progression-free survival (PFS), in patients with primary head and neck squamous cell carcinoma treated with surgery followed or not by adjuvant therapies. MATERIALS AND METHODS This systematic review was performed according to the guidelines reported in the Cochrane Handbook and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Meta-analysis of OS and DFS was performed using the inverse of variance test. Random-effect models were used on the basis of high heterogeneity. Risk of bias assessment, quality of evidence within studies (GRADE) and trial sequential analysis (TSA) were also performed. RESULTS The analysis revealed that a higher value of pretreatment PLR correlates with a statistically significant decrease of OS (HR, 1.85; 95% CI: [1.23, 2.80]; P < .00001), confirmed by TSA. The meta-analysis reports an association between high PLR and DFS (HR,1.46; 95% CI: [1.03, 2.06]; P = .003); but TSA suggests that it his should be considered as a false positive. Further studies are needed to validate the efficacy of PLR in predicting CSS and PFS outcomes. CONCLUSION Pretreatment PLR is an independent prognostic factor for OS in HNSCC.
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Affiliation(s)
- Russo Diana
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy.
| | - Mariani Pierluigi
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Menditti Dardo
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Arena Claudia
- Department of Mental, Physical Health, and Rehabilitation Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Rullo Rosario
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Laino Luigi
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy
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Zhao W, Li X, Lv L, Sun X, Xue J, Yang P, Tang J, Lv X. Systematic review and metanalysis of neutrophil to lymphocyte ratio and prognosis in patients with nasopharyngeal carcinoma. Laryngoscope Investig Otolaryngol 2023; 8:1522-1531. [PMID: 38130245 PMCID: PMC10731536 DOI: 10.1002/lio2.1161] [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: 06/22/2023] [Revised: 07/29/2023] [Accepted: 09/23/2023] [Indexed: 12/23/2023] Open
Abstract
Background Hematological parameters have been associated with prognosis in patients with nasopharyngeal carcinoma (NPC). The present meta-analysis investigated the utility of neutrophil-lymphocyte ratio (NLR) in the prognosis of patients with NPC. Methods Multiple electronic databases, including PubMed, Embase, the Cochrane Library, and the Web of Science, were systematically searched for studies assessing the association between NLR and NPC from 2011 to 2021. The primary outcomes were overall survival (OS) and progression-free survival (PFS). Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were utilized to estimate effect size. Use of a fixed effect or random effect model was based on heterogeneity stability was tested by sensitivity analysis, and the risk of bias was assessed by funnel plots. Random effects models were used based on the actual results. Because the NLR grouping criteria for the included studies differed, subgroup analyses were performed. Results A search of the electronic databases identified 14 studies, encompassing 6693 patients, that met the selection criteria. NLR higher than the cutoff value was significantly associated with poorer OS [HR 1.760, 95% CI 1.470-2.120, p <0.00001] and PFS [HR 1.850, 95% CI 1.430-2.390, p = .006]. Sensitivity analysis showed that the results of the meta-analysis were relatively stable, and funnel plots were used to exclude the risk of bias. Conclusions Elevated pretreatment NLR in peripheral blood is predictive of poorer OS and PFS in patients with NPC. NLR is an easily measured and important prognostic factor in patients with NPC.
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Affiliation(s)
- Wanying Zhao
- Department of RadiotherapyFirst Affiliated Hospital of Dalian Medical UniversityDalian CityLiaoning ProvinceChina
| | - Xiaofeng Li
- School of Basic Medicine and Public HealthDalian Medical UniversityDalian CityLiaoning ProvinceChina
| | - Li Lv
- Department of PathologySecond Affiliated Hospital of Dalian Medical UniversityDalian CityLiaoning ProvinceChina
| | - Xiance Sun
- School of Basic Medicine and Public HealthDalian Medical UniversityDalian CityLiaoning ProvinceChina
| | - Juan Xue
- Department of RadiotherapyFirst Affiliated Hospital of Dalian Medical UniversityDalian CityLiaoning ProvinceChina
| | - Ping Yang
- Department of RadiotherapyFirst Affiliated Hospital of Dalian Medical UniversityDalian CityLiaoning ProvinceChina
| | - Jinhai Tang
- Department of RadiotherapyFirst Affiliated Hospital of Dalian Medical UniversityDalian CityLiaoning ProvinceChina
| | - Xiupeng Lv
- Department of RadiotherapyFirst Affiliated Hospital of Dalian Medical UniversityDalian CityLiaoning ProvinceChina
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Mireștean CC, Stan MC, Iancu RI, Iancu DPT, Bădulescu F. The Prognostic Value of Platelet-Lymphocyte Ratio, Neutrophil-Lymphocyte Ratio, and Monocyte-Lymphocyte Ratio in Head and Neck Squamous Cell Carcinoma (HNSCC)-A Retrospective Single Center Study and a Literature Review. Diagnostics (Basel) 2023; 13:3396. [PMID: 37998532 PMCID: PMC10670617 DOI: 10.3390/diagnostics13223396] [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: 10/10/2023] [Revised: 10/28/2023] [Accepted: 10/30/2023] [Indexed: 11/25/2023] Open
Abstract
INTRODUCTION Neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and pallets-to-lymphocyte ratio (PLR) are currently validated as cheap and accessible biomarkers in different types of solid tumors, including head and neck cancers (HNC). THE PURPOSE OF THE STUDY To evaluate the possible purposes and biomarker value of NLR, PLR, and MLR recorded pre-treatment (radiotherapy/chemotherapy) in HNC. MATERIALS AND METHODS From 190 patients with HNC included in the oncology records in the oncology outpatient clinic of the Craiova County Emergency Hospital (from January 2002 to December 2022), 39 cases met the inclusion criteria (squamous cell carcinoma and the possibility to calculate the pre-treatment (chemotherapy/radiotherapy) value of NLR, PLR, and MLR. Overall survival (OS) values were correlated with NLR, PLR, and MLR. RESULTS The median values for NLR, PLR, and MLR were 6.15 (1.24-69), 200.79 (61.3-1775.0), and 0.53 (0.12-5.5), respectively. In the study, the mean values for NLR, PLR, and MLR of 2.88, 142.97, and 0.36, respectively, were obtained. The median OS in the study group was 11 months (1-120). Although a negative Pearson's correlation was present, the relationship between the variables was only weak, with values of R = 0.07, p = 0.67, R = 0.02, p = 0.31, and R = 0.07, p = 0.62 being related to NLR, PLR, and MLR, respectively, in correlation with OS. The median values of NLR, PLR, and MLR were calculated (1.53, 90.32, and 0.18, respectively) for the HNC cases with pre-treatment values of NLR < 2 and for the HNC cases with NLR values ≥ 6 (23.5, 232.78, and 0.79, respectively). The median OS for cases with NLR < 2 and NLR ≥ 6 were 17.4 and 13 months, respectively. CONCLUSIONS The comparative analysis of the data highlights a benefit to OS for cases low values of NLR. The role of not only borderline NLR values (between 2 and 6) as a prognostic marker in HNSCC but also the inclusion of PLR and MLR in a prognostic score must also be defined in the future. Prospective studies with more uniformly selected inclusion criteria could demonstrate the value of pre-treatment NLR, PLR, and MLR for treatment stratification through the intensification or de-escalation of non-surgical curative treatment in HNSCC.
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Affiliation(s)
- Camil Ciprian Mireștean
- Department of Medical Oncology and Radiotherapy, University of Medicine and Pharmacy Craiova, 200349 Craiova, Romania; (C.C.M.); (F.B.)
- Department of Surgery, Railways Clinical Hospital, 700506 Iasi, Romania
| | - Mihai Cosmin Stan
- Department of Surgery, Railways Clinical Hospital, 700506 Iasi, Romania
- Department of Medical Oncology, Vâlcea County Emergency Hospital, 200300 Râmnicu Vâlcea, Romania
| | - Roxana Irina Iancu
- Faculty of Dental Medicine, Oral Pathology Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania;
- Department of Clinical Laboratory, “Saint Spiridon” County Hospital, 700111 Iasi, Romania
| | - Dragoș Petru Teodor Iancu
- Oncology and Radiotherapy Department, Faculty of Medicine, “Gr. T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
- Department of Radiation Oncology, Regional Institute of Oncology, 700483 Iași, Romania
| | - Florinel Bădulescu
- Department of Medical Oncology and Radiotherapy, University of Medicine and Pharmacy Craiova, 200349 Craiova, Romania; (C.C.M.); (F.B.)
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Yanar KE, Eren E, Aktaş MS, Eroğlu MS, Kandemir Ö, Aydın G. Prognostic potential of inflammatory markers, oxidative status, thrombocyte indices, and renal biochemical markers in neonatal calf diarrhoea-induced systemic inflammatory response syndrome. Vet Immunol Immunopathol 2023; 265:110680. [PMID: 37980800 DOI: 10.1016/j.vetimm.2023.110680] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 11/08/2023] [Accepted: 11/08/2023] [Indexed: 11/21/2023]
Abstract
The study aimed to assess the prognostic value of inflammatory markers, indicators of oxidative stress, thrombocyte indices, and renal biochemical markers in neonatal calf diarrhoea (NCD) induced by systemic inflammatory response syndrome (SIRS) upon admission. A prospective, observational, and case-control study was conducted on 56 calves diagnosed with NCD. Mean concentrations of interleukin-6 (IL-6), malondialdehyde (MDA), glutathione (GSH), mean platelet volume (MPV), platelet distribution width (PDW), blood urea nitrogen (BUN), and creatinine (Crea) were measured. Furthermore, the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were also calculated for SIRS survivors [SIRS (survivor)] and non-survivors [SIRS (non-survivor)] induced by NCD. A prognostic cut-off value for predicting the prognosis of the SIRS's induced by NCD was obtained via receiver operating characteristic (ROC) curve analysis. Upon admission, the SIRS (non-survivor) calves had significantly higher (P < .001) average levels of IL-6, MDA, BUN, Crea, MPV, and PDW compared to the SIRS (survivor) calves and significantly lower (P < .001) average levels of GSH. Despite an apparent increase in the NLR and PLR values of calves diagnosed with SIRS, no significant difference was found between the survival and non-survivor SIRS cases. Positive predictive values (PPVs) for survival were determined as 100 %, 100 %, 80 %, 100 %, 80 %, and 80 %, respectively, using cut-off values of IL-6 (≤259.67 ng/L), MDA (≤2.87 nmol/mL), MPV (≤12.5 fL), PDW (≤34.25 %), BUN (≤168.3 mg/dL), and Crea (≤2.11 mg/dL). The determined threshold values are those obtained upon admission to the hospital. Based on the sensitivity, specificity, and PPVs derived from the ROC analysis, it has been concluded that IL-6, MDA, MPV, PDW, BUN, and Crea are the most relevant biomarkers used for predicting the prognosis of NCD-induced SIRS in calves. Furthermore, it is also noteworthy that IL-6 exhibited the highest effectiveness among all biomarkers.
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Affiliation(s)
- Kerim Emre Yanar
- Department of Internal Medicine, Faculty of Veterinary Medicine, Atatürk University, Erzurum, Turkey.
| | - Emre Eren
- Department of Internal Medicine, Faculty of Veterinary Medicine, Atatürk University, Erzurum, Turkey.
| | - Mustafa Sinan Aktaş
- Department of Internal Medicine, Faculty of Veterinary Medicine, Atatürk University, Erzurum, Turkey
| | - Muhammed Sertaç Eroğlu
- Department of Internal Medicine, Faculty of Veterinary Medicine, Atatürk University, Erzurum, Turkey
| | - Özge Kandemir
- Aksaray Technical Sciences Vocatinal School, Aksaray University, Aksaray, Turkey
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Afsar S, Turan G, Guney G, Sahin G, Talmac MA, Afsar CU. The Relationship between Furin and Chronic Inflammation in the Progression of Cervical Intraepithelial Neoplasia to Cancer: A Cross-Sectional Study. Cancers (Basel) 2023; 15:4878. [PMID: 37835572 PMCID: PMC10571943 DOI: 10.3390/cancers15194878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 09/22/2023] [Accepted: 10/06/2023] [Indexed: 10/15/2023] Open
Abstract
OBJECTIVE The current study aimed to delineate the relationship between furin and chronic inflammation while cervical intraepithelial neoplasia progresses to cancer. STUDY DESIGN This cross-sectional study included 81 women who required colposcopic examinations. The study groups were formed based on pathological results: Group I included women with cervical intraepithelial neoplasia (CIN) I (n = 30); Group II included women with CIN II-III (n = 28); and Group III included women with cervical cancer (CC) (n = 23). Furin, ki-67, and p16 levels were evaluated based on immunostaining intensity. The inflammatory indices were calculated in parallel with the literature from routine blood samples retrieved within one week before the procedure. RESULTS Furin expression gradually increased from CIN I to CIN II-III and from CIN II-III to CC, respectively (p < 0.001, p = 0.005). NLR, MLR, PLR, and SII were significantly higher in the CC group (p < 0.001). ROC curve analysis unveiled that NLR, MLR, PLR, and SII predicted the presence of CC with a cutoff value of 2.39 for NLR (sensitivity: 91.3%, specificity: 63.8%, AUROC: 0.79, p < 0.001); a cutoff value of 0.27 for MLR (sensitivity: 78.3%, specificity: 72.4%, AUROC: 0.77, p = 0.009); a cutoff value of 123 for PLR (sensitivity: 100%, specificity: 41.4%, AUROC: 0.70, p = 0.04); and a cutoff value of 747 for SII (sensitivity: 69.6%, specificity: 90.7%, AUROC: 0.71, p = 0.014). CONCLUSION Furin expression increased gradually in parallel with the severity of cervical intraepithelial neoplasia. The inflammatory indices were higher in the presence of CC and denoted a good discrimination ability for predicting cervical cancer.
