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Wang Q, Liang T, Li Y, Liu X. Machine Learning for Prediction of Non-Small Cell Lung Cancer Based on Inflammatory and Nutritional Indicators in Adults: A Cross-Sectional Study. Cancer Manag Res 2024; 16:527-535. [PMID: 38832344 PMCID: PMC11146620 DOI: 10.2147/cmar.s454638] [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: 01/11/2024] [Accepted: 05/23/2024] [Indexed: 06/05/2024] Open
Abstract
Purpose The aim of this study was to evaluate the potential benefit of blood inflammation in the diagnosis of non-small cell lung cancer (NSCLC) and propose a machine-learning-based method to predict NSCLC in asymptomatic adults. Patients and Methods A cross-sectional study was evaluated using medical records of 139 patients with non-small cell lung cancer and physical examination data from May 2022 to May 2023 of 198 healthy controls. The NSCLC cohort comprised 128 cases of adenocarcinoma, 3 cases of squamous cell carcinoma, and 8 cases of other NSCLC subtypes. The correlation between inflammatory and nutritional markers, such as monocytes, neutrophils, LMR, NLR, PLR, PHR and non-small cell lung cancer was examined. Features were selected using Python's feature selection library and analyzed by five algorithms. The predictive ability of the model for non-small cell lung cancer diagnosis was assessed by precision, accuracy, recall, F1 score, and area under the curve (AUC). Results The results showed that the top 14 important factors were PDW, age, TP, RBC, HGB, LYM, LYM%, RDW, PLR, LMR, PHR, MONO, MONO%, gender. Additionally, the naive Bayes (NB) algorithm demonstrated the highest overall performance in predicting adult NSCLC among the five machine learning algorithms, achieving an accuracy of 0.87, a macro average F1 score of 0.85, a weighted average F1 score of 0.87, and an AUC of 0.84. Conclusion In feature ranking, platelet distribution width was the most important feature, and the NB algorithm performed best in predicting adult NSCLC diagnosis.
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Affiliation(s)
- Qiaoli Wang
- Department of Health Screening Center, Deyang Peoples' Hospital, Deyang, Sichuan, 618000, People's Republic of China
| | - Tao Liang
- Department of Gastroenterology, Deyang Peoples' Hospital, Deyang, Sichuan, 618000, People's Republic of China
| | - Yuexi Li
- Department of Health Screening Center, Deyang Peoples' Hospital, Deyang, Sichuan, 618000, People's Republic of China
| | - Xiaoqin Liu
- Department of Health Screening Center, Deyang Peoples' Hospital, Deyang, Sichuan, 618000, People's Republic of China
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Xue M, Liu J, Li Z, Lu M, Zhang H, Liu W, Tian H. The role of adenocarcinoma subtypes and immunohistochemistry in predicting lymph node metastasis in early invasive lung adenocarcinoma. BMC Cancer 2024; 24:139. [PMID: 38287300 PMCID: PMC10823663 DOI: 10.1186/s12885-024-11843-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 01/04/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND Identifying lymph node metastasis areas during surgery for early invasive lung adenocarcinoma remains challenging. The aim of this study was to develop a nomogram mathematical model before the end of surgery for predicting lymph node metastasis in patients with early invasive lung adenocarcinoma. METHODS In this study, we included patients with invasive lung adenocarcinoma measuring ≤ 2 cm who underwent pulmonary resection with definite pathology at Qilu Hospital of Shandong University from January 2020 to January 2022. Preoperative biomarker results, clinical features, and computed tomography characteristics were collected. The enrolled patients were randomized into a training cohort and a validation cohort in a 7:3 ratio. The training cohort was used to construct the predictive model, while the validation cohort was used to test the model independently. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors. The prediction model and nomogram were established based on the independent risk factors. Recipient operating characteristic (ROC) curves were used to assess the discrimination ability of the model. Calibration capability was assessed using the Hosmer-Lemeshow test and calibration curves. The clinical utility of the nomogram was assessed using decision curve analysis (DCA). RESULTS The overall incidence of lymph node metastasis was 13.23% (61/461). Six indicators were finally determined to be independently associated with lymph node metastasis. These six indicators were: age (P < 0.001), serum amyloid (SA) (P = 0.008); carcinoma antigen 125 (CA125) (P = 0. 042); mucus composition (P = 0.003); novel aspartic proteinase of the pepsin family A (Napsin A) (P = 0.007); and cytokeratin 5/6 (CK5/6) (P = 0.042). The area under the ROC curve (AUC) was 0.843 (95% CI: 0.779-0.908) in the training cohort and 0.838 (95% CI: 0.748-0.927) in the validation cohort. the P-value of the Hosmer-Lemeshow test was 0.0613 in the training cohort and 0.8628 in the validation cohort. the bias of the training cohort corrected C-index was 0.8444 and the bias-corrected C-index for the validation cohort was 0.8375. demonstrating that the prediction model has good discriminative power and good calibration. CONCLUSIONS The column line graphs created showed excellent discrimination and calibration to predict lymph node status in patients with ≤ 2 cm invasive lung adenocarcinoma. In addition, the predictive model has predictive potential before the end of surgery and can inform clinical decision making.
