Low neutrophil-to-lymphocyte ratio and pan-immune-inflammation-value predict nodal pathologic complete response in 1274 breast cancer patients treated with neoadjuvant chemotherapy: a multicenter analysis
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PROVIDER: S-EPMC10504832 | biostudies-literature | 2023 Jan
REPOSITORIES: biostudies-literature
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Project description:Background: The prognostic value of neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio, and the combined NLR-PLR score in patients with stage IV gastric carcinoma (GC) has not yet been clarified. Therefore, this study aimed to explore the potential association of NLR, PLR, and NLR-PLR score with the prognosis of patients with stage IV GC. Methods: This retrospective study included 466 patients with GC diagnosed between 2010 and 2017. High NLR and high PLR were defined using the median values as the cutoff values. We then combined the NLR and PLR value and generated the NLR-PLR score as a new biomarker. Patients were divided into three groups according to their NLR-PLR score. Univariate and multivariate analyses were conducted to compare survival outcomes. Results: Median overall survival (OS) and progression-free survival (PFS) were 15.5 months (range, 0.7-96.8 months) and 6.7 months (range, 0.5-30.4 months), respectively. The NLR, PLR, and the NLR-PLR scores were correlated with clinical outcomes such as OS and PFS. Median OS for patients with NLR-PLR scores of 0, 1, and 2 was 22.5, 15.7, and 11.2 months, respectively. Median PFS for patients with these NLR-PLR scores of 0, 1, and 2 was 7.8, 7.1, and 5.2 months, respectively (P < 0.001). High NLR-PLR scores predicted poor survival in patients with stage IV GC (all P < 0.05). Conclusion: Our findings provide scientific evidence to support that the NLR-PLR score may be able to independently predict survival outcomes in patients with stage IV GC.
| S-EPMC7317009 | biostudies-literature
Project description:The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been presented to be a prognostic indicator in several types of cancer. However, these issues have not been concluded yet. The present study was therefore performed to determine the prognostic value of NLR and PLR in gastric cancer (GC).A total of 182 GC patients, diagnosed between January 2011 and January 2014, were enrolled in the study. The clinicopathological parameters, laboratory analyses, and outcomes were collected. The association between NLR, PLR, and clinicopathological characters was analyzed with univariate and multivariate analyses.NLR was significantly related to age (P = .026), surgery (P = .006), node status (P = .004), and clinical stage (P = .009). The median overall survival (OS) and progression-free survival (PFS) were poor in the High-NLR group (OS: 36.0 vs 20.5 months, P < .001, PFS: 33.0 vs 12.0 months, P < .001) and High-PLR group (OS: 31.5 vs 18.5 months, P = .003, PFS: 26.0 vs 11.0 months, P = .01). Multivariate analyses indicated both surgery [for OS hazard ratio (HR) = 2.092, 95% confidence interval (95% CI): 1.345-3.253, P = .001; for PFS HR = 1.939, 95% CI: 1.259-2.988, P = .003] and NLR (for OS HR = 1.585, 95% CI: 1.011-2.485, P = .045) were independent prognostic factors.Elevated NLR and PLR were related with poor prognosis in GC patients before treatment. The NLR was an independent prognostic factor for OS. More studies should be conducted to address the potential prognostic value of NLR and PLR in GC.
| S-EPMC5895303 | biostudies-literature
Project description:The aim of this study is to investigate the diagnostic efficacy of neutrophil-to-lymphocyte ratio (NLR), neutrophil-to-monocyte ratio (NMR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR) in patients with Crohn's disease (CD) and non-CD controls. These ratios were all derived from complete blood counts. Two hundred and six participants including CD inpatients and non-CD controls were retrospectively enrolled. We found statistically higher NLR and PLR and lower LMR in CD patients than in non-CD controls (all P < 0.01). However, NMR was not different between the two groups (P = 0.18). In addition, NLR, PLR, and LMR were associated with CRP and ESR. Optimal cutoffs for NLR and PLR were 2.72 (sensitivity: 68.3%, specificity: 75.9%, and overall accuracy: 70.1%) and 132.88 (sensitivity: 76.7%, specificity: 84.8%, and overall accuracy: 80.8%), respectively. In conclusion, the NLR and PLR might be effective, readily available, and low-cost biomarkers for differentiating CD patients from non-CD controls.
