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Numakura K, Sekine Y, Osawa T, Naito S, Tokairin O, Muto Y, Sobu R, Kobayashi M, Sasagawa H, Yamamoto R, Nara T, Saito M, Narita S, Akashi H, Tsuchiya N, Shinohara N, Habuchi T. The lymphocyte-to-monocyte ratio as a significant inflammatory marker associated with survival of patients with metastatic renal cell carcinoma treated using nivolumab plus ipilimumab therapy. Int J Clin Oncol 2024; 29:1019-1026. [PMID: 38797782 DOI: 10.1007/s10147-024-02538-8] [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: 02/03/2024] [Accepted: 04/14/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND Nivolumab plus ipilimumab (NIVO + IPI) is the first-line treatment for patients with metastatic renal cell carcinoma (mRCC). While approximately 40% of patients treated with NIVO + IPI achieve a durable response, 20% develop primary resistance with severe consequences. Therefore, there is a clinical need for criteria to select patients suitable for NIVO + IPI therapy to optimize its therapeutic efficacy. Accordingly, our aim was to evaluate the association between candidate biomarkers measured before treatment initiation and survival. METHODS This was a multi-institutional, retrospective, cohort study of 183 patients with mRCC treated with systematic therapies between August 2015 and July 2023. Of these, 112 received NIVO + IPI as first-line therapy: mean age, 68 years; men, 83.0% (n = 93), and clear cell histology, 80.4% (n = 90). Univariable and multivariable analyses were used to evaluate associations between biomarkers and survival. RESULTS On univariate analysis, high C-reactive protein and systemic index, a high neutrophil-to-lymphocyte and platelet-to-lymphocyte ratio, and a low lymphocyte-to-monocyte ratio (LMR) were associated with shorter overall survival (OS). On multivariable analysis, a LMR ≤ 3 was retained as an independent factor associated to shorter OS with the highest accuracy (C-index, 0.656; hazard ratio, 7.042; 95% confidence interval, 2.0-25.0; p = 0.002). CONCLUSION A low LMR may identify patients who would be candidate for NIVO + IPI therapy for mRCC.
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Affiliation(s)
- Kazuyuki Numakura
- Department of Urology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.
| | - Yuya Sekine
- Department of Urology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Takahiro Osawa
- Department of Urology, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Sei Naito
- Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Ojiro Tokairin
- Department of Urology, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Yumina Muto
- Department of Urology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Ryuta Sobu
- Department of Urology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Mizuki Kobayashi
- Department of Urology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Hajime Sasagawa
- Department of Urology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Ryohei Yamamoto
- Department of Urology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Taketoshi Nara
- Department of Urology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Mitsuru Saito
- Department of Urology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Shintaro Narita
- Department of Urology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Hideo Akashi
- Department of Anatomy, Akita University Graduate School of Medicine, Akita, Japan
| | - Norihiko Tsuchiya
- Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Nobuo Shinohara
- Department of Urology, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Tomonori Habuchi
- Department of Urology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
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Zemskova O, Yu NY, Löser A, Leppert J, Rades D. Prognostic Role of Platelet-to-Lymphocyte and Neutrophil-to-Lymphocyte Ratios in Patients Irradiated for Glioblastoma Multiforme. CANCER DIAGNOSIS & PROGNOSIS 2024; 4:408-415. [PMID: 38962535 PMCID: PMC11215454 DOI: 10.21873/cdp.10340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 04/25/2024] [Indexed: 07/05/2024]
Abstract
Background/Aim Previous studies suggested pre-operative platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) to be predictive factors in patients with glioblastoma multiforme (GBM). This study investigated the prognostic role of PLR and NLR prior to or at the beginning of radiotherapy. Patients and Methods In 80 patients with GBM receiving conventionally fractionated radiotherapy plus concurrent temozolomide following resection or biopsy, 12 factors including PLR and NLR were retrospectively evaluated regarding progression-free survival (PFS) and overall survival (OS). Results On multivariable analyses, PLR ≤150, Karnofsky performance score (KPS) 90-100, and O6-methylguanine-DNA methyltransferase promoter methylation were significantly associated with improved PFS. Single lesion, KPS 90-100, and adjuvant chemotherapy were significantly associated with OS; PLR ≤150 showed a trend. NLR ≤3 showed a trend for associations with PFS and OS on univariable analyses. Conclusion PLR prior to or at the beginning of radiotherapy was associated with treatment outcomes in patients irradiated for GBM and should be considered in future clinical trials.