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Affiliation(s)
- Mengchao Xue
- Department of Thoracic Surgery, Qilu Hospital, Shandong University, Lixia District, Jinan City, Shandong Province, China
| | - Junjie Liu
- Department of Thoracic Surgery, Qilu Hospital, Shandong University, Lixia District, Jinan City, Shandong Province, China
| | - Zhenyi Li
- Department of Thoracic Surgery, Qilu Hospital, Shandong University, Lixia District, Jinan City, Shandong Province, China
| | - Ming Lu
- Department of Thoracic Surgery, Qilu Hospital, Shandong University, Lixia District, Jinan City, Shandong Province, China
| | - Huiying Zhang
- Department of Thoracic Surgery, Qilu Hospital, Shandong University, Lixia District, Jinan City, Shandong Province, China
| | - Wen Liu
- Department of Thoracic Surgery, Qilu Hospital, Shandong University, Lixia District, Jinan City, Shandong Province, China
| | - Hui Tian
- Department of Thoracic Surgery, Qilu Hospital, Shandong University, Lixia District, Jinan City, Shandong Province, China.
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Baluku JB, Namiiro S, Namanda B, Nabwana M, Andia-Biraro I, Worodria W, Salata R, Mfinanga S, Gerson S, Kirenga B. Neutrophil-Lymphocyte and Platelet-Lymphocyte Ratios in Distinguishing Lung Cancer in People with HIV. DISEASE MARKERS 2024; 2024:8822024. [PMID: 38292339 PMCID: PMC10827363 DOI: 10.1155/2024/8822024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 01/03/2024] [Accepted: 01/10/2024] [Indexed: 02/01/2024]
Abstract
Objective The neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) demonstrate good diagnostic accuracy in distinguishing lung cancer patients from healthy individuals, primarily in HIV-negative populations. We determined the sensitivity (Se), specificity (Sp), and area under the curve (AUC) of the NLR and PLR in discriminating between people living with HIV (PLWH) with and without lung cancer. Methods This is a comparative analysis of secondary data. Cases were PLWH with lung cancer from a retrospective cohort treated at the Uganda Cancer Institute. Controls were unmatched PLWH without lung cancer who were randomly selected from three HIV clinics in Uganda. Se, Sp, and AUC analysis and determination of optimal cutoffs were performed using receiver operating characteristic (ROC) curves. Results Of 115 PLWH (18 cases and 97 controls), 83 (72.2%) were female, 110 (95.7) were on ART, and the median (IQR) age was 46 (38-51) years. The median (IQR) NLR was higher among cases than controls (3.53 (3.14-7.71) vs. 0.92 (0.67-1.09), p < 0.001). Similarly, the PLR was higher among cases than controls (237.5 (177.8-361.6) vs. 123.6 (100.6-155.4), p=0.001). At a cutoff of 2.44, the respective Se, Sp, and AUC of the NLR were 87.5% (95% CI: 61.7%-98.4%), 100% (95% CI: 96.2%-100%), and 0.94 (95% CI: 0.85-1.00, p < 0.001). Similarly, the respective Se, Sp, and AUC for the PLR were 75% (95% CI: 47.6%-92.7%), 87.2% (95% CI: 78.8%-93.2%), and 0.81 (95% CI: 0.70-0.93, p < 0.001) at a cutoff of 196.3. Conclusion The NLR and PLR discriminated PLWH with and without lung cancer and could be useful in PLWH with respiratory symptoms in whom lung cancer can easily be misdiagnosed as other lung pathology.