| S-EPMC5535728 | biostudies-other
Project description:PurposeWe investigated the treatment response and prognosis using the neutrophil-to-lymphocyte ratio (NLR) and standardized uptake value (SUV) of 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) in neoadjuvant settings.MethodsBaseline NLR and maximum SUV (SUVmax) were retrospectively analyzed in 273 females with breast cancer who received neoadjuvant chemotherapy followed by surgery. Of these, 101 patients underwent 18F-FDG PET after 3-4 neoadjuvant chemotherapy cycles, which allowed the measurement of ΔSUVmax, an early reduction in SUVmax. NLR and early SUVmax reduction (ΔSUVmax) were classified as low and high, respectively, relative to the median values.ResultsThe mean NLR was lower, and the mean ΔSUVmax was higher in patients with pathologic complete response (pCR) than in those with residual tumors. The ΔSUVmax was an independent variable associated with pCR. Furthermore, the high NLR group had poor recurrence-free survival (RFS) and overall survival. Among patients with ΔSUVmax data, high NLR (adjusted hazard ratio, 2.82; 95% confidence intervals [CI], 1.26-6.28; P = 0.016) and low ΔSUVmax (adjusted hazard ratio, 2.39; 95% CI, 1.07-5.34; P = 0.037) were independent prognostic factors for poor RFS. The categorization of the patients into four groups according to the combination of NLR and ΔSUVmax showed that patients with high NLR and low ΔSUVmax had significantly poorer RFS.ConclusionBaseline NLR and ΔSUVmax were significantly associated with the prognosis of patients with breast cancer who received neoadjuvant chemotherapy. These results suggest that metabolic non-responders with defective immune systems have worse survival outcomes.
| S-EPMC9807322 | biostudies-literature
Project description:Prognostic biomarkers derived from complete blood count (CBC) have received marked interest as an indirect measure of the inflammatory pressure in cancers such as metastatic melanoma. Here, we evaluated the novel pan-immune-inflammation value (PIV) and the frequently assessed neutrophil/lymphocyte ratio (NLR) in a large cohort of patients with cutaneous melanoma (CM) without distant metastases (stages I to III). PIV and NLR were calculated at CM diagnosis. Healthy controls were also included. We used the Kaplan-Meier method to estimate crude survival probabilities and used Cox proportional hazards regression for multiple adjustment of hazard ratios. We observed that higher PIV (HR: 1.72, 95% CI 1.14 to 2.58 and HR: 1.696, 95% CI 1.029 to 2.795, respectively) and NLR (HR: 1.70, 95% CI 1.10 to 2.62) values were associated with CM relapse and CM-specific death in the crude analysis. However, when adjusting for potential confounders, in particular age and tumor thickness, the total effect of PIV and NLR on CM-relapse-free (HR: 1.28, 95% CI 0.83 to 1.98 and HR: 1.26, 95% CI 0.80 to 1.98, respectively) and CM-specific survival (HR: 1.36, 95% CI 0.80 to 2.30 and HR: 1.37, 95% CI 0.80 to 2.33, respectively) was substantially reduced. However, both PIV and NLR were positively correlated with age and tumor thickness, which are important independent predictors for CM relapse and CM-specific death. In conclusion, in stage I to III CM patients PIV as well as NLR appear to be confounded by age and tumor thickness and probably have no potential to further improve the prediction of survival of stage I to III CM patients beyond standard prognostic factors.
| S-EPMC9496745 | biostudies-literature
Project description:Accessible prognostic tools are needed to individualize treatment of neuroendocrine tumors (NETs). Data suggest neutrophil/lymphocyte ratios (NLRs) have prognostic value in some solid tumors, including NETs. In the randomized double-blind CLARINET study (NCT00353496; EudraCT 2005-004904-35), the somatostatin analog lanreotide autogel/depot increased progression-free survival (PFS) compared with placebo in patients with inoperable or metastatic intestinal and pancreatic NETs (grades 1-2, Ki-67 < 10%). The exploratory post-hoc analyses presented here evaluated the prognostic value of NLR in the CLARINET study cohort, in the context of and independently from treatment. Kaplan-Meier PFS plots were generated for patients with available NLR data, in subgroups based on NLR values, and 24-month survival rates were calculated. P values and hazard ratios for prognostic effects were generated using Cox models. 31216222 Baseline characteristics were balanced between lanreotide autogel/depot 120 mg (n = 100) and placebo (n = 101) arms. Irrespective of treatment, raw 24-month PFS rates were comparable across subgroups based on NLR tertiles [37.3% (low), 38.8% (middle), 38.8% (high); n = 67 per group] and NLR cutoff of 4 [38.1% (NLR ≤ 4; n = 176), 40.0% (NLR > 4; n = 25)]. Furthermore, NLRs were not prognostic in Cox models, irrespective of subgroups used. The therapeutic effect of lanreotide autogel/depot 120 mg was independent of NLRs (P > 0.1). These exploratory post-hoc analyses in patients with advanced intestinal and pancreatic NETs contrast with previous data suggesting NLR has prognostic potential in NETs. This may reflect the inclusion of patients with lower-grade tumors or use of higher NLR cutoff values in the current analysis.
