An increase in the neutrophil-to-lymphocyte ratio during adjuvant chemotherapy indicates a poor prognosis in patients with stage II or III gastric cancer

Mori, Mikito; Shuto, Kiyohiko; Kosugi, Chihiro; Narushima, Kazuo; Hayashi, Hideki; Matsubara, Hisahiro; Koda, Keiji

doi:10.1186/s12885-018-5171-2

Cited by 28 publications

(26 citation statements)

References 32 publications

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“…An increase in the neutrophil-to-lymphocyte ratio has been repeatedly reported to be correlated with poor prognoses including distant metastases in various types of solid cancers 8,9 . According to our data, in hosts with neutrophilia the immunosuppressive effect of neutrophils may prevail over their tumoricidal activity and lead to a net pro-tumoral effect.…”

Section: Discussionmentioning

confidence: 99%

“…However, recent preclinical studies showed that exogenous G-CSF administration and other pathological conditions associated with neutrophil expansion could potentially accelerate solid tumor metastases [3][4][5][6] . In cancer patients, increased neutrophil counts (neutrophilia), and a higher neutrophil-to-lymphocyte ratio were also reported to be associated with adverse outcomes including metastatic relapse in multiple types of solid cancers such as breast cancer, gastric cancer, pancreatic cancer and melanoma [7][8][9][10][11] .…”

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confidence: 99%

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Dual roles of neutrophils in metastatic colonization are governed by the host NK cell status

Shi

et al. 2020

Nat Commun

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The role of neutrophils in solid tumor metastasis remains largely controversial. In preclinical models of solid tumors, both pro-metastatic and anti-metastatic effects of neutrophils have been reported. In this study, using mouse models of breast cancer, we demonstrate that the metastasis-modulating effects of neutrophils are dictated by the status of host natural killer (NK) cells. In NK cell-deficient mice, granulocyte colony-stimulating factor-expanded neutrophils show an inhibitory effect on the metastatic colonization of breast tumor cells in the lung. In contrast, in NK cell-competent mice, neutrophils facilitate metastatic colonization in the same tumor models. In an ex vivo neutrophil-NK cell-tumor cell tri-cell co-culture system, neutrophils are shown to potentially suppress the tumoricidal activity of NK cells, while neutrophils themselves are tumoricidal. Intriguingly, these two modulatory effects by neutrophils are both mediated by reactive oxygen species. Collectively, the absence or presence of NK cells, governs the net tumor-modulatory effects of neutrophils.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Dual roles of neutrophils in metastatic colonization are governed by the host NK cell status

Shi

et al. 2020

Nat Commun

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“…Few studies have examined NLR in the adjuvant setting. A retrospective analysis of patients with stage II/III gastric cancer who received adjuvant chemotherapy found that an increase in NLR during adjuvant treatment was associated with a poorer prognosis (19). The precise mechanisms underlying NLR as a prognostic or predictive biomarker are unclear, but may represent a dynamic relationship between the NLR and the potential immunomodulatory effects of the treatment.…”

Section: Discussionmentioning

confidence: 99%

Neutrophil-to-Lymphocyte Ratio as a Prognostic Factor of Disease-free Survival in Postnephrectomy High-risk Locoregional Renal Cell Carcinoma: Analysis of the S-TRAC Trial

