中性粒细胞淋巴细胞比及血小板淋巴细胞比预测乳腺癌非前哨淋巴结转移的价值分析

目的:探讨中性粒细胞淋巴细胞比(NLR)、血小板淋巴细胞比(PLR)对乳腺癌非前哨淋巴结转移的预测作用.方法:回顾性分析同济大学附属第一妇婴保健院2018月01月01日至2018年12月31日收治的147名行前哨淋巴结活检乳腺癌患者的相关临床病理资料及术前外周血中性粒细胞淋巴细胞比(NLR)、血小板淋巴细胞比(PLR)...     

The Pre-Treatment Neutrophil-Lymphocyte Ratio: a Useful Tool in Predicting Non-Sentinel Lymph Node Metastasis in Breast Cancer Cases

Background: The sentinel lymph node (SLN) biopsy is a highly accurate predictor of overall axillary nodal status in early breast cancer patients. There is however, still a debate on which patients with a positive SLN can benefit from axillary lymph node dissection (ALND). Numerous studies have been designed to identify variables that are predictive of non-SLN metastasis to avoid a complete ALND. The aim of this study was to determine whether the pre-treatment neutrophil-lymphocyte ratio (NLR) can be a predictive factor of non-SLN metastasis in early breast cancer patients. Materials and Methods: The records of 214 consecutive patients with cT1-3N0 invasive breast cancer who had undergone intraoperative SLN evaluation at Songklanagarind Hospital between the 1stof March 2011 and the 30thof May 2016 were examined. Data on patient demographics, tumor variables and NLR were collected and factors for non-SLN metastasis were analyzed using multivariate logistic regression. The power of the NLR was quantified with receiver operating characteristics (ROC) curves as measured by the areas under curves (AUC). Results: Multivariate analysis established presence of lymphovascular invasion (OR 8.4, 95%CI 2.3-31.3, p=0.002), macrometastasis (OR 6.6, 95%CI 1.8-24.7, p=0.005), and NLR (OR 2.3, 95%CI 1.1-4.8, p=0.033) as predictive factors of non-SLN metastasis with statistical significance. The AUC for NLR was 0.7 (95%CI 0.6-0.8) with an optimal cut-off of 2.6 giving a sensitivity of 62%, a specificity of 83.8%, a positive predictive value of 77.3% and a negative predictive value of 70.5%. Conclusion: Pre-treatment NLR is a useful diagnostic aid for predicting additional non-SLN metastasis.     

术前NLR、PLR及RDW预测前列腺癌患者术后复发转移的价值

目的:探讨中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)、血小板与淋巴细胞比值(platelet to lymphocyte ratio,PLR)及红细胞分布宽度(red blood cell distribution width,RDW)对前列腺癌(pros-tate...     

Lack of Prognostic Value of Blood Parameters in Patients Receiving Adjuvant Radiotherapy for Breast Cancer

Aim: To determine prognostic value of blood parameters on overall and progression-free survival in casesreceived adjuvant radiotherapy and chemotherapy with diagnosis of stage I-III breast cancer. Materials andMethods: We retrospectively reviewed files of 350 patients with non-metastatic breast cancer who were treatedin the Radiation Oncology Department of Kayseri Teaching Hospital between 2005 and 2010. Pretreatmentwhite blood cell (WBC), neutrophil, monocyte, basophil and eosinophil counts, and the neutrophil/lymphocyteratio (NLR) and platelet lymphocyte ratio (PLR) were recorded. The relationship between clinicopathologicalfindings and blood parameters was assessed. Results: Overall, 344 women and 6 men were recruited. Median agewas 55.3±0.3 years (range: 22-86). Of the cases, 243 (61.4%) received radiotherapy while 329 (94.3%), receivedchemotherapy and 215 (61.4%) received hormone therapy. Mean overall survival (OS) and progression-freesurvival (PFS) was 84.4 and 78.8 months, respectively. During follow-up, 48 patients died due to either diseaserelatedor non-related causes. Local recurrence was detected in 14 cases, while distant metastasis was noted in45 cases. In univariate analysis, age, pathology, perinodal invasion were significantly associated with overallsurvival, whereas gender, stage and hormone therapy were significantly associated with progression-free survival.In multivariate analysis, histopathological diagnosis (OR: 0.3; 95%: 0.1-0.7; p=0.006) and perinodal invasion(OR: 0.1; 95% CI: 0.1-1.3; p=0.026) were significantly associated with overall survival, whereas tumor stage(OR: 2.1; 95% CI: 0.0-0.7; p=0.014) and hormone therapy (OR: 2.1; 95%: 1.2-3.8; p=0.010) were significantlyassociated with progression-free survival. Conclusions: It was found that serum inflammatory markers includingWBC, neutrophil, lymphocyte and monocyte counts, and NLR and PLR had no effect on prognosis in patientswith breast cancer who underwent surgery and received adjuvant radiotherapy and chemotherapy.     