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Affiliation(s)
- Oksana Zemskova
- Department of Radiation Oncology, University of Lübeck, Lübeck, Germany
- Department of Radioneurosurgery, Romodanov Neurosurgery Institute, Kyiv, Ukraine
| | - Nathan Y Yu
- Department of Radiation Oncology, Mayo Clinic, Phoenix, AZ, U.S.A
| | - Anastassia Löser
- Department of Radiation Oncology, University of Lübeck, Lübeck, Germany
| | - Jan Leppert
- Department of Neurosurgery, University of Lübeck, Lübeck, Germany
| | - Dirk Rades
- Department of Radiation Oncology, University of Lübeck, Lübeck, Germany
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Mao H, Yang F. Prognostic significance of albumin-to-globulin ratio in patients with renal cell carcinoma: a meta-analysis. Front Oncol 2023; 13:1210451. [PMID: 37538115 PMCID: PMC10394642 DOI: 10.3389/fonc.2023.1210451] [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: 04/22/2023] [Accepted: 07/03/2023] [Indexed: 08/05/2023] Open
Abstract
Background Whether the albumin-to-globulin ratio (AGR) predicts the prognosis of renal cell carcinoma (RCC) remains controversial. Herein, we performed a meta-analysis to critically evaluate the relationship between the AGR and RCC prognosis, as well as the association between the AGR and the clinicopathological characteristics of RCC. Methods The PubMed, Web of Science, Embase, and Cochrane Library databases were thoroughly and comprehensively searched from their inception until 24 June 2023. To determine the predictive significance of the AGR, hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) were calculated from the pooled data. The relationship between the AGR and the clinicopathological features of RCC was evaluated by estimating odds ratios (ORs) and 95% CIs in subgroup analyses. Results The meta-analysis included nine articles involving 5,671 RCC cases. A low AGR significantly correlated with worse overall survival (OS) (HR = 1.82, 95% CI = 1.37-2.41, p <0.001) and progression-free survival (PFS) (HR = 2.44, 95% CI = 1.61-3.70, p <0.001). Analysis of the pooled data also revealed significant associations between a low AGR and the following: female sex (OR = 1.48, 95% CI = 1.31-1.67, p <0.001), pT stage T3-T4 (OR = 4.12, 95% CI = 2.93-5.79, p <0.001), pN stage N1 (OR = 3.99, 95% CI = 2.40-6.64, p <0.001), tumor necrosis (OR = 3.83, 95% CI = 2.23-6.59, p <0.001), and Fuhrman grade 3-4 (OR = 1.82, 95% CI = 1.34-2.42, p <0.001). The AGR was not related to histology (OR = 0.83, 95% CI = 0.60-1.15, p = 0.267). Conclusion In patients with RCC, a low AGR strongly predicted poor OS and PFS and significantly correlated with clinicopathological features indicative of disease progression.
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Affiliation(s)
- Huaying Mao
- Clinical Laboratory, Huzhou Central Hospital, Affiliated Central Hospital of Huzhou University, Huzhou, Zhejiang, China
| | - Fan Yang
- Clinical Laboratory, Huzhou Maternity and Child Health Care Hospital, Huzhou, Zhejiang, China
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Keiner C, Meagher M, Patil D, Saito K, Walia A, Liu F, Dutt R, Miller N, Dhanji S, Saidian A, Wan F, Yasuda Y, Fujii Y, Tanaka H, Master V, Derweesh I. Association of neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, and De Ritis ratio with mortality in renal cell carcinoma: A multicenter analysis. Front Oncol 2022; 12:995991. [PMID: 36505802 PMCID: PMC9731093 DOI: 10.3389/fonc.2022.995991] [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: 07/16/2022] [Accepted: 10/19/2022] [Indexed: 11/25/2022] Open
Abstract
Background Several markers of inflammation have been associated with oncologic outcomes. Prognostic markers are not well-defined for renal cell carcinoma (RCC). We sought to investigate the association of preoperative neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and De Ritis ratio with mortality in RCC. Methods Multi-center retrospective analysis of patients undergoing surgery for RCC. Primary outcome of interest was all-cause mortality (ACM). Secondary outcomes were non-cancer mortality (NCM) and cancer-specific mortality (CSM). Elevated NLR was defined as ≥2.27, elevated PLR as ≥165, and elevated De Ritis ratio as ≥ 2.72. Multivariable cox regression analysis (MVA) was conducted to elucidate risk factors for primary and secondary outcomes, and Kaplan-Meier analysis (KMA) was used to evaluate survival outcomes comparing elevated and non-elevated NLR, PLR, and De Ritis ratio. Results 2656 patients were analyzed (874 patients had elevated