Patel¹,

Ravaud

Motzer

et al. 2020

Clinical Cancer Research

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In the S-TRAC trial, adjuvant sunitinib improved disease-free survival (DFS) compared with placebo in patients with locoregional renal cell carcinoma (RCC) at high risk of recurrence. This post hoc exploratory analysis investigated the neutrophil-tolymphocyte ratio (NLR) for predictive and prognostic significance in the RCC adjuvant setting. Experimental Design: Kaplan-Meier estimates and Cox proportional analyses were performed on baseline NLR and change from baseline at week 4 to assess their association with DFS. Univariate P values were two-sided and based on an unstratified log-rank test. Results: 609 of 615 patients had baseline NLR values; 574 patients had baseline and week 4 values. Sunitinib-treated patients with baseline NLR <3 had longer DFS versus placebo (7.1 vs. 4.7; HR, 0.71; P ¼ 0.02). For baseline NLR ≥3, DFS was similar regardless of treatment (sunitinib 6.8 vs. placebo not reached; HR, 1.03; P ¼ 0.91). A ≥25% NLR decrease at week 4 was associated with longer DFS versus no change (6.8 vs. 5.3 years; HR, 0.71; P ¼ 0.01). A greater proportion of sunitinib-treated patients had ≥25% NLR decrease at week 4 (71.2%) versus placebo (17.4%). Patients with ≥25% NLR decrease at week 4 received a higher median cumulative sunitinib dose (10,137.5 mg) versus no change (8,168.8 mg) or ≥25% increase (6,712.5 mg). Conclusions: In the postnephrectomy high-risk RCC patient cohort, low baseline NLR may help identify those most suitable for adjuvant sunitinib. A ≥25% NLR decrease at week 4 may be an early indicator of those most likely to tolerate treatment and derive DFS benefit.

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“…Многообразие субпопуляций иммунных клеток, а также основных продуктов их синтеза и путей совместного взаимодействия может объяснять как активацию путей противоопухолевой защиты, так и потенциирование прогрессирования заболевания. Кроме этого, анализ данных литературы последних лет показал несомненную прогностическую ценность системных воспалительных индексов, основанных на подсчете соотношений нейтрофилов, лимфоцитов и тромбоцитов в периферической крови пациентов с колоректальным раком [10], РЖ [11,12] и гепатоцеллюлярным раком [13], что позволяет использовать эти показатели в клинической практике на этапе планирования комплексного лечения пациентов со злокачественными новообразованиями, а также максимально рано выявлять признаки развития рецидива заболевания.…”

Section: экспериментальные статьиunclassified

Analysis of systemic immunity and inflammation in the prognosis of gastric adenocarcinoma

et al. 2020

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Objective: to study the state of cellular immunity in patients with gastric adenocarcinoma.Materials and methods. From 2017 to 2018, 45 previously untreated patients with gastric adenocarcinoma (25 with stage I–III, 20 with stage IV) received surgical / combined treatment or independent chemotherapy, respectively, at the N. N. Blokhin National Medical ResearchCenter of Oncology. Peripheral blood sampling was carried out before starting treatment. We studied the cellular composition of peripheral blood, as well as systemic immunity parameters determined by flow cytometry (CD3+CD4+; CD3+CD8+; CD4+CD8+; CD4+/CD8+; CD3–CD16+CD56+; CD3–CD19+), and their prognostic significance in relation to overall survival and progression-free survival.Results. The prognostic value of the relative indicator of platelet lymphocytic index was determined: progression-free survival in patients with a high level of platelet-lymphocytic index (>208.7) was higher: 8.1 months versus 4.5 months (p = 0.0027). A favorable prognosis for overall survival was an increase in the number of CD3–CD19+ lymphocytes (hazard ratio (HR) 0.91; 95 % confidence interval (CI) 0.85–0.97; p = 0.007), and an unfavorable prognosis was an increase in the number of neutrophils (HR 1.26; 95 % CI 1.05–1.50; p = 0.012), platelet count (HR 1.01; 95 % CI 1.0–1.01; p = 0.043), as well as an increase in the number of NK cells (HR 1.04, 95 % CI 1.0–1.09; p = 0.029).Conclusion. Indicators of the cellular composition of peripheral blood, characterizing a systemic inflammatory reaction, as well as indicators of systemic immunity, can serve as additional prognostic factors for gastric cancer.

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An increase in the neutrophil-to-lymphocyte ratio during adjuvant chemotherapy indicates a poor prognosis in patients with stage II or III gastric cancer

Cited by 28 publications

References 32 publications

Dual roles of neutrophils in metastatic colonization are governed by the host NK cell status

Dual roles of neutrophils in metastatic colonization are governed by the host NK cell status

Neutrophil-to-Lymphocyte Ratio as a Prognostic Factor of Disease-free Survival in Postnephrectomy High-risk Locoregional Renal Cell Carcinoma: Analysis of the S-TRAC Trial

Analysis of systemic immunity and inflammation in the prognosis of gastric adenocarcinoma

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