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Kong X, Liu P, Wang G, Sun S, Li L. Methods for diagnosing malnutrition in patients with esophageal cancer, and the association with nutritional and inflammatory indices: A cross‑sectional study. Oncol Lett 2025; 29:223. [PMID: 40110582 PMCID: PMC11921283 DOI: 10.3892/ol.2025.14969] [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: 11/20/2024] [Accepted: 02/14/2025] [Indexed: 03/22/2025] Open
Abstract
Clinically, it is important to diagnose malnutrition for the treatment and prognosis of cancer patients; however, at present, there are no established standards. The present study evaluated the consistency of malnutrition diagnostic tools in association with relevant nutritional and inflammatory markers in patients with advanced esophageal cancer. Specifically, the Patient-Generated Subjective Global Assessment (PG-SGA) and Global Leadership Initiative on Malnutrition (GLIM) tools were assessed. Patients with a new diagnosis of esophageal cancer at Tengzhou Central People's Hospital (Tengzhou, China) between January 2023 and December 2023 were evaluated within 24 h of admission using Nutritional Risk Screening 2002 (NRS2002), GLIM and PG-SGA. Additionally, relevant physical examinations and laboratory data were collected. The malnutrition occurrence rates based on PG-SGA, GLIM and GLIM with NRS2002 screening (NRS2002-GLIM) were 75.01, 51.88 and 41.25%, respectively. The agreement between PG-SGA and GLIM, and between PG-SGA and NRS2002-GLIM diagnoses was weak (κ=0.379, P<0.001; and κ=0.376, P<0.001, respectively). PG-SGA showed a moderate negative correlation with body mass index (BMI) (rs=-0.460), weak positive correlations with age (rs=0.234) and IL-6 (rs=0.249), and very weak negative correlations with albumin (rs=-0.178) and PNI (rs=-0.168). While the indicators correlated with GLIM and PG-SGA were consistent, the strength of correlation varied slightly. Logistic regression analysis of PG-SGA and GLIM indicated that age and BMI were independent risk factors for malnutrition. In addition, PG-SGA also showed that the neutrophil count was an independent risk factor for malnutrition. Overall, patients with esophageal cancer exhibit a high incidence of malnutrition, and different diagnostic methods provide varying results. Malnutrition is closely associated with age, inflammatory markers and BMI, suggesting their potential utility in guiding nutritional interventions for patients with esophageal cancer.
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Affiliation(s)
- Xueyuan Kong
- Department of Oncology, Tengzhou Central People's Hospital, Tengzhou, Zaozhuang, Shandong 277500, P.R. China
| | - Ping Liu
- Department of Oncology, Tengzhou Central People's Hospital, Tengzhou, Zaozhuang, Shandong 277500, P.R. China
| | - Guotian Wang
- Department of Oncology, Tengzhou Central People's Hospital, Tengzhou, Zaozhuang, Shandong 277500, P.R. China
| | - Shiqing Sun
- Department of Oncology, Tengzhou Central People's Hospital, Tengzhou, Zaozhuang, Shandong 277500, P.R. China
| | - Ling Li
- Department of Oncology, Tengzhou Central People's Hospital, Tengzhou, Zaozhuang, Shandong 277500, P.R. China
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Chmielewski PP, Strzelec B, Mozdziak P, Kempisty B. Neutrophil-to-Lymphocyte Ratio as a Prognostic Biomarker for Long-Term Survival in Older Adults at a Mental Health Care Center: A Historical Cohort Analysis. J Clin Med 2025; 14:2509. [PMID: 40217958 PMCID: PMC11989978 DOI: 10.3390/jcm14072509] [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: 02/25/2025] [Revised: 03/24/2025] [Accepted: 04/03/2025] [Indexed: 04/14/2025] Open
Abstract
Background/Objectives: Identifying reliable biomarkers for healthy aging and longevity is a fundamental challenge in aging research and medical sciences. The neutrophil-to-lymphocyte ratio (NLR) is a readily measurable indicator of immune balance that reflects the interplay between innate immune activation and adaptive immune suppression. Methods: This study examined NLR values in 204 physically healthy residents (98 men and 106 women) stratified into four lifespan categories based on death certificates. Page's test and ordinal regression (Cumulative Link Model) were used to assess trends with longevity. Results: In men, a downward trend in NLR values was observed. In women, a significant age-related decline in NLR was identified, with longer-lived individuals showing notably lower NLR values compared to their shorter-lived counterparts. The findings suggest that lower NLR is associated with longer survival, particularly in older women, reflecting superior immune regulation and reduced systemic inflammation. Conversely, elevated NLR may indicate immune dysfunction and heightened inflammatory burden. Conclusions: The results of this study complement existing findings, reinforcing the critical importance of immune balance in supporting healthy aging and longevity. These findings also underscore the potential of NLR as a robust biomarker for evaluating immune function and anticipating resilience to age-related decline, offering a practical tool for assessing immune health in the aging population.
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Affiliation(s)
- Piotr Paweł Chmielewski
- Division of Anatomy, Department of Human Morphology and Embryology, Faculty of Medicine, Wroclaw Medical University, 6a Chalubinskiego Street, 50-368 Wroclaw, Poland;
| | - Bartłomiej Strzelec
- 2nd Department of General Surgery and Surgical Oncology, Medical University Hospital, 50-345 Wroclaw, Poland;
| | - Paul Mozdziak
- Prestige Department of Poultry Science, College of Agriculture and Life Sciences, North Carolina State University, Raleigh, NC 27695-7608, USA;
| | - Bartosz Kempisty
- Division of Anatomy, Department of Human Morphology and Embryology, Faculty of Medicine, Wroclaw Medical University, 6a Chalubinskiego Street, 50-368 Wroclaw, Poland;
- Prestige Department of Poultry Science, College of Agriculture and Life Sciences, North Carolina State University, Raleigh, NC 27695-7608, USA;
- Department of Veterinary Surgery, Institute of Veterinary Medicine, Nicolaus Copernicus University, 87-100 Toruń, Poland
- Center of Assisted Reproduction, Department of Obstetrics and Gynecology, University Hospital and Masaryk University, 625 00 Brno, Czech Republic
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Zhao B, Wang YQ, Zhu HT, Li XT, Shi YJ, Sun YS. Integrating tumour and lymph node radiomics features for predicting disease-free survival in locally advanced esophageal squamous cell cancer after neoadjuvant chemotherapy and complete resection. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2025; 51:109547. [PMID: 39729864 DOI: 10.1016/j.ejso.2024.109547] [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: 05/16/2024] [Revised: 11/27/2024] [Accepted: 12/11/2024] [Indexed: 12/29/2024]
Abstract
PURPOSE To investigate the utility of combined tumour and lymph node (LN) radiomics features in predicting disease-free survival (DFS) among patients with locally advanced esophageal squamous cell carcinoma (ESCC) after neoadjuvant chemotherapy and resection. METHODS We retrospectively enrolled 176 ESCC patients from January 2013 to December 2016. Tumour and targeted LN segmentation were performed on venous phase CT images. Models were constructed using LASSO Cox regression: a clinical model, a clinical-tumour radiomics model, and a clinical-tumour-LN radiomics model. Model fitting was evaluated using Akaike information criterion and likelihood ratio (LR), while performance was assessed using Harrell's concordance index (C-index) and time-dependent receiver operating characteristic analysis. RESULTS The clinical model included clinical stage and neutrophil-to-lymphocyte ratio (NLR). Integration of tumour features significantly improved prognostic accuracy (clinical-tumour model vs. clinical model, LR: 17.84 vs. 11.84, P = 0.049). Subsequent integration of LN features further augmented model performance (clinical-tumour-LN model vs. clinical-tumour model, LR: 24.48 vs. 17.84, P = 0.009). The final model included clinical stage, NLR, two tumour features (Conventional_mean and GLZLM_HGZE), and one LN feature (GLCM_entropy). The C-index was 0.68 for the training set and 0.70 for the test set. The nomogram based on these features effectively stratified patients into high- and low-risk groups (P < 0.001). CONCLUSIONS The clinical-tumour-LN model, integrating clinical stage, NLR, and radiomics features, outperformed simpler models in predicting DFS among ESCC patients after neoadjuvant chemotherapy and resection. This underscores the potential of radiomics data to enhance prognostic models, offering clinicians a more robust tool for assessment.
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Affiliation(s)
- Bo Zhao
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiology, Peking University Cancer Hospital & Institute, Beijing, 100142, China
| | - Ya-Qi Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Thoracic Surgery II, Peking University Cancer Hospital & Institute, Beijing, 100142, China
| | - Hai-Tao Zhu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiology, Peking University Cancer Hospital & Institute, Beijing, 100142, China
| | - Xiao-Ting Li
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiology, Peking University Cancer Hospital & Institute, Beijing, 100142, China
| | - Yan-Jie Shi
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiology, Peking University Cancer Hospital & Institute, Beijing, 100142, China
| | - Ying-Shi Sun
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiology, Peking University Cancer Hospital & Institute, Beijing, 100142, China.
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Ürün YY, Beypinar İ. Inflammatory Biomarkers from Blood Counts as Prognostic Tools in Metastatic Esophageal Cancer. Med Sci Monit 2025; 31:e947202. [PMID: 39923126 PMCID: PMC11823267 DOI: 10.12659/msm.947202] [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: 01/03/2025] [Accepted: 12/19/2024] [Indexed: 02/10/2025] Open
Abstract
BACKGROUND Globally, esophageal cancer ranks as the sixth leading cause of cancer-related mortality. This retrospective study from a single center in Turkey aimed to evaluate hematological inflammatory biomarkers in complete blood count (CBC) data and outcomes in 113 patients with advanced esophageal carcinomas. MATERIAL AND METHODS We conducted a retrospective analysis of 113 patients with metastatic esophageal cancer composed of squamous (92), adenocarcinoma (18), and small cell (3) histology. We investigated neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), neutrophil-to-platelet lymphocyte ratio (NLPR), neutrophile-to-monocyte ratio (NMR), systemic inflammation index (SII), systemic inflammatory response index (SIRI), and aggregate index of systemic inflammation (AISI) in terms of prognosis. RESULTS The initial treatment for 25.7% of patients consisted of a carboplatin-paclitaxel combination. In response to the initial round of chemotherapy, 52.2% of patients showed improvement (15% complete, 37.2% partial), while 18.6% experienced disease progression. Neutropenia was observed as the most prevalent severe (grades 3-4) adverse reaction, affecting 19.8% of patients. Higher NLR, PLR, SII, NLPR, SIRI, and AISI values were associated with worse survival (P=0.016, P=0.008, P=0.011, P=0.028, P=0.014, P=0.001, respectively), whereas higher LMR was correlated with better survival (P=0.001). The NMR analysis showed no significant association (P=0.46). Multivariate analysis identified independent prognostic factors except histology, PLR, and NLPR. CONCLUSIONS Research indicates that inflammatory indicators obtained from complete blood count analyses possess prognostic significance for individuals with metastatic esophageal cancer. These biomarkers demonstrate diverse capacities in forecasting the course of the disease. These simple and inexpensive markers need further confirmation to guide individualized treatment planning.
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Affiliation(s)
- Yonca Yılmaz Ürün
- Department of Gastroenterology, Van Yüzüncüyıl University, Van, Türkiye
| | - İsmail Beypinar
- Department of Medical Oncology, Alanya Alaaddin Keykubat University, Alanya, Türkiye
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Popa C, Schlanger D, Aiolfi A, ElShafei M, Triantafyllou T, Theodorou D, Skrobic O, Simic A, Al Hajjar N, Bonavina L. Biomarkers associated with anastomotic leakage after esophagectomy: a systematic review. Langenbecks Arch Surg 2025; 410:55. [PMID: 39875600 PMCID: PMC11775071 DOI: 10.1007/s00423-025-03617-8] [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: 06/09/2024] [Accepted: 01/16/2025] [Indexed: 01/30/2025]
Abstract
PURPOSE Anastomotic leakage (AL) is one of the most important complications that occurs after upper gastrointestinal surgery, registering rates of 20-30% after esophagectomy. The role of systemic inflammatory biomarkers to predict anastomotic leaks is controversial and needs systematization. METHODS A systematic review based on the PRISMA guidelines criteria was performed. PubMed, Scopus, and Embase were queried using MESH Terms and All Fields key words to identify studies investigating a range of immune-inflammatory factors in predicting AL. RESULTS Twenty-four studies were included in this review. The total number of included patients was 5903, ranging in each study from 42 to 612. The included studies reported patients that underwent different techniques of esophagectomy (Ivor Lewis, McKeown, Orringer or thoracoabdominal esophagectomy) and 23 out of 24 studies included patients that underwent neoadjuvant treatment. While different biomarkers at different timepoints were analyzed, most studies have indicated postoperative biomarkers, between day 3 and day 5 to reach statistical significance. CONCLUSIONS Systemic inflammatory biomarkers represent potential risk stratification and predicting tools for AL after esophageal surgery, but more studies need to be conducted to validate their clinical utility.
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Affiliation(s)
- Călin Popa
- University of Medicine and Pharmacy Iuliu Hatieganu Cluj-Napoca, Regional Institute of Gastroenterology and Hepatology O. Fodor Cluj-Napoca, Croitorilor 19-21, 400162, Cluj-Napoca-Napoca, Romania
| | - Diana Schlanger
- University of Medicine and Pharmacy Iuliu Hatieganu Cluj-Napoca, Regional Institute of Gastroenterology and Hepatology O. Fodor Cluj-Napoca, Croitorilor 19-21, 400162, Cluj-Napoca-Napoca, Romania.
| | - Alberto Aiolfi
- General Surgery, Istituto Clinico Sant'Ambrogio, Milan, Italy
| | - Moustafa ElShafei
- Krakenhaus Nordwest, Allgemein-Viszeral- Und Minimal Invasive Chirurgie, Frankfurt, Germany
| | | | | | - Ognjan Skrobic
- Department of Esophageal and Gastric Surgery, University Clinical Centre of Serbia, University of Belgrade, Belgrade, Serbia
| | - Aleksandar Simic
- Department of Esophageal and Gastric Surgery, University Clinical Centre of Serbia, University of Belgrade, Belgrade, Serbia
| | - Nadim Al Hajjar
- University of Medicine and Pharmacy Iuliu Hatieganu Cluj-Napoca, Regional Institute of Gastroenterology and Hepatology O. Fodor Cluj-Napoca, Croitorilor 19-21, 400162, Cluj-Napoca-Napoca, Romania
| | - Luigi Bonavina
- Division of General and Foregut Surgery, University of Milan, IRCCS Policlinico San Donato, San Donato Milanese (Milano), Italy
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Brown LR, Soupashi M, Yule MS, Grossart CM, McMillan DC, Laird BJA, Wigmore SJ, Skipworth RJE. A Comparison of Established Diagnostic Criteria for Cachexia and Their Impacts on Prognostication in Patients with Oesophagogastric Cancer. Cancers (Basel) 2025; 17:448. [PMID: 39941814 PMCID: PMC11816078 DOI: 10.3390/cancers17030448] [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: 01/04/2025] [Revised: 01/23/2025] [Accepted: 01/26/2025] [Indexed: 02/16/2025] Open
Abstract
BACKGROUND Cachexia is common in patients with oesophagogastric cancer. The syndrome is characterised by tissue wasting (muscle and fat), anorexia, and reduced physical function, which result from complex interactions between the tumour and its host. Heterogeneity in the diagnostic criteria used for cachexia has hindered their clinical utilisation. This study aimed to compare the two established cachexia definitions (Fearon's consensus definition and the Global Leadership Initiative on Malnutrition [GLIM] criteria) and their relationships with survival in patients with oesophagogastric cancer. METHODS Consecutive patients newly diagnosed with oesophagogastric cancer (January 2019 to December 2020) were identified from a prospective regional database. Involuntary weight loss, BMI, CT body composition analyses, and neutrophil-lymphocyte ratios were recorded at clinical staging. These data were used to assess patients for cachexia according to Fearon and GLIM diagnostic criteria. The primary outcome of interest was overall survival. RESULTS Overall, 465 patients (66.9% male, median 71 years) were diagnosed with oesophagogastric cancer during the 2-year study period. Cachectic proportions differed between definitions (Fearon: 59.1% vs. GLIM: 44.1%), and only 49.1% of the 322 patients who met one set of diagnostic criteria were cachectic according to both. Patients who met the GLIM criteria were significantly more comorbid and had a poorer performance status; however, no such difference was evident when using the Fearon definition. Those patients who met either set of diagnostic criteria had shorter survival than those who met neither (p < 0.001). Following adjustment for confounders, GLIM-defined cachexia was more strongly associated with reduced survival (aHR: 1.57 [95% CI: 1.25-1.96], p < 0.001) than Fearon-defined cachexia (aHR: 1.41 [95% CI: 1.13-1.76], p = 0.002). Patients who only met the Fearon diagnostic criteria had prolonged survival (median: 363 days) when compared to those who met only GLIM (median: 158 days) or both definitions (median: 120 days). A secondary analysis of those patients who met the GLIM diagnostic criteria (n = 205) compared the three potential phenotypical criteria used in this definition. Only reduced muscle mass, and not low BMI or weight loss, was associated with poorer survival (aHR: 1.88 [95% CI: 1.15-3.07], p = 0.012) in this group. CONCLUSIONS Cancer cachexia is strongly associated with shortened survival in patients with oesophagogastric cancer. Classification using the GLIM criteria provides more effective prognostication and this definition should be utilised in multidisciplinary patient care.