NLR; 480 patients had elevated PLR and 932 patients had elevated De Ritis). Elevated NLR was a significant predictor of ACM (HR 1.32, 95% CI: 1.07-1.64, p=0.003) and NCM (HR 1.79, 95% CI: 1.30-2.46, p<0.001) in MVA. Elevated De Ritis was a significant predictor of ACM (HR 2.04, 95% CI: 1.65-2.52), NCM (HR 1.84, 95% CI: 1.33-2.55, p<0.001), and CSM (HR 1.97, 95% CI:1.48-2.63, p<0.001). KMA revealed significant difference in 5-year overall survival (OS) (48% vs. 68%, p<0.001), non-cancer survival (NCS) (69% vs. 87%, p<0.001), and cancer-specific survival (CSS) (60% vs. 73%, p<0.001) for elevated versus non-elevated NLR. For PLR, there was a difference in 5-year OS (51% vs. 61%, p<0.001) and CSS (60% vs. 73%, p<0.001) with KMA. Conclusions Elevated NLR was independently associated with worse ACM and NCM, while elevated De Ritis was predictive for CSM in addition to ACM and NCM. These differences may be useful in refining risk stratification with respect to cancer-related and non-cancer mortality in RCC patients and deserve further investigation.
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Affiliation(s)
- Cathrine Keiner
- Department of Urology, UC San Diego School of Medicine, La Jolla, CA, United States
| | - Margaret Meagher
- Department of Urology, UC San Diego School of Medicine, La Jolla, CA, United States
| | - Dattatraya Patil
- Department of Urology, Emory University School of Medicine, Atlanta, GA, United States
| | - Kazutaka Saito
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Arman Walia
- Department of Urology, UC San Diego School of Medicine, La Jolla, CA, United States
| | - Franklin Liu
- Department of Urology, UC San Diego School of Medicine, La Jolla, CA, United States
| | - Raksha Dutt
- Department of Urology, UC San Diego School of Medicine, La Jolla, CA, United States
| | - Nathan Miller
- Department of Urology, UC San Diego School of Medicine, La Jolla, CA, United States
| | - Sohail Dhanji
- Department of Urology, UC San Diego School of Medicine, La Jolla, CA, United States
| | - Ava Saidian
- Department of Urology, UC San Diego School of Medicine, La Jolla, CA, United States
| | - Fang Wan
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yosuke Yasuda
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yasuhisa Fujii
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hajime Tanaka
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Viraj Master
- Department of Urology, Emory University School of Medicine, Atlanta, GA, United States
| | - Ithaar Derweesh
- Department of Urology, UC San Diego School of Medicine, La Jolla, CA, United States,*Correspondence: Ithaar Derweesh,
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Rades D, Cacicedo J, Lomidze D, Al-Salool A, Segedin B, Groselj B, Schild SE. Prognostic Value of Preclinical Markers after Radiotherapy of Metastatic Spinal Cord Compression-An Additional Analysis of Patients from Two Prospective Trials. Cancers (Basel) 2022; 14:cancers14102547. [PMID: 35626151 PMCID: PMC9139528 DOI: 10.3390/cancers14102547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/18/2022] [Accepted: 05/20/2022] [Indexed: 02/04/2023] Open
Abstract
For optimal personalization of treatment for metastatic spinal cord compression (MSCC), the patient’s survival prognosis should be considered. Estimation of survival can be facilitated by prognostic factors. This study investigated the prognostic value of pre-treatment preclinical markers, namely hemoglobin, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lactate dehydrogenase (LDH), and c-reactive protein (CRP), in 190 patients from two prospective trials who had poor or intermediate survival prognoses and were irradiated for MSCC with motor deficits. In addition, clinical factors including radiation regimen, age, gender, tumor type, interval from tumor diagnosis to MSCC, number of affected vertebrae, visceral metastases, other bone metastases, time developing motor deficits, ambulatory status, sensory function, and sphincter function were evaluated. On univariate analyses, NLR (p = 0.033), LDH (p < 0.001), CRP (p < 0.001), tumor type (p < 0.001), pre-radiotherapy ambulatory status (p < 0.001), and sphincter function (p = 0.011) were significant. In the subsequent Cox regression analysis, LDH (p = 0.007), CRP (p = 0.047), tumor type (p = 0.003), and ambulatory status (p = 0.010) maintained significance. In addition to clinical factors, preclinical markers may help in estimating the survival of patients irradiated for MSCC. Additional prospective trials are warranted.
