Inflammation-Based Prognostic Score Predicts Postoperative Survival of Patients with Interstitial Pneumonia After Undergoing Lung Cancer Resection

Serum amyloid A protein in cancer prognosis: a meta-analysis and systematic review

Background

Published studies showed divergent results of the prognostic value of serum amyloid A protein (SAA) in patients with different cancers. Therefore, we conducted this meta-analysis so as to assess the association between SAA and cancer prognosis.

Methods

A comprehensive search was conducted to identify the literatures working over SAA and survival in patients with cancers published until January 2020. Sufficient data for assessing overall survival in cancers were extracted descriptively and quantitatively from the studies and a pooled odds ratio was calculated using the Mantel-Haenszel fixed-effect or random-effect model.

Results

Ten eligible papers were identified by two reviewers independently, including 4 studies that evaluated renal cell carcinoma (RCC), 2 studies evaluated lung cancer and the other 3 studies evaluated melanoma, gastric cancer and different cancers. Elevated SAA expression and shorter overall survival (OS) had a statistically significant relation [pooled 1-year OR was 5.07, 95% confidence interval (CI), 3.71–6.94, Q=9.15, I²=0%; pooled 3-year OR was 4.21, 95% CI, 3.18–5.56, Q=14.94, I²=46%; pooled 5-year OR was 5.69, 95% CI, 2.66–12.18, Q=24.83, I²=80%]. Subgroup analysis of RCC patients showed remarkable association between SAA and shorter OS (pooled 1-year OR =4.76, 95% CI, 3.00–7.56, Q=4.18, I²=4%; pooled 3-year OR =4.89, 95% CI, 3.06–7.81, Q=2.88, I²=0%).

Conclusions

High SAA status is correlated with an unfavorable OS in different cancers, especially in RCC, and digestive cancer.

Prognostic and Predictive Value of Circulating Inflammation Signature in Non-Metastatic Nasopharyngeal Carcinoma: Potential Role for Individualized Induction Chemotherapy

Purpose

We sought to assess the prognostic and predictive value of a circulating inflammation signature (CISIG) and develop CISIG-based tools for predicting prognosis and guiding individualized induction chemotherapy (ICT) in non-metastatic nasopharyngeal carcinoma (NPC).

Patients and Methods

We retrospectively collected a candidate inflammatory biomarker panel from patients with NPC treated with definitive radiotherapy between 2012 and 2017. We developed the CISIG using candidate biomarkers identified by a least absolute shrinkage and selection operator (LASSO) Cox regression model. The Cox regression analyses were used to evaluate the CISIG prognostic value. A CISIG-based prediction model was constructed, validated, and assessed. Potential stratified ICT treatment effects were examined.

Results

A total of 1149 patients were analyzed. Nine biomarkers selected by LASSO regression in the training cohort were used to construct the CISIG, including hyaluronidase, laminin, procollagen III, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, high-density lipoprotein, lactate dehydrogenase, and C-reactive protein-to-albumin ratio. CISIG was an independent prognostic factor for disease-free survival (DFS; hazard ratio: 2.65, 95% confidence interval: 1.93–3.64; P < 0.001). High CISIG group (>−0.2) was associated with worse 3-year DFS than low CISIG group in both the training (67.5% vs 88.3%, P < 0.001) and validation cohorts (72.3% vs 85.1%, P < 0.001). We constructed and validated a CISIG-based nomogram, which showed better performance than the clinical stage and Epstein–Barr virus DNA classification methods. A significant interaction between CISIG and the ICT treatment effect was observed (P for interaction = 0.036). Patients with high CISIG values did not benefit from ICT, whereas patients with low CISIG values significantly benefited from ICT.

Conclusion

The developed CISIG, based on a circulating inflammatory biomarker panel, adds prognostic information for patients with NPC. The proposed CISIG-based tools offer individualized risk estimation to facilitate suitable ICT candidate identification.

Serum Carcinoembryonic Antigen Level Predicts Cancer-Specific Outcomes of Resected Non-Small Cell Lung Cancer With Interstitial Pneumonia

Background

It has been well accepted that the prognosis of non-small cell lung cancer (NSCLC) patients with interstitial pneumonia (IP) is significantly poor. However, there are only a few studies that indicated the prognostic factors, especially tumor markers, among NSCLC patients with IP.

Methods

Forty-one NSCLC patients with IP who underwent surgery at our institution were included. Patients died of other diseases including postoperative acute exacerbation (AE) of IP were excluded. Univariate and multivariate analyses were calculated by the Cox proportional hazards regression model.

Results

The 5-year cancer-specific survival of overall and stage I patients were 37.4% and 39.2%, respectively. The 5-year cancer-specific survival of patients with high serum carcinoembryonic antigen (CEA) level was 9.4%, while that with normal serum CEA level was 55.6%. However, serum cytokeratin-19 fragment (CYFRA 21-1) and squamous cell carcinoma-related antigen (SCC) levels were not associated with patients’ survival. Furthermore, serum CEA level was significantly associated with poorer cancer-specific survival in univariate and multivariate analyses.

Conclusions

This study demonstrated that serum CEA level might serve as an efficient prognostic indicator after surgery in NSCLC with IP.