Cargando…
Neutrophil-to-Lymphocyte Ratio in Rectal Cancer—Novel Biomarker of Tumor Immunogenicity During Radiotherapy or Confounding Variable?
The aim of this study was to investigate the predictive value of blood-derived makers of local and systemic inflammatory responses on early and long-term oncological outcomes. A retrospective analysis of patients with locally advanced rectal cancer treated with preoperative long-course 5-fluorouraci...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6566677/ https://www.ncbi.nlm.nih.gov/pubmed/31108935 http://dx.doi.org/10.3390/ijms20102448 |
_version_ | 1783426903106912256 |
---|---|
author | Braun, Lore Helene Baumann, David Zwirner, Kerstin Eipper, Ewald Hauth, Franziska Peter, Andreas Zips, Daniel Gani, Cihan |
author_facet | Braun, Lore Helene Baumann, David Zwirner, Kerstin Eipper, Ewald Hauth, Franziska Peter, Andreas Zips, Daniel Gani, Cihan |
author_sort | Braun, Lore Helene |
collection | PubMed |
description | The aim of this study was to investigate the predictive value of blood-derived makers of local and systemic inflammatory responses on early and long-term oncological outcomes. A retrospective analysis of patients with locally advanced rectal cancer treated with preoperative long-course 5-fluorouracil-based radiochemotherapy was performed. Differential blood counts before neoadjuvant treatment were extracted from the patients’ electronic charts. Optimal cut-off values for neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) were determined. Potential clinical and hematological prognostic factors for disease-free survival (DFS) were studied using uni- and multivariate analysis. A total of 220 patients were included in the analysis. Median follow-up was 67 months. Five-year DFS and overall survival (OS) were 70% and 85%, respectively. NLR with a cut-off value of 4.06 was identified as optimal to predict DFS events. In multivariate analysis, only tumor volume (HR 0.33, 95% CI (0.14–0.83), p = 0.017) and NLR (HR 0.3, 95% CI (0.11–0.81), p = 0.017) remained significant predictors of DFS. Patients with a good histological response (Dworak 3 and 4) to radiotherapy also had a lower NLR than patients with less pronounced tumor regression (3.0 vs. 4.2, p = 0.015). A strong correlation between primary tumor volume and NLR was seen (Pearson’s r = 0.64, p < 0.001). Moreover, patients with T4 tumors had a significantly higher NLR than patients with T1–T3 tumors (6.6 vs. 3.3, p < 0.001). An elevated pretherapeutic NLR was associated with higher T stage, inferior DFS, and poor pathological response to neoadjuvant radiochemotherapy. A strong correlation between NLR and primary tumor volume was seen. This association is important for the interpretation of study results and for the design of translational studies which are warranted. |
format | Online Article Text |
id | pubmed-6566677 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-65666772019-06-17 Neutrophil-to-Lymphocyte Ratio in Rectal Cancer—Novel Biomarker of Tumor Immunogenicity During Radiotherapy or Confounding Variable? Braun, Lore Helene Baumann, David Zwirner, Kerstin Eipper, Ewald Hauth, Franziska Peter, Andreas Zips, Daniel Gani, Cihan Int J Mol Sci Article The aim of this study was to investigate the predictive value of blood-derived makers of local and systemic inflammatory responses on early and long-term oncological outcomes. A retrospective analysis of patients with locally advanced rectal cancer treated with preoperative long-course 5-fluorouracil-based radiochemotherapy was performed. Differential blood counts before neoadjuvant treatment were extracted from the patients’ electronic charts. Optimal cut-off values for neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) were determined. Potential clinical and