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Affiliation(s)
- Dirk Rades
- Department of Radiation Oncology, University of Lubeck, 23562 Lubeck, Germany;
- Correspondence: ; Tel.: +49-451-500-45400
| | - Jon Cacicedo
- Department of Radiation Oncology, Cruces University Hospital/Biocruces Health Research Institute, 48903 Barakaldo, Bizkaia, Spain;
| | - Darejan Lomidze
- Radiation Oncology Department, Tbilisi State Medical University and Ingorokva High Medical Technology University Clinic, Tbilisi 0177, Georgia;
| | - Ahmed Al-Salool
- Department of Radiation Oncology, University of Lubeck, 23562 Lubeck, Germany;
| | - Barbara Segedin
- Department of Radiotherapy, Institute of Oncology Ljubljana, University of Ljubljana, 1000 Ljubljana, Slovenia; (B.S.); (B.G.)
| | - Blaz Groselj
- Department of Radiotherapy, Institute of Oncology Ljubljana, University of Ljubljana, 1000 Ljubljana, Slovenia; (B.S.); (B.G.)
| | - Steven E. Schild
- Department of Radiation Oncology, Mayo Clinic, Scottsdale, AZ 85259, USA;
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Zhou X, Luo G. A meta-analysis of the platelet-lymphocyte ratio: A notable prognostic factor in renal cell carcinoma. Int J Biol Markers 2022; 37:123-133. [PMID: 35238678 DOI: 10.1177/03936155221081536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The platelet-lymphocyte ratio (PLR) has been assessed in some studies on renal cell carcinoma (RCC), but the results have been inconsistent. This meta-analysis aims to review and report the latest data regarding the prognostic role of the PLR in RCC patients. METHOD Articles were searched in the PubMed, EMBASE, and Cochrane Library electronic databases. Studies were filtered according to a selection strategy, and data corresponding to the index of interest were extracted. A fixed-effects model or random-effects model was selected based on heterogeneity. The sensitivity analysis was carried out by eliminating the studies one by one. Finally, funnel plots and Egger's test were used to assess publication bias, and the trim and fill method was used to assess the impact of bias on the results. RESULTS In total, 15,193 patients with RCC from 44 studies were included in this meta-analysis. The pooled analysis indicated that the higher the PLR was, the poorer the prognosis for RCC patients in terms of overall survival (hazard ratio (HR) = 1.01 (95% confidence interval (CI) 1.00, 1.02), P = 0.010), cancer-special survival (CSS) (HR = 1.21 (95% CI 1.00, 1.46), P = 0.05), progression-free survival (HR = 1.44 (95% CI 1.28, 1.62), P < 0.00001), recurrence-free survival (HR = 1.73 (95% CI 1.11, 2.71), P = 0.02), disease-free survival (HR = 1.63 (95% CI 0.91, 2.94), P = 0.01) and metastasis-free survival (HR = 1.223 (95% CI 0.712, 2.099), P = 0.466). In the subgroup analysis of high PLR, targeted treatment, TKI use, nivolumab use, surgical treatment, clear cell RCC, metastasis, Asian race, and high PLR were related to poor prognosis. CONCLUSION This study showed that a high PLR was associated with the poor prognosis of RCC patients, but more studies are needed to confirm the value of the PLR.