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Affiliation(s)
- Joseph Baruch Baluku
- Makerere University Lung Institute, Kampala, Uganda
- Division of Pulmonology, Kiruddu National Referral Hospital, Kampala, Uganda
| | - Sharon Namiiro
- Department of Internal Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Brenda Namanda
- Division of Pulmonology, Kiruddu National Referral Hospital, Kampala, Uganda
| | - Martin Nabwana
- Makerere University–Johns Hopkins University Research Collaboration, Kampala, Uganda
| | - Irene Andia-Biraro
- Department of Internal Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - William Worodria
- Makerere University Lung Institute, Kampala, Uganda
- Department of Internal Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Robert Salata
- Department of Medicine, UH Cleveland Medical Center, Cleveland, USA
| | - Sayoki Mfinanga
- Muhimbili Center, National Institute for Medical Research, Dar es Salaam, Tanzania
| | - Stanton Gerson
- School of Medicine, Case Western Reserve University, Cleveland, USA
| | - Bruce Kirenga
- Makerere University Lung Institute, Kampala, Uganda
- Department of Internal Medicine, Makerere University College of Health Sciences, Kampala, Uganda
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Erciyestepe M, Selvi O, Dinç Sonuşen Ş, Öztürk AE, Dinç G, Güneş TK, Aydın O, Yaşar N, Balkaya Aykut G, Vatansever S. Prognostic Value of Inflammation and Nutrition-Based Scores in Non-Small Cell Lung Cancer. Med Princ Pract 2023; 33:122-132. [PMID: 38091965 PMCID: PMC11095608 DOI: 10.1159/000535781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 12/11/2023] [Indexed: 04/24/2024] Open
Abstract
OBJECTIVE In studies conducted on non-small cell lung cancer (NSCLC) patients, many factors such as age, stage, weight loss, lymph node, and pleural involvement have been shown to affect survival. On the other hand, systemic inflammation plays a critical role in proliferation, migration, invasion, and metastasis. Inflammation and nutrition-based prognostic scores are reported to be associated with survival in patients with NSCLC. The aim of our study is to show the effects of these scores on survival and disease progression in NSCLC patients. SUBJECTS AND METHODS Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), modified Glasgow prognostic score (mGPS), and prognostic nutritional index (PNI) values in 102 patients with stages 1, 2, and 3A NSCLC were analyzed retrospectively. RESULTS NLR (p < 0.001), PLR (p = 0.001), PNI (p < 0.001), and mGPS (p = 0.001) variables showed a statistically significant difference according to mortality groups. NLR and PLR values were higher in exitus patients. However, PNI values were higher in surviving patients. NLR (p < 0.001), PLR (p = 0.004), PNI (p = 0.001), and mGPS (p = 0.015) variables showed a statistically significant difference in terms of locoregional recurrence. PNI (p = 0.001) and mGPS (p = 0.001) in terms of distant metastasis development during follow-up and treatment showed a statistically significant difference. CONCLUSION NLR, PLR, PNI, and mGPS are easily accessible noninvasive parameters and provide predictive information about survival and disease course. We showed the effect of these parameters on the prognosis.
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Affiliation(s)
- Mert Erciyestepe
- Sağlık Bilimleri University Professor Dr. Cemil Taşcıoğlu City Hospıtal, Department of Medical Oncology, Istanbul, Turkey
| | - Oğuzhan Selvi
- Sağlık Bilimleri University Professor Dr. Cemil Taşcıoğlu City Hospıtal, Department of Medical Oncology, Istanbul, Turkey
| | - Şermin Dinç Sonuşen
- Sağlık Bilimleri University Professor Dr. Cemil Taşcıoğlu City Hospıtal, Department of Medical Oncology, Istanbul, Turkey
| | - Ahmet Emin Öztürk
- Sağlık Bilimleri University Professor Dr. Cemil Taşcıoğlu City Hospıtal, Department of Medical Oncology, Istanbul, Turkey
| | - Gülhan Dinç
- Sağlık Bilimleri University Professor Dr. Cemil Taşcıoğlu City Hospıtal, Department of Medical Oncology, Istanbul, Turkey
| | - Tuğçe Kübra Güneş
- Sağlık Bilimleri University Professor Dr. Cemil Taşcıoğlu City Hospıtal, Department of Medical Oncology, Istanbul, Turkey
| | - Okan Aydın
- Sağlık Bilimleri University Professor Dr. Cemil Taşcıoğlu City Hospıtal, Department of Medical Oncology, Istanbul, Turkey
| | - Nurgül Yaşar
- Sağlık Bilimleri University Professor Dr. Cemil Taşcıoğlu City Hospıtal, Department of Medical Oncology, Istanbul, Turkey
| | - Gözde Balkaya Aykut
- Sağlık Bilimleri University Professor Dr. Cemil Taşcıoğlu City Hospıtal, Department of Medical Oncology, Istanbul, Turkey
| | - Sezai Vatansever
- Sağlık Bilimleri University Professor Dr. Cemil Taşcıoğlu City Hospıtal, Department of Medical Oncology, Istanbul, Turkey
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Hajipour S, Hosseini SM, Irani S, Tavallaie M. Identification of novel potential drugs and miRNAs biomarkers in lung cancer based on gene co-expression network analysis. Genomics Inform 2023; 21:e38. [PMID: 37813634 PMCID: PMC10584645 DOI: 10.5808/gi.23039] [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: 05/11/2023] [Revised: 08/01/2023] [Accepted: 08/02/2023] [Indexed: 10/11/2023] Open
Abstract
Non-small cell lung cancer (NSCLC) is an important cause of cancer-associated deaths worldwide. Therefore, the exact molecular mechanisms of NSCLC are unidentified. The present investigation aims to identify the miRNAs with predictive value in NSCLC. The two datasets were downloaded from the Gene Expression Omnibus (GEO) database. Differentially expressed miRNAs (DEmiRNA) and mRNAs (DEmRNA) were selected from the normalized data. Next, miRNA-mRNA interactions were determined. Then, co-expression network analysis was completed using the WGCNA package in R software. The co-expression network between DEmiRNAs and DEmRNAs was calculated to prioritize the miRNAs. Next, the enrichment analysis was performed for DEmiRNA and DEmRNA. Finally, the drug-gene interaction network was constructed by importing the gene list to dgidb database. A total of 3,033 differentially expressed genes and 58 DE miRNA were recognized from two datasets. The co-expression network analysis was utilized to build a gene co-expression network. Next, four modules were selected based on the Zsummary score. In the next step, a bipartite miRNA-gene network was constructed and hub miRNAs (let-7a-2-3p, let-7d-5p, let-7b-5p, let-7a-5p, and let-7b-3p) were selected. Finally, a drug-gene network was constructed while SUNITINIB, MEDROXYPROGESTERONE ACETATE, DOFETILIDE, HALOPERIDOL, and CALCITRIOL drugs were recognized as a beneficial drug in NSCLC. The hub miRNAs and repurposed drugs may act a vital role in NSCLC progression and treatment, respectively; however, these results must validate in further clinical and experimental assessments.