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Affiliation(s)
- Selim Afsar
- Department of Obstetrics & Gynecology, School of Medicine, Balıkesir University, Cagis Yerleskesi, Bigadic Yolu 17. km, Balikesir 10145, Turkey;
| | - Gulay Turan
- Department of Pathology, School of Medicine, Balıkesir University, Balıkesir 10145, Turkey;
| | - Gurhan Guney
- Department of Obstetrics & Gynecology, School of Medicine, Balıkesir University, Cagis Yerleskesi, Bigadic Yolu 17. km, Balikesir 10145, Turkey;
| | - Gozde Sahin
- Department of Gynecologic Oncology, Health Sciences University, Istanbul 34668, Turkey; (G.S.); (M.A.T.)
| | - Merve Aldıkactıoglu Talmac
- Department of Gynecologic Oncology, Health Sciences University, Istanbul 34668, Turkey; (G.S.); (M.A.T.)
| | - Cigdem Usul Afsar
- Department of Medical Oncology, Health Sciences University, Istanbul 34668, Turkey;
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Lin B, Lin J, Wang F, Wang Y, Shen S, Hong X, Yang H, Wang S, Yang H. Computed tomography-defined sarcopenia as a risk factor for short-term postoperative complications in oral cancer patients with free flap reconstruction: A retrospective population-based cohort study. Head Neck 2023; 45:2555-2570. [PMID: 37565367 DOI: 10.1002/hed.27479] [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: 12/07/2022] [Revised: 07/10/2023] [Accepted: 07/18/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND Postoperative complications after free flap reconstruction for oral cancer can increase cost and prolong hospitalization. This study explored risk factors for complications, focusing on sarcopenia. METHODS The study explored the associations between computed tomography-defined sarcopenia and the occurrence of postoperative complications, adjusted for age, gender, smoking, alcohol, ASA scoring, clinical stage of tumor, tumor site, type of free flap used, presence of tracheotomy, and blood test parameters. RESULTS Of 253 patients, 17.39% (44/253) of oral cancer patients had comorbid sarcopenia. Univariate analysis showed an overall postoperative complication rate of 65.90% in the sarcopenia group and 51.67% in the non-sarcopenia group. Multivariate modeling showed sarcopenia and smoking were major risk factors for total and respiratory complications, increasing the risks by over two-fold. No factors significantly impacted surgery-specific complications. CONCLUSIONS This study identified sarcopenia as a risk factor for postoperative complications in oral cancer patients undergoing flap reconstruction.
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Affiliation(s)
- Bo Lin
- Department of Oral and Maxillofacial Surgery, Stomatological Center, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
- Department of Oral and Maxillofacial Surgery, Guangdong Provincial High-Level Clinical Key Specialty, Shenzhen, Guangdong, China
- Department of Oral and Maxillofacial Surgery, Guangdong Province Engineering Research Center of Oral Disease Diagnosis and Treatment, Shenzhen, Guangdong, China
| | - Jianlin Lin
- Department of Oral and Maxillofacial Surgery, Guangdong Provincial High-Level Clinical Key Specialty, Shenzhen, Guangdong, China
- Department of Oral and Maxillofacial Surgery, Guangdong Province Engineering Research Center of Oral Disease Diagnosis and Treatment, Shenzhen, Guangdong, China
| | - Feng Wang
- Department of Oral and Maxillofacial Surgery, Stomatological Center, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
- Department of Oral and Maxillofacial Surgery, Guangdong Provincial High-Level Clinical Key Specialty, Shenzhen, Guangdong, China
- Department of Oral and Maxillofacial Surgery, Guangdong Province Engineering Research Center of Oral Disease Diagnosis and Treatment, Shenzhen, Guangdong, China
| | - Yufan Wang
- Department of Oral and Maxillofacial Surgery, Stomatological Center, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
- Department of Oral and Maxillofacial Surgery, Guangdong Provincial High-Level Clinical Key Specialty, Shenzhen, Guangdong, China
- Department of Oral and Maxillofacial Surgery, Guangdong Province Engineering Research Center of Oral Disease Diagnosis and Treatment, Shenzhen, Guangdong, China
| | - Shiyue Shen
- Department of Oral and Maxillofacial Surgery, Stomatological Center, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
- Department of Oral and Maxillofacial Surgery, Guangdong Provincial High-Level Clinical Key Specialty, Shenzhen, Guangdong, China
- Department of Oral and Maxillofacial Surgery, Guangdong Province Engineering Research Center of Oral Disease Diagnosis and Treatment, Shenzhen, Guangdong, China
| | - Xia Hong
- Department of Oral and Maxillofacial Surgery, Stomatological Center, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
- Department of Oral and Maxillofacial Surgery, Guangdong Provincial High-Level Clinical Key Specialty, Shenzhen, Guangdong, China
- Department of Oral and Maxillofacial Surgery, Guangdong Province Engineering Research Center of Oral Disease Diagnosis and Treatment, Shenzhen, Guangdong, China
| | - HuiJun Yang
- Department of Oral and Maxillofacial Surgery, Stomatological Center, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
- Department of Oral and Maxillofacial Surgery, Guangdong Provincial High-Level Clinical Key Specialty, Shenzhen, Guangdong, China
- Department of Oral and Maxillofacial Surgery, Guangdong Province Engineering Research Center of Oral Disease Diagnosis and Treatment, Shenzhen, Guangdong, China
| | - Shunji Wang
- Department of Oral and Maxillofacial Surgery, Stomatological Center, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
- Department of Oral and Maxillofacial Surgery, Guangdong Provincial High-Level Clinical Key Specialty, Shenzhen, Guangdong, China
- Department of Oral and Maxillofacial Surgery, Guangdong Province Engineering Research Center of Oral Disease Diagnosis and Treatment, Shenzhen, Guangdong, China
| | - Hongyu Yang
- Department of Oral and Maxillofacial Surgery, Stomatological Center, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
- Department of Oral and Maxillofacial Surgery, Guangdong Provincial High-Level Clinical Key Specialty, Shenzhen, Guangdong, China
- Department of Oral and Maxillofacial Surgery, Guangdong Province Engineering Research Center of Oral Disease Diagnosis and Treatment, Shenzhen, Guangdong, China
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Cao SL, Zhang GQ, Li J, Bao L, Lan XM, Jin QP, Luo HY, E J, Li B, Ma D, Bao X, Zheng YL. Platelet-to-albumin ratio is a potential biomarker for predicting diabetic nephropathy in patients with type 2 diabetes. Biomark Med 2023; 17:841-848. [PMID: 38180339 DOI: 10.2217/bmm-2023-0527] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2024] Open
Abstract
Aim: To evaluate whether platelet-to-albumin ratio (PAR) can predict diabetic nephropathy (DN) in type 2 diabetes mellitus (T2DM). Materials & methods: A total of 140 patients with T2DM and 40 healthy individuals were enrolled retrospectively. T2DM patients were divided into three groups based on the urinary albumin-to-creatinine ratio, PAR was compared and receiver operating characteristic curve was constructed to evaluate the predictive value of PAR in DN in T2DM. Results: There was a significant increase of PAR in DN among T2DM patients and PAR was positively correlated with serum creatinine, retinol-conjugated protein and β2-microglobulin. Moreover, PAR was a risk factor for DN in T2DM patients, which predicted DN in T2DM with high sensitivity and specificity. Conclusion: PAR can be a potential candidate to predict DN in T2DM.
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Affiliation(s)
- Shi-Lu Cao
- Department of Nephrology, Ningxia Medical University Affifiliated People's Hospital of Autonomous Region of Ningxia, Yinchuan, Ningxia, 750004, China
- The Third Clinical Medical College of Ningxia Medical University, Yinchuan, Ningxia, 750004, China
| | - Guo-Qing Zhang
- Department of Nephrology, Ningxia Medical University Affifiliated People's Hospital of Autonomous Region of Ningxia, Yinchuan, Ningxia, 750004, China
- The Third Clinical Medical College of Ningxia Medical University, Yinchuan, Ningxia, 750004, China
| | - Jing Li
- Department of Pathology, Ningxia Medical University Affiliated People's Hospital of Autonomous Region of Ningxia, Yinchuan, Ningxia, 750004, China
| | - Li Bao
- Department of Nephrology, Ningxia Medical University Affifiliated People's Hospital of Autonomous Region of Ningxia, Yinchuan, Ningxia, 750004, China
- The Third Clinical Medical College of Ningxia Medical University, Yinchuan, Ningxia, 750004, China
| | - Xiao-Mei Lan
- Department of Geriatrics, Ningxia Medical University Affiliated People's Hospital of Autonomous Region of Ningxia, Yinchuan, Ningxia, 750004, China
- Dialysis Department of Nephrology Hospital, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710000, China
| | - Quan-Peng Jin
- Department of Endocrinology, Ningxia Medical University Affiliated People's Hospital of Autonomous Region of Ningxia, Yinchuan, Ningxia, 750004, China
| | - Hong-Yan Luo
- Department of Nephrology, Ningxia Medical University Affifiliated People's Hospital of Autonomous Region of Ningxia, Yinchuan, Ningxia, 750004, China
- The Third Clinical Medical College of Ningxia Medical University, Yinchuan, Ningxia, 750004, China
| | - Jing E
- Department of Nephrology, Ningxia Medical University Affifiliated People's Hospital of Autonomous Region of Ningxia, Yinchuan, Ningxia, 750004, China
- The Third Clinical Medical College of Ningxia Medical University, Yinchuan, Ningxia, 750004, China
- Department of Nephrology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710000, China
| | - Bo Li
- Department of Nephrology, Ningxia Medical University Affifiliated People's Hospital of Autonomous Region of Ningxia, Yinchuan, Ningxia, 750004, China
- The Third Clinical Medical College of Ningxia Medical University, Yinchuan, Ningxia, 750004, China
- Dialysis Department of Nephrology Hospital, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710000, China
| | - Danna Ma
- Department of Nephrology, Ningxia Medical University Affifiliated People's Hospital of Autonomous Region of Ningxia, Yinchuan, Ningxia, 750004, China
- The Third Clinical Medical College of Ningxia Medical University, Yinchuan, Ningxia, 750004, China
- Department of Nephrology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710000, China
| | - Xi Bao
- Department of Nephrology, Ningxia Medical University Affifiliated People's Hospital of Autonomous Region of Ningxia, Yinchuan, Ningxia, 750004, China
- The Third Clinical Medical College of Ningxia Medical University, Yinchuan, Ningxia, 750004, China
| | - Ya-Li Zheng
- Department of Nephrology, Ningxia Medical University Affifiliated People's Hospital of Autonomous Region of Ningxia, Yinchuan, Ningxia, 750004, China
- The Third Clinical Medical College of Ningxia Medical University, Yinchuan, Ningxia, 750004, China
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Huang CH, Peng TC, Chou YF, Peng YH. Investigating sarcopenia, physical activity, and inflammation biomarkers in newly diagnosed oral cancer patients during curative treatment: A prospective longitudinal study. Asia Pac J Oncol Nurs 2023; 10:100261. [PMID: 37497155 PMCID: PMC10365980 DOI: 10.1016/j.apjon.2023.100261] [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: 04/14/2023] [Accepted: 06/07/2023] [Indexed: 07/28/2023] Open
Abstract
Objective This prospective longitudinal study aimed to investigate changes in sarcopenia, physical activity, and inflammation biomarkers in patients with oral cavity cancer during curative treatment and explore their association with treatment outcomes. Methods Patients newly diagnosed with oral cavity cancer who underwent primary surgery with (chemo)radiation therapy were included. Along with physical activity and inflammatory markers, sarcopenia was assessed using a 5-time chair stand test, hand grip strength, and skeletal muscle index (SMI). Data were collected before operation and after 3 months (T2) and 6 months after operation. Logistic regression and Cox proportional hazards models were used to identify predictors of treatment outcomes. Results Out of 56 patients, 21 (37.5%) had sarcopenia. SMI score, physical activity, and neutrophil-to-lymphocyte ratio (NLR) showed significant changes after surgery, with exacerbation at T2. Patients with sarcopenia exhibited a significant decrease in SMI scores at T2. Advanced cancer stage and sarcopenia were associated with treatment-related dysphagia (odds ratio [OR] = 3.01, P = 0.034; OR = 7.62, P = 0.018). Sarcopenia (OR = 3.02, P = 0.002) and NLR (OR = 5.38, P < 0.001) were significantly associated with infections. Pretreatment SMI independently predicted poor survival outcomes (hazard ratio = 7.00, P = 0.005). Conclusions Identifying patients with oral cavity cancer, sarcopenia, and high NLR levels can ensure prompt education and vigilant monitoring, potentially improving treatment outcomes and patient well-being during curative treatment.