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Affiliation(s)
- Leo R. Brown
- Clinical Surgery, University of Edinburgh, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK (R.J.E.S.)
| | - Maria Soupashi
- Clinical Surgery, University of Edinburgh, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK (R.J.E.S.)
| | - Michael S. Yule
- Clinical Surgery, University of Edinburgh, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK (R.J.E.S.)
- Institute of Genetics and Cancer, Western General Hospital, University of Edinburgh, Crewe Road South, Edinburgh EH4 2XU, UK
- St Columba’s Hospice, Edinburgh EH5 3RW, UK
| | - Cathleen M. Grossart
- Clinical Surgery, University of Edinburgh, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK (R.J.E.S.)
| | - Donald C. McMillan
- Academic Unit of Surgery, University of Glasgow, Royal Infirmary, Glasgow G4 0SF, UK
| | - Barry J. A. Laird
- Institute of Genetics and Cancer, Western General Hospital, University of Edinburgh, Crewe Road South, Edinburgh EH4 2XU, UK
- St Columba’s Hospice, Edinburgh EH5 3RW, UK
| | - Stephen J. Wigmore
- Clinical Surgery, University of Edinburgh, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK (R.J.E.S.)
| | - Richard J. E. Skipworth
- Clinical Surgery, University of Edinburgh, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK (R.J.E.S.)
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Eruslanov E, Nefedova Y, Gabrilovich DI. The heterogeneity of neutrophils in cancer and its implication for therapeutic targeting. Nat Immunol 2025; 26:17-28. [PMID: 39747431 PMCID: PMC12055240 DOI: 10.1038/s41590-024-02029-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2024] [Accepted: 11/05/2024] [Indexed: 01/04/2025]
Abstract
Neutrophils have a pivotal role in safeguarding the host against pathogens and facilitating tissue remodeling. They possess a large array of tools essential for executing these functions. Neutrophils have a critical role in cancer, where they are largely associated with negative clinical outcome and resistance to therapy. However, the specific role of neutrophils in cancer is complex and controversial, owing to their high functional diversity and acute sensitivity to the microenvironment. In this Perspective, we discuss the accumulated evidence that suggests that the functional diversity of neutrophils can be ascribed to two principal functional states, each with distinct characteristics: classically activated neutrophils and pathologically activated immunosuppressive myeloid-derived suppressor cells. We discuss how the antimicrobial factors in neutrophils can contribute to tumor progression and the fundamental mechanisms that govern the pathologically activated myeloid-derived suppressor cells. These functional states play divergent roles in cancer and thus require separate consideration in therapeutic targeting.
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Affiliation(s)
- Evgeniy Eruslanov
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Ghasemi S, Mortezagholi B, Movahed E, Ghaedi A, Bazrgar A, Abdolalizadehil S, Khanzadeh S. Systematic review and meta-analysis of the association of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio with periodontitis. Eur J Med Res 2024; 29:581. [PMID: 39696713 DOI: 10.1186/s40001-024-02175-x] [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: 12/07/2023] [Accepted: 11/25/2024] [Indexed: 12/20/2024] Open
Abstract
INTRODUCTION Recent evidence suggests the relationship between periodontitis and systemic inflammation, which complete blood count can assess (CBC)-derived biomarkers such as neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR). We conducted this meta-analysis to evaluate the levels of NLR and PLR of patients with periodontitis compared to those of healthy controls. METHODS: Web of Science, PubMed, ProQuest, Scopus, and Open Grey were searched for studies published before October 20, 2024, without any limitation on date and language; then, using the random-effects model, we reported a standardized mean difference (SMD) with a 95% confidence interval (CI). In order to assess the quality of publications, we used the Newcastle-Ottawa scale (NOS). Our study was registered in PROSPERO (CRD42023475214). RESULTS Overall, 11 articles were included in the analysis. We found that patients with periodontitis had elevated levels of NLR compared to healthy controls (SMD = 0.30, 95% CI 0.08-0.52, p = 0.007) In the subgroup analysis according to race, patients with periodontitis had elevated levels of NLR compared to healthy controls in among East Asian patients (SMD = 0.35, 95% CI 0.15-0.55, p = 0.001), but not among Turkish (SMD = 0.15, 95% CI - 0.30-0.61, p = 0.50) and Indian (SMD = 0.38, 95% CI - 0.17-0.94, p = 0.18) patients. In addition, PLR level was not different among patients with periodontitis and healthy controls (SMD = 0.06, 95% CI - 0.71-0.83, p = 0.87). CONCLUSIONS The findings of our investigation, which indicate higher NLR levels in periodontitis patients, show that immune dysregulation plays a role in the etiology of the disease.
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Affiliation(s)
- Saeideh Ghasemi
- Dental School, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Bardia Mortezagholi
- Dental Research Center, Faculty of Dentistry, Islamic Azad University of Medical Sciences, Tehran, Iran
| | - Emad Movahed
- Dental Research Center, Faculty of Dentistry, Islamic Azad University of Medical Sciences, Tehran, Iran
| | - Arshin Ghaedi
- Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Aida Bazrgar
- Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Samira Abdolalizadehil
- Department of Epidemiology and Biostatistics, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
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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] [MESH Headings] [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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Wu G, Pan B, Shi H, Yi Y, Zheng X, Ma H, Zhao M, Zhang Z, Cheng L, Huang Y, Guo W. Neutrophils' dual role in cancer: from tumor progression to immunotherapeutic potential. Int Immunopharmacol 2024; 140:112788. [PMID: 39083923 DOI: 10.1016/j.intimp.2024.112788] [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: 02/01/2024] [Revised: 06/12/2024] [Accepted: 07/23/2024] [Indexed: 08/02/2024]
Abstract
The tumor microenvironment (TME) is intricately associated with cancer progression, characterized by dynamic interactions among various cellular and molecular components that significantly impact the carcinogenic process. Notably, neutrophils play a crucial dual role in regulating this complex environment. These cells oscillate between promoting and inhibiting tumor activity, responding to a multitude of cytokines, chemokines, and tumor-derived factors. This response modulates immune reactions and affects the proliferation, metastasis, and angiogenesis of cancer cells. A significant aspect of their influence is their interaction with the endoplasmic reticulum (ER) stress responses in cancer cells, markedly altering tumor immunodynamics by modulating the phenotypic plasticity and functionality of neutrophils. Furthermore, neutrophil extracellular traps (NETs) exert a pivotal influence in the progression of malignancies by enhancing inflammation, metastasis, immune suppression, and thrombosis, thereby exacerbating the disease. In the realm of immunotherapy, checkpoint inhibitors targeting PD-L1/PD-1 and CTLA-4 among others have underscored the significant role of neutrophils in enhancing therapeutic responses. Recent research has highlighted the potential of using neutrophils for targeted drug delivery through nanoparticle systems, which precisely control drug release and significantly enhance antitumor efficacy. This review thoroughly examines the diverse functions of neutrophils in cancer treatment, emphasizing their potential in regulating immune therapy responses and as drug delivery carriers, offering innovative perspectives and profound implications for the development of targeted diagnostic and therapeutic strategies in oncology.
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Affiliation(s)
- Gujie Wu
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Binyang Pan
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Haochun Shi
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yanjun Yi
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xiaobin Zheng
- Department of Radiation Oncology, Cancer Center, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Huiyun Ma
- Research Center of Clinical Medicine, Affiliated Hospital of Nantong University, Nantong, China
| | - Mengnan Zhao
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Zhenshan Zhang
- Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Center, Shanghai, China
| | - Lin Cheng
- Regenerative Medicine Institute, School of Medicine, National University of Ireland (NUI), Galway, Ireland.
| | - Yiwei Huang
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
| | - Weigang Guo
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
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11
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Liu X, Zhang J, An H, Wang W, Zheng Y, Wei F. The role of lymphocyte-C-reactive protein ratio in the prognosis of gastrointestinal cancer: a systematic review and meta-analysis. Front Oncol 2024; 14:1407306. [PMID: 39267838 PMCID: PMC11390424 DOI: 10.3389/fonc.2024.1407306] [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: 03/26/2024] [Accepted: 08/05/2024] [Indexed: 09/15/2024] Open
Abstract
Objective The lymphocyte-to-C-reactive protein (LCR) ratio, an immune-inflammatory marker, shows prognostic potential in various cancers. However, its utility in gastrointestinal malignancies remains uncertain due to inconsistent findings. This systematic review and meta-analysis synthesizes recent evidence to elucidate the association between LCR and prognosis in gastrointestinal cancer patients, aiming to clarify LCR's potential role as a prognostic biomarker. Methods We searched PubMed, Embase, Cochrane, and Web of Science databases up to May 2024 to evaluate the association between LCR and prognosis in gastrointestinal cancer patients. The main outcomes included overall survival (OS), recurrence-free survival (RFS), and disease-free survival (DFS). We also analyzed secondary parameters such as geographical region, study duration, sample size, LCR threshold, and patient characteristics (age, gender, tumor location, and TNM stage). Results This meta-analysis of 21 cohort studies (n=9,131) finds a significant association between reduced LCR levels and poor prognosis in gastrointestinal cancer. Lower LCR levels were associated with worse overall survival (HR=2.01, 95% CI=1.75-2.31, P<0.001), recurrence-free survival (HR=1.90, 95% CI=1.32-2.76, P<0.001), and disease-free survival (HR=1.76, 95% CI=1.45-2.13, P<0.001). Subgroup analyses by cancer type, timing, and LCR threshold consistently confirmed this relationship (P<0.05). Conclusion LCR may serve as a prognostic marker in gastrointestinal cancer patients, with lower LCR levels associated with poorer prognosis. However, more high-quality studies are needed to validate these findings, considering the limitations of the current evidence. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier CRD42023486858.
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Affiliation(s)
- XiaoMeng Liu
- School of Basic Medicine, Tianjin Medical University, Tianjin, China
| | - JingChen Zhang
- National Population Health Data Center, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - HaoYu An
- School of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - WanYao Wang
- School of Basic Medicine, Tianjin Medical University, Tianjin, China
| | - YuKun Zheng
- School of Food Science and Engineering, Tianjin University of Science and Technology, Tianjin, China
| | - FengJiang Wei
- School of Basic Medicine, Tianjin Medical University, Tianjin, China
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12
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Wu X, Liu S, Li F, Chen Y. Association between preoperative neutrophil-to-lymphocyte ratio and the survival outcomes of esophageal cancer patients underwent esophagectomy: a systematic review and meta-analysis. Front Oncol 2024; 14:1404711. [PMID: 39224809 PMCID: PMC11366628 DOI: 10.3389/fonc.2024.1404711] [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: 03/21/2024] [Accepted: 07/26/2024] [Indexed: 09/04/2024] Open
Abstract
Objectives The purpose of this study was to assess the association between preoperative neutrophil-to-lymphocyte ratio (NLR) and the survival outcomes of esophageal cancer patients who underwent esophagectomy, the latest and comprehensive systematic review performed. Methods Related literature retrieved from PubMed, Web of Science, Embase, and Cochrane before January 2024, according to the inclusion criteria. Outcomes measured were overall survival (OS), disease-free survival (DFS), relapse-free survival (RFS), and cancer-specific survival (CSS). Results Eighteen studies with 6,119 esophageal cancer patients were retained for analysis. Meta-analysis demonstrated that OS (HR: 1.47; 95% CI: 1.29, 1.67; P < 0.00001), DFS (HR: 1.62; 95% CI: 1.29, 2.05; P < 0.0001), and CSS (HR: 1.62; 95% CI: 1.29, 2.05; P < 0.0001) were significantly shorter in the high NLR group compared with the low NLR group. In addition, meta-analysis revealed a similar RFS (HR: 1.47; 95% CI: 0.92, 2.35; P = 0.10) among the two groups. Subgroup analysis of OS and DFS based on mean/median age, NLR cutoff, and region found that all subgroups remained significant difference between two groups. Conclusion Among esophageal cancer patients who underwent esophagectomy, preoperative NLR can be used as prognostic factor independently. High-preoperative NLR is associated with poor prognosis. More large-scale, multicenter prospective clinical studies are needed to further validate the relationship between preoperative NLR and prognosis of esophageal cancer.
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Affiliation(s)
| | | | | | - YingTai Chen
- Department of Thoracic Surgery, Beijing Aerospace General Hospital, Beijing, China
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13
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Vaishnav B, Pailla R, Wadivkar A, Ummaleti H, Doshi NI. The Biomarker Potential of the Neutrophil-to-Lymphocyte Ratio in Acute Exacerbation of Chronic Obstructive Pulmonary Disease. Cureus 2024; 16:e66750. [PMID: 39268318 PMCID: PMC11391329 DOI: 10.7759/cureus.66750] [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: 07/30/2024] [Accepted: 08/12/2024] [Indexed: 09/15/2024] Open
Abstract
Background Chronic obstructive pulmonary disease (COPD) is characterized by periods of exacerbations and seasonal variations due to the recruitment of inflammatory cells. Various cells, such as neutrophils, lymphocytes, and the inflammatory mediators released by them, play a role in its pathogenesis. The current study was conducted to determine the role of the neutrophil-to-lymphocyte ratio (NLR) as a marker in acute exacerbation of COPD (AECOPD). Materials and methods We conducted a cross-sectional observational study at a tertiary care center in Western Maharashtra over six months after receiving approval from the institutional ethics committee. The study included 50 patients with AECOPD and 30 age and gender-matched controls without COPD. The patients were examined with a detailed history, complete blood count, and spirometry. The NLR was calculated and patients' disease severity was assessed using Global Initiative for Chronic Obstructive Lung Disease (GOLD) staging. Results The mean age in the AECOPD group was 67.5 ± 12.5 years, whereas it was 46.2 ± 18.5 years in the control group. There was a male predominance in the AECOPD group (32/50). The majority of patients were in the GOLD stage 2 (42/50), followed by GOLD stage 3 (7/50). A total of 28 out of 50 AECOPD patients required admission to the medical intensive care unit. In the AECOPD group, 39 were smokers, and 11 were nonsmokers. Smoking was significantly associated with AECOPD when compared with controls. The mean NLR was 10.9 ± 10.2 in AECOPD patients and 4.3 ± 3.1 in the controls. Among cases with high NLR (≥5), seven required mechanical ventilation, 13 required noninvasive ventilation (NIV), and six succumbed to death. The mean duration of mechanical ventilation in this group was 12.5 ± 4.5 days, and for NIV, it was 7.5 ± 5.5 days. Conversely, patients with lower NLR (≤5) were more likely to avoid artificial ventilation and had a better in-hospital outcome. Conclusion COPD exacerbations can harm a patient's health, lead to disease progression, and increase mortality rates. Predicting exacerbations in advance can aid in early detection and treatment. NLR is an inexpensive, noninvasive, and easily available marker of inflammation and a predictor of outcome in AECOPD patients and hence should be calculated routinely in all patients with COPD.
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Affiliation(s)
- Bhumika Vaishnav
- General Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune (Deemed to Be University), Pune, IND
| | - Ruchitha Pailla
- General Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune (Deemed to Be University), Pune, IND
| | - Aniruddh Wadivkar
- General Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune (Deemed to Be University), Pune, IND
| | - Harshitha Ummaleti
- General Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune (Deemed to Be University), Pune, IND
| | - Nikhil I Doshi
- General Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune (Deemed to Be University), Pune, IND
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14
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Saboorifar H, Zafarani Y, Gholampour G, Roghani A, Qiu F, Dequaniter D, Yu Q. Serum inflammatory markers as prognostic marker for nasopharyngeal carcinoma with liver metastasis: a multi-center retrospective study. Eur Arch Otorhinolaryngol 2024; 281:4315-4324. [PMID: 38642085 DOI: 10.1007/s00405-024-08649-2] [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: 11/12/2023] [Accepted: 03/28/2024] [Indexed: 04/22/2024]
Abstract
BACKGROUND This retrospective study investigated the prognostic value of serum inflammatory markers in nasopharyngeal carcinoma (NPC) patients, focusing on their association with overall survival (OS) and liver metastasis-free survival (LMFS). METHODS The study included 314 NPC patients treated between 2010 and 2020. Clinical characteristics, treatment methods, and serum inflammatory markers were assessed. Patients were categorized into two groups of with and without liver metastasis. Univariate and multivariate Cox regression and Kaplan-Meier survival analyses were performed to investigate the prognostic value of serum inflammatory markers in NPC patients with and without liver metastasis. RESULTS In the whole cohort, univariate Cox regression analysis singled out tumor necrosis factor-α (TNF-α) (HR = 1.57, 95% CI 1.44-4.90, p = 0.004) and neutrophil-to-lymphocyte ratio (NLR) (HR = 2.13, 95% CI 1.33-3.99, p = 0.009), which were significantly associated with poorer OS. In patients with liver metastasis, TNF-α and NLR could not independently predict OS. However, high TNF-α levels were independently associated with worse OS in patients without liver metastasis (HR (95% CI) = 2.75 (1.67-8.68), p < 0.001). High NLR levels could independently predict poor OS in both groups with (HR (95% CI) = 1.94 (1.77-6.38), p = 0.010) and without liver metastasis (HR (95% CI) = 1.58 (1.19-7.54), p = 0.009). Ultimately, TNF-α and NLR could not significantly predict LMFS. CONCLUSION This study highlights the prognostic significance of TNF-α and NLR in NPC patients, especially in those with liver metastasis. These inflammatory markers could serve as valuable indicators for assessing the prognosis of NPC patients. Further research is warranted to validate their clinical utility and explore potential therapeutic implications.