疗前绝对淋巴细胞计数及其相关参数比对局部晚期宫颈癌患者疗效的预测价值

目的:探讨治疗前绝对淋巴细胞计数(ALC)及其中性粒-淋巴细胞比(NLR)、单核细胞-淋巴细胞比(MLR)以及血小板-淋巴细胞比(PLR)对局部晚期宫颈癌(LACC)患者预后的预测价值。方法:纳入2016—2019年间新疆医科大学附属肿瘤医院收治的初诊LACC患者175例,完整记录患者的临床资料及治疗前ALC并计算NL...     

Pretreatment Neutrophil-to-Lymphocyte ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR) as a Predictive Value of Hematological Markers in Cervical Cancer

Background: Inflammation represents a pivotal role in the progression of cervical cancer. The hematologicalmarkers of inflammation in complete blood count (CBC) panel are potentially useful in determining the prognosis ofthe disease. Objective: The aim of the study was to investigate whether the pretreatment neutrophil-to-lymphocyte ratio(NLR) and platelet-to-lymphocyte ratio (PLR) could be used as in predicting the stage of cervical cancer. Methods:A retrospective cross-sectional study involving 282 patients with cervical cancer was enrolled at Sanglah GeneralHospital for five years (2013-2017). The histopathological records and complete blood counts (CBC) of the patients werecollected and analyzed using SPSS ver. 16 software. FIGO stage I–II and III-IV were classified as early and advancestage respectively. Results: The median NLR and PLR were significantly higher in the advance stage compared withearly stage (7.58 (1.36-33.20) and 247.89 (97.10-707.11); p-value = 0.001). A strong positive correlation was foundbetween the staging of cervical cancer and NLR (r=0.638) and PLR (r=0.668). The AUC, sensitivity, and specificityvalue of NLR and PLR were 0.803 (82%; 71%) and 0.716 (72%; 70%). Advanced stage of cervical cancer was foundin high NLR (adjusted OR: 9.02; 95%CI=2.42-33.64; p=0.001) and PLR (adjusted OR = 2.47; 95% CI = 1.45-4.85;p = 0.032). Conclusion: Increased pretreatment NLR and PLR values may provide a useful information in predictingthe staging of cervical cancer.     

Utility of Peripheral Blood Parameters in Predicting Breast Cancer Risk

Purpose: We aimed to study the inflammatory parameters of complete blood count in breast cancer cases.Materials and Methods: This retrospective study covered 178 breast cancer patients and 107 age and body massindex matched healthy women. Complete blood count parameters, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) and MPV/platelet were analyzed. Results: The leukocyte, neutrophil and neutrophil/lymphocyte ratio were higher in the patient group (p values 0.001, 0.0001 and 0.0001, respectively) whilehaemoglobin and hematocrit were higher in the control group (p=0.0001 for both). Logistic regression analysisshowed that elevated neutrophils and platelet distribution width (PDW) (OR: 0.627, 95%CI: 0.508-0.774, p=0.001and OR: 1.191 95%CI: 1.057-1.342 p=0.003) were independent variables for predicting breast cancer. The cutoffvalue for the neutrophil/lymphocyte ratio was 2.56. Conclusions: According to our study results, neutrophillevels as part of complete blood count may be used as an independent predictor of breast cancer risk.     