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Affiliation(s)
- Sara Hajipour
- Biology Department, Science and Research Branch, Islamic Azad University, Tehran 14155-4933, Iran
| | - Sayed Mostafa Hosseini
- Chemical Injuries Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran 14359-16471, Iran
| | - Shiva Irani
- Biology Department, Science and Research Branch, Islamic Azad University, Tehran 14155-4933, Iran
| | - Mahmood Tavallaie
- Human Genetic Research Center, Baqiyatallah University of Medical Sciences, Tehran 14359-16471, Iran
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Qi H. Role and research progress of hematological markers in laryngeal squamous cell carcinoma. Diagn Pathol 2023; 18:50. [PMID: 37081512 PMCID: PMC10120220 DOI: 10.1186/s13000-023-01335-7] [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: 10/14/2022] [Accepted: 04/03/2023] [Indexed: 04/22/2023] Open
Abstract
Laryngeal cancer is one of the most common malignant tumors of the head and neck, accounting for about 20%. Due to its high disability rate, the diagnosis and treatment of laryngeal cancer have always been the focus and difficulty of head and neck surgery. The outcome of cancer is affected not only by tumor-related factors but also by host-related factors, especially systemic inflammation, this is usually reflected by a variety of hematological markers. Studies have confirmed that there is a significant correlation between hematological markers and the occurrence, development, and prognosis of laryngeal squamous cell carcinoma (LSCC), and has a certain value in auxiliary diagnosis and prognosis prediction of LSCC. We reviewed various hematological markers related to LSCC aim to summarize the role and research progress of hematological markers in LSCC.
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Affiliation(s)
- Hui Qi
- Nursing College, Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China.
- Shanxi Key Laboratory of Otorhinolaryngology Head and Neck Cancer, First Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China.
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Çimen F, Aloğlu M, Düzgün S, Şentürk A, Atikcan Ş. Role of Inflammatory Response Biomarkers, Monocytes, and Platelets as Prognostic Indicators in Lung Cancer Patients Presenting with Malignant Pleural Effusion. CYPRUS JOURNAL OF MEDICAL SCIENCES 2023. [DOI: 10.4274/cjms.2022.2022-46] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
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Łochowski M, Chałubińska-Fendler J, Zawadzka I, Łochowska B, Rębowski M, Brzeziński D, Kozak J. The Prognostic Significance of Preoperative Platelet-to-Lymphocyte and Neutrophil-to-Lymphocyte Ratios in Patients Operated for Non-Small Cell Lung Cancer. Cancer Manag Res 2021; 13:7795-7802. [PMID: 34675674 PMCID: PMC8517424 DOI: 10.2147/cmar.s317705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 09/09/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction The aim of the study was to determine the prognostic significance of PLR and NLR ratios in patients operated due to non-small cell lung cancer. Material The study group consisted of 532 (174 women, 358 men) patients with non-small cell lung cancer (NSCLC) staged IA-IIIA. The mean age was 63.6 years (range 36 to 84 years). Together with platelet/lymphocyte ratio (PLR) and neutrophil/lymphocyte ratio (NLR), the following factors were included in the statistical analysis: age, sex, smoking history, the number of leukocytes, neutrophils, and platelets, histopathology, T-stage, N-stage, concomitant diseases according to the Charlson Comorbidity Index (CCI), type of operation, adjuvant chemotherapy, and overall survival. Results Univariate analysis showed an association between the value of PLR and NLR and the length of survival. Multivariate analysis found that the stage of advancement of the neoplastic disease (p=0.00003), adjuvant chemotherapy (p=0.009), CCI > 4 (0.00008), and PLR > 144 (p=0.001) were negative prognostic factors for survival > 2 years; however, this effect diminishes in patients surviving more than 5 years. Conclusion PLR might serve as a prognostic factor in patients affected by NSCLC with expected two-year overall survival.