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Affiliation(s)
- Hossein Saboorifar
- Department of Head and Neck Surgery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Yasamin Zafarani
- Department of Head and Neck Surgery, School of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Golsa Gholampour
- Department of Head and Neck Surgery, Tehran University of Medical Sciences, Tehran, Iran
| | - Arman Roghani
- Department of Head and Neck Surgery, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Feng Qiu
- Department of Radiation Oncology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, China
| | - Dideir Dequaniter
- Medicine Faculty, Université Libre de Bruxelles (ULB), Route de Lennik 808, Brussels, Belgium
| | - Qiao Yu
- Otorhinolaryngology and Maxillofacial Department, First Affiliated Hospital of Nanchang University, Nanchang, China.
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Lu YC, Tseng LW, Wu CE, Yang CW, Yang TH, Chen HY. Can Chinese herbal medicine offer feasible solutions for newly diagnosed esophageal cancer patients with malnutrition? a multi-institutional real-world study. Front Pharmacol 2024; 15:1364318. [PMID: 38855746 PMCID: PMC11157104 DOI: 10.3389/fphar.2024.1364318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 05/06/2024] [Indexed: 06/11/2024] Open
Abstract
Background Esophageal cancer (EC) is a major cause of cancer-related mortality in Taiwan and globally. Patients with EC are highly prone to malnutrition, which adversely affects their prognosis. While Chinese herbal medicine (CHM) is commonly used alongside conventional anti-cancer treatments, its long-term impact on EC patients with malnutrition remains unclear. Methods This study utilized a multi-center cohort from the Chang Gung Research Database, focusing on the long-term outcomes of CHM in EC patients with malnutrition between 1 January 2001, and 31 December 2018. Patients were monitored for up to 5 years or until death. Overall survival (OS) rates were calculated using the Kaplan-Meier method. Overlap weighting and landmark analysis were employed to address confounding and immortal time biases. Additionally, the study analyzed prescription data using a CHM network to identify key CHMs for EC with malnutrition, and potential molecular pathways were investigated using the Reactome database. Results EC patients with malnutrition who used CHM had a higher 5-year OS compared with nonusers (22.5% vs. 9% without overlap weighting; 24.3% vs. 13.3% with overlap weighting; log-rank test: p = 0.006 and 0.016, respectively). The median OS of CHM users was significantly longer than that of nonusers (19.8 vs. 12.9 months, respectively). Hazard ratio (HR) analysis showed a 31% reduction in all-cause mortality risk for CHM users compared with nonusers (HR: 0.69, 95% confidence interval: 0.50-0.94, p = 0.019). We also examined 665 prescriptions involving 306 CHM, with Hedyotis diffusa Willd. exhibiting the highest frequency of use. A CHM network was created to determine the primary CHMs and their combinations. The identified CHMs were associated with the regulation of immune and metabolic pathways, particularly in areas related to immune modulation, anti-cancer cachexia, promotion of digestion, and anti-tumor activity. Conclusion The results of this study suggest a correlation between CHM use and improved clinical outcomes in EC patients with malnutrition. The analysis identified core CHMs and combinations of formulations that play a crucial role in immunomodulation and metabolic regulation. These findings lay the groundwork for more extensive research on the use of CHM for the management of malnutrition in patients with EC.
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Affiliation(s)
- Yi-Chin Lu
- Division of Chinese Internal Medicine, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Liang-Wei Tseng
- Division of Chinese Acupuncture and Traumatology, Center of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chiao-En Wu
- Division of Haematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Ching-Wei Yang
- Division of Chinese Internal Medicine, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Tsung-Hsien Yang
- Division of Chinese Internal Medicine, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Hsing-Yu Chen
- Division of Chinese Internal Medicine, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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Aoyama T, Atsumi Y, Kawahara S, Tamagawa H, Tamagawa A, Maezawa Y, Kano K, Murakawa M, Kazama K, Numata M, Oshima T, Yukawa N, Masuda M, Rino Y. The clinical impacts of the prognostic nutritional index for the esophageal cancer patients who received curative treatment. J Cancer Res Ther 2024; 20:898-903. [PMID: 38102916 DOI: 10.4103/jcrt.jcrt_1595_20] [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: 11/23/2020] [Accepted: 08/23/2022] [Indexed: 12/17/2023]
Abstract
BACKGROUND We investigated the impact of the prognostic nutritional index (PNI) on esophageal cancer survival and recurrence after curative treatment. METHODS This study included 120 patients who underwent curative surgery followed by the adjuvant treatment for esophageal cancer between 2008 and 2018. The risk factors for overall survival (OS) and recurrence-free survival (RFS) were identified. RESULTS The PNI of 49 was regarded to be the optimal critical point of classification considering the 1-year, 3-year, and 5-year survival rate. The OS rates at three and five years after surgery were 47.4% and 36.0% in the PNI low group, respectively, and 62.5% and 56.5% in the PNI high group, which amounted to a statistically significant difference ( P = 0.020). The RFS rates at three and five years after surgery were 31.0% and 24.8% in the PNI low group, respectively, and 50.9% and 42.8% in the PNI high group, which amounted to a statistically significant difference ( P = 0.020). A multivariate analysis demonstrated that the PNI was a significant independent risk factor for the OS and a marginally significant independent risk factor forRFS. CONCLUSION The PNI was a risk factor for survival in patients who underwent curative treatment for esophageal cancer. It is necessary to develop the effective plan of the perioperative care and the surgical strategy according to the PNI.
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Affiliation(s)
- Toru Aoyama
- Department of Surgery, Yokohama City University, Yokohama, Japan
| | - Yosuke Atsumi
- Department of Surgery, Yokohama City University, Yokohama, Japan
| | | | - Hiroshi Tamagawa
- Department of Surgery, Yokohama City University, Yokohama, Japan
| | - Ayako Tamagawa
- Department of Surgery, Yokohama City University, Yokohama, Japan
| | - Yukio Maezawa
- Department of Surgery, Yokohama City University, Yokohama, Japan
- Department of Surgery, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo, Japan
| | - Kazuki Kano
- Department of Surgery, Yokohama City University, Yokohama, Japan
| | - Masaaki Murakawa
- Department of Surgery, Yokohama City University, Yokohama, Japan
| | - Keisuke Kazama
- Department of Surgery, Yokohama City University, Yokohama, Japan
| | - Masakatsu Numata
- Department of Surgery, Yokohama City University, Yokohama, Japan
| | - Takashi Oshima
- Department of Surgery, Yokohama City University, Yokohama, Japan
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan
| | - Norio Yukawa
- Department of Surgery, Yokohama City University, Yokohama, Japan
| | - Munetaka Masuda
- Department of Surgery, Yokohama City University, Yokohama, Japan
| | - Yasushi Rino
- Department of Surgery, Yokohama City University, Yokohama, Japan
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Rusidi HA, Rosyidi RM, Wardhana DPW, Baskoro W, Ramadhana GA. The role of preoperative hematological inflammatory markers as a predictor of meningioma grade: A systematic review and meta-analysis. Surg Neurol Int 2024; 15:77. [PMID: 38628519 PMCID: PMC11021116 DOI: 10.25259/sni_849_2023] [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: 10/19/2023] [Accepted: 02/09/2024] [Indexed: 04/19/2024] Open
Abstract
Background Inflammatory processes play an important role in the aggressiveness of a tumor. However, the relationship between inflammatory markers in meningioma grade is not well known. Knowledge of preoperative meningioma grade plays an important role in the prognosis and treatment of this tumor. This study aims to assess preoperative hematological inflammatory markers as a predictor of the pathological grade of meningioma. Methods To ensure comprehensive retrieval of relevant studies, we searched the following key databases, PubMed, Science Direct, and Biomed Central, with evidence related to preoperative hematological inflammatory markers among meningioma up to September 2023. The studies involved were selected based on established eligibility criteria. The analysis in this study uses Review Manager 5.4. Results Six studies were obtained from the search results. The total number of patients 2789 (469 high-grade meningioma and 2320 low-grade meningioma) analysis shows elevated neutrophil-to-lymphocyte ratio (NLR) (mean difference [MD]: 0.29; 95% confidence interval [CI] 0.13-0.45; P = 0.0004), monocyte-to-lymphocyte ratio (MLR) (MD: 0.02; 95% CI 0.00-0.04; P = 0.003), and low lymphocyte-to-monocyte ratio (LMR) (MD: -0.82; 95% CI -1.46--0.18; P = 0.005) significantly associated with high-grade meningioma compared to low-grade meningioma. No significant correlation between high-grade and low-grade meningioma based on platelet-lymphocyte ratio value is observed. Conclusion The parameters of NLR, MLR, and LMR have been found to be cost-effective preoperative methods that demonstrate potential value in the prediction of meningioma grade. To enhance the reliability of the findings, it is imperative to do further prospective study.
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Affiliation(s)
- Hanan Anwar Rusidi
- Department of Neurosurgery, Dr. Soeradji Tirtonegoro Central Public Hospital, Klaten, Indonesia
| | - Rohadi Muhammad Rosyidi
- Department of Neurosurgery, Faculty of Medicine, Mataram University/West Nusa Tenggara General Hospital, Mataram City Lombok Island, Indonesia
| | - Dewa Putu Wisnu Wardhana
- Department of Neurosurgery, Faculty of Medicine, Udayana University/Prof. Dr. I Goesti Ngoerah Gde Ngoerah Hospital, Denpasar, Indonesia
| | - Wisnu Baskoro
- Department of Neurosurgery, Dr. Soeradji Tirtonegoro Central Public Hospital, Klaten, Indonesia
| | - Geizar Arsika Ramadhana
- Department of Neurosurgery, Faculty of Medicine, Sebelas Maret University/Dr. Moewardi General Public Hospital, Surakarta, Indonesia
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Hashimoto I, Kano K, Suematsu H, Yamada T, Watanabe H, Kanematsu K, Nagasawa S, Aoyama T, Ogata T, Rino Y, Saito A, Oshima T. Survival Predictors Before Preoperative Adjuvant Chemotherapy in Patients With Locally Advanced Esophageal Squamous Cell Carcinoma. In Vivo 2024; 38:881-889. [PMID: 38418152 PMCID: PMC10905439 DOI: 10.21873/invivo.13514] [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: 10/14/2023] [Revised: 11/21/2023] [Accepted: 12/06/2023] [Indexed: 03/01/2024]
Abstract
BACKGROUND/AIM Radical resection after preoperative adjuvant chemotherapy (NAC) is a standard treatment for patients with locally advanced esophageal squamous cell carcinoma (LAESCC), but its outcome remains unsatisfactory. In order to develop a personalized treatment program for LAES, we herein compared the survival prediction utility of five pre-NAC nutritional, inflammatory, and immune indexes in patients with LAESCC. PATIENTS AND METHODS We evaluated the survival of 203 patients with LAESCC who underwent radical resection after NAC from January 2011 to September 2019 for the following representative pre-NAC nutritional, inflammatory, and immune indices: modified Glasgow Prognostic Score, Prognostic Nutritional Index, C-reactive protein/albumin ratio, serum neutrophil/lymphocyte ratio, and Geriatric Nutrition Risk Index (GNRI) were evaluated for their impact on survival. RESULTS Of the five indices, GNRI was the best predictor of survival as determined by the area under the curve (p<0.05). When patients were divided into three groups according to the nutritional risk assessment of Bouillanne et al. using the pre-NAC GNRI, the 5-year overall survival (OS) and recurrence-free survival (RFS) were significantly stratified (p<0.001). On multivariate analysis, the GNRI independently identified a poor OS group [group 1: hazard ratio (HR)=2.598, p=0.002; group 2: HR=6.257, p<0.001] and a high recurrence risk group (group 1: HR=1.967, p=0.016; group 2: HR=4.467, p<0.001). CONCLUSION In patients with LAESCC, GNRI may be the most accurate, reliable, and useful prognostic factor among the five major systemic inflammatory and nutritional indices.
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Affiliation(s)
- Itaru Hashimoto
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan
- Department of Surgery, Yokohama City University, Yokohama, Japan
| | - Kazuki Kano
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan
- Department of Surgery, Yokohama City University, Yokohama, Japan
| | - Hideaki Suematsu
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan
- Department of Surgery, Yokohama City University, Yokohama, Japan
| | - Takanobu Yamada
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan
- Department of Surgery, Yokohama City University, Yokohama, Japan
| | - Hayato Watanabe
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan
- Department of Surgery, Yokohama City University, Yokohama, Japan
| | - Kyohei Kanematsu
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan
| | - Shinsuke Nagasawa
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan
- Department of Surgery, Yokohama City University, Yokohama, Japan
| | - Toru Aoyama
- Department of Surgery, Yokohama City University, Yokohama, Japan
| | - Takashi Ogata
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan
| | - Yasushi Rino
- Department of Surgery, Yokohama City University, Yokohama, Japan
| | - Aya Saito
- Department of Surgery, Yokohama City University, Yokohama, Japan
| | - Takashi Oshima
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan;
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19
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Su MX, Lin HW, Nguyen HTH, Lin TC, Chen CJ, Wang HC, Wu CT, Wu YC, He GY, Liu LC, Huang CH. Monitoring trends in the absolute lymphocyte count and the neutrophil-to-lymphocyte ratio in patients with breast cancer receiving eribulin. BMC Cancer 2024; 24:195. [PMID: 38347468 PMCID: PMC10860250 DOI: 10.1186/s12885-024-11923-5] [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: 10/18/2023] [Accepted: 01/26/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Studies have shown that the absolute lymphocyte count (ALC) and the neutrophil-to-lymphocyte ratio (NLR) are related to the outcomes in patients with breast cancer receiving specific chemotherapies. However, the reports have focussed on the initial blood test and there is a lack of evidence or data to support that dynamic changes of ALC or NLR are associated with the patients' survival outcomes. METHODS We retrospectively reviewed electronic medical records from patients with breast cancer treated with eribulin from 2015 to 2019 at our institution. Blood test data were available prior to starting eribulin (baseline), and at 1, 3 and 6 months after initiating eribulin. We classified the patients into ALC and NLR high and low groups using the following cut-offs: 1000/µl for ALC and 3 for NLR. We defined ALC and NLR trends as increasing or decreasing compared with the initial data. We assessed the associations between the ALC and NLR with progression-free survival and overall survival. RESULTS There were 136 patients with breast cancer treated with eribulin. Of these patients, 60 had complete blood tests and follow-up data. Neither a high ALC nor a low baseline NLR was associated with the survival outcome. One month after initiating eribulin treatment, a high ALC and a low NLR were significantly associated with longer progression-free survival (p = 0.044 for each). Three months after initiating eribulin, a high ALC was significantly associated with better overall survival (p = 0.006). A high NLR at 3 or 6 months after initiating eribulin was associated with worse overall survival (p = 0.017 and p = 0.001, respectively). The ALC and NLR trends across times were not associated with survivals. CONCLUSION We showed that 1, 3 and 6 months after initiating eribulin, a high ALC and a low NLR may be related to the patients' survival outcomes. The ALC and NLR trends were not associated with survival. Accordingly, we believe patients who maintain a high ALC and a low NLR may have better clinical outcomes after initiating eribulin.