放疗前中性粒细胞/淋巴细胞血小板/淋巴细胞预后营养指数及CA19-9与胰腺腺癌放疗后预后关系的分析

  目的  探讨胰腺癌患者放疗前外周血中性粒细胞与淋巴细胞的比值（neutrophil to lymphocyte ratio,NLR）、血小板与淋巴细胞的比值（platelet to lymphocyte ratio,PLR）、预后营养指数（prognostic nutritional index,PNI）及糖类抗原19-9（carbohydrate antigen 19-9,CA19-9）与总生存时间（overall survival,OS）关系。  方法  回顾性分析2008年3月~2013年3月空军总医院61例经病理确诊为胰腺腺癌的患者临床资料,并通过电子病历查询患者治疗前检验结果,通过电子病历记录或电话随访获得患者OS。采用Ka? plan-Meier方法构建生存曲线,组间差异比较用Log-rank检验,单因素及多因素的分析运用Cox比例风险模型进行。  结果  利用log-rank检验及单因素回归分析,提示NLR、PLR、CA19-9增高、PNI降低、TNM分期晚,患者生存期短,差异具有统计学意义。多因素回归分析显示,NLR（P=0.029,OR 2.344,95%CI:1.090~5.041）;PNI（P=0.026,OR 0.477,95%CI:0.248~0.917）是胰腺癌患者OS的独立影响因素。  结论  NLR、PLR、PNI等是评价胰腺癌患者预后较为简单、有效的可靠指标之一.      

cN0期胃癌患者术前中性粒细胞淋巴细胞比?血小板淋巴细胞比和C反应蛋白白蛋白比与术后淋巴结转移的关系

  目的  探讨cN0期（术前影像学诊断）胃癌患者术前外周血中性粒细胞与淋巴细胞比值（neutrophil-to-lymphocyte ratio,NLR）、血小板与淋巴细胞比值（platelet-to-lymphocyte ratio,PLR）和C反应蛋白（C-reactive protein,CRP）与白蛋白比值（C-reac?tive protein-to-albumin ratio,CAR）等系统性炎症反应指标与患者术后淋巴结转移的关系,并建立指数预测模型。  方法  回顾性分析四川省肿瘤医院2019年1月至12月行根治性手术切除的cN0期胃癌患者206例,按照术后病理诊断分为淋巴结转移组（grouppN+）和无淋巴结转移组（group pN0）,同时选取200例同期健康体检者作为健康对照组,比较炎症反应指标之间的差异,以及NLR、PLR、CAR与淋巴结转移数、转移率、淋巴结状态等之间的关系,利用多因素Logistic回归模型筛选cN0期胃癌患者淋巴结转移的独立危险因素。  结果  pN+组胃癌患者术前白细胞计数、中性粒细胞计数、CRP、PLR、NLR、CAR、癌胚抗原（carcinoembryonicantigen,CEA）明显高于pN0组患者,差异均具有统计学意义（均P< 0.05）,而pN0组与健康对照组之间差异均无统计学意义（均P>0.05）;而淋巴细胞计数、血小板计数和白蛋白水平的组间差异无统计意义（均P> 0.05）。术前高NLR组、高PLR组和高CAR组患者的淋巴结分期构成及淋巴结转移数量分别低于术前低NLR组、低PLR组和低CAR组,差异具有统计学意义（均P< 0.05）。单因素及多因素Logistic回归分析显示,肿瘤大小、浸润深度、NLR和CAR是术前诊断为cN0期胃癌患者术后淋巴结转移的独立危险因素,OR值分别为1.358、8.174、3.049和2.254。术前诊断cN0期胃癌患者淋巴结转移的指数预测模型表达式为h（t）=h0exp（1.358X₁+8.174X₂+3.049X₃+2.254X₄）。  结论  术前高PLR、NLR和CAR水平与患者淋巴结分期及淋巴结转移数量密切相关,术前高NLR和CAR水平是cN0期胃癌患者淋巴结转移的独立影响因素。      

Absolute lymphocyte count and C-reactive protein-albumin ratio can predict prognosis and adverse events in patients with recurrent esophageal cancer treated with nivolumab therapy