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Affiliation(s)
- Mariusz Łochowski
- Clinic of Thoracic Surgery and Respiratory Rehabilitation, Medical University of Lodz, Lodz, Poland
| | | | - Izabela Zawadzka
- "Synevo" Medical Laboratory, Regional Multi-Specialist Center for Oncology and Traumatology of the Nicolaus Copernicus Memorial Hospital in Lodz, Lodz, Poland
| | - Barbara Łochowska
- Department of Radiotherapy and General Oncology, Regional Multi-Specialist Center for Oncology and Traumatology of the Nicolaus Copernicus Memorial Hospital in Lodz, Lodz, Poland
| | - Marek Rębowski
- Clinic of Thoracic Surgery and Respiratory Rehabilitation, Medical University of Lodz, Lodz, Poland
| | - Daniel Brzeziński
- Clinic of Thoracic Surgery and Respiratory Rehabilitation, Medical University of Lodz, Lodz, Poland
| | - Józef Kozak
- Clinic of Thoracic Surgery and Respiratory Rehabilitation, Medical University of Lodz, Lodz, Poland
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Systemic Immune-Inflammation Index Predicts Overall Survival in Patients with Gastric Cancer: a Propensity Score-Matched Analysis. J Gastrointest Surg 2021; 25:1124-1133. [PMID: 32607856 DOI: 10.1007/s11605-020-04710-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Accepted: 06/22/2020] [Indexed: 01/31/2023]
Abstract
BACKGROUND The systemic immune-inflammation index (SII), integrated by peripheral lymphocyte, neutrophil, and platelet counts, is used as an objective biomarker that reflects the balance between host inflammatory and immune response status in cancer patients. Herein, we examined the prognostic significance of SII in gastric cancer patients. METHODS We retrospectively reviewed data of 415 patients who underwent curative laparoscopic gastrectomy using propensity score-matched (PSM) analysis. The prognostic value of SII was compared between two groups based on SII values: low SII group (SII < 661.9) and high SII group (SII ≥ 661.9). RESULTS In multivariate analysis, the American Society of Anesthesiologists physical status (ASA-PS) (p < 0.001), tumor differentiation (p = 0.019), pathological stage (p = 0.046), carcinoembryonic antigen (CEA) level (p < 0.001), SII (p = 0.006), and operative procedure (p = 0.009) were independent prognostic factors of overall survival (OS) in the overall PSM cohort. The log-rank test demonstrated that patients with a high SII had significantly worse OS than did those with low SII (p = 0.002). In age-stratified subgroups analysis (< 65/≥ 65 years), multivariate analysis revealed that ASA-PS (p < 0.001), tumor differentiation (p = 0.019), CEA level (p = 0.008), SII (p = 0.013), and operative procedure (p = 0.026) were independent prognostic factors of OS in the elderly group. Similarly, elderly patients with a high SII had significantly worse OS than did those with a low SII (p = 0.009). Meanwhile, SII was not an independent prognostic factor of OS, and no significant association was observed between SII and OS in non-elderly patients. CONCLUSIONS SII was an independent prognostic indicator in gastric cancer patients, especially in the elderly population.
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Łochowski M, Łochowska B, Chałubińska-Fendler J, Zawadzka I, Rębowski M, Kozak J. Prognostic Factors Determining Survival of Patients Operated for Non-Small Cell Lung Cancer with Consideration Given to Morphological Parameters of Blood. Cancer Manag Res 2021; 13:479-487. [PMID: 33500661 PMCID: PMC7822080 DOI: 10.2147/cmar.s280252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 11/28/2020] [Indexed: 12/23/2022] Open
Abstract
Introduction Prognostic biomarkers are the area of high interest in non-small cell lung cancer (NSCLC). Inflammatory blood markers can be routinely determined from complete blood counts which are inexpensive and reliable. The aim of the study was to determine prognostic parameters which, in early diagnostics, best determine survival of patients, operated on due to NSCLC. Materials The study was conducted on 532 (174 females and 358 males) patients, operated on due to NSCLC, in stages IA – III, aged 36–84 years (the mean age: 63.6 years). The following parameters were subjected to a statistical analysis, conducted in order to determine prognostic values of the number of leukocytes, neutrophils, monocytes, platelets, haemoglobin, RDW-CV and MCV, calculated values of PLR, NLR, and LMR ratios, age, sex, smoking, histopathological diagnosis, T stage, N stage, the Charlson Comorbidity Index (CCI), type of surgery, and potential complications. Results The univariate analysis revealed an impact of NLR, PLR, and LMR values, RDW-CW and CCI ranges, and also the number of monocytes on patients’ overall survival (OS). The multivariate analysis identified six independent negative prognostic factors: male sex (0.001), CCI > 4 (p=0.000007), RDW-CV > 14.5% and PLR > 144 (p=0.000001, p= 0.001, respectively), the number of metastatic N2 lymphatic nodes (p=0.0003), and existence of post-operative complications (p=0.008). Conclusion Patients’ sex, RDW and PLR values, Charlson index, the number of involved N2 nodes by cancer and postoperative complications are independent and significant prognostic factors in patients operated on due to NSCLC.