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Affiliation(s)
- Chun-Hou Huang
- Department of Nursing, Tzu Chi University, Hualien, Taiwan
| | - Tai-Chu Peng
- Department of Nursing, Tzu Chi University, Hualien, Taiwan
| | - Yu-Fu Chou
- Department of Otolaryngology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
- School of Medicine, College of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Yun-Hsin Peng
- Department of Nursing, Tzu Chi University, Hualien, Taiwan
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Zhong Q, Zhou W, Lin J, Sun W, Qin Y, Li X, Xu H. Independent and Combined Associations of Blood Manganese, Cadmium and Lead Exposures with the Systemic Immune-Inflammation Index in Adults. TOXICS 2023; 11:659. [PMID: 37624164 PMCID: PMC10457758 DOI: 10.3390/toxics11080659] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/27/2023] [Accepted: 07/28/2023] [Indexed: 08/26/2023]
Abstract
Manganese (Mn), cadmium (Cd) and lead (Pb) have toxic effects on the immune system. However, their independent and combined effects on immune-inflammation responses are unclear. In recent years, the systemic immune-inflammation index (SII) has been developed as an integrated and novel inflammatory indicator. A retrospective cross-sectional study of 2174 adults ≥20 years old from the National Health and Nutrition Examination Survey (NHANES) 2015-2016 was conducted. Generalized linear models were used to evaluate the independent and combined associations of SII with blood Mn, Cd and Pb levels. As continuous variables, both blood Cd and Mn showed dose-dependent relationships with the SII before and after adjusting for all potential confounding factors. Metal concentrations were then converted into categorical variables. Compared with the adults in the lowest Cd or Mn tertile, those in the highest tertile had higher risks of elevated SII. Furthermore, co-exposure to Mn and Cd also showed a positive relationship with the SII after adjusting for all confounding factors. However, the single effect of Pb exposure and the joint effect of Pb and other metal exposures on the SII were not observed. This study provides important epidemiological evidence of the associations of SII with single and co-exposure effects of blood Mn, Cd, and Pb.
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Affiliation(s)
- Qiya Zhong
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China;
| | - Wenxin Zhou
- School of Public Health, Hangzhou Medical College, Hangzhou 310013, China; (W.Z.); (J.L.); (W.S.); (Y.Q.)
| | - Jiaqi Lin
- School of Public Health, Hangzhou Medical College, Hangzhou 310013, China; (W.Z.); (J.L.); (W.S.); (Y.Q.)
| | - Wen Sun
- School of Public Health, Hangzhou Medical College, Hangzhou 310013, China; (W.Z.); (J.L.); (W.S.); (Y.Q.)
| | - Yao Qin
- School of Public Health, Hangzhou Medical College, Hangzhou 310013, China; (W.Z.); (J.L.); (W.S.); (Y.Q.)
| | - Xiang Li
- School of Nursing, Yanbian University, Yanji 133000, China;
| | - Huadong Xu
- School of Public Health, Hangzhou Medical College, Hangzhou 310013, China; (W.Z.); (J.L.); (W.S.); (Y.Q.)
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Yu B, Ma SJ, Khan M, Gill J, Iovoli A, Fekrmandi F, Farrugia MK, Wooten K, Gupta V, McSpadden R, Kuriakose MA, Markiewicz MR, Al-Afif A, Hicks WL, Seshadri M, Ray AD, Repasky EA, Singh AK. Association of pre-treatment lymphocyte-monocyte ratio with survival outcome in patients with head and neck cancer treated with chemoradiation. BMC Cancer 2023; 23:572. [PMID: 37344761 DOI: 10.1186/s12885-023-11062-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/13/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND Given the role of systematic inflammation in cancer progression, lymphocyte-monocyte ratio (LMR) from peripheral blood has been suggested as a biomarker to assess the extent of inflammation in several solid malignancies. However, the role of LMR as a prognostic factor in head and neck cancer was unclear in several meta-analyses, and there is a paucity of literature including patients in North America. We performed an observational cohort study to evaluate the association of LMR with survival outcomes in North American patients with head and neck cancer. METHODS A single-institution, retrospective database was queried for patients with non-metastatic head and neck cancer who underwent definitive chemoradiation from June 2007 to April 2021 at the Roswell Park Comprehensive Cancer Center. Primary endpoints were overall survival (OS) and cancer-specific survival (CSS). The association of LMR with OS and CSS was examined using nonlinear Cox proportional hazard model using restricted cubic splines (RCS). Cox multivariable analysis (MVA) and Kaplan-Meier method were used to analyze OS and CSS. Pre-radiation LMR was then stratified into high and low based on its median value. Propensity scored matching was used to reduce the selection bias. RESULTS A total of 476 patients met our criteria. Median follow up was 45.3 months (interquartile range 22.8-74.0). The nonlinear Cox regression model showed that low LMR was associated with worse OS and CSS in a continuous fashion without plateau for both OS and CSS. On Cox MVA, higher LMR as a continuous variable was associated with improved OS (adjusted hazard ratio [aHR] 0,90, 95% confidence interval [CI] 0.82-0.99, p = 0.03) and CSS (aHR 0.83, 95% CI 0.72-0.95, p = 0.009). The median value of LMR was 3.8. After propensity score matching, a total of 186 pairs were matched. Lower LMR than 3.8 remained to be associated with worse OS (HR 1.59, 95% CI 1.12-2.26, p = 0.009) and CSS (HR 1.68, 95% CI 1.08-2.63, p = 0.02). CONCLUSION Low LMR, both as a continuous variable and dichotomized variable, was associated with worse OS and CSS. Further studies would be warranted to evaluate the role of such prognostic marker to tailor interventions.
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Affiliation(s)
- Brian Yu
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, 955 Main Street, Buffalo, NY, 14203, USA
| | - Sung Jun Ma
- Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY, 14203, USA
| | - Michael Khan
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, 955 Main Street, Buffalo, NY, 14203, USA
| | - Jasmin Gill
- University at Buffalo, The State University of New York, 12 Capen Hall, Buffalo, NY, 14260, USA
| | - Austin Iovoli
- Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY, 14203, USA
| | - Fatemeh Fekrmandi
- Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY, 14203, USA
| | - Mark K Farrugia
- Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY, 14203, USA
| | - Kimberly Wooten
- Department of Head and Neck Surgery, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY, 14203, USA
| | - Vishal Gupta
- Department of Head and Neck Surgery, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY, 14203, USA
| | - Ryan McSpadden
- Department of Head and Neck Surgery, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY, 14203, USA
| | - Moni A Kuriakose
- Department of Head and Neck Surgery, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY, 14203, USA
| | - Michael R Markiewicz
- Department of Oral and Maxillofacial Surgery, School of Dental Medicine, University at Buffalo, The State University of New York, 3435 Main Street, Buffalo, NY, 14214, USA
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, 955 Main Street, Buffalo, NY, 14203, USA
| | - Ayham Al-Afif
- Department of Head and Neck Surgery, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY, 14203, USA
| | - Wesley L Hicks
- Department of Head and Neck Surgery, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY, 14203, USA
| | - Mukund Seshadri
- Department of Oral Oncology, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY, 14203, USA
| | - Andrew D Ray
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY, 14203, USA
| | - Elizabeth A Repasky
- Department of Immunology, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY, 14203, USA
| | - Anurag K Singh
- Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY, 14203, USA.
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Oka T, Sato F, Ono T, Kawaguchi T, Murotani K, Sueyoshi S, Kuroiwa T, Kurita T, Fukahori M, Mitsuhashi T, Sato K, Chitose S, Umeno H. Prognostic values of systemic inflammation and nutrition-based prognostic indices in oropharyngeal carcinoma. Laryngoscope Investig Otolaryngol 2023; 8:675-685. [PMID: 37342125 PMCID: PMC10278114 DOI: 10.1002/lio2.1070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 04/11/2023] [Accepted: 04/17/2023] [Indexed: 06/22/2023] Open
Abstract
Objective Pretreatment systemic inflammation and nutrition-based prognostic indices (SINBPI) have demonstrated significance. This study investigated the prognostic value of pretreatment SINBPI for patients with oropharyngeal cancer and identified unfavorable prognostic markers. Methods We retrospectively reviewed the data of 124 patients with oropharyngeal squamous cell carcinoma (OPSCC) who received definitive treatment between January 2010 and December 2018. The prognostic utility of the neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), prognostic nutritional index, and high-sensitivity modified Glasgow prognostic score (HS-mGPS) was assessed for disease-free survival (DFS), disease-specific survival (DSS), and overall survival (OS) using univariate and multivariate analyses. Results Multivariate analyses revealed that human papillomavirus (HPV) status and HS-mGPS were significantly associated with DFS, DSS, and OS. Patients with a HS-mGPS of 2 had a significantly higher rate of treatment-related deaths than those with a HS-mGPS of 0 or 1. The combination of the HS-mGPS and PLR had more accurate predictive ability in DFS and OS compared with the HS-mGPS alone, and the combination of the HS-mGPS and LMR had more accurate predictive ability in DSS and OS. Conclusion Our results indicated that the HS-mGPS was a useful prognostic marker for patients with OPSCC, and combined markers consisting of the HS-mGPS and PLR or LMR may provide more accurate prognostic predictions.Level of Evidence: 3.
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Affiliation(s)
- Tsunehiro Oka
- Department of Otolaryngology‐Head and Neck SurgeryKurume University School of MedicineKurumeJapan
| | - Fumihiko Sato
- Department of Otolaryngology‐Head and Neck SurgeryKurume University School of MedicineKurumeJapan
| | - Takeharu Ono
- Department of Otolaryngology‐Head and Neck SurgeryKurume University School of MedicineKurumeJapan
| | - Toshihiko Kawaguchi
- Department of Otolaryngology‐Head and Neck SurgeryKurume University School of MedicineKurumeJapan
| | | | - Shintaro Sueyoshi
- Department of Otolaryngology‐Head and Neck SurgeryKurume University School of MedicineKurumeJapan
| | - Taikai Kuroiwa
- Department of Otolaryngology‐Head and Neck SurgeryKurume University School of MedicineKurumeJapan
| | - Takashi Kurita
- Department of Otolaryngology‐Head and Neck SurgeryKurume University School of MedicineKurumeJapan
| | - Mioko Fukahori
- Department of Otolaryngology‐Head and Neck SurgeryKurume University School of MedicineKurumeJapan
| | - Toshiyuki Mitsuhashi
- Department of Otolaryngology‐Head and Neck SurgeryKurume University School of MedicineKurumeJapan
| | - Kiminobu Sato
- Department of Otolaryngology‐Head and Neck SurgeryKurume University School of MedicineKurumeJapan
| | - Shun‐Ichi Chitose
- Department of Otolaryngology‐Head and Neck SurgeryKurume University School of MedicineKurumeJapan
| | - Hirohito Umeno
- Department of Otolaryngology‐Head and Neck SurgeryKurume University School of MedicineKurumeJapan
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Volpe S, Gaeta A, Colombo F, Zaffaroni M, Mastroleo F, Vincini MG, Pepa M, Isaksson LJ, Turturici I, Marvaso G, Ferrari A, Cammarata G, Santamaria R, Franzetti J, Raimondi S, Botta F, Ansarin M, Gandini S, Cremonesi M, Orecchia R, Alterio D, Jereczek-Fossa BA. Blood- and Imaging-Derived Biomarkers for Oncological Outcome Modelling in Oropharyngeal Cancer: Exploring the Low-Hanging Fruit. Cancers (Basel) 2023; 15:cancers15072022. [PMID: 37046683 PMCID: PMC10093133 DOI: 10.3390/cancers15072022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/23/2023] [Accepted: 03/26/2023] [Indexed: 03/31/2023] Open
Abstract
Aims: To assess whether CT-based radiomics and blood-derived biomarkers could improve the prediction of overall survival (OS) and locoregional progression-free survival (LRPFS) in patients with oropharyngeal cancer (OPC) treated with curative-intent RT. Methods: Consecutive OPC patients with primary tumors treated between 2005 and 2021 were included. Analyzed clinical variables included gender, age, smoking history, staging, subsite, HPV status, and blood parameters (baseline hemoglobin levels, neutrophils, monocytes, and platelets, and derived measurements). Radiomic features were extracted from the gross tumor volumes (GTVs) of the primary tumor using pyradiomics. Outcomes of interest were LRPFS and OS. Following feature selection, a radiomic score (RS) was calculated for each patient. Significant variables, along with age and gender, were included in multivariable analysis, and models were retained if statistically significant. The models’ performance was compared by the C-index. Results: One hundred and five patients, predominately male (71%), were included in the analysis. The median age was 59 (IQR: 52–66) years, and stage IVA was the most represented (70%). HPV status was positive in 63 patients, negative in 7, and missing in 35 patients. The median OS follow-up was 6.3 (IQR: 5.5–7.9) years. A statistically significant association between low Hb levels and poorer LRPFS in the HPV-positive subgroup (p = 0.038) was identified. The calculation of the RS successfully stratified patients according to both OS (log-rank p < 0.0001) and LRPFS (log-rank p = 0.0002). The C-index of the clinical and radiomic model resulted in 0.82 [CI: 0.80–0.84] for OS and 0.77 [CI: 0.75–0.79] for LRPFS. Conclusions: Our results show that radiomics could provide clinically significant informative content in this scenario. The best performances were obtained by combining clinical and quantitative imaging variables, thus suggesting the potential of integrative modeling for outcome predictions in this setting of patients.