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Affiliation(s)
- Meng-Xia Su
- Surgical Department, China Medical University Hospital, No. 2, Yude Rd. North Dist, Taichung, 404327, Taiwan
| | - Hsiang-Wen Lin
- School of Pharmacy and Graduate Institute, China Medical University, No. 100, Sec. 1, Jingmao Rd., Taichung, 406040, Taiwan
- Department of Pharmacy, China Medical University Hospital, No. 2, Yude Rd., North Dist., Taichung, 404327, Taiwan
- Department of Pharmacy System, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, Chicago, 833 S. Wood St., Chicago, 60612, Illinois, United States of America
| | - Hanh T H Nguyen
- School of Pharmacy and Graduate Institute, China Medical University, No. 100, Sec. 1, Jingmao Rd., Taichung, 406040, Taiwan
- Department of Clinical Pharmacy, Hanoi University of Pharmacy, No. 144, Xuan Thuy, Cau giay, Hanoi, Vietnam
| | - Tien-Chao Lin
- School of Pharmacy and Graduate Institute, China Medical University, No. 100, Sec. 1, Jingmao Rd., Taichung, 406040, Taiwan
- Department of Pharmacy, China Medical University Hospital, No. 2, Yude Rd., North Dist., Taichung, 404327, Taiwan
| | - Chih-Jung Chen
- Surgical Department, China Medical University Hospital, No. 2, Yude Rd. North Dist, Taichung, 404327, Taiwan
| | - Hwei-Chung Wang
- Surgical Department, China Medical University Hospital, No. 2, Yude Rd. North Dist, Taichung, 404327, Taiwan
| | - Chen-Teng Wu
- Surgical Department, China Medical University Hospital, No. 2, Yude Rd. North Dist, Taichung, 404327, Taiwan
| | - Yao-Chung Wu
- Surgical Department, China Medical University Hospital, No. 2, Yude Rd. North Dist, Taichung, 404327, Taiwan
| | - Geng-Yan He
- Surgical Department, China Medical University Hospital, No. 2, Yude Rd. North Dist, Taichung, 404327, Taiwan
| | - Liang-Chih Liu
- Surgical Department, China Medical University Hospital, No. 2, Yude Rd. North Dist, Taichung, 404327, Taiwan.
- College of Medicine, China Medical University, No. 100, Sec. 1, Jingmao Rd., Taichung, 406040, Taiwan.
| | - Chih-Hao Huang
- Surgical Department, China Medical University Hospital, No. 2, Yude Rd. North Dist, Taichung, 404327, Taiwan.
- College of Medicine, China Medical University, No. 100, Sec. 1, Jingmao Rd., Taichung, 406040, Taiwan.
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20
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Yin C, Okugawa Y, Kitajima T, Shimura T, Ma R, Kawamura M, Yoshiyama S, Okita Y, Ohi M, Toiyama Y. Clinical Significance of the Preoperative Inflammatory Burden Index in Esophageal Cancer. Oncology 2023; 102:556-564. [PMID: 38142688 PMCID: PMC11216362 DOI: 10.1159/000535727] [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: 10/23/2023] [Accepted: 12/07/2023] [Indexed: 12/26/2023]
Abstract
INTRODUCTION The inflammatory burden index (IBI) serves as a prognostic marker for several cancers. Here, we evaluated the predictive value of preoperative IBI associated with the surgical and oncological outcomes of patients with esophageal cancer (EC). METHODS The IBI was formulated as C-reactive protein × neutrophil/lymphocyte. We retrospectively analyzed preoperative IBI of 147 EC patients receiving esophagectomy between 2008 and 2018. Cox proportional hazards models and multivariable logistic regression were employed to identify independent risk factors of surgical site infection and prognosis. RESULTS Increased preoperative IBI significantly correlated with higher tumor stage. Patients with high IBI experienced shorter overall survival (p = 0.0002) and disease-free survival (p = 0.002) compared with those with low IBI. In the adjusted Cox proportional hazards regression models, increased IBI served as an independent prognostic factor for overall survival (hazard ratio, 3.56; 95% confidence interval, 1.79-7.34; p = 0.0003) and disease-free survival (hazard ratio, 3.03; 95% confidence interval, 1.60-5.92; p = 0.007). Multivariable analysis identified preoperative high IBI which served as an independent risk factor for overall surgical site infection (odds ratio, 2.53; 95% confidence interval, 1.00-6.38; p = 0.049). CONCLUSION Preoperative IBI may serve as a useful predictor of prognosis and surgical site infection of patients with EC after esophagectomy.
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Affiliation(s)
- Chengzeng Yin
- Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, Tsu, Japan,
| | - Yoshinaga Okugawa
- Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, Tsu, Japan
- Department of Genomic Medicine, Mie University Hospital, Tsu, Japan
| | - Takahito Kitajima
- Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, Tsu, Japan
- Department of Genomic Medicine, Mie University Hospital, Tsu, Japan
| | - Tadanobu Shimura
- Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, Tsu, Japan
| | - Ruiya Ma
- Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, Tsu, Japan
| | - Mikio Kawamura
- Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, Tsu, Japan
| | - Shigeyuki Yoshiyama
- Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, Tsu, Japan
| | - Yoshiki Okita
- Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, Tsu, Japan
| | - Masaki Ohi
- Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, Tsu, Japan
| | - Yuji Toiyama
- Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, Tsu, Japan
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Cotet C, Alarcan H, Hérault O, Corcia P, Vourc’h P, Andres CR, Blasco H, Veyrat-Durebex C. Neutrophil to Lymphocyte Ratio as a Prognostic Marker in Amyotrophic Lateral Sclerosis. Biomolecules 2023; 13:1689. [PMID: 38136561 PMCID: PMC10741910 DOI: 10.3390/biom13121689] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 11/16/2023] [Accepted: 11/21/2023] [Indexed: 12/24/2023] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is the most common neurodegenerative motor neuron disease and remains misunderstood with a difficult diagnosis and prognosis. The implication of the immune system is recognized in ALS pathophysiology, hence the interest in leucocyte count as lymphocytes and neutrophils. The neutrophil-to-lymphocyte ratio (NLR) has recently been used as a prognosis factor to assess the progression of ALS. Thus, the aim of this study was to analyze the evolution of the NLR during disease evolution in a French cohort of ALS patients and its relation with survival. In this monocentric retrospective study, clinical parameters and NLR were collected in ALS patients followed at the University Hospital of Tours (France). ALS patients were subdivided into three groups regarding their NLR value at inclusion: group 1 (NLR < 2); group 2 (NLR: 2-3); group 3 (NLR > 3). A comparison of qualitative and quantitative clinical and biological variables between NLR groups was performed. Then, Cox regressions were carried out to determine the association of NLR with survival. We observed a significant correlation of NLR with ALSFRS-r score (p < 0.0001) and with vital forced capacity (p = 0.0004) at inclusion. We observed that increased NLR at diagnosis is associated with decreased ALS patients' survival.
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Affiliation(s)
- Camille Cotet
- Laboratoire de Biochimie et Biologie Moléculaire, CHRU Bretonneau, 2 Boulevard Tonnellé, 37000 Tours, France (H.A.); (P.V.); (C.R.A.); (H.B.)
| | - Hugo Alarcan
- Laboratoire de Biochimie et Biologie Moléculaire, CHRU Bretonneau, 2 Boulevard Tonnellé, 37000 Tours, France (H.A.); (P.V.); (C.R.A.); (H.B.)
- UMR 1253 iBrain, Université de Tours, Inserm, 10 Boulevard Tonnellé, 37000 Tours, France;
| | - Olivier Hérault
- Service d’Hématologie Biologique, CHRU Bretonneau, 2 Boulevard Tonnellé, 37000 Tours, France;
| | - Philippe Corcia
- UMR 1253 iBrain, Université de Tours, Inserm, 10 Boulevard Tonnellé, 37000 Tours, France;
- Service de Neurologie, CHRU Bretonneau, 2 Boulevard Tonnellé, 37000 Tours, France
| | - Patrick Vourc’h
- Laboratoire de Biochimie et Biologie Moléculaire, CHRU Bretonneau, 2 Boulevard Tonnellé, 37000 Tours, France (H.A.); (P.V.); (C.R.A.); (H.B.)
- UMR 1253 iBrain, Université de Tours, Inserm, 10 Boulevard Tonnellé, 37000 Tours, France;
| | - Christian R. Andres
- Laboratoire de Biochimie et Biologie Moléculaire, CHRU Bretonneau, 2 Boulevard Tonnellé, 37000 Tours, France (H.A.); (P.V.); (C.R.A.); (H.B.)
- UMR 1253 iBrain, Université de Tours, Inserm, 10 Boulevard Tonnellé, 37000 Tours, France;
| | - Hélène Blasco
- Laboratoire de Biochimie et Biologie Moléculaire, CHRU Bretonneau, 2 Boulevard Tonnellé, 37000 Tours, France (H.A.); (P.V.); (C.R.A.); (H.B.)
- UMR 1253 iBrain, Université de Tours, Inserm, 10 Boulevard Tonnellé, 37000 Tours, France;
| | - Charlotte Veyrat-Durebex
- Laboratoire de Biochimie et Biologie Moléculaire, CHRU Bretonneau, 2 Boulevard Tonnellé, 37000 Tours, France (H.A.); (P.V.); (C.R.A.); (H.B.)
- UMR 1253 iBrain, Université de Tours, Inserm, 10 Boulevard Tonnellé, 37000 Tours, France;
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22
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Ho YC, Lai YC, Lin HY, Ko MH, Wang SH, Yang SJ, Chou TW, Hung LC, Huang CC, Chang TH, Lin JB, Lin JC. Cardiac Dose Predicts the Response to Concurrent Chemoradiotherapy in Esophageal Squamous Cell Carcinoma. Cancers (Basel) 2023; 15:4580. [PMID: 37760549 PMCID: PMC10526131 DOI: 10.3390/cancers15184580] [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: 08/08/2023] [Revised: 09/11/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
Definitive concurrent chemoradiation (CCRT) is the standard treatment for cervical esophageal cancer and non-surgical candidates. Initial treatment response affects survival; however, few validated markers are available for prediction. This study evaluated the clinical variables and chemoradiation parameters associated with treatment response. Between May 2010 and April 2016, 86 completed CCRT patients' clinical, dosimetric, and laboratory data at baseline and during treatment were collected. Cox regression analysis assessed the risk factors for overall survival (OS). A receiver operating characteristic curve with Youden's index was chosen to obtain the optimal cut-off value of each parameter. Treatment response was defined per Response Evaluation Criteria in Solid Tumors v.1.1 at the first post-CCRT computed tomography scan. Responders had complete and partial responses; non-responders had stable and progressive diseases. Logistic regression (LR) was used to evaluate the variables associated with responders. The Cox regression model confirmed the presence of responders (n = 50) vs. non-responders (n = 36) with a significant difference in OS. In multivariate LR, cardiac dose-volume received ≥10 Gy; the baseline hemoglobin level, highest neutrophil to lymphocyte ratio during CCRT, and cumulative cisplatin dose were significantly associated with the responders. The initial clinical treatment response significantly determines disease outcome. Cardiac irradiation may affect the treatment response.
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Affiliation(s)
- Yu-Chieh Ho
- Department of Radiation Oncology, Changhua Christian Hospital, Changhua 500, Taiwan; (Y.-C.H.); (S.-J.Y.); (T.-W.C.); (L.-C.H.); (C.-C.H.); (T.-H.C.); (J.-C.L.)
| | - Yuan-Chun Lai
- Division of Medical Physics, Department of Radiation Oncology, Changhua Christian Hospital, Changhua 500, Taiwan; (Y.-C.L.); (M.-H.K.)
- Department of Medical Imaging Radiological Science, Central Taiwan University of Science and Technology, Taichung 406, Taiwan
| | - Hsuan-Yu Lin
- Division of Haematology/Oncology, Department of Internal Medicine, Changhua Christian Hospital, Changhua 500, Taiwan;
| | - Ming-Hui Ko
- Division of Medical Physics, Department of Radiation Oncology, Changhua Christian Hospital, Changhua 500, Taiwan; (Y.-C.L.); (M.-H.K.)
| | - Sheng-Hung Wang
- Department of Radiation Oncology, Lukang Christian Hospital, Changhua Christian Medical Foundation, Lukang 505, Taiwan;
| | - Shan-Jun Yang
- Department of Radiation Oncology, Changhua Christian Hospital, Changhua 500, Taiwan; (Y.-C.H.); (S.-J.Y.); (T.-W.C.); (L.-C.H.); (C.-C.H.); (T.-H.C.); (J.-C.L.)
| | - Tsai-Wei Chou
- Department of Radiation Oncology, Changhua Christian Hospital, Changhua 500, Taiwan; (Y.-C.H.); (S.-J.Y.); (T.-W.C.); (L.-C.H.); (C.-C.H.); (T.-H.C.); (J.-C.L.)
| | - Li-Chung Hung
- Department of Radiation Oncology, Changhua Christian Hospital, Changhua 500, Taiwan; (Y.-C.H.); (S.-J.Y.); (T.-W.C.); (L.-C.H.); (C.-C.H.); (T.-H.C.); (J.-C.L.)
| | - Chia-Chun Huang
- Department of Radiation Oncology, Changhua Christian Hospital, Changhua 500, Taiwan; (Y.-C.H.); (S.-J.Y.); (T.-W.C.); (L.-C.H.); (C.-C.H.); (T.-H.C.); (J.-C.L.)
| | - Tung-Hao Chang
- Department of Radiation Oncology, Changhua Christian Hospital, Changhua 500, Taiwan; (Y.-C.H.); (S.-J.Y.); (T.-W.C.); (L.-C.H.); (C.-C.H.); (T.-H.C.); (J.-C.L.)
- Department of Medical Imaging Radiological Science, Central Taiwan University of Science and Technology, Taichung 406, Taiwan
- Department of Medical Imaging and Radiological Technology, Yuanpei University of Science and Technology, Hsinchu 300, Taiwan
| | - Jhen-Bin Lin
- Department of Radiation Oncology, Changhua Christian Hospital, Changhua 500, Taiwan; (Y.-C.H.); (S.-J.Y.); (T.-W.C.); (L.-C.H.); (C.-C.H.); (T.-H.C.); (J.-C.L.)
| | - Jin-Ching Lin
- Department of Radiation Oncology, Changhua Christian Hospital, Changhua 500, Taiwan; (Y.-C.H.); (S.-J.Y.); (T.-W.C.); (L.-C.H.); (C.-C.H.); (T.-H.C.); (J.-C.L.)
- Research Department, Division of Translation Research, Changhua Christian Hospital, Changhua 500, Taiwan
- Institute of Clinical Medicine, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei 112, Taiwan
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23
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Huang YY, Zheng Y, Liang SH, Wu LL, Liu X, Xing WQ, Ma GW. Establishment and validation of a prognostic risk classification for patients with stage T1-3N0M0 esophageal squamous cell carcinoma. J Cardiothorac Surg 2023; 18:192. [PMID: 37316912 PMCID: PMC10265826 DOI: 10.1186/s13019-023-02294-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 04/15/2023] [Indexed: 06/16/2023] Open
Abstract
INTRODUCTION At present, clinical factors and hematological indicators have been proved to have great potential in predicting the prognosis of cancer patients, and no one has combined these two valuable indicators to establish a prognostic model for esophageal squamous cell carcinoma (ESCC) patients with stage T1-3N0M0 after R0 resection. To verify, we aimed to combine these potential indicators to establish a prognostic model. METHODS Stage T1-3N0M0 ESCC patients from two cancer centers (including training cohort: N = 819, and an external validation cohort: N = 177)-who had undergone esophagectomy in 1995-2015 were included. We integrated significant risk factors for death events by multivariable logistic regression methods and applied them to the training cohort to build Esorisk. The parsimonious aggregate Esorisk score was calculated for each patient; the training set was divided into three prognostic risk classes according to the 33rd and 66th percentiles of the Esorisk score. The association of Esorisk with cancer-specific survival (CSS) was assessed using Cox regression analyses. RESULTS The Esorisk model was: [10 + 0.023 × age + 0.517 × drinking history - 0.012 × hemoglobin-0.042 × albumin - 0.032 × lymph nodes]. Patients were grouped into three classes-Class A (5.14-7.26, low risk), Class B (7.27-7.70, middle risk), and Class C (7.71-9.29, high risk). In the training group, five-year CSS decreased across the categories (A: 63%; B: 52%; C: 30%, Log-rank P < 0.001). Similar findings were observed in the validation group. Additionally, Cox regression analysis showed that Esorisk aggregate score remained significantly associated with CSS in the training cohort and validation cohort after adjusting for other confounders. CONCLUSIONS We combined the data of two large clinical centers, and comprehensively considered their valuable clinical factors and hematological indicators, established and verified a new prognostic risk classification that can predict CSS of stage T1-3N0M0 ESCC patients.
