Diagnosis and survival values of neutrophil-lymphocyte ratio (NLR) and red blood cell distribution width (RDW) in esophageal cancer

Han, Fuyan; Liu, Yiqing; Cheng, Shiqing; Sun, Zhonghua; Sheng, Chenchen; Sun, Xiya; Shang, Xuming; Tian, Wenjun; Wang, Xiaoying; Li, Jiamei; Liu, Dong; Wang, Yong; Zhang, Bingchang; Ju, Ying

doi:10.1016/j.cca.2018.10.042

Cited by 58 publications

(50 citation statements)

References 43 publications

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“…Similar to elevated platelet count, high PLR has been found to be associated with worse survival in a variety of solid (hepatocellular, ovarian, cervix, colorectal, bile duct, breast, lung, renal cell, gastric, prostate, and oesophageal) tumours [30][31][32][33][34][35][36][37][38][39][40]. Moreover, several studies confirmed the relationship between elevated NLR and a worse prognosis in patients with malignant oesophageal [41], colorectal [42,43], pancreas [44,45], prostate [46,47], hepatic [48,49], bile duct [50], breast [51], gastric [52,53], cutaneous melanocytic [54], thyroid medullary [55], and lung [56] tumours. It is important to note, however, that NLR may be elevated also in many benign disorders [57,58].…”

Section: Discussionmentioning

confidence: 86%

Neutrophil-To-Lymphocyte and Platelet-To-Lymphocyte Ratios as Prognostic Markers of Survival in Patients with Head and Neck Tumours—Results of a Retrospective Multicentric Study

Szilasi

Jósa

Zrubka

et al. 2020

IJERPH

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Background: The neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) may be useful for drawing conclusions about the survival of head and neck squamous cell carcinoma (HNSCC) patients. Methods: Clinical data of 156 patients managed for HNSCC at two head and neck surgery centres were analyzed retrospectively. We studied the relationships between survival and PLR as well as NLR. Results: With regards to 5-year survival, the difference between the two groups with PLR values lower or higher than the threshold was statistically significant (p = 0.004), and we found the same for disease-free survival (p = 0.05), and tumour-specific mortality (p = 0.009). Concerning NLR, the difference in tumour-specific survival was statistically significant (p = 0.006). According to the multivariate analysis, NLR values higher than the threshold indicated an enhanced risk for overall as well as for tumour-specific mortality. Conclusion: In HNSCC patients, a high NLR may be considered as an independent risk factor for 5-year overall survival.Malignant tumours influence the number of platelets and alter their functioning. However, the mechanisms of the relationship between thrombocytosis and the tumour have not yet been fully elucidated and several hypotheses have been proposed [2].The facilitatory role of chronic inflammation in the development and progression of solid tumours have been described for malignancies of the lung, breast, and gastrointestinal tract, the prostate, and the ovaries [3-7], as well as for HNSCC [8,9].Neutrophils might, in fact, facilitate tumour growth and the formation of metastases-these cells can inhibit the activities of the lymphocytes and thereby attenuate the antitumour immune response [10]. Neutrophil cells can contribute to carcinogenesis and tumour progression in many ways [11]: (1) These cells can release genotoxic substances, which damage the DNA of epithelial cells [12]. (2) They can promote tumour growth by releasing soluble factors and proteases, such as prostaglandin E2 and neutrophil elastase [13,14]. (3) Neutrophils facilitate metastasis formation by enhancing the capabilities of the tumour cells for migration, invasive spread, and colony formation, as well as by breaking down the extracellular matrix [15]. (4) They contribute to the formation of new blood vessels by producing pro-angiogenic factors, such as matrix metalloproteinase-9, and vascular endothelial growth factor [16]. (5) Neutrophils exert immunosuppressive action by inhibiting effector T-cells along with the proliferation and the functioning of natural killer cells, as well the fact that they enhance tumour growth and metastasis formation through the modulation of macrophage activity [17].These observations suggest that neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) determined in the blood of patients with a malignancy might be related to tumour growth [18].Our study intended to ascertain whether pre-treatment NLR and PLR values determined in HNSCC patients are suitable predi...

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Section: Discussionmentioning

confidence: 86%

Neutrophil-To-Lymphocyte and Platelet-To-Lymphocyte Ratios as Prognostic Markers of Survival in Patients with Head and Neck Tumours—Results of a Retrospective Multicentric Study

Szilasi

Jósa

Zrubka

et al. 2020

IJERPH

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“…Blood routine test (BRT), as one of the most basic peripheral blood biochemical tests, can quickly and accurately detect the values of blood components such as white blood cells (WBC), lymphocytes (LY), red blood cells (RBC), hemoglobin (HGB) and platelets (PLT), as well as other related indicators, in order to effectively indicate abnormalities of infection, anemia and cruor [7][8][9] . In recent years, a wide variety of blood indicators with different changes were concerned and discussed in the study of malignant tumor diseases including CRC: Qian W, et al reported that the post-/pre-treatment MPV (Mean Platelet Volume) ratio were prognostic factors for OS in resectable CRCs [10] ; Preoperative neutrophil-lymphocyte ratio (NLR) and red blood cell distribution width (RDW), especially the independent prediction of NLR, were confirmed as effective biomarkers for clinical diagnosis and prognosis evaluation of esophageal cancers [11] ; In patients with pathologic stage I non-small cell lung cancer undergoing surgical resection, high LY and PLT count from peripheral blood could provide poor prognostic value independently [12] ; Even the ratios between indicators were developed into new indexes, which had fairly good prognostic significance, including NLR, Platelet-to-Lymphocyte Ratio (PLR), Lymphocyte-to-Monocyte ratio (LMR). [13][14][15][16] .…”

