Do immune inflammatory markers correlate with anal dysplasia and anal cancer risk in patients living with HIV?

Stem, Jonathan; Yang, Qiuyu; Carchman, Evie H.; Striker, Rob; Geltzeiler, Cristina B.

doi:10.1007/s00384-022-04123-9

Cited by 3 publications

(5 citation statements)

References 25 publications

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“…Immune inflammatory markers such as NLR, PLR, and PNI have been shown to stratify risk in patients diagnosed with solid organ cancers and are calculated based on routinely drawn lab values. [14][15][16][17][18][19] The predictive value of NLR and PNI for anal cancer has been previously demonstrated in a single center civilian cohort. 19 In this current study of veterans, however, when controlling for confounders, PNI was statistically predictive of anal cancer risk but NLR was not.…”

Section: Discussionmentioning

confidence: 92%

“…[14][15][16][17][18][19] The predictive value of NLR and PNI for anal cancer has been previously demonstrated in a single center civilian cohort. 19 In this current study of veterans, however, when controlling for confounders, PNI was statistically predictive of anal cancer risk but NLR was not. The CD4/CD8 ratio was also predictive of anal cancer risk but with a greater magnitude of effect.…”

Section: Discussionmentioning

confidence: 92%

“…In our current study, we sought to determine if other immune inflammatory biomarkers would also predict risk in PLWH. Immune inflammatory markers such as NLR, PLR, and PNI have been shown to stratify risk in patients diagnosed with solid organ cancers and are calculated based on routinely drawn lab values 14–19 . The predictive value of NLR and PNI for anal cancer has been previously demonstrated in a single center civilian cohort 19 .…”

Section: Discussionmentioning

confidence: 99%

“…The commonly drawn immunologic marker, CD4/CD8 ratio, has been shown to correlate with risk of HSIL and anal cancer in PLWH 9,13 . Additional immune inflammatory markers, such as neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), and prognostic nutritional index (PNI), have shown value as prognostic indicators in numerous solid tumors, including anal cancer 14–19 . Although these immune inflammatory markers have shown promise in prognostication in some patient populations with anal cancer, it is unknown if these markers can predict anal cancer risk in veterans and how they compare to CD4/CD8 ratio as a risk predictor.…”

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confidence: 99%

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Commonly Drawn Immunologic and Inflammatory Markers as Risk Predictors for Anal Cancer in Veterans Living With HIV

Stem,

Hewitt,

Yang

et al. 2024

J Low Genit Tract Dis

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Objectives This study aimed to determine if immune inflammatory markers (neutrophil lymphocyte ratio [NLR], platelet lymphocyte ratio [PLR], and prognostic nutritional index [PNI]) correlate with anal cancer risk in people living with HIV and to compare these markers with the CD4/CD8 ratio. Materials and Methods This is a regional retrospective cohort study of veterans living with HIV who were screened for or diagnosed with anal neoplasia or cancer from 2001 to 2019. The NLR, PLR, PNI, and CD4/CD8 ratio within 1 year of anal pathology results were computed. Patients with anal cancer were compared to patients without anal cancer. Regression modeling was used to estimate the odds of developing anal cancer. Results Three hundred thirty-four patients were included (37 with anal cancer, 297 without anal cancer). In patients with anal cancer, NLR and PLR were higher (2.17 vs 1.69, p = .04; 140 vs 110, p = .02, respectively), while PNI and CD4/CD8 ratio were lower (44.65 vs 50.01, p < .001; 0.35 vs 0.80, p < .001, respectively). On multivariate logistic regression modeling, only PNI (odds ratio, 0.90; p = .001) and CD4/CD8 ratio (odds ratio, 0.05; p < .001) were associated with increased anal cancer risk. Conclusions Although NLR and PLR independently correlate with anal cancer risk, when controlling for other risk predictors, only PNI and CD4/CD8 ratio were statistically significant biomarkers for anal cancer. The CD4/CD8 ratio is the strongest immune inflammatory marker that predicts risk of anal cancer among veterans living with HIV.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Commonly Drawn Immunologic and Inflammatory Markers as Risk Predictors for Anal Cancer in Veterans Living With HIV