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Rachman A, Iriani A, Irawan C, Sukrisman L, Rajabto W, Mulansari NA, Lubis AM, Prasetyawaty F, Cahyanur R, Priantono D, Rumondor BB, Betsy R, Juanputra S. Complete blood count derived inflammatory biomarkers and the level of anti-SARS-CoV-2 NAb and S-RBD IgG among cancer survivors receiving COVID-19 vaccines. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2023. [DOI: 10.29333/ejgm/12851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
<b>Background</b>: In the era of coronavirus disease 2019 (COVID-19), it is mandatory to identify vulnerable people with cancers as they have impaired immune system that can lead to high mortality. This study analyzes the complete blood count (CBC) derived inflammatory biomarkers and the level of anti-SARS-CoV-2 neutralizing antibody (NAb) and spike protein’s receptor-binding domain immunoglobulin G (S-RBD IgG) among cancer survivors.<br />
<b>Methods</b>: A cross-sectional study was conducted in patients with either solid or hematological cancers who had received two-doses of COVID-19 vaccinations within six months.<br />
<b>Results</b>: From 119 subjects, the COVID-19 vaccines demonstrated laboratory efficacy (median NAb=129.03 AU/mL; median S-RBD IgG=270.53 AU/mL). The seropositive conversion of NAb reached 94.1% and S-RBD IgG reached 93.3%. Additionally, the S-RBD IgG had very weak correlation with absolute monocyte count (R=-0.185; <i>p</i>-value=0.044). The NAb also had very weak correlation with leukocyte (Kendall’s tau-b (τb)=-0.147; <i>p</i>-value=0.019), absolute neutrophil count (τb=-0.126; <i>p</i>-value=0.044), absolute eosinophil count (τb=-0.132; <i>p</i>-value=0.034).<br />
<b>Conclusion</b>: The seropositivity rate of anti-SARS-CoV-2 NAb and S-RBD IgG were significantly high. However, the CBC derived inflammatory biomarkers had poor correlation with anti-SARS-CoV-2 NAb and S-RBD IgG. Thus, anti-SARS-CoV-2 NAb and S-RBD IgG are currently the only reliable markers for measuring the COVID-19 vaccine efficacy which should be widely accessible.
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Affiliation(s)
- Andhika Rachman
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Dr. Cipto Mangunkusumo General Hospital-Faculty of Medicine Universitas Indonesia, Jakarta, INDONESIA
| | - Anggraini Iriani
- Department of Clinical Pathology, Yarsi University, Jakarta, INDONESIA
| | - Cosphiadi Irawan
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Dr. Cipto Mangunkusumo General Hospital-Faculty of Medicine Universitas Indonesia, Jakarta, INDONESIA
| | - Lugyanti Sukrisman
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Dr. Cipto Mangunkusumo General Hospital-Faculty of Medicine Universitas Indonesia, Jakarta, INDONESIA
| | - Wulyo Rajabto
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Dr. Cipto Mangunkusumo General Hospital-Faculty of Medicine Universitas Indonesia, Jakarta, INDONESIA
| | - Nadia Ayu Mulansari
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Dr. Cipto Mangunkusumo General Hospital-Faculty of Medicine Universitas Indonesia, Jakarta, INDONESIA
| | - Anna Mira Lubis
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Dr. Cipto Mangunkusumo General Hospital-Faculty of Medicine Universitas Indonesia, Jakarta, INDONESIA
| | - Findy Prasetyawaty
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Dr. Cipto Mangunkusumo General Hospital-Faculty of Medicine Universitas Indonesia, Jakarta, INDONESIA
| | - Rahmat Cahyanur
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Dr. Cipto Mangunkusumo General Hospital-Faculty of Medicine Universitas Indonesia, Jakarta, INDONESIA
| | - Dimas Priantono
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Dr. Cipto Mangunkusumo General Hospital-Faculty of Medicine Universitas Indonesia, Jakarta, INDONESIA
| | - Bayu Bijaksana Rumondor
- Department of Internal Medicine, Dr. Cipto Mangunkusumo General Hospital-Faculty of Medicine Universitas Indonesia, Jakarta, INDONESIA
| | - Rachelle Betsy
- Department of Internal Medicine, Dr. Cipto Mangunkusumo General Hospital-Faculty of Medicine Universitas Indonesia, Jakarta, INDONESIA
| | - Samuel Juanputra
- Department of Internal Medicine, Dr. Cipto Mangunkusumo General Hospital-Faculty of Medicine Universitas Indonesia, Jakarta, INDONESIA
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Zhang G, Yang C, Zhao C, Xian F, Qing D, Guo Q, Song J, Liu X, Bie J. Prognostic Value of the Neutrophil-to-Lymphocyte Ratio in Patients Treated with Definitive Chemoradiotherapy for Locally Advanced Oesophageal Squamous Cell Carcinoma. Cancer Manag Res 2023; 15:101-112. [PMID: 36743459 PMCID: PMC9896972 DOI: 10.2147/cmar.s395191] [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: 10/28/2022] [Accepted: 01/17/2023] [Indexed: 01/31/2023] Open
Abstract
Background The neutrophil-to-lymphocyte ratio (NLR) has been shown to have prognostic value in several common cancers. This study aimed to investigate the prognostic value of NLR in patients with advanced oesophageal squamous cell carcinoma (ESCC) after definitive chemoradiotherapy (dCRT). Methods A retrospective analysis was performed on 158 patients with advanced ESCC who received dCRT from January 2012 to December 2018. The NLR for different treatment stages was calculated based on laboratory test results. The Kaplan-Meier (KM) method and Cox proportional regression model were used to analyse the relationship between NLR and overall survival (OS). Results The mean NLR of 158 patients with ESCC was 3.403 ± 2.479. The pre-treatment NLR cut-off was 4.839, and patients were divided into the low NLR group (NLR < 4.839) and the high NLR group (NLR ≥ 4.839). NLR in patients with ESCC was related to N stage (P < 0.05). The KM analysis showed that the median OS of all enrolled patients was 29.3 months, the median OS periods of patients in the high and low NLR groups were 15.6 and 35.8 months, respectively, and the OS of the low NLR group was better than that of the high NLR group (P < 0.001). In the multivariate analysis, NLR was an independent prognostic factor that affects the prognosis of patients with ESCC receiving dCRT. Furthermore, patients who maintained a high NLR before and after treatment showed worse clinical outcomes than the other groups. Conclusion Our findings suggest that NLR can effectively assess the prognosis of patients with advanced ESCC undergoing dCRT.
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Affiliation(s)
- Guojun Zhang
- Department of Oncology, Nanchong Central Hospital and The Second Clinical Medical College of North Sichuan Medical College, Nanchong, People’s Republic of China
| | - Chuan Yang
- Department of Oncology, Guangyuan Central Hospital, Guangyuan, People’s Republic of China
| | - Caixia Zhao
- Department of Oncology, Nanchong Central Hospital and The Second Clinical Medical College of North Sichuan Medical College, Nanchong, People’s Republic of China
| | - Feng Xian
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, People’s Republic of China
| | - Dong Qing
- Department of Oncology, Nanchong Central Hospital and The Second Clinical Medical College of North Sichuan Medical College, Nanchong, People’s Republic of China
| | - Qiyu Guo
- Department of Oncology, Nanchong Central Hospital and The Second Clinical Medical College of North Sichuan Medical College, Nanchong, People’s Republic of China
| | - Junmei Song
- Department of Oncology, Nanchong Central Hospital and The Second Clinical Medical College of North Sichuan Medical College, Nanchong, People’s Republic of China
| | - Xilin Liu
- Department of Oncology, Nanchong Central Hospital and The Second Clinical Medical College of North Sichuan Medical College, Nanchong, People’s Republic of China
| | - Jun Bie
- Department of Oncology, Nanchong Central Hospital and The Second Clinical Medical College of North Sichuan Medical College, Nanchong, People’s Republic of China
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Sansa A, Valero C, Holgado A, Vásquez R, Quer M, Patel SG, León X. External validation of the H-index (host index) in patients with head and neck squamous cell carcinomas. Head Neck 2023; 45:178-186. [PMID: 36225167 DOI: 10.1002/hed.27224] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 08/22/2022] [Accepted: 10/04/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The aim of the current study is to perform an external validation of the prognostic capacity of the H-index in patients with head and neck squamous cell carcinoma (HNSCC). METHODS Retrospective study of 835 patients with HNSCC located in the oral cavity, oropharynx, hypopharynx, or larynx. RESULTS When applying the cutoffs proposed in the original description of the H-index (1.5 and 3.5), we observed an orderly and significant decrease in the disease-specific survival and overall survival as H-index increased. Additionally, we were able to observe a decrease in survival as the H-index increased regardless of the location, the extension of the tumor or the type of treatment performed. CONCLUSION We have validated the prognostic capacity of the H-index in patients with HNSCC regardless of the location of the primary tumor, the extent of the disease, or the type of treatment performed.
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Affiliation(s)
- Aina Sansa
- Department of Otorhinolaryngology, Hospital Parc Taulí, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Cristina Valero
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Anna Holgado
- Department of Otorhinolaryngology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Rosselin Vásquez
- Department of Otorhinolaryngology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Miquel Quer
- Department of Otorhinolaryngology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain
| | - Snehal G Patel
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Xavier León
- Department of Otorhinolaryngology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain.,UVIC-Universitat Central de Catalunya, Vic, Spain
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Guven DC, Erul E, Yilmaz F, Yasar S, Yildirim HC, Ercan F, Kaygusuz Y, Cayiroz K, Ucdal MT, Yesil F, Yazici G, Cengiz M, Gullu I, Aksoy S. The association between pan-immune-inflammation value and survival in head and neck squamous cell carcinoma. Eur Arch Otorhinolaryngol 2022; 280:2471-2478. [PMID: 36565325 DOI: 10.1007/s00405-022-07804-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 12/16/2022] [Indexed: 12/25/2022]
Abstract
PURPOSE A significant portion of patients with locally advanced head and neck squamous cell carcinoma (HNSCC) relapse despite multimodality treatment denoting the need for biomarkers. The pan-immune-inflammation value (PIV) is a recently developed blood count-based prognostic biomarker. We evaluated the relationship between PIV and survival in locally advanced HNSCC patients treated with chemoradiotherapy (CRT). METHODS A total of 199 patients who underwent CRT at Hacettepe University Oncology Hospital were included. The relationship between clinical and laboratory parameters with overall survival (OS) and disease-free survival (DFS) was analyzed by multivariate analyses. RESULTS The median age was 59 years and 90.5% of the patients were male. 66.8% of the patients had laryngeal primaries, and 78.9% had T3-T4 disease. 84.9% of the patients received CRT with cisplatin. The optimal PIV threshold value was calculated as 404 in ROC analyses. This PIV value had 75.8% sensitivity and 70.4% specificity for OS prediction (AUC 0.781; 95% CI 0.715-0.846; p < 0.001). In multivariate analyses, high PIV levels (≤ 404 vs. > 404, HR 2.862; 95% CI 1.553-5.276; p = 0.001), higher NLR (≤ 2.5 vs. > 2.5, HR 1.827; 95% CI 1.017-3.281; p = 0.044) levels and ECOG performance score of 2 (HR 2.267; 95% CI 1.385-3.711; p = 0.001) were associated with shorter OS. These factors were associated with shorter DFS also (HR for PIV 2.485, 95% CI 1.383-4.467, p = 0.002). CONCLUSIONS We observed shorter OS and DFS in locally advanced HNSCC patients with high PIV levels. If prospective studies support our findings, the PIV score could be a prognostic biomarker in HNSCC.