| S-EPMC7028287 | biostudies-literature
Project description: Not available
| S-EPMC11925938 | biostudies-literature
Project description:OBJECTIVES:The clinical course and prognosis of follicular lymphoma (FL) are diverse and associated with the patient's immune response. We investigated the lymphocyte-to-monocyte ratio (LMR) and neutrophil-to-lymphocyte ratio (NLR) as prognostic factors in patients with FL, including those receiving radiotherapy. DESIGN:A retrospective cohort study. SETTING:Regional cancer centre in Hong Kong. PARTICIPANTS:88 patients with histologically proven FL diagnosed between 2000 and 2014. MATERIALS AND METHODS:The best LMR and NLR cut-off values were determined using cross-validated areas under the receiver operating characteristic curves. The extent to which progression-free survival (PFS) and overall survival differed by NLR and LMR cut-off values was assessed using Kaplan-Meier analysis and log-rank tests. A Cox proportional hazards model was fitted to adjust for confounders. RESULTS:The best cut-off values for LMR and NLR were 3.20 and 2.18, respectively. The 5-year PFS was 73.6%. After multivariate adjustment, high LMR (>3.20) at diagnosis was associated with superior PFS, with a HR of 0.31 (95% CI 0.13 to 0.71), whereas high NLR at relapse was associated with poorer postprogression survival (HR 1.24, 95% CI 1.04 to 1.49). CONCLUSIONS:Baseline LMR and NLR at relapse were shown to be independent prognostic factors in FL. LMR and NLR are cheap and widely available biomarkers that could be used in combination with the Follicular Lymphoma International Prognostic Index by clinicians to better predict prognosis.
| S-EPMC5695484 | biostudies-literature
Project description:BackgroundNeutrophil-lymphocyte ratio (NLR) reflects the balance between pro- and anti-tumor immune activities. We evaluated whether NLR is associated with pathologic tumor response and prognosis in rectal cancer patients that underwent preoperative chemoradiaton therapy (CRT) with surgery.MethodsOne hundred two patients with rectal cancer that were treated by preoperative CRT followed by surgery were enrolled. A total of 50.4 GY of radiation and 5-FU-based chemotherapy were delivered. An NLR ≥ 3 was considered to be elevated. Pathologic tumor response based on ypTNM stage was categorized into two groups, good response (n = 35, pathologic complete response and ypTNM I) and poor response groups (n = 67, ypTNM II, III, and IV).ResultsTwenty-five patients (24.5%) had elevated NLR. Multivariate analysis showed that an elevated CEA level (p = 0.001), larger tumor (p = 0.03), and elevated NLR (p = 0.04) were significant predictors for a poor response. Poor pathological tumor response and elevated NLR were risk factors for cancer-specific and recurrence-free survivals.ConclusionAn elevated NLR before CRT can be used as predictors for poor tumor response and unfavorable prognostic factors. Dominant pro-tumor activities of neutrophils or reduced anti-tumor immune response by lymphocytes, as determined by NLR, may have a impact on poor tumor response and unfavorable prognosis.
| S-EPMC4242604 | biostudies-literature
Project description:BackgroundTo evaluate the prognostic value of neutrophil-lymphocyte ratio (NLR) in rectal cancer patients treated with preoperative chemoradiotherapy (CRT) and curative surgery.MethodsA comprehensive search of the EMBASE and PubMed databases was performed to screen studies that compared treatment outcomes according to the pre-CRT and/or post-CRT NLR in patients receiving preoperative CRT and curative surgery for locally advanced rectal cancer. Hazard ratios (HRs) for disease-free survival (DFS) and/or overall survival (OS) were extracted, and a random-effects model was used for pooled analysis.ResultsTotally, 22 retrospective studies comprising 6316 patients were included. Preoperative CRT was administered with concurrent chemotherapy (mostly fluoropyrimidine-based regimens). The elevated pre-CRT NLR was significantly associated with an increased risk of recurrence (HR, 1.54; 95% confidence interval [CI], 1.31-1.81) and death (HR, 2.14; 95% CI, 1.61-2.84). Post-CRT NLR was reported in only 3 of 22 studies, and the correlation was not statistically significant for recurrence (HR, 1.44; 95% CI, 0.86-2.41) or death (HR, 2.38; 95% CI, 0.94-6.07).ConclusionsElevated pre-CRT NRL, but not post-CRT NRL, is associated with inferior DFS and OS. Further studies are needed to confirm the prognostic value of NLR in rectal cancer patients receiving preoperative CRT.
| S-EPMC8873579 | biostudies-literature