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Affiliation(s)
- Mariusz Łochowski
- Clinic of Thoracic Surgery and Respiratory Rehabilitation, Medical University of Lodz, Regional Multi-Specialist Center for Oncology and Traumatology of the Nicolaus Copernicus Memorial Hospital in Lodz, Lodz, Poland
| | - Barbara Łochowska
- Department of Radiotherapy and General Oncology, Regional Multi-Specialist Center for Oncology and Traumatology of the Nicolaus Copernicus Memorial Hospital in Lodz, Lodz, Poland
| | | | - Izabela Zawadzka
- "Synevo" Medical Laboratory, Regional Multi-Specialist Center for Oncology and Traumatology of the Nicolaus Copernicus Memorial Hospital in Lodz, Lodz, Poland
| | - Marek Rębowski
- Clinic of Thoracic Surgery and Respiratory Rehabilitation, Medical University of Lodz, Regional Multi-Specialist Center for Oncology and Traumatology of the Nicolaus Copernicus Memorial Hospital in Lodz, Lodz, Poland
| | - Józef Kozak
- Clinic of Thoracic Surgery and Respiratory Rehabilitation, Medical University of Lodz, Regional Multi-Specialist Center for Oncology and Traumatology of the Nicolaus Copernicus Memorial Hospital in Lodz, Lodz, Poland
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Yan Q, Ertao Z, Zhimei Z, Weigang D, Jianjun P, Jianhui C, Chuangqi C. Systemic immune-inflammation index (SII): A More Promising Inflammation-Based Prognostic Marker for Patients with synchronic colorectal peritoneal carcinomatosis. J Cancer 2020; 11:5264-5272. [PMID: 32742472 PMCID: PMC7391211 DOI: 10.7150/jca.46446] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 06/24/2020] [Indexed: 12/13/2022] Open
Abstract
Objective: Synchronic colorectal peritoneal carcinomatosis (SCRPC) was recognized as a predictor of poor prognosis. The aim of this study was to investigate the role of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and systemic immune-inflammation index (SII) on the survival outcome, which might help determine the treatment management of SCRPC patients. Methods: A total of 103 SCRPC patients following cytoreduction surgery (CRS) and systematic chemotherapy (CT) between 1997 and 2013 in the First Affiliated Hospital of Sun Yat-sen University were retrospectively analyzed. The comparison of the clinicopathological variables and systematic inflammatory biomarkers, including NLR, PLR and SII, was performed by Chi-test and Cox regression analysis. According to the results of multivariate analysis, a prognostic nomogram was generated, and its prediction ability was measured by the concordance index (C-index). The survival curves were generated using the Kaplan-Meier method and survival comparison between groups was conducted via the log-rank test. Results: Univariate analysis revealed that elevated NLR, PLR and SII were significantly correlate with worse survival outcome. Only low SII value was recognized as an independent favorable prognostic factor for overall survival (HR=1.772, 95% CI=1.015-3.095, P=0.044), except for NLR and PLR. The nomogram could perform well in the prediction of overall survival in SCRPC patients (c-index 0.782). Moreover, SII had strong prognostic discriminatory ability to predict survival outcome for the patients receiving completeness of cytoreduction score (CCR) 0/1 or CCR2/3, rather than NLR and PLR. Conclusions: SII was a better inflammation factor to predict the outcomes of SCRPC patients receiving CRS and systematic CT. Low SII value was the most favorable factor benefiting from different level of CRS and it was useful for determining the appropriate treatment strategy for SCRPC patients.
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Affiliation(s)
- Qian Yan
- Division of Gastrointestinal Surgery Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.,Gastric Cancer Center, Sun Yat-sen University, Guangzhou 510080, China
| | - Zhai Ertao
- Division of Gastrointestinal Surgery Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.,Gastric Cancer Center, Sun Yat-sen University, Guangzhou 510080, China
| | - Zhang Zhimei
- Department of Pathology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - Dai Weigang
- Division of Gastrointestinal Surgery Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.,Gastric Cancer Center, Sun Yat-sen University, Guangzhou 510080, China
| | - Peng Jianjun
- Division of Gastrointestinal Surgery Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.,Gastric Cancer Center, Sun Yat-sen University, Guangzhou 510080, China
| | - Chen Jianhui
- Division of Gastrointestinal Surgery Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.,Gastric Cancer Center, Sun Yat-sen University, Guangzhou 510080, China
| | - Chen Chuangqi
- Gastric Cancer Center, Sun Yat-sen University, Guangzhou 510080, China
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12
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Dynamic evaluation of neutrophil-to-lymphocyte ratio as prognostic factor in stage III non-small cell lung cancer treated with chemoradiotherapy. Clin Transl Oncol 2020; 22:2333-2340. [PMID: 32449125 DOI: 10.1007/s12094-020-02396-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 05/12/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE Locally advanced non-small cell lung cancer (LA-NSCLC) is frequently treated with chemoradiotherapy (CRT). Despite the efforts, long-term outcomes are poor, and novel therapies have been introduced to improve results. Biomarkers are needed to detect early treatment failure and plan future follow-up and therapies. Our aim is to evaluate the role of dynamics of neutrophil-to-lymphocyte ratio (NLR) in patients with locally advanced NSCLC treated with CRT. METHODS We retrospectively reviewed patients diagnosed with LA-NSCLC receiving definitive CRT at our center from 2010 to 2015. Baseline and post-treatment NLR were collected from our center database. NLR was dichotomized (threshold = 4) and patients were divided into two groups based on the variation from baseline to post-treatment NLR. The prognostic role and association with response were examined with logistic regression and multivariate Cox regression model, respectively. RESULTS Ninety-two patients were included. Our analysis shows that NLR after treatment is associated with response to treatment [OR in the multivariate analysis 4.94 (1.01-24.48); p value = 0.048]. Furthermore, NLR and ECOG are independent prognostic factors for progression-free survival (PFS) and overall survival (OS). Specifically, PFS was 25.79 months for the good prognosis group and 12.09 for the poor prognosis group [HR 2.98 (CI 95% = 1.74-5.10), p < 0.001]; and OS was 42.94 months and 18.86 months, respectively [HR 2.81 (CI 95% = 1.62-4.90), p < 0.001]. CONCLUSION Dynamics of NLR have a prognostic value in stage III NSCLC treated with definitive CRT. Pre- and post-CRT NLR should be evaluated in prospective clinical trials involving consolidation treatment with immunotherapy.