Predicting the prognosis and adverse events (AEs) of nivolumab therapy for recurrent esophageal cancer is very important. The present study investigated whether a simple blood biochemical examination could be used to predict prognosis and AEs following nivolumab treatment for relapse of esophageal cancer. A total of 41 patients who received nivolumab treatment for recurrent esophageal cancer after esophagectomy were analyzed. The absolute lymphocyte count (ALC), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte-lymphocyte ratio (MLR) and C-reactive protein-albumin ratio (CAR) were assessed at the time of nivolumab induction as indices that can be calculated by blood biochemical examinations alone. Median values were 1,015 for ALC, 3.401 for NLR, 242.6 for PLR, 0.458 for MLR and 0.119 for CAR, and patients were divided into two groups according to values. A high ALC, low NLR, low PLR, low MLR and low CAR were associated with a better response to nivolumab. In addition, patients with the aforementioned indices, with the exception of low PLR, or better response were more likely to develop AEs in univariate analysis. In multivariate analysis, a high ALC [odds ratio (OR): 4.857, P=0.043] and low CAR (OR: 9.099, P=0.004) were identified as independent risk factors for AEs. Survival analysis revealed that overall survival and progression-free survival (PFS) rates after nivolumab treatment differed significantly between the high and low groups of ALC, NLR, PLR, MLR and CAR. The multivariate analysis identified a low ALC [hazard ratio (HR): 3.710, P=0.003] and high CAR (HR: 2.953, P=0.007) as independent poor prognostic factors of PFS. In conclusion, ALC and CAR have potential as biomarkers for outcomes of recurrent esophageal cancer following nivolumab treatment.     

Neutrophil/Lymphocyte and Platelet/Lymphocyte Ratios are Not Different among Breast Cancer Subtypes

Background: Breast cancer is a heterogeneous complex of diseases comprising different subtypes that have different treatment responses and clinical outcomes. Systemic inflammation is known to be associated with poor prognosis in many types of cancer. The neutrophil / lymphocyte ratio (NLR) and platelet / lymphocyte ratio (PLR) are factors used as indicators of inflammation. In this study, we evaluated NLR and PLR ratios in breast cancer subtypes. Methods: A total of 255 breast cancer patients were evaluated retrospectively. Patients were classified into three subtypes: estrogen receptor (ER)- or progesterone receptor (PR)-positive tumors were classified as luminal tumors; human epidermal growth factor receptor-2 (HER2)-overexpressed and ER-negative tumors were classified as HER2-positive tumors; and ER, PR, and HER2-negative tumors were classified as triple-negative tumors. The NLR and PLR were calculated. Results: The median NLR and PLR were 3 (0.37–37,1) and 137 (37.1–421.3), respectively. 66.7% of the patients were luminal type, 19.2% were HER2 positive, and 14.1% were triple negative. NLR was not associated with grade (p: 0.412), lymphovascular invasion (p: 0.326), tumor size (p: 0.232) and metastatic lymph node involvement (p: 0.406). PLR was higher in the patients with lymph node metastasis than in those without lymph node metastasis (p: 0.03). The NLR was 2 in the luminal group, 1.8 in the HER2-positive group, and 1.9 in the triple-negative group, but the differences were not significant(p: 0.051). PLR was 141 in the luminal group, 136 in the HER2-positive group, and 130 in the triple-negative group, but the differences were not significant. Conclusion: We could not find any significant differences for NLR and PLR according to breast cancer subtypes.     

术前血液学炎性反应标志物在胶质瘤患者预后中的价值

目的 探讨术前血液学炎性反应标志物（中性粒细胞与淋巴细胞比率（NLR）、单核细胞与淋巴细胞比率（MLR）和血小板与淋巴细胞比率（PLR））在胶质瘤患者临床预后中的预测价值。方法 纳入180例胶质瘤患者。应用ROC曲线确定NLR、MLR和PLR的最佳临床分界值并分组。变量组间比较采用χ²检验，通过Kaplan-Meier法和Log rank检验分析患者术后生存情况。Cox多因素回归分析预后因素。Pearson’s相关系数检验标志物间的相关性。结果 NLR、MLR和PLR的最佳分界值分别为1.90、0.33和133.38。高NLR和MLR组患者中位总生存期分别为16.8和14.8月，低NLR和MLR组分别为40.5和24.6月（均P<0.05）。高NLR组中位肿瘤复发时间为10.3月，低NLR组为28.8月（P=0.002）。NLR是胶质瘤患者的独立危险因素（HR=1.725, 95%CI: 1.042~2.853, P=0.034）。且NLR与MLR（r=0.62, P<0.001）和PLR（r=0.59, P<0.001）具有相关性。结论 术前高NLR、MLR与胶质瘤患者不良预后相关，且NLR是患者生存的独立预后因素，与肿瘤复发率密切相关。     