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Affiliation(s)
- Xiao Zhou
- Department of Urology, 66366Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Guangcheng Luo
- Department of Urology, 66366Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
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Wu X, Yao Y, Dai Y, Diao P, Zhang Y, Zhang P, Li S, Jiang H, Cheng J. Identification of diagnostic and prognostic signatures derived from preoperative blood parameters for oral squamous cell carcinoma. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:1220. [PMID: 34532357 PMCID: PMC8421978 DOI: 10.21037/atm-21-631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 05/17/2021] [Indexed: 11/06/2022]
Abstract
Background We aimed to develop novel diagnostic and prognostic signatures based on preoperative inflammatory, immunological, and nutritional parameters in blood (PIINPBs) by machine learning algorithms for patients with oral squamous cell carcinoma (OSCC). Methods A total of 486 OSCC patients and 200 age and gender-matched non-OSCC patients who were diagnosed and treated at our institution for noninfectious, nontumor diseases were retrospectively enrolled and divided into training and validation cohorts. Based on PIINPB, 6 machine learning classifiers including random forest, support vector machine, extreme gradient boosting, naive Bayes, neural network, and logistic regression were used to derive diagnostic models, while least absolute shrinkage and selection operator (LASSO) analyses were employed to construct prognostic signatures. A novel prognostic nomogram integrating a PIINPB-derived prognostic signature and selected clinicopathological parameters was further developed. Performances of these signatures were assessed by receiver operating characteristic (ROC) curves, calibrating curves, and decision tree. Results Diagnostic models developed by machine learning algorithms from 13 PIINPBs, which included counts of white blood cells (WBC), neutrophils (N), monocytes (M), lymphocytes (L), platelets (P), albumin (ALB), and hemoglobin (Hb), along with albumin-globulin ratio (A/G), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), lymphocyte-monocyte ratio (LMR), systemic immune-inflammation index (SII), and prognostic nutritional index (PNI), displayed satisfactory discriminating capabilities in patients with or without OSCC, and among OSCC patients with diverse pathological grades and clinical stages. A prognostic signature based on 6 survival-associated PIINPBs (L, P, PNI, LMR, SII, A/G) served as an independent factor to predict patient survival. Moreover, a novel nomogram integrating prognostic signature and tumor size, pathological grade, cervical node metastasis, and clinical stage significantly enhanced prognostic power [3-year area under the curve (AUC) =0.825; 5-year AUC =0.845]. Conclusions Our results generated novel and robust diagnostic and prognostic signatures derived from PIINPBs by machine learning for OSCC. Performance of these signatures suggest the potential for PIINPBs to supplement current regimens and provide better patient stratification and prognostic prediction.
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Affiliation(s)
- Xiang Wu
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, China.,Department of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital, Nanjing Medical University, Nanjing, China
| | - Yuan Yao
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, China
| | - Yibin Dai
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, China
| | - Pengfei Diao
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, China
| | - Yuchao Zhang
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, China
| | - Ping Zhang
- Department of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital, Nanjing Medical University, Nanjing, China
| | - Sheng Li
- Department of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital, Nanjing Medical University, Nanjing, China
| | - Hongbing Jiang
- Department of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital, Nanjing Medical University, Nanjing, China
| | - Jie Cheng
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, China.,Department of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital, Nanjing Medical University, Nanjing, China
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Duan S, Sun L, Zhang C, Wu L, Nie G, Huang Z, Xing C, Zhang B, Yuan Y. Association of platelet-to-lymphocyte ratio with kidney clinicopathologic features and renal outcomes in patients with diabetic kidney disease. Int Immunopharmacol 2021; 93:107413. [PMID: 33524800 DOI: 10.1016/j.intimp.2021.107413] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 01/15/2021] [Accepted: 01/17/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND Growing evidence points to the pivotal role of inflammation in the pathogenesis of diabetic kidney disease (DKD). However, as an inflammation-based prognostic score, the significance of platelet-to-lymphocyte ratio (PLR) in biopsy-proven DKD remains uncertain. Therefore, the current study aimed to evaluate the association of PLR with the clinicopathological features and the progression of DKD. METHODS In total, 167 patients with biopsy-proven T2DKD were retrospectively recruited. Clinicopathological characteristics were compared according to the tertiles of baseline PLR. Pearson's or Spearman correlations were used to examine the associations between PLR and baseline characteristics. Assessment of the prospective relationship of PLR with the kidney outcomes defined as a doubling of baseline serum creatinine or onset of end stage renal disease (ESRD), were investigated by Kaplan-Meier survival analysis. Moreover, a cubic spline curve was further calculated to explore the significance of PLR in DKD prognosis. On top of that, identification of the risk factors associated with DKD progression was executed by a model of Cox proportional hazards. RESULTS Median follow-up period was 23.77 months, during which 92 (55.1%) patients confronted DKD progression. Pearson's correlation indicated that urinary protein increased along with PLR rising (r = 0.193, P = 0.012). Kaplan-Meier survival curves revealed a significantly increased probability of event-free survival in the lowest tertile of PLR compared to those in the highest tertile (P = 0.018). A statistical linear correlation between PLR and DKD development was demonstrated by a restricted cubic spline analysis (P for nonlinear = 0.784). In addition, the analyses of multivariate Cox regression indicated that elevated PLR had an association with a greater risk of DKD progression (HR 1.004, 95%CI [1.000-1.008], P = 0.035), which was verified to be an independent risk factor for renal outcomes. CONCLUSIONS Our findings demonstrated that the PLR was associated with proteinuria and prognosis in DKD patients. It was an independent risk factor for kidney progression in biopsy-proven DKD.