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Affiliation(s)
- Yang-Yu Huang
- The Department of Thoracic Surgery, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University, No. 651 Dongfengdong Road, Guangzhou, 510060 People’s Republic of China
- Faculty of Biology, Medicine and Health, School of Biological Sciences, The University of Manchester, Manchester, UK
| | - Yan Zheng
- The Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, No. 1 Jianshedong Road, Zhengzhou, 45000 People’s Republic of China
| | - Shen-Hua Liang
- The Department of Thoracic Surgery, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University, No. 651 Dongfengdong Road, Guangzhou, 510060 People’s Republic of China
| | - Lei-Lei Wu
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of China
| | - Xuan Liu
- The Department of Thoracic Surgery, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University, No. 651 Dongfengdong Road, Guangzhou, 510060 People’s Republic of China
| | - Wen-Qun Xing
- The Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, No. 1 Jianshedong Road, Zhengzhou, 45000 People’s Republic of China
| | - Guo-Wei Ma
- The Department of Thoracic Surgery, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University, No. 651 Dongfengdong Road, Guangzhou, 510060 People’s Republic of China
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24
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Lu H, Yu C, Maimaiti M, Li G. The predictive value of perioperative circulating markers on surgical complications in patients undergoing robotic-assisted radical prostatectomy. World J Surg Oncol 2023; 21:179. [PMID: 37308992 DOI: 10.1186/s12957-023-03049-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 05/26/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND The occurrence of postoperative complications was associated with poor outcomes for patients undergoing robotic-assisted radical prostatectomy. A prediction model with easily accessible indices could provide valuable information for surgeons. This study aims to identify novel predictive circulating biomarkers significantly associated with surgical complications. METHODS We consecutively assessed all multiport robotic-assisted radical prostatectomies performed between 2021 and 2022. The clinicopathological factors and perioperative levels of multiple circulating markers were retrospectively obtained from the included patients. The associations of these indices with Clavien-Dindo grade II or greater complications, and surgical site infection were assessed using univariable and multivariable logistic regression models. Further, the models were validated for the overall performance, discrimination, and calibration. RESULTS In total, 229 patients with prostate cancer were enrolled in this study. Prolonged operative time could independently predict surgical site infection (OR, 3.39; 95% CI, 1.09-10.54). Higher RBC (day 1-pre) implied lower risks of grade II or greater complications (OR, 0.24; 95% CI, 0.07-0.76) and surgical site infection (OR, 0.23; 95% CI, 0.07-0.78). Additionally, RBC (day 1-pre) independently predicted grade II or greater complications of obese patients (P value = 0.005) as well as those in higher NCCN risk groups (P value = 0.012). Regarding the inflammatory markers, NLR (day 1-pre) (OR, 3.56; 95% CI, 1.37-9.21) and CRP (day 1-pre) (OR, 4.16; 95% CI, 1.69-10.23) were significantly associated with the risk of grade II or greater complications, and both the indices were independent predictors in those with higher Gleason score, or in higher NCCN risk groups (P value < 0.05). The NLR (day 0-pre) could also predict the occurrence of surgical site infection (OR, 5.04; 95% CI, 1.07-23.74). CONCLUSIONS The study successfully identified novel circulating markers to assess the risk of surgical complications. Postoperative increase of NLR and CRP were independent predictors for grade II or greater complications, especially in those with higher Gleason score, or in higher NCCN risk groups. Additionally, a marked decrease of RBC after the surgery also indicated a higher possibility of surgical complications, especially for the relatively difficult procedures.
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Affiliation(s)
- Haohua Lu
- Department of Urology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, 310016, Zhejiang, China
| | - Chenhao Yu
- Department of Urology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, 310016, Zhejiang, China
| | - Muzhapaer Maimaiti
- Department of Urology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, 310016, Zhejiang, China
| | - Gonghui Li
- Department of Urology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, 310016, Zhejiang, China.
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Aoyama T, Nagasawa S, Nakazono M, Segami K, Tamagawa H, Tamagawa A, Hara K, Oshima T, Yukawa N, Masuda M, Rino Y. The clinical impacts of lymphocyte-to-C-reactive protein ratio for esophageal cancer patients who receive curative treatment. J Cancer Res Ther 2023; 19:556-561. [PMID: 37470574 DOI: 10.4103/jcrt.jcrt_139_21] [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] [Indexed: 07/21/2023]
Abstract
Background We investigated the impact of the lymphocyte-to-C-reactive protein ratio (LCR) on esophageal cancer survival and recurrence after curative treatment. Patients and Methods This study included 89 patients who underwent curative surgery followed by adjuvant treatment for esophageal cancer between 2008 and 2018. The risk factors for overall survival (OS) and recurrence-free survival (RFS) were identified. Results LCR of 12,177 was regarded to be the optimal critical point of classification considering the 1-year, 3-year, and 5-year survival rates. The OS rates at 3 and 5 years after surgery were 33.2% and 29.9% in the LCR low group, respectively, and 74.0% and 60.9% in the LCR high group, which amounted to a statistically significant difference (P = 0.001). The RFS rates at 3 and 5 years after surgery were 25.3% and 21.7% in the LCR low group, respectively, and 52.1% and 47.4% in the LCR high group, which amounted to a statistically significant difference (P = 0.001). A multivariate analysis demonstrated that the LCR was a significant independent risk factor for both the OS and RFS. Conclusion LCR was a risk factor for survival in patients who underwent curative treatment for esophageal cancer. It is necessary to develop the effective plan of the perioperative care and the surgical strategy according to the LCR.
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Affiliation(s)
- Toru Aoyama
- Department of Surgery, Yokohama City University; Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan
| | | | - Masato Nakazono
- Department of Surgery, Yokohama City University, Yokohama, Japan
| | - Kenki Segami
- Department of Surgery, Yokohama City University, Yokohama, Japan
| | - Hiroshi Tamagawa
- Department of Surgery, Yokohama City University, Yokohama, Japan
| | - Ayako Tamagawa
- Department of Surgery, Yokohama City University, Yokohama, Japan
| | - Kentaro Hara
- Department of Surgery, Yokohama City University, Yokohama, Japan
| | - Takashi Oshima
- Department of Surgery, Yokohama City University; Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan
| | - Norio Yukawa
- Department of Surgery, Yokohama City University, Yokohama, Japan
| | - Munetaka Masuda
- Department of Surgery, Yokohama City University, Yokohama, Japan
| | - Yasushi Rino
- Department of Surgery, Yokohama City University, Yokohama, Japan
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Impact of early postoperative factors on changes in skeletal muscle mass after esophagectomy in older patients with esophageal cancer. Eur Geriatr Med 2023; 14:203-210. [PMID: 36586085 PMCID: PMC9902305 DOI: 10.1007/s41999-022-00735-0] [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: 05/15/2022] [Accepted: 12/19/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND Loss of skeletal muscle mass, measured by the skeletal muscle mass index (SMI), after esophagectomy negatively impacts prognosis. However, the information to develop novel supportive care options for preventing loss of skeletal muscle mass is limited. The purpose of this retrospective cohort study was to investigate the impact of early postoperative factors on change in SMI 4 months after curative esophagectomy in older patients with esophageal cancer. METHODS This study included 113 subjects who underwent esophagectomy between 2015 and 2020. Preoperative and postoperative SMI (cm2/m2) were calculated from computed tomography images. The percentage change in SMI 4 months after surgery (SMI%) was calculated as follows: ([postoperative SMI - preoperative SMI] ÷ preoperative SMI) × 100. Potential factors affecting percentage change of SMI after surgery were analyzed by multiple regression. RESULTS The mean SMI% was - 5.6%. The percentage change (per 1%) in quadriceps muscle strength in the first month after surgery (standardized β = 0.190, p = 0.048) impacted the SMI%, which was independent of age, sex, preoperative SMI, comorbidity, pathological stage, and neoadjuvant chemotherapy. CONCLUSION Quadriceps muscle weakness in the first month after esophagectomy impacted the SMI% in a dose-dependent relationship.
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Solmaz S, Uzun O, Sevindik OG, Demirkan F, Ozcan MA, Ozsan GH, Alacacıoglu I. The effect of haemoglobin, albumin, lymphocyte and platelet score on the prognosis in patients with multiple myeloma. Int J Lab Hematol 2023; 45:13-19. [PMID: 36053932 DOI: 10.1111/ijlh.13958] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 08/09/2022] [Indexed: 01/18/2023]
Abstract
INTRODUCTION In multiple myeloma cases, a variety of prognostic parameters have been identified, which contain the Durie-Salmon classification and the international staging system (ISS) that takes the serum ß2 microglobulin and albumin levels, platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), and monocyte-to-lymphocyte ratio (MLR). This study investigates the effect of haemoglobin, albumin, lymphocyte and platelet (HALP) score which is a marker of inflammation status and nutrition, at the time of diagnosis for the patients with multiple myeloma on prognosis. METHODS A total of 200 multiple myeloma patients with HALP scores calculated from serum haemoglobin, albumin, lymphocyte count and platelet levels at the time of diagnosis were retrospectively examined. The effect of HALP score on overall survival (OS) and progression-free survival and its relationship between the previously evaluated prognostic parameters were investigated. RESULTS The optimal cut-off value with the ROC curves for the HALP score was 28.8. The patients were divided into two groups according to the optimal value of the HALP score (low-score group: HALP ≤28.8 [n: 134] and high-score group HALP >28.8 [n: 66]). In the group with the high HALP score, the OS was statistically longer than the low HALP score group (84 months and 53 months; p = 0.0001). In addition, when the effects of NLR, PLR, HALP score and ISS stage on OS were examined by multivariate analysis, all these markers were found to be statistically significant predictors. CONCLUSIONS HALP score may be a valuable prognostic marker for patients with multiple myeloma.
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Affiliation(s)
- Serife Solmaz
- Department of Hematology, Izmir Katip Celebi Training and Research Hospital, IZMIR, Turkey
| | - Ozcan Uzun
- Department of Nephrology, Faculty of Medicine, Dokuz Eylul University, IZMIR, Turkey
| | | | - Fatih Demirkan
- Department of Hematology, Faculty of Medicine, Dokuz Eylul University, IZMIR, Turkey
| | - Mehmet Ali Ozcan
- Department of Hematology, Faculty of Medicine, Dokuz Eylul University, IZMIR, Turkey
| | - Guner Hayri Ozsan
- Department of Hematology, Faculty of Medicine, Dokuz Eylul University, IZMIR, Turkey
| | - Inci Alacacıoglu
- Department of Hematology, Faculty of Medicine, Dokuz Eylul University, IZMIR, Turkey
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AOYAMA TORU, KAZAMA KEISUKE, MAEZAWA YUKIO, HARA KENTARO. Usefulness of Nutrition and Inflammation Assessment Tools in Esophageal Cancer Treatment. In Vivo 2023; 37:22-35. [PMID: 36593006 PMCID: PMC9843752 DOI: 10.21873/invivo.13051] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 11/22/2022] [Accepted: 11/24/2022] [Indexed: 01/04/2023]
Abstract
Multidisciplinary treatment for esophageal cancer leads to nutritional and inflammatory changes. Recent studies showed that nutritional and inflammatory changes during multidisciplinary treatment affect both short and long-term oncological outcomes in esophageal cancer treatment. Therefore, evaluation of the nutritional and inflammatory status during treatment is necessary in order to optimize and utilize multidisciplinary therapy for esophageal cancer. If patients with esophageal cancer are able to determine their nutritional and inflammatory status, they will be able to select the optimal esophageal cancer, anti-inflammation, and nutritional treatments. Various types of nutrition and inflammation assessment tools have been developed and reported for esophageal cancer, with each tool having its own clinical characteristics, which must be understood before being applied in clinical practice. This review summarizes the background, current status, and future perspectives on the application of nutrition and inflammation assessment tools in esophageal cancer treatment.
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Affiliation(s)
- TORU AOYAMA
- Department of Surgery, Yokohama City University, Yokohama, Japan,Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Kanagawa, Japan
| | - KEISUKE KAZAMA
- Department of Surgery, Yokohama City University, Yokohama, Japan,Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Kanagawa, Japan
| | - YUKIO MAEZAWA
- Department of Surgery, Yokohama City University, Yokohama, Japan,Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Kanagawa, Japan,Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - KENTARO HARA
- Department of Surgery, Yokohama City University, Yokohama, Japan,Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Kanagawa, Japan,Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
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Wang X, Wang P, Huang X, Han Y, Zhang P. Biomarkers for immunotherapy in esophageal cancer. Front Immunol 2023; 14:1117523. [PMID: 37197663 PMCID: PMC10183563 DOI: 10.3389/fimmu.2023.1117523] [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: 12/06/2022] [Accepted: 04/19/2023] [Indexed: 05/19/2023] Open
Abstract
The development of immunotherapy, especially immune-checkpoint inhibitors targeting PD-1/PD-L1, has improved the outcomes of patients with esophageal cancer. However, not all population derives benefit from the agents. Recently, kinds of biomarkers were introduced to predict the response to immunotherapy. However, the effects of these reported biomarkers are controversial and many challenges remain. In this review, we aim to summarize the current clinical evidence and provide a comprehensive understanding of the reported biomarkers. We also discuss the limits of the present biomarkers and propose our own opinions on which viewers' discretion are advised.
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Affiliation(s)
- Xuelian Wang
- Department of Oncology and Hematology, Zhongxian People’s Hospital, Chongqing, China
| | - Ping Wang
- Department of Urology, Zhongxian People’s Hospital, Chongqing, China
| | - Xiang Huang
- Department of Radiation Oncology, The First Center of the Chinese PLA General Hospital, Beijing, China
| | - Yanan Han
- Department of Radiation Oncology, The First Center of the Chinese PLA General Hospital, Beijing, China
- *Correspondence: Yanan Han, ; Pei Zhang,
| | - Pei Zhang
- Department of Radiation Oncology, The Fifth Center of the Chinese PLA General Hospital, Beijing, China
- *Correspondence: Yanan Han, ; Pei Zhang,
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Da L, Qu Z, Zhang C, Shen Y, Huang W, Zhang Y, Gu K. Prognostic value of inflammatory markers and clinical features for survival in advanced or metastatic esophageal squamous cell carcinoma patients receiving anti-programmed death 1 treatment. Front Oncol 2023; 13:1144875. [PMID: 37035159 PMCID: PMC10076857 DOI: 10.3389/fonc.2023.1144875] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 03/06/2023] [Indexed: 04/11/2023] Open
Abstract
Purpose This study aims to assess the prognostic value of inflammatory markers and clinical features in advanced or metastatic esophageal squamous cell carcinoma (ESCC) patients receiving anti-programmed death 1 (PD-1) treatment. Methods Based on receiver operating characteristic curve (ROC) analysis, Youden's indexes were applied to determine the cut-off values for inflammatory markers, including neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocye ratio (dNLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII). Wilcoxon test was conducted to evaluate the changes in above inflammatory markers. Kaplan-Meier method was utilized to estimate progression-free survival (PFS) and overall survival (OS), and the Log-rank test was used to compare the different survival between groups. Univariate and multivariate Cox regression analyses were performed to assess the prognostic value of inflammatory markers and clinical features. Results 162 advanced or metastatic ESCC patients receiving anti-PD-1 treatment were enrolled in this retrospective study. The cut-off values of NLR, dNLR, MLR, PLR, and SII were 4.748, 2.214, 0.309, 250.505, and 887.895, respectively. NLR, dNLR, PLR, and SII declined significantly among the partial response (PR) (P<0.001, P<0.001, P=0.036, P<0.001), objective response rate (ORR) (P<0.001, P<0.001, P=0.036, P<0.001), and disease control rate (DCR) (P<0.001, P<0.001, P=0.038, P<0.001) groups, respectively. Significant increases were found in NLR (P<0.001), dNLR (P<0.001), MLR (P=0.001), and SII (P=0.024) when anti-PD-1 treatment failed. Multivariate Cox regression analysis indicated that NLR (P<0.001, P=0.002), lymph node metastasis (P=0.013, P=0.001), Eastern Cooperative Oncology Group Performance Status (ECOG PS) (P=0.008, P=0.002), and treatment lines (P=0.037, P=0.048) were significant prognostic indicators of PFS and OS. Additionally, SII (P=0.016) was also significantly related to OS in ESCC patients. The risk score model showed that low risk patients prolonged PFS and OS than those with middle or high risk (P<0.001, P<0.001). Conclusion Inflammatory markers can reflect short-term outcomes of anti-PD-1 treatment for ESCC patients. NLR, lymph node metastases, ECOG PS, and treatment lines are significant prognostic indicators for PFS and OS. And the risk score model constructed based on the above factors has favourable prognostic predictive value.