术前系统性炎症指标预测结直肠癌淋巴结转移的列线图模型构建

目的:探究术前系统性炎症指标对结直肠癌患者淋巴结转移的预测价值,建立并验证结直肠癌淋巴结转移的列线图模型。方法:回顾性分析2018年12月至2019年12月我院胃肠外科初诊行手术治疗的结直肠癌患者临床资料,按术后病理结果分为淋巴结转移组与非淋巴结转移组,比较两组术前各炎症指标差异。采用单因素分析和多因素Logistic回归分析方法分析结直肠癌淋巴结转移的影响因素,应用R软件构建预测结直肠癌淋巴结转移的列线图模型,并进行内部验证。结果:共174例结直肠癌患者纳入本研究中,其中男性98例,女性76例,年龄(59.2±10.2)岁,术后病理证实72例伴淋巴结转移。淋巴结转移组患者术前中性粒细胞、血小板、纤维蛋白原、C-反应蛋白、中性粒细胞淋巴细胞比(NLR)、血小板淋巴细胞比(PLR)、淋巴细胞单核细胞比(LMR)、纤维蛋白原白蛋白比(FAR)、C-反应蛋白白蛋白比(CAR)显著高于非淋巴结转移组,差异有统计学意义(P<0.05);单因素分析显示,年龄、NLR、PLR、LMR、FAR、CAR与结直肠癌患者淋巴结转移有关(P均<0.05);多因素Logistic回归分析显示,年龄、...     

Prognostic and Predictive Value of Hematologic Parameters inPatients with Metastatic Renal Cell Carcinoma: Second LineSunitinib Treatment Following IFN-alpha

Background: Long-term survival is a problem with locally advanced and metastatic renal cell carcinomas.Sunitinib malate is an oral multitargeted tyrosine kinase inhibitor, but data on sunitinib use as a second linetreatment in metastatic renal cell carcinoma (mRCC) are limited. Prognostic and predictive value of peripheralblood markers has been shown for many cancers. Materials and Methods: Efficacy and safety profiles ofsunitinib after interferon alpha (IFN-α) were evaluated based on retrospective data for 23 patients with mRCC.Hematological parameters (neutrophils, lymphocytes, platelets, mean platelet volume, neutrophil/lymphocyteratio, platelet/lymphocyte ratio) were recorded at the time of metastasis. It was evaluated whether hematologicalparameters were prognostic and predictive factors. Results: Median progression-free survival (PFS) time was16.5 months (95%CI: 0-34.5). Median overall survival (OS) time was 25.7 months (95%CI: 10.8-40.0). Mostcommon side effects were neutropenia (52.2%), stomatitis (26.1%) and hand-food syndrome (26.1%). PFS wasfound 3.13 vs 17.1 months in patients with neutrophil / lymphocyte ratio (NLR)>3 vs NLR≤3 (p:0.012). MedianOS was 6.96 vs 27.1 months in patients with NLR>3 vs NLR≤3 (p:0.001).While 75% of patients who respondedto sunitinib had NLR≤3, in 72% of patients with no response to sunitinib NLR>3 was detected (p:0.036). Theassociation between the Memorial Sloan-Kettering Cancer Center (MSKCC) criteria and NLR was statisticallysignificant (p:0.022). Conclusions: Data on second line sunitinib treatment following cytokine in mRCC arelimited. In our study, we observed second line sunitinib treatment following IFN-α to be effective and tolerable.NLRappeared to have prognostic and predictive value.     

Preoperative NLR and PLR in the middle or lower ESCC patients with radical operation

Neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) had been analysed in many kind of tumours, but its role of predict the oesophageal squamous cell carcinoma (ESCC) patients’ prognosis was not reach a consensus. Relationship between NLR, PLR and ESCC located in the middle or lower segment was evaluated. 317 patients with ESCC who underwent attempted curative oesophagectomy were analysed in this study. 157 and 98 patients had elevated NLR and PLR respectively (NLR >3.3 and PLR >150). The median overall survival time (OS) and disease‐free survival (DFS) was 34.1 and 19.2 months respectively. Multivariate analysis found PLR >150 (P = 0.018, HR 1.426, 95%CI 1.063–1.912) accompanied by male, lymphatic metastases, tumour size more than 3 cm, tumour located at middle segment and poor differentiation were associated with significantly worse DFS. Meanwhile, gender, lymphatic metastases, tumour location and differentiation along with PLR >150 (P = 0.003, HR 1.595, 95% CI 1.172–2.170) and NLR>3.3 (P = 0.039, HR 1.367, 95% CI 1.015–1.840) were all independent prognostic factors for OS. Preoperative NLR and PLR might be used as predictive factors in patients with ESCC. For DFS, elevated PLR compared to NLR may have an advantage to indicate poor prognosis.     