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Affiliation(s)
- Suyan Duan
- Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, PR China
| | - Lianqin Sun
- Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, PR China
| | - Chengning Zhang
- Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, PR China
| | - Lin Wu
- Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, PR China
| | - Guangyan Nie
- Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, PR China
| | - Zhimin Huang
- Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, PR China
| | - Changying Xing
- Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, PR China.
| | - Bo Zhang
- Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, PR China.
| | - Yanggang Yuan
- Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, PR China.
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Zhuang Z, Li Y, Hong Y, Chen L, Qian J, Lin J, Chen Q, Qiu Y, Lin L, Shi B, Pan L, Zheng X, Wang J, Liu F, He B, Chen F. A novel prognostic score based on systemic inflammatory biomarkers for patients with oral squamous cell carcinoma. Oral Dis 2021; 28:631-638. [PMID: 33426698 DOI: 10.1111/odi.13774] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 12/17/2020] [Accepted: 01/04/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To explore the prognostic value of systemic inflammatory biomarkers (albumin/globulin ratio [AGR], neutrophil/lymphocyte ratio [NLR], and platelet/lymphocyte ratio [PLR]) in patients with oral squamous cell carcinoma (OSCC), and further develop a novel prognostic score (AGR-NLR). METHODS A large-scale prospective study enrolling 792 eligible patients from December 2002 to June 2018 was carried out at the First Affiliated Hospital of Fujian Medical University. Three multivariate Cox regression models were performed to assess the association of overall survival (OS) with systemic inflammatory biomarkers, quantified by Akaike information criterion (AIC). Then, a novel AGR-NLR score was established and incorporated into a prognostic nomogram. RESULTS In the univariate analysis, the increased AGR was associated with a reduced risk of death. Conversely, the higher NLR and PLR, the worse the OS. In the multivariate Cox regression models, AGR and NLR were stably independent prognostic indicators in all models, with Model 2 showing a lowest AIC (AGR: HR = 0.56, 95%CI: 0.41-0.78; NLR: HR = 1.80, 95%CI: 1.07-3.04). Then, a novel AGR-NLR score was established, which showed a more excellent performance than either AGR or NLR alone (area under curve [AUC]: 0.589, 0.559, and 0.556, respectively). The C-index of the nomogram based on AGR-NLR was superior to that of traditional TNM staging system (C-index: 0.658 versus. 0.596, p < .001). Similar results were also showed by decision curve analysis, indicating the nomogram had more positive net benefit compared to TNM staging system. CONCLUSION The novel AGR-NLR score is strongly associated with outcome in patients with OSCC and could be serve as a useful tool to accurately predict the OS of OSCC patients.
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Affiliation(s)
- Zhaocheng Zhuang
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fujian, China.,Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fujian, China
| | - Yanfen Li
- Department of Periodontology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Yihong Hong
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fujian, China.,Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fujian, China
| | - Lin Chen
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fujian, China.,Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fujian, China
| | - Jiawen Qian
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fujian, China.,Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fujian, China
| | - Jing Lin
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fujian, China.,Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fujian, China
| | - Qing Chen
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fujian, China.,Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fujian, China
| | - Yu Qiu
- Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Lisong Lin
- Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Bin Shi
- Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Lizhen Pan
- Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Xiaoyan Zheng
- Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Jing Wang
- Laboratory Center, The Major Subject of Environment and Health of Fujian Key Universities, School of Public Health, Fujian Medical University, Fujian, China
| | - Fengqiong Liu
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fujian, China.,Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fujian, China
| | - Baochang He
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fujian, China.,Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fujian, China.,Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Fa Chen
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fujian, China.,Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fujian, China
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