Clinical utility of lymphocyte to C-reactive protein ratio in predicting survival and postoperative complication for esophago-gastric junction cancer |
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| Institution: | 1. Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu City, Mie, 514-8507, Japan;2. Department of Genomic Medicine, Mie University, 2-174 Edobashi, Tsu City, Mie, 514-8507, Japan;1. Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu City, Mie, 514-8507, Japan;2. Department of Genomic Medicine, Mie University, 2-174 Edobashi, Tsu City, Mie, 514-8507, Japan;1. Department of Chemotherapy, Kazakh Institute of Oncology and Radiology, Almaty, Republic of Kazakhstan;2. Department of Oncology with the Course of Hematology, Kazakh Medical University of Continuing Education, Almaty, Republic of Kazakhstan;3. Department of Administration, Kazakh Institute of Oncology and Radiology, Almaty, Republic of Kazakhstan;4. Consultative and Diagnostic Center, Kazakh Institute of Oncology and Radiology, Almaty, Republic of Kazakhstan;5. Operating Theatre, Kazakh Institute of Oncology and Radiology, Almaty, Republic of Kazakhstan;6. Department of Oncology, S.D. Asfendiyarov Kazakh National Medical University, Almaty, Republic of Kazakhstan;1. Department of Cardiothoracic Surgery, Heart Center, University Hospital Cologne, Kerpener Strasse 62 50937, Cologne, Germany;2. Clinic for Pneumology and Allergology, Hospital Bethanien, Aufderhöher Strasse, 169 42699, Solingen, Germany;1. Department of Oncology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Viet Nam;2. Department of Head & Neck Surgery, Oncology Hospital, Ho Chi Minh City, Viet Nam;3. Division of Head and Neck Surgery, Tufts Medical Center, Boston, MA, USA;1. Unit of Medical Oncology 2, Azienda Ospedaliero-Universitaria Pisana, Via Roma 67, 56126, Pisa, Italy;2. Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Risorgimento 36, 56126, Pisa, Italy;3. Department of Diagnostic and Interventional Radiology, and Nuclear Medicine, Azienda Ospedaliero-Universitaria Pisana, Via Paradisa 2, 56124, Pisa, Italy;4. General Surgery, Azienda Ospedaliero-Universitaria Pisana, Via Paradisa 2, 56124, Pisa, Italy;5. Hepatology Unit, Azienda Ospedaliero-Universitaria Pisana, Via Paradisa 2, 56124, Pisa, Italy;6. Regional Center of Nuclear Medicine, University Hospital of Pisa, Via Roma 67, 56126, Pisa, Italy;1. Department of Oral and Craniomaxillofacial Plastic Surgery, UKGM GmbH, University Hospital Marburg, Faculty of Medicine, Philipps-University of Marburg, Marburg, Germany;2. Faculty of Medicine, Goethe University, Frankfurt am Main, Germany;3. Department of Statistics, Chulalongkorn University Business School, Bangkok, Thailand;4. Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand;5. Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand;6. Department of Pediatric Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand;7. Department of Plastic, Reconstructive, Esthetic and Maxillofacial Surgery, Henri Mondor University Hospital, AP-HP, Faculty of Medicine, University Paris-Est Créteil Val de Marne (Paris XII), Créteil, France |
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| Abstract: | BackgroundThere are still no useful predictive biomarkers for esophago-gastric junction (EGJ) cancer. We compared 15 candidate inflammation-based markers and investigated the clinical impact of the selected biomarker.MethodsOne hundred three patients with EGJ cancer between 2002 and 2020 were enrolled, and associations between clinicopathological data and inflammatory biomarkers were retrospectively analyzed. Area under the curve (AUC) values of 15 candidate biomarkers were compared in receiver operating characteristic (ROC) curves regarding overall survival (OS). Clinical impacts of the selected marker were further investigated regarding long-term prognosis, postoperative complications, and preoperative chemotherapy effects.ResultsLymphocyte/CRP ratio (LCR) demonstrated the highest AUC (0.68552) and was chosen as a candidate biomarker. The high LCR group (LCR >4610) demonstrated significantly better OS (p < 0.0001) and relapse-free survival (RFS) (p < 0.0001) compared with the low LCR group (LCR ≤4610), and preoperative LCR was an independent prognostic factor for both OS (HR 4.97, 95% CI:2.24–11.58; p < 0.0001) and RFS (HR 2.84, 95% CI:1.33–6.14, p = 0.007) in EGJ cancer patients. Another cut-off value was established for postoperative complications, and the incidence rates were significantly higher in the low LCR group (LCR ≤12000) than in the high LCR group (LCR >12000) for all postoperative complications, infectious complications, and surgical site infection (p = 0.013, p = 0.016, and p = 0.030, respectively). Furthermore, patients with decreased LCR after preoperative chemotherapy demonstrated significantly worse RFS compared with patients with increased LCR (p = 0.043).ConclusionsLCR is a potential biomarker to predict long-term prognosis as well as occurrence of postoperative complications in patients with EGJ cancer. |
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| Keywords: | Esophago-gastric junction cancer Lymphocyte/CRP ratio (LCR) Biomarker |
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