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Affiliation(s)
| | | | | | | | | | - Yiyin Zhang
- *Correspondence: Yiyin Zhang, ; Kangsheng Gu,
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31
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Takegawa N, Hirabayashi T, Tanaka S, Nishikawa M, Tokuyama N, Mimura T, Kushida S, Tsumura H, Yamamoto Y, Miki I, Tsuda M. The impact of nutritional status in nivolumab-treated patients with advanced esophageal cancer. PLoS One 2023; 18:e0285365. [PMID: 37146004 PMCID: PMC10162549 DOI: 10.1371/journal.pone.0285365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 04/21/2023] [Indexed: 05/07/2023] Open
Abstract
Although phase III trials have reported improved overall survival in patients with advanced esophageal squamous cell carcinoma following treatment with nivolumab, as compared with chemotherapy (paclitaxel or docetaxel), the treatment was effective only in a limited number of patients. Therefore, the aim of this study is to determine whether there is a correlation between nutritional status (Glasgow prognostic score, prognostic nutritional index, and neutrophil-to-lymphocyte ratio) and prognosis of advanced esophageal cancer in patients treated with taxane or nivolumab therapy. The medical records of 35 patients who received taxane monotherapy (paclitaxel or docetaxel), for advanced esophageal cancer between October 2016 and November 2018 (taxane cohort) were reviewed. The clinical data of 37 patients who received nivolumab therapy between March 2020 and September 2021 (nivolumab cohort) were collected. The median overall survival was 9.1 months for the taxane cohort and 12.5 months for the nivolumab cohort. In the nivolumab cohort, patients with good nutritional status had significantly better median overall survival than those with poor nutritional status (18.1 vs. 7.6 months, respectively, p = 0.009, classified by prognostic nutritional index, 15.5 vs. 4.3 months, respectively, p = 0.012, classified by Glasgow prognostic score), whereas the prognosis of the patients treated with taxane therapy was less affected by the nutritional status. This suggests that the pretreatment nutritional status of patients with advanced esophageal cancer is a key factor for successful outcomes, especially for treatment with nivolumab.
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Affiliation(s)
- Naoki Takegawa
- Department of Gastroenterology, Hyogo Cancer Center, Akashi, Hyogo, Japan
| | - Taku Hirabayashi
- Department of Gastroenterology, Hyogo Cancer Center, Akashi, Hyogo, Japan
| | - Shunta Tanaka
- Department of Gastroenterology, Hyogo Cancer Center, Akashi, Hyogo, Japan
| | - Michiko Nishikawa
- Department of Gastroenterology, Hyogo Cancer Center, Akashi, Hyogo, Japan
| | - Nagahiro Tokuyama
- Department of Gastroenterology, Hyogo Cancer Center, Akashi, Hyogo, Japan
| | - Takuya Mimura
- Department of Gastroenterology, Hyogo Cancer Center, Akashi, Hyogo, Japan
| | - Saeko Kushida
- Department of Gastroenterology, Hyogo Cancer Center, Akashi, Hyogo, Japan
| | - Hidetaka Tsumura
- Department of Gastroenterology, Hyogo Cancer Center, Akashi, Hyogo, Japan
| | - Yoshinobu Yamamoto
- Department of Gastroenterology, Hyogo Cancer Center, Akashi, Hyogo, Japan
| | - Ikuya Miki
- Department of Gastroenterology, Hyogo Cancer Center, Akashi, Hyogo, Japan
| | - Masahiro Tsuda
- Department of Gastroenterology, Hyogo Cancer Center, Akashi, Hyogo, Japan
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Mikulski D, Kościelny K, Nowicki M, Wawrzyniak E, Kalwas M, Kowalik M, Pryt M, Sęczkowska E, Świątek A, Wierzbowska A, Fendler W. Neutrophil to lymphocyte ratio (NLR) impact on the progression-free survival and overall survival of multiple myeloma patients treated with high-dose chemotherapy and autologous stem cell transplantation. Leuk Lymphoma 2023; 64:98-106. [PMID: 36318865 DOI: 10.1080/10428194.2022.2136946] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
High-dose chemotherapy with autologous stem-cell transplantation (ASCT) remains the standard of care in multiple myeloma (MM) patients. This retrospective study aimed to assess the impact of neutrophil-to-lymphocyte ratio (NLR) and other complete blood count (CBC)-based predictors on PFS and OS of transplant-eligible MM patients. The CBC-based biomarkers were evaluated in a single-center cohort of 176 MM patients at three time points: at the diagnosis, the time of ASCT, and +100 d after ASCT. Univariable and multivariable Cox's regression analyses and Kaplan-Meier estimate were used in statistical analysis. NLR at ASCT (HR 1.15, 95% CI: 1.05-1.26) and hemoglobin at ASCT (HR 0.80, 95% CI: 0.68-0.94) were independent factors influencing PFS. In the model for OS, the only statistically significant factors were NLR at ASCT (HR 1.15, 95% CI: 1.04-1.27), bortezomib administration prior to ASCT (HR 0.52, 95% CI: 0.33-0.83) and age at diagnosis (HR 1.03, 95% CI: 1.00-1.06). NLR at ASCT is an independent predictive factor in MM patients undergoing ASCT.
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Affiliation(s)
- Damian Mikulski
- Department of Biostatistics and Translational Medicine, Medical University of Lodz, Lodz, Poland.,Department of Hematology, Copernicus Memorial Hospital in Lodz Comprehensive Cancer Center and Traumatology, Lodz, Poland
| | - Kacper Kościelny
- Department of Biostatistics and Translational Medicine, Medical University of Lodz, Lodz, Poland
| | - Mateusz Nowicki
- Department of Hematology, Copernicus Memorial Hospital in Lodz Comprehensive Cancer Center and Traumatology, Lodz, Poland.,Department of Hematology, Medical University of Lodz, Lodz, Poland
| | - Ewa Wawrzyniak
- Department of Hematology, Medical University of Lodz, Lodz, Poland
| | - Marta Kalwas
- Department of Pathology, Chair of Oncology, Medical University of Lodz, Lodz, Poland
| | - Monika Kowalik
- Department of Hematology, Copernicus Memorial Hospital in Lodz Comprehensive Cancer Center and Traumatology, Lodz, Poland
| | - Mateusz Pryt
- Department of Biostatistics and Translational Medicine, Medical University of Lodz, Lodz, Poland
| | - Emilia Sęczkowska
- Department of Anesthesiology and Intensive Medical Therapy, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
| | - Agnieszka Świątek
- Department of Internal Medicine and Gastroenterology, Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, Poland
| | - Agnieszka Wierzbowska
- Department of Hematology, Copernicus Memorial Hospital in Lodz Comprehensive Cancer Center and Traumatology, Lodz, Poland.,Department of Hematology, Medical University of Lodz, Lodz, Poland
| | - Wojciech Fendler
- Department of Biostatistics and Translational Medicine, Medical University of Lodz, Lodz, Poland.,Department of Radiation Oncology, Dana‑Farber Cancer Institute, Boston, MA, USA
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Yamada M, Tanaka K, Yamasaki M, Yamashita K, Makino T, Saito T, Takahashi T, Kurokawa Y, Motoori M, Kimura Y, Nakajima K, Eguchi H, Doki Y. Neutrophil-to-lymphocyte ratio after neoadjuvant chemotherapy as an independent prognostic factor in patients with esophageal squamous cell carcinoma. Oncol Lett 2022; 25:58. [PMID: 36644140 PMCID: PMC9827446 DOI: 10.3892/ol.2022.13644] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 10/19/2022] [Indexed: 01/17/2023] Open
Abstract
Studies have shown that neoadjuvant chemotherapy (NAC) followed by surgical resection improves the survival of patients with esophageal squamous cell carcinoma (ESCC), and that the neutrophil-to-lymphocyte ratio (NLR) nay be a prognostic biomarker in various types of cancer. Despite the noTable changes in the tumor and its microenvironment during NAC, it remains unclear how the NLR changes and which values (before or after NAC) best predict prognosis. The present study aimed to analyze changes in the NLR before and after NAC, and to determine which was a better prognostic factor. This study retrospectively analyzed 338 consecutive patients with ESCC who received NAC followed by curative resection. NLRs before (pre-NLR) and after (post-NLR) NAC were calculated, after which the impact of NAC on NLR, overall survival (OS) and recurrence-free survival (RFS), as well as the relationship between hematological toxicities and NLR, was evaluated. Cutoff values for pre- and post-NLR were 3.7 and 2.5, respectively. Patients with high post-NLR had a worse OS (P=0.0001) and 3-year RFS (P=0.03) than those with low post-NLR. Multivariate analysis identified high post-NLR, pN1 and clinical response as independent prognostic factors. In conclusion, post-NLR was revealed as a better prognostic factor than pre-NLR for patients receiving NAC followed by surgical resection.
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Affiliation(s)
- Moyuru Yamada
- Department of Gastroenterological Surgery, Osaka University, Suita, Osaka 565-0871, Japan
| | - Koji Tanaka
- Department of Gastroenterological Surgery, Osaka University, Suita, Osaka 565-0871, Japan,Correspondence to: Dr Koji Tanaka, Department of Gastroenterological Surgery, Osaka University, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan, E-mail:
| | - Makoto Yamasaki
- Department of Gastroenterological Surgery, Osaka University, Suita, Osaka 565-0871, Japan
| | - Kotaro Yamashita
- Department of Gastroenterological Surgery, Osaka University, Suita, Osaka 565-0871, Japan
| | - Tomoki Makino
- Department of Gastroenterological Surgery, Osaka University, Suita, Osaka 565-0871, Japan
| | - Takuro Saito
- Department of Gastroenterological Surgery, Osaka University, Suita, Osaka 565-0871, Japan
| | - Tsuyoshi Takahashi
- Department of Gastroenterological Surgery, Osaka University, Suita, Osaka 565-0871, Japan
| | - Yukinori Kurokawa
- Department of Gastroenterological Surgery, Osaka University, Suita, Osaka 565-0871, Japan
| | - Masaaki Motoori
- Department of Surgery, Osaka General Medical Center, Osaka 558-8558, Japan
| | - Yutaka Kimura
- Department of Surgery, Kindai University Nara Hospital, Ikoma, Nara 630-0293, Japan
| | - Kiyokazu Nakajima
- Department of Gastroenterological Surgery, Osaka University, Suita, Osaka 565-0871, Japan
| | - Hidetoshi Eguchi
- Department of Gastroenterological Surgery, Osaka University, Suita, Osaka 565-0871, Japan
| | - Yuichiro Doki
- Department of Gastroenterological Surgery, Osaka University, Suita, Osaka 565-0871, Japan
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Zhu H, Li Z, Zhou Y, Zheng R, Diao C, Li K, Feng Q, Wang D. Neutrophil-lymphocyte ratio as a risk factor for osteoporotic vertebrae fractures and femoral neck fractures. Medicine (Baltimore) 2022; 101:e32125. [PMID: 36482639 PMCID: PMC9726278 DOI: 10.1097/md.0000000000032125] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 11/10/2022] [Indexed: 12/13/2022] Open
Abstract
Fracture is associated with osteopenia after osteoporosis. Neutrophil-lymphocyte ratio (NLR) is common in inflammatory diseases. NLR can be used as an effective clinical tool to assess postmenopausal osteoporosis. The aim of this study is to further explore the relationship between elevated NLR and the severity of osteoporotic vertebrae fractures and femoral neck fracture based on magnetic resonance imaging (MRI). A total of 80 patients with osteoporotic vertebrae fractures, osteoporotic femoral neck fracture in Baoding Second Central Hospital from 2017 to 2020 were selected as the research objects. This study included a series of pretreatment factors, mainly including white blood cell count, red blood cell count, hemoglobin, and the general condition of the patients. Statistical methods included Pearson chi-square test, Spearman correlation test, logistic regression analysis and receiver operator characteristic (ROC) curve. According to Pearson chi-square test, Spearman correlation test, univariate/multivariate logistic regression analysis, the severity of osteoporotic vertebrae fractures, osteoporotic femoral neck fracture was significantly correlated with NLR (P < .001). NLR (odds ratio [OR] = 13.229, 95% CI: 4.167-41.998, P < .001) was a significant independent risk factor for osteoporotic vertebrae fractures, osteoporotic femoral neck fracture. receiver operator characteristic (ROC) curve was used to detect the specificity and sensitivity. The level of NLR has an important influence on the severity of osteoporotic vertebrae fractures and femoral neck fracture. The higher the level of NLR, the more serious the osteoporotic vertebrae fractures and femoral neck fracture.
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Affiliation(s)
- Hao Zhu
- Department of Orthopedics, The Second Central Hospital of Baoding, Zhuozhou City, Hebei Province, PR China
| | - Zheng Li
- Department of Orthopedics, The Second Central Hospital of Baoding, Zhuozhou City, Hebei Province, PR China
| | - Yizhai Zhou
- Department of Orthopedics, The Second Central Hospital of Baoding, Zhuozhou City, Hebei Province, PR China
| | - Rugeng Zheng
- Department of Orthopedics, The Second Central Hospital of Baoding, Zhuozhou City, Hebei Province, PR China
| | - Cong Diao
- Obstetrics Department, The Second Central Hospital of Baoding, Zhuozhou City, Hebei Province, PR China
| | - Kepeng Li
- Department of Orthopedics, The Second Central Hospital of Baoding, Zhuozhou City, Hebei Province, PR China
| | - Qi Feng
- Department of Orthopedics, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, PR China
| | - Donglai Wang
- Department of Orthopedics, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, PR China
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35
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Elevated Platelet-to-Lymphocyte Ratio and Neutrophil-to-Lymphocyte Ratio after First Cycle of Chemotherapy and Better Survival in Esophageal Cancer Patients Receiving Concurrent Chemoradiotherapy. Curr Oncol 2022; 29:8825-8834. [PMID: 36421347 PMCID: PMC9689285 DOI: 10.3390/curroncol29110694] [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: 09/26/2022] [Revised: 10/28/2022] [Accepted: 11/15/2022] [Indexed: 11/18/2022] Open
Abstract
Background: Prognostic factors for poor survival have been proposed in esophageal squamous cell carcinoma (SCC) patients receiving concurrent chemoradiotherapy (CCRT). We conducted a retrospective study on hematological profile after first cycle of chemotherapy for esophageal SCC patients receiving CCRT. Methods: From January 2008 to December 2017, a total of 420 patients with esophageal SCC were enrolled. All included patients had undergone CCRT. Complete blood count, differential count, NLR, and PLR before chemotherapy (CHT) and after first cycle of CHT were obtained. Univariate and multivariate Cox regression analyses were used to assess the association between survival and patient, disease, and treatment characteristics. Results: On univariate analysis, significant factors for overall survival (OS) and disease specific survival (DSS) included ECOG performance status, clinical staging, operation, cisplatin dose, prechemotherapy NLR and PLR, and elevated postchemotherapy NLR. On multivariate analysis, ECOG performance status 0-I, Clinical staging I-II, Operation, cisplatin dose >150 mg/m2, prechemotherapy PLR <375, and postchemotherapy platelet count ≥150 × 109/L were independent factors for predicting better OS. Independent factors for predicting better DSS included ECOG performance status 0-I, Clinical staging I-II, Operation, cisplatin dose >150 mg/m2, and prechemotherapy PLR <375. Conclusions: Our study showed that low levels of prechemotherapy PLR and NLR were associated with better OS and DSS. Elevated platelet count and NLR after first cycle of CHT were associated with better OS. Elevated PLR and NLR after first cycle of CHT were associated with better DSS.
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Zhang X, Ren Y, Xie B, Ye Q, Ban C, Zhang S, Zhu M, Liu Y, Wang S, Geng J, He X, Jiang D, He J, Shu S, Luo S, Wang X, Song D, Fan M, Sun H, Dai H. Blood monocyte counts as a prognostic biomarker and predictor in Chinese patients with idiopathic pulmonary fibrosis. Front Med (Lausanne) 2022; 9:955125. [PMID: 36425108 PMCID: PMC9679289 DOI: 10.3389/fmed.2022.955125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 10/18/2022] [Indexed: 09/08/2023] Open
Abstract
OBJECTIVES We sought to evaluate the prognostic value of blood routine parameters and biochemical parameters, especially inflammation-related biomarkers, and establish an inflammation-related prognostic model in Chinese patients with idiopathic pulmonary fibrosis (IPF). MATERIAL/METHODS Patients diagnosed as IPF at Beijing Chaoyang Hospital and aged 40 years and older were consecutively enrolled from June 2000 to March 2015, and finally, a total of 377 patients were enrolled in the derivation cohort. The follow-up ended in December 2016. We used Cox proportional hazard model to calculate the hazard ratio (HR) and establish the prognostic model. The discrimination and calibration of the prognostic model were evaluated in an independent validation cohort enrolled from China-Japan Friendship Hospital between January 2015 and December 2019. RESULTS Multivariate analysis revealed that patients with elevated monocyte-to-red blood cell count ratio (MRR) and monocyte counts showed increased risk of mortality. The clinical-physiological-biomarker (CPB) index and CPB stage we established in this study were a significant predictor, and the C-index for CPB index and CPB stage in the validation cohort was 0.635 (95% CI: 0.558-0.712) and 0.619 (95% CI: 0.544-0.694), respectively. Patients in CPB stage III had the poorest survival. CONCLUSION We developed and validated a new inflammation-related prognostic model (CPB index and CPB stage) which was integration of age, gender, FVC (%, predicted), DLCO (%, predicted), Charlson Comorbidity Index, and blood monocyte counts. This prediction model exhibited strong ability in predicting mortality in Chinese patients with IPF.