Section: Ivyspringmentioning

confidence: 99%

Prognostic evaluation of colorectal cancer using three new comprehensive indexes related to infection, anemia and coagulation derived from peripheral blood

Li¹,

Wu²,

Xing³

et al. 2020

J. Cancer

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Background: Many indicators of peripheral blood in routine blood test (BRT) results of colorectal cancer (CRC) patients are related to prognosis. Currently, indexes such as NLR (Neutrophil-to-Lymphocyte Ratio), PLR (Platelet-to-Lymphocyte Ratio) and LMR (Lymphocyte-to-Monocyte ratio) evaluate the survival risk of patients by assessing the inflammatory-immune status of CRCs. These indexes are more comprehensive and accurate than independent estimates. We hope to design more effective indexes through fully considering the correlation and significance between BRT indicators and prognosis, so as to play a guiding role in clinical malignant estimation of CRCs. Methods: 701 CRCs in training set and 256 CRCs in test set were included in the study samples, and their clinical data, tumor pathology results and peripheral blood routine results were collected. The prognosis, progression, and survival status of all patients were determined after follow-up. Above data were used for statistical analysis and designing new indexes. Results: It was found that high NE, MONO, RDW-CV/SD and PLT in peripheral blood indicated poor prognosis of DFS and OS. Conversely, CRCs with postoperative tumor progression or death had lower LY, EO, RBC, HGB, HCT, MCV, MCH, MCHC, PDW, and P-LCR. IRR, ARR and CRR related to infection, anemia and coagulation were designed respectively using the largest AUC indicators (P<0.05) selected by ROC curve. The formula: IRR= (NE*MONO)/(LY*EO); ARR= (HGB*MCHC)/RDW-CV; CRR=PLT/PDW. Results of Kaplan-Meier survival analysis and multivariate COX proportional hazard analysis adjusted for age, gender, TNM stage, infiltration, adhesion showed IRR, ARR, CRR were all able to be used as the evaluation standard of survival of CRC. The result was also authenticated in the test set. Conclusion: We designed three different prognostic indexes of colorectal cancer, IRR, ARR and CRR, which could be used as risk indicators of CRC prognosis, tumor progression and survival.

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“…Other studies showed a better relationship of preoperative NLR and PLR for survival rates for esophageal cancer, albeit in heterogenic neoadjuvant therapy population. 8, 36,37…”

Section: Discussionmentioning

confidence: 99%

The value of cellular components of blood in the setting of trimodal therapy for esophageal cancer

Tustumi

Takeda

Viyuela

et al. 2019

Journal of Surgical Oncology

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Background Inflammation status plays an important role in the natural history of malignancy. Consequently, hematological markers of systemic inflammation may predict prognosis in neoplasms. This study evaluated the value of cellular blood components changes during neoadjuvant chemoradiotherapy followed by esophagectomy for cancer in predicting prognosis. Methods A cohort of 149 patients was analyzed. Cellular components of blood were assessed before neoadjuvant therapy (A); before surgery (B); and 3 to 5 months after surgery (C); for the following outcomes: pathological response, overall survival (OS), and disease‐free survival (DFS). Univariate and multivariate Cox regression models were applied to evaluate the independent prognostic significance of blood count variables. Results Low hematocrit (Ht) (C) (HR, 0.85; 95% CI, 0.79‐0.92) and high neutrophil‐to‐lymphocyte ratio (NLR) (C) (HR, 1.07; 95% CI, 1.07‐1.10) were related to poor OS. Low Hb (C) (HR, 0.72; 95% CI, 0.58‐0.88), red cell distribution width (RDW) (C‐A) (HR, 1.16; 95% CI, 1.02‐1.31), and NLR (C‐A) (1.06; 95% CI, 1.03‐1.09) were related to poor DFS. RDW (B‐A) (HR, 1.15; 95% CI, 1.08‐1.22), RDW (C) (HR, 1.12; 95% CI, 1.04‐1.2), NLR (C) (HR, 1.12; 95% CI, 1.08‐1.17) were related to systemic recurrence. Conclusion Variables of routine blood count are easily assessable and their changes throughout trimodal therapy for esophageal carcinoma provide important information for cancer patient's prognosis.

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Diagnosis and survival values of neutrophil-lymphocyte ratio (NLR) and red blood cell distribution width (RDW) in esophageal cancer

Cited by 58 publications

References 43 publications

Neutrophil-To-Lymphocyte and Platelet-To-Lymphocyte Ratios as Prognostic Markers of Survival in Patients with Head and Neck Tumours—Results of a Retrospective Multicentric Study

Neutrophil-To-Lymphocyte and Platelet-To-Lymphocyte Ratios as Prognostic Markers of Survival in Patients with Head and Neck Tumours—Results of a Retrospective Multicentric Study

Prognostic evaluation of colorectal cancer using three new comprehensive indexes related to infection, anemia and coagulation derived from peripheral blood

The value of cellular components of blood in the setting of trimodal therapy for esophageal cancer

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