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Affiliation(s)
- Deniz Can Guven
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Enes Erul
- Department of Internal Medicine, Faculty of Medicine, Hacettepe University, 06100, Sihhiye, Ankara, Turkey.
| | - Feride Yilmaz
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Serkan Yasar
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Hasan Cagri Yildirim
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Fatih Ercan
- Department of Internal Medicine, Faculty of Medicine, Hacettepe University, 06100, Sihhiye, Ankara, Turkey
| | - Yunus Kaygusuz
- Department of Internal Medicine, Faculty of Medicine, Hacettepe University, 06100, Sihhiye, Ankara, Turkey
| | - Kerim Cayiroz
- Department of Internal Medicine, Faculty of Medicine, Hacettepe University, 06100, Sihhiye, Ankara, Turkey
| | - Mete Tugcan Ucdal
- Department of Internal Medicine, Faculty of Medicine, Hacettepe University, 06100, Sihhiye, Ankara, Turkey
| | - Furkan Yesil
- Department of Internal Medicine, Faculty of Medicine, Hacettepe University, 06100, Sihhiye, Ankara, Turkey
| | - Gozde Yazici
- Department of Radiation Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Mustafa Cengiz
- Department of Radiation Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Ibrahim Gullu
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Sercan Aksoy
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
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Prognostic Value of Lymphocyte-to-Monocyte Ratio (LMR) in Cancer Patients Undergoing Immune Checkpoint Inhibitors. DISEASE MARKERS 2022; 2022:3610038. [PMID: 36590752 PMCID: PMC9803580 DOI: 10.1155/2022/3610038] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 11/16/2022] [Accepted: 11/24/2022] [Indexed: 12/24/2022]
Abstract
Background There is accumulating evidence that the lymphocyte-to-monocyte ratio (LMR) is related to the outcomes of cancer patients treated with immune checkpoint inhibitors (ICIs). However, the results remain controversial. Method Electronic databases were searched to retrieve the studies that explore the relationship between LMR and the efficacy of ICIs. The primary endpoints were overall survival (OS) and progression-free survival (PFS), evaluated by the hazard ratios (HRs) with 95% confidence intervals (CI), and the secondary endpoints included disease control rate (DCR) and immune-related adverse events (irAEs), assessed by the odd ratios (ORs) with 95% CI. Results A total of 27 studies involving 4,322 patients were eligible for analysis. The results indicated that increased LMR at baseline was associated with a superior OS (HR: 0.46, 95% CI: 0.39-0.56, p < 0.001), PFS (HR: 0.60, 95% CI: 0.49-0.74, p < 0.001), and DCR (OR: 3.16, 95% CI: 1.70-5.87, p < 0.001). Posttreatment LMR was linked to a better PFS (HR: 0.46, 95% CI: 0.29-0.71, p = 0.001), but failed to show this correlation in the analysis of OS and DCR. No correlation existed between LMR and irAEs regardless of the testing time (baseline or posttreatment). Subgroup analyses focusing on baseline LMR revealed that higher baseline LMR possessed a better OS in renal cell cancer (RCC) arm, nonsmall cell lung cancer (NSCLC) arm, multiple cancer arm, monotherapy arm, LMR <2 arm, LMR ≥2 arm, western countries arm, eastern countries arm, and anti-PD-1 arm. Higher baseline LMR correlated with better PFS in RCC arm, NSCLC arm, gastric cancer (GC) arm, multiple cancer arm, LMR <2 arm, LMR ≥2 arm, western countries arm, and eastern countries arm. Conclusions Higher LMR at baseline was positively correlated with a superior OS, PFS, and DCR for ICIs, but not with irAEs.
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Tian BW, Yang YF, Yang CC, Yan LJ, Ding ZN, Liu H, Xue JS, Dong ZR, Chen ZQ, Hong JG, Wang DX, Han CL, Mao XC, Li T. Systemic immune-inflammation index predicts prognosis of cancer immunotherapy: systemic review and meta-analysis. Immunotherapy 2022; 14:1481-1496. [PMID: 36537255 DOI: 10.2217/imt-2022-0133] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Objective: This meta-analysis was designed to explore the association between the systemic immune-inflammation index (SII) and the therapeutic effect of immune checkpoint inhibitors. Materials & methods: The authors retrieved relevant studies published before May 25, 2022. Hazard ratio (HR) with 95% CI was used to evaluate the relationship between SII and overall survival (OS) and progression-free survival (PFS). Results: 14 articles comprising 2721 patients were included in this study. The pooled results proved that high SII levels were closely related to poor prognosis in cancer patients receiving immune checkpoint inhibitors (OS HR = 2.40; 95% CI: 2.04-2.82; PFS HR = 1.57; 95% CI: 1.33-1.86) and that an SII value of 750 was appropriate as a cut-off value (OS HR = 2.20; 95% CI: 1.83-2.63; PFS HR = 1.54; 95% CI: 1.33-1.80). Conclusion: High SII levels (>750) may be an indicator of worse OS and PFS in cancer patients treated with immune checkpoint inhibitors.
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Affiliation(s)
- Bao-Wen Tian
- Department of General Surgery, Qilu Hospital, Shandong University, Jinan, 250012, People's Republic of China
| | - Ya-Fei Yang
- Department of General Surgery, Qilu Hospital, Shandong University, Jinan, 250012, People's Republic of China
| | - Chun-Cheng Yang
- Department of General Surgery, Qilu Hospital, Shandong University, Jinan, 250012, People's Republic of China
| | - Lun-Jie Yan
- Department of General Surgery, Qilu Hospital, Shandong University, Jinan, 250012, People's Republic of China
| | - Zi-Niu Ding
- Department of General Surgery, Qilu Hospital, Shandong University, Jinan, 250012, People's Republic of China
| | - Hui Liu
- Department of General Surgery, Qilu Hospital, Shandong University, Jinan, 250012, People's Republic of China
| | - Jun-Shuai Xue
- Department of General Surgery, Qilu Hospital, Shandong University, Jinan, 250012, People's Republic of China
| | - Zhao-Ru Dong
- Department of General Surgery, Qilu Hospital, Shandong University, Jinan, 250012, People's Republic of China
| | - Zhi-Qiang Chen
- Department of General Surgery, Qilu Hospital, Shandong University, Jinan, 250012, People's Republic of China
| | - Jian-Guo Hong
- Department of General Surgery, Qilu Hospital, Shandong University, Jinan, 250012, People's Republic of China
| | - Dong-Xu Wang
- Department of General Surgery, Qilu Hospital, Shandong University, Jinan, 250012, People's Republic of China
| | - Cheng-Long Han
- Department of General Surgery, Qilu Hospital, Shandong University, Jinan, 250012, People's Republic of China
| | - Xin-Cheng Mao
- Department of General Surgery, Qilu Hospital, Shandong University, Jinan, 250012, People's Republic of China
| | - Tao Li
- Department of Hepatobiliary Surgery, Second Hospital of Shandong University, Jinan, 250012, People's Republic of China
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Monocyte-Lymphocyte Ratio and Dysglycemia: A Retrospective, Cross-Sectional Study of the Saudi Population. Healthcare (Basel) 2022; 10:healthcare10112289. [PMID: 36421613 PMCID: PMC9690849 DOI: 10.3390/healthcare10112289] [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: 11/01/2022] [Revised: 11/10/2022] [Accepted: 11/13/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Abnormalities in fasting blood glucose (FBG) resulting in hypoglycemia (OG), impaired fasting glycemia (IFG), or hyperglycemia (HG) arise from disordered metabolic regulation caused in part by inflammation. To date, there is a dearth of evidence regarding the clinical utility of the monocyte−lymphocyte ratio (MLR), an emerging inflammatory index, in the management of dysglycemia. Methods: This retrospective, cross-sectional study explored MLR fluctuations as a function of glycemic control in 14,173 Saudi subjects. Data collected from 11 August 2014 to 18 July 2020 were retrieved from Al-Borg Medical Laboratories. Medians were compared by Mann−Whitney U or Kruskal−Wallis tests and the prevalence, relative risk (RR), and odds ratio (OR) were calculated. Results: MLR was significantly elevated in IFG (p < 0.0001) and HG (p < 0.05) groups compared to the normoglycemia (NG) group, and individuals with elevated MLR (>0.191) had significantly increased FBG (p < 0.001). The risk of IFG (RR = 1.12, 95% CI: 1.06−1.19, p < 0.0002) and HG (RR = 1.10, 95% CI: 1.01−1.20, p < 0.0216) was significantly increased if MLR was elevated, and individuals with elevated MLR were 1.17 times more likely to have IFG (OR = 1.17, 95% CI: 1.08−1.26, p < 0.0002) and 1.13 times more likely to have HG (OR = 1.13, 95% CI: 1.02−1.24, p < 0.0216). Conclusion: Elevated MLR is correlated with and carries a greater risk for IFG and HG. However, large prospective cohort studies are needed to establish the temporal relationship between MLR and FBG and to examine the prognostic value of this novel marker.
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Li Y, Zhao D, Liu G, Liu Y, Bano Y, Ibrohimov A, Chen H, Wu C, Chen X. Intradialytic hypotension prediction using covariance matrix-driven whale optimizer with orthogonal structure-assisted extreme learning machine. Front Neuroinform 2022; 16:956423. [PMID: 36387587 PMCID: PMC9659657 DOI: 10.3389/fninf.2022.956423] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 09/28/2022] [Indexed: 09/19/2023] Open
Abstract
Intradialytic hypotension (IDH) is an adverse event occurred during hemodialysis (HD) sessions with high morbidity and mortality. The key to preventing IDH is predicting its pre-dialysis and administering a proper ultrafiltration prescription. For this purpose, this paper builds a prediction model (bCOWOA-KELM) to predict IDH using indices of blood routine tests. In the study, the orthogonal learning mechanism is applied to the first half of the WOA to improve the search speed and accuracy. The covariance matrix is applied to the second half of the WOA to enhance the ability to get out of local optimum and convergence accuracy. Combining the above two improvement methods, this paper proposes a novel improvement variant (COWOA) for the first time. More, the core of bCOWOA-KELM is that the binary COWOA is utilized to improve the performance of the KELM. In order to verify the comprehensive performance of the study, the paper sets four types of comparison experiments for COWOA based on 30 benchmark functions and a series of prediction experiments for bCOWOA-KELM based on six public datasets and the HD dataset. Finally, the results of the experiments are analyzed separately in this paper. The results of the comparison experiments prove fully that the COWOA is superior to other famous methods. More importantly, the bCOWOA performs better than its peers in feature selection and its accuracy is 92.41%. In addition, bCOWOA improves the accuracy by 0.32% over the second-ranked bSCA and by 3.63% over the worst-ranked bGWO. Therefore, the proposed model can be used for IDH prediction with future applications.
