Cargando…

NCR, an Inflammation and Nutrition Related Blood-Based Marker in Colon Cancer Patients: A New Promising Biomarker to Predict Outcome

Background: Colorectal carcinoma (CRC) is a heterogeneous disease, and differences in outcomes have been reported among patients diagnosed with the same disease stage. Prognostic and predictive biomarkers provide information for patient risk stratification and guide treatment selection. Although num...

Descripción completa

Detalles Bibliográficos
Autores principales: Langheinrich, Melanie, Siebenhüner, Alexander Reinhard, Baecker, Justus, Miragall, Maximilian, Wiesmüller, Felix, Schellerer, Vera, Merkel, Susanne, Brunner, Maximilian, Krautz, Christian, Weber, Klaus, Grützmann, Robert, Kersting, Stephan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9818830/
https://www.ncbi.nlm.nih.gov/pubmed/36611408
http://dx.doi.org/10.3390/diagnostics13010116
_version_ 1784865082193215488
author Langheinrich, Melanie
Siebenhüner, Alexander Reinhard
Baecker, Justus
Miragall, Maximilian
Wiesmüller, Felix
Schellerer, Vera
Merkel, Susanne
Brunner, Maximilian
Krautz, Christian
Weber, Klaus
Grützmann, Robert
Kersting, Stephan
author_facet Langheinrich, Melanie
Siebenhüner, Alexander Reinhard
Baecker, Justus
Miragall, Maximilian
Wiesmüller, Felix
Schellerer, Vera
Merkel, Susanne
Brunner, Maximilian
Krautz, Christian
Weber, Klaus
Grützmann, Robert
Kersting, Stephan
author_sort Langheinrich, Melanie
collection PubMed
description Background: Colorectal carcinoma (CRC) is a heterogeneous disease, and differences in outcomes have been reported among patients diagnosed with the same disease stage. Prognostic and predictive biomarkers provide information for patient risk stratification and guide treatment selection. Although numerous studies have analyzed the effects of systemic inflammatory factors on CRC outcomes, clinical significance remains to be elucidated. In particular, the treatment strategy of colon cancer patients is different from that of rectal cancer due to outcome and recurrence differences. The identification of patients with a poor prognosis who might benefit from intensive treatment approaches is clinically necessary. Methods: This study aimed to evaluate the value of different blood-based markers and assess the significance of our newly developed inflammatory-nutrition-related biomarker (NCR = BMI × albumin/CRP) in patients with colon cancer. A two-stage design was used with 212 patients with colon cancer (CC) in the discovery cohort (n = 159) and in an external validation cohort (n = 53). Results: A lower preoperative NCR level was significantly correlated with a worse prognosis, sidedness, undifferentiated histology, nodal involvement, and advanced UICC stage. We compared the NCR with other established prognostic indices and showed that the NCR is a more reliable indicator of a poor prognosis for patients with CC. Patients with low NCR levels experienced a significantly shorter Overall Survival (OS) than patients with high levels. Multivariate analysis confirmed preoperative NCR levels as an independent predictor for overall survival with a hazard ratio of 3.3 (95% confidence interval 1.628–6.709, p < 0.001). Finally, we confirmed the predictive value of the NCR in an independent validation cohort and confirmed NCR as an independent prognostic factor for OS. Conclusion: Taken together, we discovered a new prognostic index (NCR) based on BMI, albumin, and CRP levels as an independent prognostic predictor of OS in patients with colon cancer. In all UICC stages, our newly developed NCR marker is able to distinguish patients with better and worse prognoses. We, therefore, propose that NCR may serve as a supplement to the TNM staging system to optimize the risk stratification in CC patients towards personalized oncology. In particular, NCR can be used in clinical trials to stratify patients with UICC II and III tumors and help better select patients who might benefit from adjuvant treatment.
format Online
Article
Text
id pubmed-9818830
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-98188302023-01-07 NCR, an Inflammation and Nutrition Related Blood-Based Marker in Colon Cancer Patients: A New Promising Biomarker to Predict Outcome Langheinrich, Melanie Siebenhüner, Alexander Reinhard Baecker, Justus Miragall, Maximilian Wiesmüller, Felix Schellerer, Vera Merkel, Susanne Brunner, Maximilian Krautz, Christian Weber, Klaus Grützmann, Robert Kersting, Stephan Diagnostics (Basel) Article Background: Colorectal carcinoma (CRC) is a heterogeneous disease, and differences in outcomes have been reported among patients diagnosed with the same disease stage. Prognostic and predictive biomarkers provide information for patient risk stratification and guide treatment selection. Although numerous studies have analyzed the effects of systemic inflammatory factors on CRC outcomes, clinical significance remains to be elucidated. In particular, the treatment strategy of colon cancer patients is different from that of rectal cancer due to outcome and recurrence differences. The identification of patients with a poor prognosis