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Jin X, Guan Y, Zhang Z, Wang H. Microarray data analysis on gene and miRNA expression to identify biomarkers in non-small cell lung cancer. BMC Cancer 2020; 20:329. [PMID: 32299382 PMCID: PMC7164187 DOI: 10.1186/s12885-020-06829-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 04/05/2020] [Indexed: 01/22/2023] Open
Abstract
Background The aim of this study was to gain further investigation of non-small cell lung cancer (NSCLC) tumorigenesis and identify biomarkers for clinical management of patients through comprehensive bioinformatics analysis. Methods miRNA and mRNA microarray datasets were downloaded from GEO (Gene Expression Omnibus) database under the accession number GSE102286 and GSE101929, respectively. Genes and miRNAs with differential expression were identified in NSCLC samples compared with controls, respectively. The interaction between differentially expressed genes (DEGs) and differentially expressed miRNAs (DEmiRs) was predicted, followed by functional enrichment analysis, and construction of miRNA-gene regulatory network, protein-protein interaction (PPI) network, and competing endogenous RNA (ceRNA) network. Through comprehensive bioinformatics analysis, we anticipate to find novel therapeutic targets and biomarkers for NSCLC. Results A total of 123 DEmiRs (5 up- and 118 down-regulated miRNAs) and 924 DEGs (309 up- and 615 down-regulated genes) were identified. These genes and miRNAs were significantly involved in different pathways including adherens junction, relaxin signaling pathway, and axon guidance. Furthermore, hsa-miR-9-5p, has-miR-196a-5p and hsa-miR-31-5p, as well as hsa-miR-1, hsa-miR-218-5p and hsa-miR-135a-5p were shown to have higher degree in the miRNA-gene regulatory network and ceRNA network, respectively. Furthermore, BIRC5 and FGF2, as well as RTKN2 and SLIT3 were hubs in the PPI network and ceRNA network, respectively. Conclusion Several pathways (adherens junction, relaxin signaling pathway, and axon guidance) miRNAs (hsa-miR-9-5p, has-miR-196a-5p, hsa-miR-31-5p, hsa-miR-1, hsa-miR-218-5p and hsa-miR-135a-5p) and genes (BIRC5, FGF2, RTKN2 and SLIT3) may play important roles in the pathogenesis of NSCLC.
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Affiliation(s)
- Xiang Jin
- Department of Respiration, The First Hospital of Jilin University, No. 1 Xinminda Street, Changchun, 130021, China
| | - Yinghui Guan
- Department of Respiration, The First Hospital of Jilin University, No. 1 Xinminda Street, Changchun, 130021, China.
| | - Zhen Zhang
- PICU, The First Hospital of Jilin University, Changchun, 130021, China
| | - Hongyue Wang
- Department of Nephrology, The First Hospital of Jilin University, Changchun, 130021, China
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14
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Łochowski M, Łochowska B, Zawadzka I, Cieślik-Wolski B, Kozik D, Kozak J. Prognostic value of neutrophil-to-lymphocyte, platelet-to-lymphocyte and lymphocyte-to-monocyte ratio ratios in patients operated on due to non-small cell lung cancer. J Thorac Dis 2019; 11:3377-3384. [PMID: 31559041 DOI: 10.21037/jtd.2019.07.72] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background The aim of the study was to determine a prognostic value of the neutrophil to lymphocyte ratio (NLR), the platelet to lymphocyte ratio (PLR) and the lymphocyte to monocyte ratio (LMR) ratios for survival of patients, operated on due to non-small cell lung cancer (NSCLC). Methods The study was conducted on 532 patients, operated on due to NSCLC, in stages IA-IIIA. A total of 174 females and 358 males, aged 36-84 years (the mean age: 63.6 years) were included in the study. The following factors were subject to a statistical analysis, conducted for determination of potential prognostic values of NLR, PLR and LMR ratios: age, sex, nicotinism, the number of leukocytes, neutrophils, monocytes, platelets, histopathological diagnosis, T category, N category, the Charlson comorbidity index (CCI), kind of surgery, patient survival. Results The single-factor analysis revealed a relationship between NLR, PLR and LMR values, CCI values, the number of monocytes and the length of survival. The multi-factor analysis confirmed that for patients with expected 2-year survival, PLR above 138 (P=0.0008) is another negative prognostic factor, apart from the stage of the neoplastic disease and CCI above 4. For 5-year survival, such a relationship was not observed. Conclusions The PLR ratio is an independent and significant prognostic factor for expected, over 2-year survival of patients operated on due to NSCLC.