hematological prognostic factors for disease-free survival (DFS) were studied using uni- and multivariate analysis. A total of 220 patients were included in the analysis. Median follow-up was 67 months. Five-year DFS and overall survival (OS) were 70% and 85%, respectively. NLR with a cut-off value of 4.06 was identified as optimal to predict DFS events. In multivariate analysis, only tumor volume (HR 0.33, 95% CI (0.14–0.83), p = 0.017) and NLR (HR 0.3, 95% CI (0.11–0.81), p = 0.017) remained significant predictors of DFS. Patients with a good histological response (Dworak 3 and 4) to radiotherapy also had a lower NLR than patients with less pronounced tumor regression (3.0 vs. 4.2, p = 0.015). A strong correlation between primary tumor volume and NLR was seen (Pearson’s r = 0.64, p < 0.001). Moreover, patients with T4 tumors had a significantly higher NLR than patients with T1–T3 tumors (6.6 vs. 3.3, p < 0.001). An elevated pretherapeutic NLR was associated with higher T stage, inferior DFS, and poor pathological response to neoadjuvant radiochemotherapy. A strong correlation between NLR and primary tumor volume was seen. This association is important for the interpretation of study results and for the design of translational studies which are warranted. MDPI 2019-05-17 /pmc/articles/PMC6566677/ /pubmed/31108935 http://dx.doi.org/10.3390/ijms20102448 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Braun, Lore Helene Baumann, David Zwirner, Kerstin Eipper, Ewald Hauth, Franziska Peter, Andreas Zips, Daniel Gani, Cihan Neutrophil-to-Lymphocyte Ratio in Rectal Cancer—Novel Biomarker of Tumor Immunogenicity During Radiotherapy or Confounding Variable? |
title | Neutrophil-to-Lymphocyte Ratio in Rectal Cancer—Novel Biomarker of Tumor Immunogenicity During Radiotherapy or Confounding Variable? |
title_full | Neutrophil-to-Lymphocyte Ratio in Rectal Cancer—Novel Biomarker of Tumor Immunogenicity During Radiotherapy or Confounding Variable? |
title_fullStr | Neutrophil-to-Lymphocyte Ratio in Rectal Cancer—Novel Biomarker of Tumor Immunogenicity During Radiotherapy or Confounding Variable? |
title_full_unstemmed | Neutrophil-to-Lymphocyte Ratio in Rectal Cancer—Novel Biomarker of Tumor Immunogenicity During Radiotherapy or Confounding Variable? |
title_short | Neutrophil-to-Lymphocyte Ratio in Rectal Cancer—Novel Biomarker of Tumor Immunogenicity During Radiotherapy or Confounding Variable? |
title_sort | neutrophil-to-lymphocyte ratio in rectal cancer—novel biomarker of tumor immunogenicity during radiotherapy or confounding variable? |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6566677/ https://www.ncbi.nlm.nih.gov/pubmed/31108935 http://dx.doi.org/10.3390/ijms20102448 |
work_keys_str_mv | AT braunlorehelene neutrophiltolymphocyteratioinrectalcancernovelbiomarkeroftumorimmunogenicityduringradiotherapyorconfoundingvariable AT baumanndavid neutrophiltolymphocyteratioinrectalcancernovelbiomarkeroftumorimmunogenicityduringradiotherapyorconfoundingvariable AT zwirnerkerstin neutrophiltolymphocyteratioinrectalcancernovelbiomarkeroftumorimmunogenicityduringradiotherapyorconfoundingvariable AT eipperewald neutrophiltolymphocyteratioinrectalcancernovelbiomarkeroftumorimmunogenicityduringradiotherapyorconfoundingvariable AT hauthfranziska neutrophiltolymphocyteratioinrectalcancernovelbiomarkeroftumorimmunogenicityduringradiotherapyorconfoundingvariable AT peterandreas neutrophiltolymphocyteratioinrectalcancernovelbiomarkeroftumorimmunogenicityduringradiotherapyorconfoundingvariable AT zipsdaniel neutrophiltolymphocyteratioinrectalcancernovelbiomarkeroftumorimmunogenicityduringradiotherapyorconfoundingvariable AT ganicihan neutrophiltolymphocyteratioinrectalcancernovelbiomarkeroftumorimmunogenicityduringradiotherapyorconfoundingvariable |