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Affiliation(s)
- Yupeng Li
- College of Computer Science and Technology, Changchun Normal University, Changchun, China
| | - Dong Zhao
- College of Computer Science and Technology, Changchun Normal University, Changchun, China
| | - Guangjie Liu
- College of Computer Science and Technology, Changchun Normal University, Changchun, China
| | - Yi Liu
- Department of Nephrology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yasmeen Bano
- Department of Nephrology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Alisherjon Ibrohimov
- Department of Nephrology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Huiling Chen
- College of Computer Science and Artificial Intelligence, Wenzhou University, Wenzhou, China
| | - Chengwen Wu
- College of Computer Science and Artificial Intelligence, Wenzhou University, Wenzhou, China
| | - Xumin Chen
- Department of Nephrology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou University, Wenzhou, China
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OCT-Based Biomarkers are Associated with Systemic Inflammation in Patients with Treatment-Naïve Diabetic Macular Edema. Ophthalmol Ther 2022; 11:2153-2167. [PMID: 36166152 DOI: 10.1007/s40123-022-00576-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 09/12/2022] [Indexed: 10/14/2022] Open
Abstract
INTRODUCTION Diabetic macular edema (DME) is one of the major sight-threatening complications of diabetic retinopathy, which is associated with retinal inflammation. However, it is still unknown whether DME is associated with systemic inflammation. The study aimed to investigate the association between systemic inflammatory and optical coherence tomography (OCT) biomarkers in patients with treatment-naïve center-involving diabetic macular edema (DME) and to further explore the role of systemic inflammation in DME. METHODS Medical records including clinical characteristics and ophthalmic examinations were collected from patients with treatment-naïve center-involving DME. Systemic inflammation markers including systemic immune-inflammatory index (SII), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) were calculated. OCT biomarkers, including intraretinal cyst (IRC) size, disorganization of retinal inner layers (DRIL), external limiting membrane (ELM)/ellipsoid zone (EZ) integrity, retinal hyperreflective foci (HRF), subretinal fluid (SRF) and vitreomacular (VM) status were evaluated manually. Correlation analysis and multivariable linear regression models were used to investigate the relationship between systemic inflammatory markers and OCT biomarkers. RESULTS A total of 82 patients with treatment-naïve center-involving DME were included. The number of HRF on OCT was correlated with SII, NLR, and PLR and positively associated with SII (p < 0.001) in both univariate and multivariate linear regression analyses. The differences remained largely the same during subgroup analysis controlling DM duration, SRF, and ELM/EZ integrity. No significant association was observed between other OCT biomarkers and blood inflammatory markers. CONCLUSION Retinal HRF in diabetic macular edema is associated with blood inflammatory markers, which supports the theory of HRF's inflammatory nature and emphasizes the important role of inflammation in DME. SII may be a potential marker for DME treatment decisions.
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Yan W, Ou X, Shen C, Hu C. A nomogram involving immune-inflammation index for predicting distant metastasis-free survival of major salivary gland carcinoma following postoperative radiotherapy. Cancer Med 2022; 12:2772-2781. [PMID: 36052414 PMCID: PMC9939092 DOI: 10.1002/cam4.5167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 07/23/2022] [Accepted: 07/24/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Postoperative radiotherapy (PORT) is beneficial in the improvement of local-regional control and overall survival (OS) for major salivary gland carcinomas (SGCs), and distant metastasis remained the main failure pattern. This study was designed to develop a nomogram model involving immune-inflammation index to predict distant metastasis-free survival (DMFS) of major SGCs. PATIENTS AND METHODS A total of 418 patients with major SGCs following PORT were randomly divided into a training (n = 334) and validation set (n = 84). The pre-radiotherapy neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) were calculated and transformed as continuous variables for every patient. Associations between DMFS and variables were performed by univariate and multivariable analysis using Log-rank and Cox regression methods. A nomogram was constructed based on the prognostic factors identified by the Cox hazards model. The decision curve analysis (DCA) was conducted with the training and validation set. RESULTS The estimated 3-, 5-, and 10-year DMFS were 79.4%, 71.8%, and 59.1%, respectively. The multivariate analysis revealed that age (p = 0.033), advanced T stage (p = 0.003), positive N stage (p < 0.001), high-risk pathology (p = 0.011), and high PLR (p = 0.001) were significantly associated with worse DMFS. The nomogram showed good calibration and discrimination in the training (AUC = 80.9) and validation set (AUC = 87.9). Furthermore, the DCA demonstrated favorable applicability, and a significant difference (p < 0.001) was observed for the DMFS between the subgroups based on the nomogram points. CONCLUSION The nomogram incorporating clinicopathological features and PLR presented accurate individual prediction for DMFS of the patients with major SGCs following PORT. Further external validation of the model is warranted for clinical utility.
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Affiliation(s)
- Wenbin Yan
- Department of Radiation OncologyFudan University Shanghai Cancer CenterShanghaiChina,Department of OncologyShanghai Medical CollegeShanghaiChina
| | - Xiaomin Ou
- Department of Radiation OncologyFudan University Shanghai Cancer CenterShanghaiChina,Department of OncologyShanghai Medical CollegeShanghaiChina
| | - Chunying Shen
- Department of Radiation OncologyFudan University Shanghai Cancer CenterShanghaiChina,Department of OncologyShanghai Medical CollegeShanghaiChina
| | - Chaosu Hu
- Department of Radiation OncologyFudan University Shanghai Cancer CenterShanghaiChina,Department of OncologyShanghai Medical CollegeShanghaiChina
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Li J, Yang W, Yuan Y, Zuo M, Li T, Wang Z, Liu Y. Preoperative Naples prognostic score is a reliable prognostic indicator for newly diagnosed glioblastoma patients. Front Oncol 2022; 12:775430. [PMID: 36052263 PMCID: PMC9424989 DOI: 10.3389/fonc.2022.775430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 07/08/2022] [Indexed: 11/13/2022] Open
Abstract
Background Glioblastoma (GBM) accounts for approximately 80% of malignant gliomas and is characterized by considerable cellularity and mitotic activity, vascular proliferation, and necrosis. Naples prognostic score (NPS), based on inflammatory markers and nutritional status, has a prognostic ability in various cancers. In the current study, we aim to explore the prognostic value of operative NPS in GBM patients and compare the prognostic ability between NPS and controlling nutritional status (CONUT). Materials and methods The retrospective analysis was carried out on consecutive newly diagnosed GBM patients who had underwent tumor resection at West China Hospital from February 2016 to March 2019. All statistical analyses were conducted using SPSS software and R software. Results A total of 276 newly diagnosed GBM patients were enrolled in the current study. Overall survival (OS) (p < 0.001) and tumor location (p = 0.007) were significantly related to NPS. Serum albumin concentrate, cholesterol concentrate, neutrophil-to-lymphocyte ratio, lymphocyte ratio, and CONUT score were all significantly associated with NPS (p < 0.001). The Kaplan–Meier curve indicated that NPS (log-rank test, p < 0.001) and CONUT score (log-rank test, p = 0.023) were significantly associated with OS. Multivariate Cox regression revealed that both NPS and CONUT score served as independent prognostic indicators. The prognostic model with NPS had the strongest prognostic capability and best model-fitting. Conclusion In the current study, NPS is found as an independent prognostic indicator for patients with newly diagnosed GBM, and the prognostic ability of NPS is superior to CONUT score.
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González-Moles MÁ, Warnakulasuriya S, López-Ansio M, Ramos-García P. Hallmarks of Cancer Applied to Oral and Oropharyngeal Carcinogenesis: A Scoping Review of the Evidence Gaps Found in Published Systematic Reviews. Cancers (Basel) 2022; 14:cancers14153834. [PMID: 35954497 PMCID: PMC9367256 DOI: 10.3390/cancers14153834] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/04/2022] [Accepted: 08/04/2022] [Indexed: 02/07/2023] Open
Abstract
Simple Summary This scoping review of systematic reviews aims to accurately assess the degree of existing scientific evidence on the cancer hallmarks proposed in 2011 by Hanahan and Weinberg, in the form of systematic reviews and meta-analyses, applied to oral potentially malignant disorders, oral cavity and oropharyngeal squamous cell carcinomas, in order to point out gaps in evidence and lines of research that should be implemented in the future to improve the malignant transformation prediction, diagnosis and/or prognosis of these diseases. Abstract In 2000 and 2011, Hanahan and Weinberg published two papers in which they defined the characteristics that cells must fulfil in order to be considered neoplastic cells in all types of tumours that affect humans, which the authors called “hallmarks of cancer”. These papers have represented a milestone in our understanding of the biology of many types of cancers and have made it possible to reach high levels of scientific evidence in relation to the prognostic impact that these hallmarks have on different tumour types. However, to date, there is no study that globally analyses evidence-based knowledge on the importance of these hallmarks in oral and oropharyngeal squamous cell carcinomas. For this reason, we set out to conduct this scoping review of systematic reviews with the aim of detecting evidence gaps in relation to the relevance of the cancer hallmarks proposed by Hanahan and Weinberg in oral and oropharyngeal cancer, and oral potentially malignant disorders, and to point out future lines of research in this field.
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Affiliation(s)
- Miguel Ángel González-Moles
- School of Dentistry, University of Granada, 18011 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
| | - Saman Warnakulasuriya
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London SE1 9RT, UK
- WHO Collaborating for Oral Cancer, King's College London, London SE1 9RT, UK
| | - María López-Ansio
- School of Dentistry, University of Granada, 18011 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
| | - Pablo Ramos-García
- School of Dentistry, University of Granada, 18011 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
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Chen YW, Tucker MD, Brown LC, Yasin HA, Ancell KK, Armstrong AJ, Beckermann KE, Davis NB, Harrison MR, Kaiser EG, McAlister RK, Schaffer KR, Wallace DE, George DJ, Rathmell WK, Rini BI, Zhang T. The Association between a Decrease in On-Treatment Neutrophil-to-Eosinophil Ratio (NER) at Week 6 after Ipilimumab Plus Nivolumab Initiation and Improved Clinical Outcomes in Metastatic Renal Cell Carcinoma. Cancers (Basel) 2022; 14:cancers14153830. [PMID: 35954493 PMCID: PMC9367298 DOI: 10.3390/cancers14153830] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/23/2022] [Accepted: 07/27/2022] [Indexed: 11/16/2022] Open
Abstract
A lower baseline neutrophil-to-eosinophil ratio (NER) has been associated with improved responses to immune checkpoint inhibitors (ICI)-treated metastatic renal cell carcinoma (mRCC). This study investigated the decrease in NER at week 6 after ipilimumab/nivolumab (ipi/nivo) initiation and treatment responses in mRCC. A retrospective study of ipi/nivo-treated mRCC at two US academic cancer centers was conducted. A landmark analysis at week 6 was performed to assess the association between the change in NER and clinical responses (progression-free survival (PFS)/overall survival (OS)). Week 6 NER was modeled as a continuous variable, after log transformation (Ln NER), and a categorical variable by percent change. There were 150 mRCC patients included: 78% had clear cell histology, and 78% were IMDC intermediate/poor risk. In multivariable regression analysis, every decrease of 1 unit of Ln NER at week 6 was associated with improved PFS (adjusted hazard ratio (AHR): 0.78, p-value:0.005) and OS (AHR: 0.67, p-value: 0.002). When NER was modeled by percent change, decreased NER > 50% was associated with improved PFS (AHR: 0.55, p-value: 0.03) and OS (AHR: 0.37, p-value: 0.02). The decrease in week 6 NER was associated with improved PFS/OS in ipi/nivo-treated mRCC. Prospective studies are warranted to validate NER change as a biomarker to predict ICI responses.
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Affiliation(s)
- Yu-Wei Chen
- Division of Hematology Oncology, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN 37232, USA
| | - Matthew D. Tucker
- Division of Hematology Oncology, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN 37232, USA
- Grandview Cancer Center, Alabama Oncology, 3670 Grandview Pkwy, Birmingham, AL 35243, USA
| | - Landon C. Brown
- Levine Cancer Institute, Atrium Health, 1021 Morehead Medical Drive, Charlotte, NC 28204, USA
| | - Hesham A. Yasin
- Division of Hematology Oncology, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN 37232, USA
| | - Kristin K. Ancell
- Division of Hematology Oncology, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN 37232, USA
| | - Andrew J. Armstrong
- Duke Cancer Institute, 2 Seeley Mudd, 10 Bryan Searle Drive, Durham, NC 27710, USA
| | - Kathryn E. Beckermann
- Division of Hematology Oncology, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN 37232, USA
| | - Nancy B. Davis
- Division of Hematology Oncology, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN 37232, USA
| | - Michael R. Harrison
- Duke Cancer Institute, 2 Seeley Mudd, 10 Bryan Searle Drive, Durham, NC 27710, USA
| | - Elizabeth G. Kaiser
- Division of Hematology Oncology, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN 37232, USA
| | - Renee K. McAlister
- Division of Hematology Oncology, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN 37232, USA
| | - Kerry R. Schaffer
- Division of Hematology Oncology, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN 37232, USA
| | - Deborah E. Wallace
- Division of Hematology Oncology, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN 37232, USA
| | - Daniel J. George
- Duke Cancer Institute, 2 Seeley Mudd, 10 Bryan Searle Drive, Durham, NC 27710, USA
| | - W. Kimryn Rathmell
- Division of Hematology Oncology, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN 37232, USA
| | - Brian I. Rini
- Division of Hematology Oncology, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN 37232, USA
| | - Tian Zhang
- Duke Cancer Institute, 2 Seeley Mudd, 10 Bryan Searle Drive, Durham, NC 27710, USA
- Division of Hematology Oncology, UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390, USA
- Correspondence: ; Tel.: +1-214-648-4180
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Yazaki LG, Faria JCP, de Souza FIS, Sarni ROS. Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios of overweight children and adolescents. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2022; 68:1006-1010. [PMID: 36134828 PMCID: PMC9574978 DOI: 10.1590/1806-9282.20211253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 06/02/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE This study aimed to compare neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio of overweight children and adolescents with the eutrophic ratios and to verify whether these ratios are associated with age, inflammation, Z-score of body mass index, and waist-to-height ratio. METHODS This is a cross-sectional study involving 64 overweight and 106 eutrophic children and adolescents. Data on weight, height, and waist circumference (body mass index and waist-to-height ratio), blood count (neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio), and high-sensitivity C-reactive protein were collected. RESULTS The mean age of participants was 8.4±3.2 years. The ratios did not differ between the overweight and non-overweight groups. The platelet-to-lymphocyte ratio has shown a direct and independent association with body mass index (p=0.031) and waist-to-height ratio (p=0.018), a fact not observed for neutrophil-to-lymphocyte ratio. The ultrasensitive C-reactive protein level was higher in the obesity group (p=0.003). Both ratios had a direct and independent association with age. CONCLUSION The ratios did not differ between the overweight and non-overweight groups. There was a direct and independent association of platelet-to-lymphocyte ratio with overweight, not observed in neutrophil-to-lymphocyte ratio. The ratios have significantly increased according to the age of the participants.