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Affiliation(s)
- Mariusz Łochowski
- Clinic of Thoracic Surgery and Respiratory Rehabilitation, Medical University of Lodz, Regional Multi-Specialist Center for Oncology and Traumatology of the Nicolaus Copernicus Memorial Hospital, Lodz, Poland
| | - Barbara Łochowska
- Department of Radiotherapy and General Oncology, Regional Multi-Specialist Center for Oncology and Traumatology of the Nicolaus Copernicus Memorial Hospital, Lodz, Poland
| | - Izabela Zawadzka
- "Synevo" Medical Laboratory, Regional Multi-Specialist Center for Oncology and Traumatology of the Nicolaus Copernicus Memorial Hospital, Lodz, Poland
| | - Bartosz Cieślik-Wolski
- Clinic of Thoracic Surgery and Respiratory Rehabilitation, Medical University of Lodz, Regional Multi-Specialist Center for Oncology and Traumatology of the Nicolaus Copernicus Memorial Hospital, Lodz, Poland
| | - Dominika Kozik
- Clinic of Thoracic Surgery and Respiratory Rehabilitation, Medical University of Lodz, Regional Multi-Specialist Center for Oncology and Traumatology of the Nicolaus Copernicus Memorial Hospital, Lodz, Poland
| | - Józef Kozak
- Clinic of Thoracic Surgery and Respiratory Rehabilitation, Medical University of Lodz, Regional Multi-Specialist Center for Oncology and Traumatology of the Nicolaus Copernicus Memorial Hospital, Lodz, Poland
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Zhong B, Gu DY, Du JT, Chen F, Liu YF, Liu SX. May the change of platelet to lymphocyte ratio be a prognostic factor for T3-T4 laryngeal squamous cell carcinoma: A retrospective study. PLoS One 2018; 13:e0210033. [PMID: 30596765 PMCID: PMC6312301 DOI: 10.1371/journal.pone.0210033] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 12/14/2018] [Indexed: 02/05/2023] Open
Abstract
Background Many blood markers have been shown to predict the recurrence and survival of various malignancies, but the effects of surgery on the body's inflammatory levels may cause changes in these inflammatory markers. Therefore, in this study, we assessed the relationship between changes in platelet to lymphocyte ratio (PLR) and survival and recurrence in patients with T3-T4 laryngeal squamous cell carcinoma (LSCC). Methods Data of patients with T3-T4 HSCC were reviewed. Continuous variables were expressed as mean ± SD and were compared using t test or Mann-Whitney U test. The covariate distributions were compared by Chi-square test. Survival curve was estimated by Kaplan-Meier analysis, and Log-Rank test were performed to estimate the survival curve and significance of the difference in survival distribution between groups, respectively. The prognostic value was uncovered by univariate and multivariate Cox hazards analysis. Results The 413 consecutive patients with LSCC were reviewed. Of these, 362 patients who met the criteria were selected, multi-factor analysis found that pathological T classification(hazard ratio [HR] = 1.878; 95% confidence interval [CI] = 1.342–3.023; P<0.001), pathological N classification (HR = 1.212; 95% CI = 0.867–2.125; P< 0.001) and change of PLR (HR = 2.158; 95% CI = 1.332–2.889; P = 0.004) associated with postoperative recurrence of T3-T4 LSCC. In addition, the pathological T classification (HR = 1.901; 95% CI = 1.255–2.999; P<0.001), pathological N classification (HR = 1.244; 95% CI = 0.810–2.212; P<0.001) and change of PLR (HR = 2.011; 95% CI = 1.354–2.753; P = 0.001) associated with postoperative survival in patients with T3-T4 LSCC. Conclusions Results demonstrate that change in PLR may serve as a useful prognostic predictor for patients with T3-T4 LSCC.
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Affiliation(s)
- Bing Zhong
- Department of Otorhinolaryngology Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan province, China
| | - De-Ying Gu
- Department of Otorhinolaryngology Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan province, China
| | - Jin-Tao Du
- Department of Otorhinolaryngology Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan province, China
| | - Fei Chen
- Department of Otorhinolaryngology Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan province, China
- * E-mail: (YFL); (FC)
| | - Ya-Feng Liu
- Department of Otorhinolaryngology Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan province, China
- * E-mail: (YFL); (FC)
| | - Shi-Xi Liu
- Department of Otorhinolaryngology Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan province, China
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