Gail模型在我国女性乳腺癌发病风险预测中的研究:系统综述与Meta分析

目的:评价Gail模型对我国女性乳腺癌发病风险预测的区分度和诊断准确性.方法:在PubMed、SpringerLink、中国知网、万方医学数据库中系统检索Gail模型对我国女性乳腺癌发病风险预测研究.由两位研究者对符合纳入标准的文献独立进行数据提取和质量评价.采用DerSimonian和Laird's随机效应模型评估G...     

Risk Factors,Patterns, and Distribution of Bone Metastases and Skeletal-Related Events in High-Risk Breast Cancer Patients

Background: More than a quarter of breast cancer patients are at risk to develop recurrent metastases to the bone. Objective: This study was designed to identify risk factors and predilections of bone metastasis and skeletal-related events (SRE) in a population of breast cancer survivors initially diagnosed in advanced stages and with high-risks of relapse. Methods: Associated risk factors, distribution, and attainable treatment of bone metastasis and SRE were analyzed in a cohort of 1,329 breast cancer patients. The association with dependent variables was subsequently analyzed using multivariable logistic regression. Sociodemographic and adverse clinical characteristics were included as covariates of progression into bone metastasis and SREs. Results: Of 1329 breast cancer patients, 246 patients (18.5%) were diagnosed as metastatic breast cancer in which 232 of them (94.3%) had bone metastases. Spines were the most common sites of bone metastases (25.6%). In multivariable analysis, advanced stage at diagnosis (OR=1.840, 95%CI:1.198-2.826, P=0.005), luminal subtype (OR=1.788, 95%CI:1.206-2.652, P=0.045), lobular histology (OR=1.795, 95%CI:1.012-3/184, P=0.046), positive axillary lymph node (OR=1.771, 95%CI:1.087-2.886, P=0.022), multiple metabolic comorbidities (OR=2.193, 95%CI:1.371-3.508, P=0.001), early menopause (OR=2.136, 95%CI:1.116-4.464, P=0.046) were significantly associated with risk of recurrent bone metastases. SREs occurred in 89 (68.5%) patients. Several risk factors for SREs were early menopausal age (OR=2.342, P=0.024), advanced stages (OR=1.404, P=0.039), lobular histology (OR=2.279, P=0.007), and having multiple metabolic comorbidities (OR=1.728, P=0.039). Conclusion: Bone metastases and SREs are relatively high in breast cancer patients diagnosed in advanced stages. Luminal subtypes, having multiple metabolic comorbidities, and lobular histology are associated with higher risks of recurrent bone metastases. Living in rural areas and advanced stage at diagnosis as a risk factors for bone metastases might represent a social gradient of care delivery.     

Association between neutrophil-lymphocyte ratio,platelet-lymphocyte ratio,and survival in undifferentiated pleomorphic sarcoma (NLR,PLR, and overall survival in UPS)

Background and objectivesCancer-related inflammation has been shown to be a driver of tumor growth and progression, and there has been a recent focus on identifying markers of the inflammatory tumor microenvironment. Neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are inflammatory indices that have been identified as prognostic biomarkers in various malignancies. However, there is limited and conflicting data regarding their prognostic value in soft tissue sarcoma (STS) and specifically in undifferentiated pleomorphic sarcoma (UPS).MethodsThis was a retrospective review of patients who underwent surgical treatment for primary UPS from 1993 to 2021. Cutoff values for NLR and PLR were determined by receiver operating curve analysis. Cox proportional hazards regression was used to determine prognostic factors on univariate and multivariate analysis.ResultsEighty-six patients were included. The optimal cutoff value was 3.3 for NLR and 190 for PLR. Both high NLR (HR 2.44; 95% CI 1.29–4.63; p = 0.005) and high PLR (HR 1.99; 95% CI 1.08–3.67, p = 0.02) were associated with worse OS on univariate analysis. On multivariate analysis, metastasis at presentation and radiotherapy were independently predictive of OS, but high NLR (HR 1.30; 95% CI 0.64–2.98; p = 0.41) and high PLR (HR 1.63; 95% CI 0.82–3.25; p = 0.17) were not predictive of survival.ConclusionsHigh pre-treatment NLR and PLR were associated with decreased overall survival but were not independent predictors of survival in patients undergoing resection for UPS. Until additional prospective studies can be done, survival outcomes are best predicted using previously established patient- and tumor-specific factors.     