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Affiliation(s)
| | - João Carlos Pina Faria
- Universidade Nove de Julho, Centro Universitário Faculdade de Medicina do ABC, Pediatrician and Pediatric Hematologist – São Paulo (SP), Brazil
- Corresponding author:
| | - Fabíola Isabel Suano de Souza
- Universidade Federal de São Paulo, Centro Universitário Faculdade de Medicina do ABC, Pediatrician and Pediatric Nutrologist – São Paulo (SP), Brazil
| | - Roseli Oselka Saccardo Sarni
- Universidade Federal de São Paulo, Centro Universitário Faculdade de Medicina do ABC, Pediatrician and Pediatric Nutrologist – São Paulo (SP), Brazil
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Ruiz-Ranz M, Lequerica-Fernández P, Rodríguez-Santamarta T, Suárez-Sánchez FJ, López-Pintor RM, García-Pedrero JM, de Vicente JC. Prognostic implications of preoperative systemic inflammatory markers in oral squamous cell carcinoma, and correlations with the local immune tumor microenvironment. Front Immunol 2022; 13:941351. [PMID: 35958590 PMCID: PMC9360320 DOI: 10.3389/fimmu.2022.941351] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 06/15/2022] [Indexed: 11/19/2022] Open
Abstract
Purpose The aim of this study was to investigate the prognostic significance of preoperative inflammatory markers in peripheral blood of patients with oral squamous cell carcinoma (OSCC), and to establish correlations with the infiltrate of macrophages and lymphocytes in the local immune tumor microenvironment (TME). Materials and Methods Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), lymphocyte-monocyte ratio (LMR), and systemic immune-inflammation index (SII) were retrospectively evaluated in a cohort of 348 OSCC patients, and correlated with overall (OS) and disease-specific survival (DSS). Immunohistochemical analysis of tumoral and stromal infiltration of CD8+, CD4+, FOXP3+ and CD20+ lymphocytes and CD68+ and CD163+ macrophages was performed in a subset of 119 OSCC patient samples, and correlations further assessed. Results NLR, SII, and LMR were significantly associated with a poorer OS in univariate analysis; however, only NLR remained a significant independent predictor in the multivariate analysis (HR = 1.626, p = 0.04). NLR and SII were inversely and significantly correlated with stromal infiltration of CD8+, CD4+, and CD20+ lymphocytes. Moreover, a significant correlation between LMR was also found to significantly associate with stromal infiltration of CD8+, CD4+, and CD20+ lymphocytes, stromal CD68+ and CD163+ macrophages, and also tumoral infiltration of CD4+ and CD20+ lymphocytes. Conclusions Preoperative NLR, SII, and LMR may serve as valuable systemic markers to predict OSCC patient survival, with NLR emerging as an independent predictor of poor OS. Moreover, strong significant correlations were exclusively observed between systemic inflammatory markers and the local stromal infiltration of lymphocytes in the TME.
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Affiliation(s)
- Marta Ruiz-Ranz
- Department of Oral and Maxillofacial Surgery, Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain
| | - Paloma Lequerica-Fernández
- Department of Biochemistry, Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Instituto Universitario de Oncología del Principado de Asturias (IUOPA), Universidad de Oviedo, Oviedo, Spain
| | - Tania Rodríguez-Santamarta
- Department of Oral and Maxillofacial Surgery, Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Instituto Universitario de Oncología del Principado de Asturias (IUOPA), Universidad de Oviedo, Oviedo, Spain
| | | | - Rosa M. López-Pintor
- ORALMED Research Group, Department of Dental Clinical Specialties, School of Dentistry, Complutense University, Madrid, Spain
| | - Juana M. García-Pedrero
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Instituto Universitario de Oncología del Principado de Asturias (IUOPA), Universidad de Oviedo, Oviedo, Spain
- Department of Otolaryngology, Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto de Salud Carlos III, Madrid, Spain
- *Correspondence: Juan C. de Vicente, ; Juana M. García-Pedrero,
| | - Juan C. de Vicente
- Department of Oral and Maxillofacial Surgery, Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Instituto Universitario de Oncología del Principado de Asturias (IUOPA), Universidad de Oviedo, Oviedo, Spain
- Department of Surgery, University of Oviedo, Oviedo, Spain
- *Correspondence: Juan C. de Vicente, ; Juana M. García-Pedrero,
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Zhang Y, Chen S, Chen H, Li W. A comprehensive analysis of Glasgow Prognostic Score (GPS)/the modified Glasgow Prognostic Score (mGPS) on immune checkpoint inhibitor efficacy among patients with advanced cancer. Cancer Med 2022; 12:38-48. [PMID: 35702873 PMCID: PMC9844653 DOI: 10.1002/cam4.4940] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 04/22/2022] [Accepted: 05/05/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND The association between Glasgow Prognostic Score (GPS) and the modified Glasgow Prognostic Score (mGPS) and clinical outcomes in patients receiving immune checkpoint inhibitors (ICIs) remains controversial. Thus, this meta-analysis aimed to examine the prognostic performance of GPS and mGPS in patients treated with ICIs. METHODS Eligible studies were retrieved from searches of EMBASE, PubMed, Web of Science, and Cochrane Library until July 2021. The hazard ratio (HR) and 95% confidence intervals (CIs) were pooled by using fixed-effect or random-effects model to evaluate the influence of GPS/mGPS on overall survival (OS) and progression-free survival (PFS). RESULTS A total of 1164 patients were included. Overall, mGPS score of 2 and 1 were related to inferior OS (p < 0.001) and PFS (p < 0.001). Subgroup analyses showed no significant association between mGPS score of 1 and OS in patients with non-small cell lung cancer (NSCLC), while this score was significantly associated with poor PFS in patients with NSCLC and head and neck squamous cell carcinoma. Higher GPS (score of 1 or 2) were associated with poor clinical outcomes (OS: p < 0.001; PFS: p = 0.036). Subgroup analysis showed high GPS levels were linked to worse OS in patients with NSCLC and gastric cancer, but not for PFS in these patients. Regarding test time point, GPS was related to worse OS and PFS in pre-treatment GPS group, but not in post-treatment GPS group. CONCLUSION GPS and mGPS showed great potential to predict survival in patients treated with ICIs. Large and perspective trial are warranted to further validate these findings.
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Affiliation(s)
- Yongchao Zhang
- Cancer Center, Beijing Ditan HospitalCapital Medical UniversityBeijingPeople's Republic of China
| | - Shanshan Chen
- Cancer Center, Beijing Ditan HospitalCapital Medical UniversityBeijingPeople's Republic of China
| | - Hualei Chen
- Cancer Center, Beijing Ditan HospitalCapital Medical UniversityBeijingPeople's Republic of China
| | - Wei Li
- Cancer Center, Beijing Ditan HospitalCapital Medical UniversityBeijingPeople's Republic of China
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45
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Yang W, Zheng X, Wu M, Zhang F, Xu S, Wang X, Song M, You C, Zhang T, Jiang M, Ding C. Development and validation of postoperative and preoperative platelets ratio (PPR) to predict the prognosis of patients undergoing surgery for colorectal cancer: A dual-center retrospective cohort study. Cancer Med 2022; 12:111-121. [PMID: 35689440 PMCID: PMC9844599 DOI: 10.1002/cam4.4930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/16/2022] [Accepted: 05/28/2022] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Platelets occupy a prominent place in tumor proliferation and metastasis, and platelet count is relevant to the prognosis of tumor patients. But preoperative platelet counts cannot be standardized and individualized due to the variability among individuals, instruments, and regions, and the connection between postoperative platelet count and prognosis remains unknown. A standardized indicator of platelet count was designed to forecast the prognosis of colorectal cancer (CRC). METHODS Five hundred and eighty six patients who suffered radical resection of CRC between 2013 and 2019 were collected. A development-validation cohort of standardized and individualized platelet counts for prognostic assessment of CRC was designed. We first determined the ability of PPR and other peripheral blood count-related indicators to predict the mortality of patients with CRC and validated them in a separate cohort. Kaplan-Meier analysis was executed to evaluate the survival and univariate and multivariate analyses were executed to explore the relevance. Time-dependent ROC was measured to estimate the predictive usefulness. Decision curve analysis was used to verify the clinical net benefit. RESULTS Important baseline variables showed a similar distribution in two independent queues. In the development cohort, postoperative platelet count and postoperative/preoperative platelets ratio (PPR) were independent predictors of prognosis in CRC patients. PPR showed the largest area under the curve (AUC) in evaluating 1-year and 5-year OS (AUC: 0.702 and 0.620) compared to others. In the validation cohort, platelet/lymphocyte ratio and PPR were validated to be independently concerned about OS of CRC patients and PPR showed the largest AUC in evaluating 1-year and 3-year OS (AUC: 0.663 and 0.673). PPR and joint index of platelet count and PPR showed better predictive value and clinical net benefit. CONCLUSIONS PPR has been identified and validated to be independently concerned about OS of patients with CRC and was a reliable and economic indicator to evaluate the prognosis.
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Affiliation(s)
- Wei Yang
- School of Laboratory Medicine and Life ScienceWenzhou Medical UniversityWenzhouZhejiangChina,Key Laboratory of Laboratory Medicine, Ministry of EducationWenzhou Medical UniversityWenzhouZhejiangChina
| | - Xiaoying Zheng
- Clinical Laboratory CenterTaizhou First People's HospitalTaizhouZhejiangChina
| | - Minghui Wu
- Clinical Laboratory CenterThe Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical UniversityWenzhouZhejiangChina
| | - Fengming Zhang
- School of Laboratory Medicine and Life ScienceWenzhou Medical UniversityWenzhouZhejiangChina,Key Laboratory of Laboratory Medicine, Ministry of EducationWenzhou Medical UniversityWenzhouZhejiangChina
| | - Shuizhi Xu
- School of Laboratory Medicine and Life ScienceWenzhou Medical UniversityWenzhouZhejiangChina,Key Laboratory of Laboratory Medicine, Ministry of EducationWenzhou Medical UniversityWenzhouZhejiangChina
| | - Xiuchao Wang
- School of Laboratory Medicine and Life ScienceWenzhou Medical UniversityWenzhouZhejiangChina,Key Laboratory of Laboratory Medicine, Ministry of EducationWenzhou Medical UniversityWenzhouZhejiangChina
| | - Menghui Song
- School of Laboratory Medicine and Life ScienceWenzhou Medical UniversityWenzhouZhejiangChina,Key Laboratory of Laboratory Medicine, Ministry of EducationWenzhou Medical UniversityWenzhouZhejiangChina
| | - Chang You
- Clinical Laboratory CenterThe Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical UniversityWenzhouZhejiangChina
| | - Ting Zhang
- Clinical Laboratory CenterThe Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical UniversityWenzhouZhejiangChina
| | - Minghua Jiang
- Clinical Laboratory CenterThe Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical UniversityWenzhouZhejiangChina
| | - Chunming Ding
- School of Laboratory Medicine and Life ScienceWenzhou Medical UniversityWenzhouZhejiangChina,Key Laboratory of Laboratory Medicine, Ministry of EducationWenzhou Medical UniversityWenzhouZhejiangChina
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Tan J, Song G, Wang S, Dong L, Liu X, Jiang Z, Qin A, Tang Y, Qin W. Platelet-to-Albumin Ratio: A Novel IgA Nephropathy Prognosis Predictor. Front Immunol 2022; 13:842362. [PMID: 35664006 PMCID: PMC9162245 DOI: 10.3389/fimmu.2022.842362] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 04/20/2022] [Indexed: 02/05/2023] Open
Abstract
Background Chronic inflammation is related to the development of IgA nephropathy (IgAN). Emerging studies have reported that platelet-related parameters including platelet (PLT), platelet-to-albumin ratio (PAR), and platelet-to-lymphocyte ratio (PLR) are proved to be novel prognostic indicators for several inflammatory diseases. Whether platelet-related parameters could serve as predictors for IgAN remains unknown. Methods A total of 966 IgAN patients were enrolled in this retrospective study and were divided into several groups based on the optimal cut-off value of the platelet-related parameters. End-stage renal disease was used as the renal endpoint. A 1:2 propensity score (PS) match was then carried out to eliminate significant differences at baseline. The area under the receiver operating characteristic curve (AUROC), Kaplan–Meier (K-M) curve, and Cox proportional hazards analyses were performed to evaluate their predictive effect. Results Without considering the effect of covariates, the K-M curve showed that PLT, PLR, and PAR were strongly correlated with the renal outcomes of IgAN. However, the AUROC revealed that the PAR and PLR had better predictive power than the PLT. Multivariate Cox regression adjusting for demographic data, pathological findings, treatment, and laboratory results indicated that compared with PLR, albumin and PLT, PAR seemed to be a better marker of adverse renal outcome, implying that PAR was the only platelet-related parameter that could be used as an independent risk factor. Notably, high PAR patients seemed to have more severe clinical manifestations and pathological lesions. However, after eliminating the influence of different baselines on outcome variables, the PAR could still predict the poor prognosis of IgAN. To more accurately evaluate the predictive power of the PAR, we analyzed the predictive effect of the PAR on patients with different clinicopathological characteristics through subgroup analysis. It was indicated that the PAR might better predict the prognosis and outcome of patients whose disease was already very severe. Conclusion PAR might be used as an independent risk factor for IgAN progression.
