CT differentiation of diffuse malignant peritoneal mesothelioma and peritoneal carcinomatosis

Gastroenterology Research and Practice

et al. 2019

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Objective. The aim of our study was to investigate the expression of EGFR and PTEN in tissues and measure the serum platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) to evaluate the prognostic factors of patients with epithelioid malignant peritoneal mesothelioma (MPeM). Methods. 33 patients of pathologically diagnosed epithelioid MPeM tissues were analyzed using immunohistochemistry to detect EGFR and PTEN; the PLR and NLR were determined by using a routine blood test. We analyzed the relationships of these markers to age, sex, asbestos exposure, elevated platelet count, ascites, and clinical stage. Results. EGFR and PTEN expressions were positive in 22 (66.67%) and 7 (21.21%) epithelioid MPeM patients, respectively. However, these two markers as well as PLR and NLR were not significantly associated with age, sex, asbestos exposure, elevated platelet counts, ascites, and clinical stage (P>0.05). The correlation between EGFR and PTEN was negative (r=−0.577, P<0.001), but the correlation between NLR and PLR was positive (r=0.456, P=0.008). The median survival of all patients was 6 months. In univariate analysis, PTEN (P<0.001), PLR (P=0.014), and NLR (P=0.015) affected the overall survival. Multivariate analysis revealed that PTEN and PLR were validated as predictive for overall survival of epithelioid MPeM (HR=0.070, P=0.001, and HR=3.379, P=0.007, respectively). Conclusion. On the basis of these results, it is suggested that PTEN and PLR are risk factors for the prognosis of epithelioid MPeM, which may be targets for selective therapies and improve the outcomes of patients with epithelioid MPeM.

Section: Introductionmentioning

confidence: 99%

Significance of EGFR and PTEN Expression and PLR and NLR for Predicting the Prognosis of Epithelioid Malignant Peritoneal Mesothelioma

Liang

Gastroenterology Research and Practice

et al. 2019

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“…Previous studies have shown that gender, asbestos exposure, and histological subtype are associated with OS in MPeM [ 21 , 23 , 39 ]. However, in our study, none of above-mentioned factors was shown to be a predictor of MPeM.…”

Section: Discussionmentioning

confidence: 99%

Analysis of prognostic factors of patients with malignant peritoneal mesothelioma

Yang³

et al. 2018

World J Surg Onc

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BackgroundThe study aims to find out independent prognostic factors for patients with malignant peritoneal mesothelioma (MPeM).MethodsPatients with pathologically proven MPeM were retrospectively reviewed. Potential prognostic factors were analyzed, including age, gender, asbestos exposure, body mass index (BMI), treatment, and laboratory results, such as blood routine examination and liver functions. The influences of various risk factors on the prognoses were analyzed by univariate analysis. A Cox regression model analysis established independent factors for the survival prognosis of the patients.ResultsSeventy MPeM patients, including 33 patients who received intraperitoneal chemotherapy with cisplatin, 14 patients who received systemic chemotherapy with cisplatin + pemetrexed, and 21 untreated patients were included in this study. The 1-year survival was 32.9%, the 2-year survival was 10%, and the 3-year survival was 2.9%. The median age of MPeM was 62 years, and the female-to-male ratio was 1:0.56. The univariate and multivariate analyses showed that treatment, albumin (ALB), and blood neutrophil-to-lymphocyte ratio (NLR) were independent factors that affected the overall survival (OS) of MPeM patients.ConclusionHigh blood NLR and hypoalbuminemia are adverse prognostic factors for MPeM patients. Systemic chemotherapy and intraperitoneal chemotherapy can prolong the survival period.

“…Here, we found that there was no significant difference in ascites LDH levels between patients with MPeM and those with PC, although the ascites-serum LDH ratio in patients with MPeM was higher. The reason for these findings might be that MPeM is originated from peritoneum; therefore, the peritoneum tumor burden is heavy with diffused and persistent infiltration [ 28 , 29 ], which is accompanied by more tissue injury induced by anaerobic glycolysis pathway and high ascites LDH levels. The major growth pattern of MPeM is peritoneal infiltration, and metastases are exceedingly rare, while the main growth pattern of PC is diffuse dissemination through the vasculature and lymph, which might account for higher serum LDH levels compared with patients with MPeM.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Significance of Blood, Serum, and Ascites Parameters in Patients with Malignant Peritoneal Mesothelioma or Peritoneal Carcinomatosis

Gastroenterology Research and Practice

et al. 2018

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To determine effects of the biochemical and cytological properties of blood, serum, and ascites on survival of patients with malignant peritoneal effusion (MPeE), including malignant peritoneal mesothelioma (MPeM) and peritoneal carcinomatosis (PC), we conducted a retrospective study of patients with MPeE and healthy controls. Potential prognostic factors were identified as follows: age, sex, blood neutrophil-to-lymphocyte ratio (NLR), serum parameters, ascites parameters, serum-ascites albumin gradient, and the ascites-serum LDH ratio. Compared to those of the control group, serum albumin levels were significantly lower, and the NLR and serum LDH levels were significantly higher in the MPeE group. Overall survival (OS) was longer in patients with MPeM compared to that in patients with PC. Compared with patients in the MPeM, patients with PC had higher NLRs, ascites glucose levels, serum-ascites albumin gradients, and serum LDH levels. In contrast, their ascites albumin levels and ascites-serum LDH ratios were lower. Univariate analyses indicated that the NLR, serum LDH levels, ascites LDH levels, ascites coenocyte levels, and the ascites coenocyte-to-monocyte ratios affected the OS. Multivariate analyses identified only serum and ascites LDH levels as independent prognostic factors.