who might benefit from intensive treatment approaches is clinically necessary. Methods: This study aimed to evaluate the value of different blood-based markers and assess the significance of our newly developed inflammatory-nutrition-related biomarker (NCR = BMI × albumin/CRP) in patients with colon cancer. A two-stage design was used with 212 patients with colon cancer (CC) in the discovery cohort (n = 159) and in an external validation cohort (n = 53). Results: A lower preoperative NCR level was significantly correlated with a worse prognosis, sidedness, undifferentiated histology, nodal involvement, and advanced UICC stage. We compared the NCR with other established prognostic indices and showed that the NCR is a more reliable indicator of a poor prognosis for patients with CC. Patients with low NCR levels experienced a significantly shorter Overall Survival (OS) than patients with high levels. Multivariate analysis confirmed preoperative NCR levels as an independent predictor for overall survival with a hazard ratio of 3.3 (95% confidence interval 1.628–6.709, p < 0.001). Finally, we confirmed the predictive value of the NCR in an independent validation cohort and confirmed NCR as an independent prognostic factor for OS. Conclusion: Taken together, we discovered a new prognostic index (NCR) based on BMI, albumin, and CRP levels as an independent prognostic predictor of OS in patients with colon cancer. In all UICC stages, our newly developed NCR marker is able to distinguish patients with better and worse prognoses. We, therefore, propose that NCR may serve as a supplement to the TNM staging system to optimize the risk stratification in CC patients towards personalized oncology. In particular, NCR can be used in clinical trials to stratify patients with UICC II and III tumors and help better select patients who might benefit from adjuvant treatment. MDPI 2022-12-30 /pmc/articles/PMC9818830/ /pubmed/36611408 http://dx.doi.org/10.3390/diagnostics13010116 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/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 (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Langheinrich, Melanie
Siebenhüner, Alexander Reinhard
Baecker, Justus
Miragall, Maximilian
Wiesmüller, Felix
Schellerer, Vera
Merkel, Susanne
Brunner, Maximilian
Krautz, Christian
Weber, Klaus
Grützmann, Robert
Kersting, Stephan
NCR, an Inflammation and Nutrition Related Blood-Based Marker in Colon Cancer Patients: A New Promising Biomarker to Predict Outcome
title NCR, an Inflammation and Nutrition Related Blood-Based Marker in Colon Cancer Patients: A New Promising Biomarker to Predict Outcome
title_full NCR, an Inflammation and Nutrition Related Blood-Based Marker in Colon Cancer Patients: A New Promising Biomarker to Predict Outcome
title_fullStr NCR, an Inflammation and Nutrition Related Blood-Based Marker in Colon Cancer Patients: A New Promising Biomarker to Predict Outcome
title_full_unstemmed NCR, an Inflammation and Nutrition Related Blood-Based Marker in Colon Cancer Patients: A New Promising Biomarker to Predict Outcome
title_short NCR, an Inflammation and Nutrition Related Blood-Based Marker in Colon Cancer Patients: A New Promising Biomarker to Predict Outcome
title_sort ncr, an inflammation and nutrition related blood-based marker in colon cancer patients: a new promising biomarker to predict outcome
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9818830/
https://www.ncbi.nlm.nih.gov/pubmed/36611408
http://dx.doi.org/10.3390/diagnostics13010116
work_keys_str_mv AT langheinrichmelanie ncraninflammationandnutritionrelatedbloodbasedmarkerincoloncancerpatientsanewpromisingbiomarkertopredictoutcome
AT siebenhuneralexanderreinhard ncraninflammationandnutritionrelatedbloodbasedmarkerincoloncancerpatientsanewpromisingbiomarkertopredictoutcome
AT baeckerjustus ncraninflammationandnutritionrelatedbloodbasedmarkerincoloncancerpatientsanewpromisingbiomarkertopredictoutcome
AT miragallmaximilian ncraninflammationandnutritionrelatedbloodbasedmarkerincoloncancerpatientsanewpromisingbiomarkertopredictoutcome
AT wiesmullerfelix ncraninflammationandnutritionrelatedbloodbasedmarkerincoloncancerpatientsanewpromisingbiomarkertopredictoutcome
AT schellerervera ncraninflammationandnutritionrelatedbloodbasedmarkerincoloncancerpatientsanewpromisingbiomarkertopredictoutcome
AT merkelsusanne ncraninflammationandnutritionrelatedbloodbasedmarkerincoloncancerpatientsanewpromisingbiomarkertopredictoutcome
AT brunnermaximilian ncraninflammationandnutritionrelatedbloodbasedmarkerincoloncancerpatientsanewpromisingbiomarkertopredictoutcome
AT krautzchristian ncraninflammationandnutritionrelatedbloodbasedmarkerincoloncancerpatientsanewpromisingbiomarkertopredictoutcome
AT weberklaus ncraninflammationandnutritionrelatedbloodbasedmarkerincoloncancerpatientsanewpromisingbiomarkertopredictoutcome
AT grutzmannrobert ncraninflammationandnutritionrelatedbloodbasedmarkerincoloncancerpatientsanewpromisingbiomarkertopredictoutcome
AT kerstingstephan ncraninflammationandnutritionrelatedbloodbasedmarkerincoloncancerpatientsanewpromisingbiomarkertopredictoutcome