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Affiliation(s)
- Xinran Zhang
- Department of Clinical Research and Data Management, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- National Center for Respiratory Medicine, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
| | - Yanhong Ren
- National Center for Respiratory Medicine, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Institute of Respiratory Medicine, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China
| | - Bingbing Xie
- National Center for Respiratory Medicine, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Institute of Respiratory Medicine, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China
| | - Qiao Ye
- Department of Pulmonary and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Chenjun Ban
- Department of Respiration, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Shu Zhang
- Department of Pulmonary and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Min Zhu
- Department of Pulmonary and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Yan Liu
- Department of Pulmonary and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Shiyao Wang
- National Center for Respiratory Medicine, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Institute of Respiratory Medicine, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China
| | - Jing Geng
- National Center for Respiratory Medicine, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Institute of Respiratory Medicine, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China
| | - Xuan He
- National Center for Respiratory Medicine, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Institute of Respiratory Medicine, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China
| | - Dingyuan Jiang
- National Center for Respiratory Medicine, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Institute of Respiratory Medicine, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China
| | - Jiarui He
- National Center for Respiratory Medicine, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Institute of Respiratory Medicine, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China
| | - Shi Shu
- National Center for Respiratory Medicine, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Institute of Respiratory Medicine, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China
| | - Sa Luo
- National Center for Respiratory Medicine, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Institute of Respiratory Medicine, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China
| | - Xin Wang
- National Center for Respiratory Medicine, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Institute of Respiratory Medicine, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China
- Beijing University of Chinese Medicine, Beijing, China
| | - Dingyun Song
- National Center for Respiratory Medicine, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Institute of Respiratory Medicine, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China
| | - Mingming Fan
- National Center for Respiratory Medicine, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Institute of Respiratory Medicine, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China
- The Second Hospital of Jilin University, Changchun, China
| | - Haishuang Sun
- National Center for Respiratory Medicine, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Institute of Respiratory Medicine, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China
- The First Hospital of Jilin University, Changchun, China
| | - Huaping Dai
- National Center for Respiratory Medicine, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Institute of Respiratory Medicine, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China
- Department of Pulmonary and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
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Tang CL, Tsai WC, Lee JY, Wang YK, Chen YH, Liu YW, Lin MC, Fang PT, Huang YL, Wu IC. Higher pre-treatment skin sympathetic nerve activity and elevated resting heart rate after chemoradiotherapy predict worse esophageal cancer outcomes. BMC Cancer 2022; 22:1086. [PMID: 36271384 PMCID: PMC9587625 DOI: 10.1186/s12885-022-10180-8] [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: 08/05/2022] [Accepted: 10/12/2022] [Indexed: 11/24/2022] Open
Abstract
Background Chemoradiotherapy (CRT), which might affect the autonomic system, is the mainstay therapy for advanced esophageal squamous cell carcinoma (ESCC). Autonomic dysfunction has been found to possibly lead to cancer mortality in those with elevated resting heart rates (RHR). Skin sympathetic nerve activity (SKNA) is a new method of stimulating electrical signals in skin to evaluate autonomic function from sympathetic tone. In this study, we investigated the association between changes in RHR and autonomic function and ESCC mortality. Methods Thirty-nine stage II-IV ESCC patients receiving CRT between March 2019 and November 2020 were prospectively enrolled and carefully selected, followed up and received the same meticulous supportive care. Serial RHR was recorded every two weeks from before CRT to eight weeks after CRT and average SKNA were recorded before and four weeks after CRT. All-cause mortality was defined as primary outcome. Results We found the RHR of ESCC patients to be significantly elevated and peaking at four weeks after CRT (p < 0.001) and then to gradually decrease. Those with an elevated RHR above the cutoff level (18 beat-per-minute) at eight weeks after CRT had worse overall survival. In addition, those with higher baseline sympathetic tone (average SKNA ≥ 0.86 μV) also had poor outcome. Conclusions Increased pre-treatment sympathetic tone and elevated RHR after CRT are alarm signs of poor ESCC outcome. Further exploration of the mechanisms underlying these associations could potentially lead to intervention strategies for reducing mortality. Trial registration This study is registered with ClinicalTrials.gov, identifier: NCT03243448. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-022-10180-8.
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Affiliation(s)
- Chen-Ling Tang
- Division of Trauma and Acute Care Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wei-Chung Tsai
- Department of Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Drug Development and Value Creation Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jui-Ying Lee
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Division of Chest Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yao-Kuang Wang
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Division of Gastroenterology, Department of Internal Medicine, Sanmin Dist, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No.100, Tzyou 1st Rd, Kaohsiung City, 80756, Taiwan
| | - Yi-Hsun Chen
- Department of Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Division of Gastroenterology, Department of Internal Medicine, Sanmin Dist, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No.100, Tzyou 1st Rd, Kaohsiung City, 80756, Taiwan
| | - Yu-Wei Liu
- Division of Chest Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ming-Chieh Lin
- Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Pen-Tzu Fang
- Department of Radiation Oncology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yu-Ling Huang
- Department of Medical Imaging, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - I-Chen Wu
- Department of Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. .,Division of Gastroenterology, Department of Internal Medicine, Sanmin Dist, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No.100, Tzyou 1st Rd, Kaohsiung City, 80756, Taiwan. .,Center for Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan.
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Chen SL, Lin WC, Chen YC, Chen JL, Wu YH, Yang SH, Chen HY. The association between mortality and use of Chinese herbal medicine among incident stage IV esophageal cancer patients: A retrospective cohort study with core herbs exploration. Front Pharmacol 2022; 13:1018281. [PMID: 36278218 PMCID: PMC9582778 DOI: 10.3389/fphar.2022.1018281] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 09/23/2022] [Indexed: 11/30/2022] Open
Abstract
Esophageal cancer (EC) remains a leading cause of death worldwide and in Taiwan. The prognosis of advanced-stage EC is notably poor, and the treatment options are limited. Chinese herbal medicine (CHM) has been widely used as a complementary treatment for cancer, yet the long-term effect of CHM in stage IV EC remains unclear. The multi-institutional cohort obtained from the Chang Gung research database (CGRD) was used to study the long-term outcome of CHM use among incident stage IV EC patients from 1 January 2002, to 31 December 2018. All patients were followed up to 5 years or the occurrence of death. The overall survival (OS) and disease-specific survival rates were conducted using Kaplan-Meier estimation. Overlap weighing and landmark analysis were used to eliminate confounding and immortal time biases. Furthermore, we demonstrated the core CHMs for stage IV EC by using the Chinese herbal medicine network (CMN) analysis on prescriptions. Nine hundred eighty-five stage IV EC patients were analyzed, including 74 CHM users and 911 non-CHM users. We found the use of CHM was associated with a higher 5-year overall survival rate than CHM nonusers (the cumulative probability: 19.52% versus 6.04%, log-rank test: p < 0.001, and the p < 0.001 with overlap weighting). In addition, the overall median survival time was about 7 months longer among CHM users. Moreover, the lower 1-, 3-, 5-year disease-specific survival rates were higher among CHM users. Additionally, the risk of all-cause mortality was lower among CHM users when considering accessible demographic covariates (adjusted hazard ratio: 0.59, 95%CI: 0.39, 0.89, p = 0.011). Furthermore, the CMN analysis revealed that CHMs improved health while relieving tumor burden. For example, Hedyotis diffusa Willd . was the core CHM with an anti-cancer effect, while Fritillaria thunbergii Miq and Sevilla maindronide Rochebrune were used together to relieve cancer-related gastrointestinal discomfort. The use of CHM seems safe and possibly beneficial among stage IV EC patients with a higher 5-year OS. Further clinical trials on CHM were guaranteed to explore the role of CHM in managing stage IV EC patients.
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Affiliation(s)
- Shu-Ling Chen
- Division of Chinese Internal and Pediatric Medicine, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan Branch, Taoyuan, Taiwan
| | - Wei-Chun Lin
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan
| | - Yu-Chun Chen
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan
| | - Jiun-Liang Chen
- Division of Chinese Internal and Pediatric Medicine, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan Branch, Taoyuan, Taiwan
- School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yi-Hong Wu
- Division of Chinese Internal and Pediatric Medicine, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan Branch, Taoyuan, Taiwan
- School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Sien-Hung Yang
- Division of Chinese Internal and Pediatric Medicine, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan Branch, Taoyuan, Taiwan
- School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Hsing-Yu Chen
- Division of Chinese Internal and Pediatric Medicine, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan Branch, Taoyuan, Taiwan
- School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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Chargi N, Breik O, Forouzanfar T, Martin T, Praveen P, Idle M, Parmar S, de Bree R. Association of low skeletal muscle mass and systemic inflammation with surgical complications and survival after microvascular flap reconstruction in patients with head and neck cancer. Head Neck 2022; 44:2077-2094. [PMID: 35652420 PMCID: PMC9540531 DOI: 10.1002/hed.27113] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 05/20/2022] [Accepted: 05/23/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Skeletal muscle mass (SMM) and chronic inflammation are associated with postoperative complications and survival. METHODS Patients with head and neck cancer (HNC) undergoing microvascular free flap reconstruction were included. SMM and neutrophil-to-lymphocyte ratio (NLR) were measured and their association with treatment outcomes analyzed. RESULTS Five hundred and fifty-four patients were included. Predictors for complications were elevated NLR in all flaps (OR 1.5), low SMM in radial forearm flap (OR 2.0), and elevated NLR combined with low SMM in fibula flap surgery (OR 4.3). Patients with solely elevated NLR were at risk for flap-related complications (OR 3.0), severe complications (OR 2.2), and when combined with low SMM for increased length of hospital stays (LOS) (+3.9 days). In early-stage HNC, low SMM (HR 2.3), and combined elevated NLR with low SMM (HR 2.6) were prognostics for decreased overall survival. CONCLUSIONS SMM and NLR are predictive for poor outcomes in patients with HNC undergoing microvascular reconstruction.
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Affiliation(s)
- Najiba Chargi
- Department of Head and Neck Surgical Oncology, Division of Imaging and Oncology CenterUniversity Medical Center UtrechtUtrechtthe Netherlands
| | - Omar Breik
- Department of Oral and Maxillofacial SurgeryUniversity Hospital Birmingham NHS Trust, Queen Elizabeth HospitalBirminghamUK
| | - Tymour Forouzanfar
- Department of Oral and Maxillofacial Surgery/Oral Pathology VU University Medical Center/Academic Centre for Dentistry AmsterdamACTA University of Amsterdam and VU University AmsterdamAmsterdamthe Netherlands
| | - Timothy Martin
- Department of Oral and Maxillofacial SurgeryUniversity Hospital Birmingham NHS Trust, Queen Elizabeth HospitalBirminghamUK
| | - Prav Praveen
- Department of Oral and Maxillofacial SurgeryUniversity Hospital Birmingham NHS Trust, Queen Elizabeth HospitalBirminghamUK
| | - Matthew Idle
- Department of Oral and Maxillofacial SurgeryUniversity Hospital Birmingham NHS Trust, Queen Elizabeth HospitalBirminghamUK
| | - Satyesh Parmar
- Department of Oral and Maxillofacial SurgeryUniversity Hospital Birmingham NHS Trust, Queen Elizabeth HospitalBirminghamUK
| | - Remco de Bree
- Department of Head and Neck Surgical Oncology, Division of Imaging and Oncology CenterUniversity Medical Center UtrechtUtrechtthe Netherlands
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Smith L, Cata JP, Forget P. Immunological Insights into Opioid-Free Anaesthesia in Oncological Surgery: A Scoping Review. Curr Oncol Rep 2022; 24:1327-1336. [PMID: 35633449 PMCID: PMC9474513 DOI: 10.1007/s11912-022-01300-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2022] [Indexed: 11/21/2022]
Abstract
PURPOSE OF REVIEW The influence of opioids on outcomes after cancer surgery when used, or avoided, intraoperatively remains unclear. There is a need to conduct a scoping review to explore the wider context and provide direction for future research. The review will examine the current state of evidence in humans, with a focus on immunological biomarkers and clinically relevant cancer outcomes in trials comparing opioid-free to opioid-based general anaesthesia. RECENT FINDINGS There is limited research on this subject area, which is mainly focused on breast cancer. The most frequently evaluated immunological parameter is the neutrophil-to-lymphocyte ratio. Cancer outcomes are mainly focused on recurrence. The central knowledge gap is understanding how the cellular effects of opioids translate into longer-term patient outcomes. The major challenge for future research is accounting for the immunomodulatory effects of a wide range of confounding factors, which have yet to be clarified.
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Affiliation(s)
- Laura Smith
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK.
| | - Juan P Cata
- Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Anaesthesiology and Surgical Oncology Research Group, Houston, TX, USA
| | - Patrice Forget
- Institute of Applied Health Sciences, Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
- Department of Anaesthesia, NHS Grampian, Aberdeen, UK
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Li X, Ma X, Liu Y, Chang E, Cui J, Ma D, Zhang J. Predictive value of Leukocyte ImmunoTest (LIT™) in cancer patients: a prospective cohort study. Front Oncol 2022; 12:897968. [PMID: 35978826 PMCID: PMC9376289 DOI: 10.3389/fonc.2022.897968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 07/05/2022] [Indexed: 12/24/2022] Open
Abstract
Early diagnosis of cancer is crucial to initiate prompt treatment for better patient outcomes. The host immune function and its associated modulators are considered to be potential biomarkers for early cancer diagnosis. Immune and immune-checkpoint biomarkers have been reported to contribute to cancer development, while a high neutrophil-to-lymphocyte ratio has been shown to be associated with poor survival outcomes in a variety of cancers. One hundred sixty-one cancer patients were recruited to take a cost-effective novel Leukocyte ImmuneTest (LIT). LIT was measured to objectively determine the pre-treatment immune status of patients. The correlation between LIT and other conventional diagnostic markers or tumor-related variables was then investigated. Significant correlations between LIT and white blood cell count, smoking status, and tumor stage 4 were found. In addition, the LIT score significantly differentiated between malignant and benign tumors in this study population. Our work raises the possibility to use LIT for general screening surveillance before further costly specialized equipment is applied for cancer diagnosis.
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Affiliation(s)
- Xiaomeng Li
- Division of Anaesthetics, Pain Medicine and Intensive Care, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Chelsea and Westminster Hospital, London, United Kingdom
- *Correspondence: Jiaqiang Zhang, ; Xiaomeng Li,
| | - Xiaojun Ma
- Department of Anaesthesiology and Perioperative Medicine, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Yifeng Liu
- Research Department of Primary Care and Population Health, University College London, London, United Kingdom
| | - Enqiang Chang
- Department of Anaesthesiology and Perioperative Medicine, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Jiang Cui
- Division of Anaesthetics, Pain Medicine and Intensive Care, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Chelsea and Westminster Hospital, London, United Kingdom
| | - Daqing Ma
- Division of Anaesthetics, Pain Medicine and Intensive Care, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Chelsea and Westminster Hospital, London, United Kingdom
| | - Jiaqiang Zhang
- Department of Anaesthesiology and Perioperative Medicine, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
- *Correspondence: Jiaqiang Zhang, ; Xiaomeng Li,
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Kurohara K, Shimizu K, Murata T, Koizumi G, Takigawa A, Nagata K, Okumura K, Arai N. Predictive Value of Neutrophil-Lymphocyte Ratio as a Marker in Antiresorptive Agent-Related Osteonecrosis of the Jaw: A Retrospective Analysis. Diagnostics (Basel) 2022; 12:diagnostics12081836. [PMID: 36010185 PMCID: PMC9406977 DOI: 10.3390/diagnostics12081836] [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: 06/24/2022] [Revised: 07/21/2022] [Accepted: 07/28/2022] [Indexed: 12/04/2022] Open
Abstract
Antiresorptive agent-related osteonecrosis of the jaw (ARONJ), a multifactorial disease, can drastically affect a patient’s quality of life. Moreover, disease progression to severe acute inflammation can hinder treatment. Therefore, we aimed to investigate the diagnostic value of the neutrophil−lymphocyte ratio (NLR) and platelet−lymphocyte ratio (PLR) in predicting the risk of acute inflammation in patients with ARONJ. In total, 147 patients with ARONJ were enrolled between 1 January 2011 and 31 December 2019. They were divided into two groups according to their baseline NLR (high NLR vs. low NLR) or PLR (high PLR vs. low PLR) to analyze the relationship between NLR and PLR and the outcomes of acute inflammatory events. An optimal NLR cut-off value of 2.83 was identified for hospitalization for an inflammatory event. Logistic regression analysis showed that NLR > 2.83 was associated with an increased risk of hospitalization for an inflammatory event. A PLR cut-off value of 165.2 was identified for hospitalization for an inflammatory event. However, logistic regression analysis showed that PLR > 165.2 was not significantly associated with hospitalization for an inflammatory event. Our study findings suggest that the NLR has diagnostic value in predicting the risk of hospitalization for inflammatory events among patients with ARONJ.