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Affiliation(s)
- Jiaxing Tan
- Division of Nephrology, Department of Medicine, West China Hospital, Sichuan University, Chengdu, China.,West China School of Medicine, Sichuan University, Chengdu, China
| | - Guojiao Song
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Siqing Wang
- Division of Nephrology, Department of Medicine, West China Hospital, Sichuan University, Chengdu, China.,West China School of Medicine, Sichuan University, Chengdu, China
| | - Lingqiu Dong
- Division of Nephrology, Department of Medicine, West China Hospital, Sichuan University, Chengdu, China.,West China School of Medicine, Sichuan University, Chengdu, China
| | - Xiang Liu
- Division of Nephrology, Department of Medicine, West China Hospital, Sichuan University, Chengdu, China.,West China School of Medicine, Sichuan University, Chengdu, China
| | - Zheng Jiang
- Division of Nephrology, Department of Medicine, West China Hospital, Sichuan University, Chengdu, China.,West China School of Medicine, Sichuan University, Chengdu, China
| | - Aiya Qin
- Division of Nephrology, Department of Medicine, West China Hospital, Sichuan University, Chengdu, China.,West China School of Medicine, Sichuan University, Chengdu, China
| | - Yi Tang
- Division of Nephrology, Department of Medicine, West China Hospital, Sichuan University, Chengdu, China.,West China School of Medicine, Sichuan University, Chengdu, China
| | - Wei Qin
- Division of Nephrology, Department of Medicine, West China Hospital, Sichuan University, Chengdu, China.,West China School of Medicine, Sichuan University, Chengdu, China
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Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio Impact on Predicting Outcomes in Patients with Acute Limb Ischemia. Life (Basel) 2022; 12:life12060822. [PMID: 35743853 PMCID: PMC9225565 DOI: 10.3390/life12060822] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/21/2022] [Accepted: 05/30/2022] [Indexed: 11/30/2022] Open
Abstract
Acute Limb Ischemia (ALI) of the lower limb is defined as a sudden drop in arterial limb perfusion, which is a medical emergency requiring prompt intervention with high amputation and mortality rates in the absence of revascularization. This observational, analytical, and retrospective cohort study with longitudinal follow-up aimed to confirm the relevance of the preoperative inflammatory biomarkers neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in predicting the 30-day poor prognosis of patients with Rutherford classification (RC) grades II and III ALI. The ROC analysis found a strong association of an NLR > 4.33 with all studied outcomes, while a PLR > 143.34 was associated with all studied outcomes, except the composite endpoint in all RC stages. Depending on the optimal cut-off value, the ROC analysis found a higher incidence of all adverse outcomes in all high NLR (>4.33) and high PLR (>143.34) groups. A multivariate analysis showed that a high baseline value for NLR and PLR was an independent predictor of amputation (OR:11.09; 95% CI: 5.48−22.42; p < 0.0001; and OR:8.97; 95% CI: 4.44−18.16; p < 0.0001), mortality (OR:22.24; 95% CI: 9.61−51.47; p < 0.0001; and OR:8.32; 95% CI: 3.90−17.73; p < 0.0001), and composite endpoint (OR:21.93; 95% CI: 7.91−60.79; p < 0.0001; and OR:9.98; 95% CI: 3.89−25.55; p < 0.0001), respectively. Furthermore, for all hospitalized patients, the RC grade III (OR:7.33; 95% CI: 3.73−14.26; p < 0.0001) was an independent predictor of amputation (OR:7.33; 95% CI: 3.73−14.26; p < 0.0001), mortality (OR:8.40; 95% CI: 4.08−17.31; p < 0.0001), and composite endpoint (OR: 10.70; 95% CI: 4.48−25.56; p < 0.0001), respectively. The NLR and PLR are excellent predictors of risks associated with ALI for primary and secondary prevention. Our study showed that increased pre-operative values for NLR and PLR are indicators of a poor outcome in patients with RC grades II and III ALI.
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Guven DC, Sahin TK, Erul E, Kilickap S, Gambichler T, Aksoy S. The Association between the Pan-Immune-Inflammation Value and Cancer Prognosis: A Systematic Review and Meta-Analysis. Cancers (Basel) 2022; 14:2675. [PMID: 35681656 PMCID: PMC9179577 DOI: 10.3390/cancers14112675] [Citation(s) in RCA: 58] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 05/25/2022] [Accepted: 05/27/2022] [Indexed: 01/27/2023] Open
Abstract
Background: Prognostic scores derived from the blood count have garnered significant interest as an indirect measure of the inflammatory pressure in cancer. The recently developed pan-immune-inflammation value (PIV), an equation including the neutrophil, platelet, monocyte, and lymphocyte levels, has been evaluated in several cohorts, although with variations in the tumor types, disease stages, cut-offs, and treatments. Therefore, we evaluated the association between survival and PIV in cancer, performing a systematic review and meta-analysis. Methods: We conducted a systematic review from the Pubmed, Medline, and Embase databases to filter the published studies until 17 May 2022. The meta-analyses were performed with the generic inverse-variance method with a random-effects model. Results: Fifteen studies encompassing 4942 patients were included. In the pooled analysis of fifteen studies, the patients with higher PIV levels had significantly increased risk of death than those with lower PIV levels (HR: 2.00, 95% CI: 1.51−2.64, p < 0.001) and increased risk of progression or death (HR: 1.80, 95% CI: 1.39−2.32, p < 0.001). Analyses were consistent across several clinical scenarios, including non-metastatic or metastatic disease, different cut-offs (500, 400, and 300), and treatment with targeted therapy or immunotherapy (p < 0.001 for each). Conclusion: The available evidence demonstrates that PIV could be a prognostic biomarker in cancer. However, further research is needed to explore the promise of PIV as a prognostic biomarker in patients with non-metastatic disease or patients treated without immunotherapy or targeted therapy.
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Affiliation(s)
- Deniz Can Guven
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara 06100, Turkey; (S.K.); (S.A.)
| | - Taha Koray Sahin
- Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara 06100, Turkey; (T.K.S.); (E.E.)
| | - Enes Erul
- Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara 06100, Turkey; (T.K.S.); (E.E.)
| | - Saadettin Kilickap
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara 06100, Turkey; (S.K.); (S.A.)
- Department of Medical Oncology, Istinye University Faculty of Medicine, Istanbul 34010, Turkey
| | - Thilo Gambichler
- Department of Dermatology, Skin Cancer Center, Ruhr-University Bochum, 44791 Bochum, Germany;
| | - Sercan Aksoy
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara 06100, Turkey; (S.K.); (S.A.)
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Yudistira G, Dewi YA, Sudiro M. Platelet to Lymphocytes Ratio to Predict Nasopharyngeal Carcinoma Progressivity. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND: Nasopharyngeal carcinoma (NPC) is a head and neck cancer that arises from the nasopharyngeal epithelium. It is one of the most common malignancies in Southeast Asia. In 2020, there were 133,354 new cases of NPC worldwide, with 113,659 occurring on the Asian continent (85.2%). In Indonesia, the prevalence of NPC is 6.2/100,000 people, with 13,000 new cases each year. NPC was the most frequent head and neck cancer in the Otorhinolaryngology-Head and Neck Surgery Department Dr. Hasan Sadikin Hospital Bandung from 2013 to 2018, with 921 (35.20%) new cases.
AIM: Platelet-to-lymphocyte-ratio (PLR) testing has the potential to be employed as a prognostic marker in the evaluation of NPC. The purpose of this study is to investigate the link between PLR and the clinical stage of NPC.
METHODS: Between 2016 and 2020, a cross-sectional study was conducted on NPC patients at Hasan Sadikin Hospital in Bandung. Patient information was gathered from the registry of the Oncology Head and Neck Surgery Study Group. Three hundred and eighty-three people met the requirements for inclusion.
RESULTS: Lymph node metastases (p = 0.001), distant metastases (p = 0.001), and clinical stage (p < 0.001) are all classified differently by PLR. The platelet to lymphocytes ratio was linked to lymph node metastasis, distant metastases, and clinical stage in a statistically significant (p < 0.05). Patients with a PLR >287 have a 3.69 times chance of developing distant metastases, while those with a PLR >160 have a 1.38 times chance of progressing to the advanced stage.
CONCLUSION: PLR is linked to the nasopharyngeal cancer clinical stage. Furthermore, in NPC patients, PLR can predict advanced stage and distant metastases.
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Gan W, Guan Q, Hu X, Zeng X, Shao D, Xu L, Xiao W, Mao H, Chen W. The association between platelet-lymphocyte ratio and the risk of all-cause mortality in chronic kidney disease: a systematic review and meta-analysis. Int Urol Nephrol 2022; 54:2959-2967. [PMID: 35581444 DOI: 10.1007/s11255-022-03234-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Accepted: 04/09/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Chronic kidney disease (CKD) patients have high levels of inflammatory mediators. These inflammatory mediators contribute to the increased risk of cardiovascular events and all-cause mortality. Platelet-lymphocyte ratio (PLR) has recently been recognized as a novel inflammatory marker and has been shown to be associated with the prognosis in CKD patients. However, the quality of these studies varies and their results are controversial. The purpose of this meta-analysis was to investigate the relationship between PLR and all-cause mortality in CKD patients. METHODS A systematic literature search of PubMed, EMBASE, CENTRAL and ISI Web of Science was conducted. The databases were searched from their inception dates up to the latest issue (31 October 2021). Two reviewers independently searched the databases and screened studies. Data were extracted using a standardized collection form. Meta-analysis was performed to compare PLR values between CKD and non-CKD patients, and to investigate the association between PLR and all-cause mortality in CKD patients. This meta-analysis is reported in adherence to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). RESULTS A total of 11 studies involving 4244 participants were selected. The pooled data indicated that PLR values were significantly higher in CKD patients than non-CKD controls (weighted mean difference = 21.6, 95% CI 17.39-25.81, p < 0.01), and PLR is associated with an increased risk of all-cause mortality in CKD patients (hazard ratio = 2.49, 95% CI 1.78-3.49, p < 0.01). CONCLUSIONS Patients with CKD have higher PLR values compared to non-CKD patients. Meanwhile, PLR values were highly associated with all-cause mortality in CKD patients. PLR is a valid predictor as a clinically accessible indicator for patients with CKD.
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Affiliation(s)
- Wenyuan Gan
- Department of Nephrology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, Hubei, China
| | - Qingyu Guan
- Department of Nephrology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, Hubei, China.,Medical School, Jianghan University, Wuhan, 430056, Hubei, China
| | - Xiaosong Hu
- Department of Nephrology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, Hubei, China
| | - Xingruo Zeng
- Department of Nephrology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, Hubei, China
| | - Danni Shao
- Department of Nephrology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, Hubei, China
| | - Li Xu
- Department of Nephrology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, Hubei, China
| | - Wei Xiao
- Department of Nephrology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, Hubei, China
| | - Huihui Mao
- Department of Nephrology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, Hubei, China
| | - Wenli Chen
- Department of Nephrology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, Hubei, China.
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