Platelet/Lymphocyte Ratio Is Superior to Neutrophil/Lymphocyte Ratio as a Predictor of Chemotherapy Response and Disease-free Survival in Luminal B-like (HER2−) Breast Cancer

BackgroundThe neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) have been associated with the prognosis in breast cancer (BC). The relationship of the NLR and PLR with chemotherapy sensitivity and prognosis in luminal B-like (human epidermal growth factor receptor 2-negative [HER2⁻]) BC are not well studied.Patients and MethodsThe clinical data from 980 patients with luminal B-like (HER2⁻) BC from June 2012 to June 2016 were collected. The differences among the variables were calculated using the χ² test. The associations among the clinicopathologic factors, pretreatment NLR, pretreatment PLR, and disease-free survival (DFS) were analyzed using Kaplan-Meier curves and Cox analyses.ResultsThe median follow-up was 37 months (range, 5-77 months). For the 480 patients who had received neoadjuvant chemotherapy, low pretreatment PLR values were associated with higher pathologic complete response (pCR) rates compared with the high PLR group (15.8% for low vs. 9.2% for high PLR group; P = .027). Multivariate analyses showed that larger tumors, a greater number of lymph nodes involved, a high Ki-67 score, and a high PLR were independent prognostic factors of worse outcomes for the patients with luminal B-like (HER2⁻) BC. The risk of metastasis and/or recurrence was greater for the high PLR group than for the low PLR group (hazard ratio, 1.576; 95% confidence interval, 1.039-2.390; P = .032). The pretreatment NLR showed no such associations among this cohort of patients.ConclusionsThe results of the present study have shown that the pretreatment PLR is superior to the NLR as a predictor of pCR and DFS outcomes in patients with luminal B-like (HER2⁻) BC. A low pretreatment PLR was associated with higher pCR rates after neoadjuvant chemotherapy and was an independent predictive factor for better DFS outcomes among patients with luminal B-like (HER2⁻) BC.     

Prognostic Significance of Preoperative Lymphocyte-Monocyte Ratio in Patients with Resectable Esophageal Squamous Cell Carcinoma

Background: The interaction between tumor cells and inflammatory cells has not been systematicallyinvestigated in esophageal squamous cell carcinoma (ESCC). The aim of the present study was to evaluatewhether preoperative the lymphocyte-monocyte ratio (LMR), the neutrophil-lymphocyte ratio (NLR), andthe platelet-lymphocyte ratio (PLR) could predict the prognosis of ESCC patients undergoing esophagectomy.Materials and Methods: Records from 218 patients with histologically diagnosed ESCC who underwent attemptedcurative surgery from January 2007 to December 2008 were retrospectively reviewed. Besides clinicopathologicalprognostic factors, we evaluated the prognostic value of the LMR, the NLR, and the PLR using Kaplan-Meiercurves and Cox regression models. Results: The median follow-up was 38.6 months (range 3-71 months). Thecut-off values of 2.57 for the LMR, 2.60 for the NLR and 244 for the PLR were chosen as optimal to discriminatebetween survival and death by applying receiver operating curve (ROC) analysis. Kaplan-Meier survivalanalysis of patients with low preoperative LMR demonstrated a significant worse prognosis for DFS (p=0.004)and OS (p=0.002) than those with high preoperative LMR. The high NLR cohort had lower DFS (p=0.004)and OS (p=0.011). Marginally reduced DFS (p=0.068) and lower OS (p=0.039) were found in the high PLRcohort. On multivariate analysis, only preoperative LMR was an independent prognostic factor for both DFS(p=0.009, HR=1.639, 95% CI 1.129-2.381) and OS (p=0.004, HR=1.759, 95% CI 1.201-2.576) in ESCC patients.Conclusions: Preoperative LMR better predicts cancer survival compared with the cellular components ofsystemic inflammation in patients with ESCC undergoing esophagectomy.