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Survival analysis of 80 elderly patients with esophageal squamous cell carcinoma receiving definitive concurrent chemoradiotherapy with S-1. Cancer Radiother 2022; 26:1064-1069. [PMID: 35864071 DOI: 10.1016/j.canrad.2022.04.007] [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: 11/10/2021] [Revised: 03/25/2022] [Accepted: 04/10/2022] [Indexed: 11/21/2022]
Abstract
PURPOSE This single-center retrospective study aimed to observe survival and prognosis of elderly patients with esophageal cancer receiving radical radiotherapy combined with S1 chemotherapy, and to preliminarily explore whether hematologic indicators or inflammatory indicators before radiotherapy are prognostic factors. MATERIAL AND METHODS We retrospectively collected data of 80 elderly patients with esophageal cancer who had received radical concurrent chemoradiotherapy from January 2015 to July 2018. The patients were older than 70 years. Radiation therapy was delivered with intensity-modulated irradiation therapy (IMRT) or volumetric modulated arc therapy (VMAT), while the chemotherapy regimen was S1 alone. Toxicities were evaluated in accordance with the criteria of the Radiation Therapy Oncology Group. Baseline hematologic basic nutritional indicators, such as hemoglobin (HGB), albumin (ALB), and prealbumin (PAB), along with inflammatory indicators, such as the ratio of neutrophils to lymphocytes (NLR), the ratio of platelets to lymphocytes (PLR), were collected to preliminarily analyze their relationship with progression and survival. RESULTS The median follow-up time was 39 months (range 30-65 months). The median overall survival and progression-free survival times were 24 and 17 months, respectively. The 1-, 2-, and 3-year overall survival rates were 76.5%, 48.1%, and 31.3%, respectively. The 1-, 2-, and 3-year progression-free survival rates were 57.5%, 37.8%, and 29.4%, respectively. T stage, clinical staging, and lesion region were independent prognostic factors for OS. No significant associations with prognosis were observed either for baseline hematologic or for inflammatory indicators (all P>0.05). The rates of esophagitis (grade 2 and above) and hematologic toxicity were 60% and 45%, respectively. CONCLUSION Oral S-1 combined with definitive concurrent radiotherapy for elderly patients with esophageal cancer has a significant survival benefit. The toxicities are well tolerated. It seems that prognosis does not correlate with baseline hematologic nutritional indicators and inflammatory indicators.
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Sakamoto T, Makinoya M, Sunaguchi T, Goto K, Morimoto M, Murakami Y, Miyatani K, Hanaki T, Shishido Y, Kihara K, Matsunaga T, Yamamoto M, Tokuyasu N, Fujiwara Y. Geriatric nutritional risk index as a prognostic factor in patients with recurrent pancreatic cancer. PLoS One 2022; 17:e0271073. [PMID: 35797279 PMCID: PMC9262175 DOI: 10.1371/journal.pone.0271073] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 06/23/2022] [Indexed: 11/18/2022] Open
Abstract
The aim of this study is to investigate the prognostic significance of geriatric nutritional risk index (GNRI) at the time of recurrence in patients with recurrent pancreatic cancer, and the relationship between GNRI and skeletal muscle mass for survival outcomes after recurrence. This study enrolled 77 patients who developed postoperative recurrence. The skeletal muscle mass index (SMI) was used in this study. The patients were divided into a high-GNRI group (n = 36) and a low-GNRI group (n = 41) for the GNRI, and were divided into a high-SMI group (n = 38) and a low-SMI group (n = 39) for SMI. The 2-year post-recurrence overall survival of patients in the high-GNRI group was significantly longer than that of patients in the low-GNRI group (P = 0.001). No significant difference for the 2-year post-recurrence OS curves between the high-SMI group and the low-SMI group was observed (P = 0.125). Upon stratifying the patients with high GNRI or low GNRI according to SMI, There was no significant difference in the 2-year post-recurrence OS curves between the patients with both high GNRI and high SMI and the patients with high GNRI and low SMI (P = 0.399). Similarly, There was no significant difference in the 2-year post-recurrence OS curves between the patients with low GNRI and high SMI and the patients with both low GNRI and low SMI (P = 0.256). Multivariate analysis revealed that the GNRI at the time of recurrence was an independent prognostic risk factor in patients with recurrent pancreatic cancer (P = 0.019). The GNRI at the time of recurrence is useful for predicting the prognosis in patients with recurrence pancreatic cancer. Skeletal muscle mass at the time of recurrence is not contributed to predict post-recurrence survival of patients with recurrent pancreatic cancer.
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Affiliation(s)
- Teruhisa Sakamoto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Tottori prefecture, Japan
| | - Masahiro Makinoya
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Tottori prefecture, Japan
| | - Teppei Sunaguchi
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Tottori prefecture, Japan
| | - Keisuke Goto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Tottori prefecture, Japan
| | - Masaki Morimoto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Tottori prefecture, Japan
| | - Yuki Murakami
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Tottori prefecture, Japan
| | - Kozo Miyatani
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Tottori prefecture, Japan
| | - Takehiko Hanaki
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Tottori prefecture, Japan
| | - Yuji Shishido
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Tottori prefecture, Japan
| | - Kyoichi Kihara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Tottori prefecture, Japan
| | - Tomoyuki Matsunaga
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Tottori prefecture, Japan
| | - Manabu Yamamoto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Tottori prefecture, Japan
| | - Naruo Tokuyasu
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Tottori prefecture, Japan
| | - Yoshiyuki Fujiwara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Tottori prefecture, Japan
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Kuikel S, Pathak N, Poudel S, Thapa S, Bhattarai SL, Chaudhary G, Pandey KR. Neutrophil-lymphocyte ratio as a predictor of adverse outcome in patients with community-acquired pneumonia: A systematic review. Health Sci Rep 2022; 5:e630. [PMID: 35509390 PMCID: PMC9060320 DOI: 10.1002/hsr2.630] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 02/18/2022] [Accepted: 04/13/2022] [Indexed: 02/04/2023] Open
Abstract
Background Community-acquired pneumonia (CAP) is the acute infection of lung tissue in an immunocompetent who acquired it from the community. Its incidence and mortality are significant and require a marker to predict the severity and mortality in these patients. Neutrophil-lymphocyte ratio (NLR) is a simple, cheap, and easy-to-use marker and this study describes its role in predicting the adverse outcome in patients with CAP. Methods PubMed, EMBASE, and Google Scholar were used to search for related studies on February 8, 2021. A total of 186 articles were retrieved upon detailed searching in the databases and search engines. After a series of removing duplicate articles, title and abstract screening, and full-text review; nine articles were found eligible and included in the study. The data from each article were collected in MS Excel and the findings were summarized in this manuscript. Results The total number of patients analyzed in this systematic review is 3340. The mean age of the patient in the included studies ranged from 61 to 90.4 years. All studies had adverse outcomes as the endpoint of the study, which included in-hospital mortality or intensive care unit (ICU) admission or deterioration from medium and low risk to high risk or 30 days' mortality. The prevalence of endpoint ranged from 5.8% to 44.8%. NLR with a cutoff value of more than 10 was shown to predict mortality compared to C-reactive protein levels, white blood cell count, neutrophil count, lymphocyte level, Pneumonia Severity Index (PSI) level, PSI class, procalcitonin, and CURB-65 (Confusion, Respiratory rate, Blood pressure, 65 years of age and older) in most of the studies. Conclusion NLR is a simple, easily measured yet promising marker for predicting outcomes in patients with CAP.
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Affiliation(s)
- Sandip Kuikel
- Maharajgunj Medical CampusTribhuvan University Institute of MedicineKathmanduNepal
| | - Nibesh Pathak
- Maharajgunj Medical CampusTribhuvan University Institute of MedicineKathmanduNepal
| | - Sagar Poudel
- Maharajgunj Medical CampusTribhuvan University Institute of MedicineKathmanduNepal
| | - Sital Thapa
- Maharajgunj Medical CampusTribhuvan University Institute of MedicineKathmanduNepal
| | - Shiva Lal Bhattarai
- Maharajgunj Medical CampusTribhuvan University Institute of MedicineKathmanduNepal
| | - Gajendra Chaudhary
- Maharajgunj Medical CampusTribhuvan University Institute of MedicineKathmanduNepal
| | - Kundan Raj Pandey
- Department of Internal MedicineTribhuvan University Institute of MedicineKathmanduNepal
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Xu J, Li Y, Fan Q, Shu Y, Yang L, Cui T, Gu K, Tao M, Wang X, Cui C, Xu N, Xiao J, Gao Q, Liu Y, Zhang T, Bai Y, Li W, Zhang Y, Dai G, Ma D, Zhang J, Bai C, Huang Y, Liao W, Wu L, Chen X, Yang Y, Wang J, Ji S, Zhou H, Wang Y, Ma Z, Wang Y, Peng B, Sun J, Mancao C. Clinical and biomarker analyses of sintilimab versus chemotherapy as second-line therapy for advanced or metastatic esophageal squamous cell carcinoma: a randomized, open-label phase 2 study (ORIENT-2). Nat Commun 2022; 13:857. [PMID: 35165274 PMCID: PMC8844279 DOI: 10.1038/s41467-022-28408-3] [Citation(s) in RCA: 79] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 01/17/2022] [Indexed: 12/14/2022] Open
Abstract
This randomized, open-label, multi-center phase 2 study (NCT03116152) assessed sintilimab, a PD-1 inhibitor, versus chemotherapy in patients with esophageal squamous cell carcinoma after first-line chemotherapy. The primary endpoint was overall survival (OS), while exploratory endpoint was the association of biomarkers with efficacy. The median OS in the sintilimab group was significantly improved compared with the chemotherapy group (median OS 7.2 vs.6.2 months; P = 0.032; HR = 0.70; 95% CI, 0.50-0.97). Incidence of treatment-related adverse events of grade 3-5 was lower with sintilimab than with chemotherapy (20.2 vs. 39.1%). Patients with high T-cell receptor (TCR) clonality and low molecular tumor burden index (mTBI) showed the longest median OS (15.0 months). Patients with NLR < 3 at 6 weeks post-treatment had a significantly prolonged median OS (16.6 months) compared with NLR ≥ 3. The results demonstrate a significant improvement in OS of sintilimab compared to chemotherapy as second-line treatment for advanced or metastatic ESCC.
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Affiliation(s)
- Jianming Xu
- Department of Gastrointestinal Oncology, The Fifth Medical Center, Chinese PLA General Hospital, Beijing, China.
| | - Yi Li
- Department of Gastrointestinal Oncology, The Fifth Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Qingxia Fan
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yongqian Shu
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Lei Yang
- Department of Radiotherapy, Nantong Tumor Hospital, Nantong, China
| | - Tongjian Cui
- Department of Medical Oncology, Fujian Provincial Hospital, Fuzhou, China
| | - Kangsheng Gu
- Department of Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Min Tao
- Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xiuwen Wang
- Department of Chemotherapy, Qilu Hospital of Shandong University, Jinan, China
| | - Chengxu Cui
- Department of Medical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Nong Xu
- Department of Medical Oncology, The First Affiliated Hospital of Zhejiang University, Hangzhou, China
| | - Juxiang Xiao
- Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Quanli Gao
- Department of Immunotherapy, Henan Cancer Hospital, Zhengzhou, China
| | - Yunpeng Liu
- Department of Oncology, The First Hospital of China Medical University, Shenyang, China
| | - Tao Zhang
- Cancer Center, Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Yuxian Bai
- Department of Gastrointestinal Oncology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Wei Li
- Cancer Center, The First Hospital of Jilin University, Changchun, China
| | - Yiping Zhang
- Department of Thoracic Oncology, Zhejiang Cancer Hospital, Hangzhou, China
| | - Guanghai Dai
- Department of Oncology, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Dong Ma
- Department of Gastrointestinal Oncology, Guangdong Provincial People's Hospital, Guangzhou, China
| | - Jingdong Zhang
- Department of Gastroenterology, Liaoning Cancer Hospital, Shenyang, China
| | - Chunmei Bai
- Department of Medical Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Yunchao Huang
- Department of Thoracic Surgery I, Yunnan Cancer Hospital, Kunming, China
| | - Wangjun Liao
- Department of Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Lin Wu
- Departmentof Thoracic Medical Oncology, Hunan Cancer Hospital, Changsha, China
| | - Xi Chen
- Department of Oncology, No. 900 Hospital of The Joint Logistic Support Force, Fuzhou, China
| | - Yan Yang
- Department of Gastrointestinal Oncology, Gansu Provincial Cancer Hospital, Lanzhou, China
| | - Junye Wang
- Department of Oncology, Affiliated Hospital of Jining Medical University, Jining, China
| | - Shoujian Ji
- Department of Gastrointestinal Oncology, The Fifth Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Hui Zhou
- Innovent Biologics, Inc., Suzhou, China
| | - Yan Wang
- Innovent Biologics, Inc., Suzhou, China
| | - Zhuo Ma
- Innovent Biologics, Inc., Suzhou, China
| | | | - Bo Peng
- Innovent Biologics, Inc., Suzhou, China
| | - Jiya Sun
- Innovent Biologics, Inc., Suzhou, China
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Prognostic value of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio during immune checkpoint inhibitor treatment in recurrent or metastatic head and neck squamous cell carcinoma patients. Oral Oncol 2022; 126:105729. [PMID: 35144206 DOI: 10.1016/j.oraloncology.2022.105729] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/12/2022] [Accepted: 01/16/2022] [Indexed: 11/21/2022]
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The Clinical Impacts of Neutrophil to Lymphocyte Ratio for Esophageal Cancer Patients Who Receive Curative Treatment. Indian J Surg 2022. [DOI: 10.1007/s12262-021-02830-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Deme D, Kovacs S, Telekes A. Overall Survival Prediction of Advanced Cancer Patients by Selection of the Most Significant Baseline Serum Biomarker Combination. PATHOLOGY AND ONCOLOGY RESEARCH 2022; 28:1610004. [PMID: 35173556 PMCID: PMC8842665 DOI: 10.3389/pore.2022.1610004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 01/04/2022] [Indexed: 12/23/2022]
Abstract
Introduction: Consistent association between elevated baseline serum values and C-reactive protein (CRP), cross-linked fibrin degradation products (D-dimer), lactate dehydrogenase (LDH), decreased baseline serum albumin, absolute lymphocyte count to absolute monocyte count ratio (LMR), elevated absolute neutrophil count to absolute lymphocyte count ratio (NLR), elevated platelet count to absolute lymphocyte count ratio (PLR), and between some combinations of these biomarkers and the short overall survival of patients with malignant diseases has already been reported. These biomarkers are independent prognostic factors for cancer. Here, the most significant biomarker combination of these values was searched and studied in real-life advanced cancer patients of a single center.Methods: The authors retrospectively analyzed the association of the aforementioned biomarkers and their combination and OS of 75 consecutive cancer patients with locally advanced, recurrent, or metastatic diseases. Validated cut-off determination was used.Results: CRP, albumin, and PLR showed marked association with OS. Cut-off values for significant shorter OS were 30.65 mg/L (p < 0.001), 44.35 g/L (p < 0.001), and 168.20 (p < 0.001), respectively. Based on assessed biomarker cut-offs, four patient groups were created to determine whether biomarker values were out of range (ORV) compared to cut-off: 1) No ORV biomarkers (n = 24; OS = 26.07 months); 2) one ORV biomarker (n = 21; OS = 13.50 months); 3) two ORV biomarkers (n = 20; OS = 7.97 months), and 4) three ORV biomarkers (n = 10; OS = 3.91 months). Significant differences in OS were detected between the groups: For 1. vs. 2. hazard ratio (HR) = 3.0 (95% CI: 1.5–6.2), p = 0.003; for 1. vs. 3. HR = 4.1 (95% CI: 2.0–8.3), p < 0.001; and for 1. vs. 4. HR = 10.2 (95% CI: 4.2–24.6), p < 0.001.Conclusion: Based on our analysis, we can confirm that the complex monitoring of CRP, albumin, and PLR would provide a good estimation of OS. Large scale prospective studies are warranted to explore this and other useful combinations of prognostic biomarkers and their relationship to the well-established prognostic systems in real-life.
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Affiliation(s)
- Daniel Deme
- Department of Medical Oncology, Szent Lázár County Hospital, Salgótarján, Hungary
- *Correspondence: Daniel Deme,
| | - Sandor Kovacs
- Department of Economical and Financial Mathematics, University of Debrecen, Debrecen, Hungary
| | - Andras Telekes
- Department of Medical Oncology, Szent Lázár County Hospital, Salgótarján, Hungary
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Youssef M, Radwan R, Makkeyah S, Taha S. Predictive value of neutrophil-to-lymphocyte, lymphocyte-to-monocyte, and platelet-to-lymphocyte ratios in adult and pediatric acute lymphoblastic leukemia patients. THE EGYPTIAN JOURNAL OF HAEMATOLOGY 2022. [DOI: 10.4103/ejh.ejh_19_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
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