Stem,

Hewitt,

Yang

et al. 2024

J Low Genit Tract Dis

Self Cite

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“…A research of the medical literature shows the absence of any studies focusing on the link between Neutrophil to Lymphocyte Ratio (NLR), Platelet to Lymphocyte Ratio (PLR), Lymphocyte to Monocyte Ratio (LMR), Systemic Inflammatory Index (SII), and Systemic inflammation response index (SIRI) and bacterial STIs. This approach was chosen due to the existing research on viral STIs in prior studies [ 3 – 5 ] and absence of research on bacterial STIs.…”

Section: Background and Aimsmentioning

confidence: 99%

Neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, lymphocyte to monocyte ratio and Systemic Inflammatory Index in sexually transmitted diseases

Pintea-Trifu,

Balici,

Vică

et al. 2024

Medicine and Pharmacy Reports

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Introduction. Hematologic biomarkers of inflammation may serve as valuable adjuncts in clinical practice, aiding in several aspects such as differential diagnosis, prognostic assessment for patient stratification and monitoring the efficacy of antimicrobial therapy. The aim of this study was to evaluate the efficacy of Neutrophil to Lymphocyte Ratio (NLR), Platelet to Lymphocyte Ratio (PLR), Lymphocyte to Monocyte Ratio (LMR), and Systemic Inflammatory Index (SII) in predicting bacterial sexually transmitted infections (STI). Methods. This prospective study was conducted in the north-west region of Romania and included patients from several medical special units such as dermatology, obstetrics-gynecology, urology, and general practice. The study group comprised patients with a high suspicion of STI, while the control group consisted of healthy subjects. Quantitative data are presented as medians (interquartile ranges). Results. The median values of SII, NLR, and SIRI were higher in the group of subjects with sexually transmitted diseases compared to the control group [604.06 (432.36 - 880.02) vs. 556.89 (388.63 - 874.19); 2.61 (1.57 - 3.3) vs. 2.29 (1.66 - 3.26); and 0.95 (0.53 - 1.52) vs. 0.89 (0.67 - 1.34)]. Regarding PLR, the median values were lower in the group of subjects with sexually transmitted diseases compared to the control group [138.1 (99.19 - 169.6) vs. 140.65 (117 - 190.32)]. As for LMR, the median values were equal between the two groups [4.64 (3.74 - 6.11) vs. 4.64 (3.75 - 5.45)]. Nevertheless, the differences did not reach the significance level. Conclusion. Our study suggests that inflammatory biomarkers might aid in detecting bacterial STIs, but their significance was not statistically confirmed. Further research on alternative laboratory tests is needed for improved STI diagnosis and management.

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Risk of developing high‐grade squamous intraepithelial lesions or anal cancer after anal condylomata treatment in people living with HIV

Hewitt,

Kawak,

Yang

et al. 2024

Colorectal Disease

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AimTo assess the risk and natural history of developing advanced anal disease after diagnosis of anal condyloma in people living with HIV (PLWH).MethodsThis was a single‐centre retrospective cohort study of PLWH and anal condyloma from 2001 to 2021. Patients who developed advanced anal disease (AAD; anal high‐grade squamous intraepithelial lesions and/or anal cancer) were compared to those who did not progress (non‐AAD). We assessed the potential association between AAD and condyloma location, recurrence, and treatment modality. AAD‐free survival was calculated utilizing Kaplan–Meier methods.ResultsA total of 118 PLWH and anal condyloma were included. Mean overall follow‐up time was 9.3 years. A total of 31% of patients developed AAD (n = 37). Average time to AAD from condyloma diagnosis was 5.6 years. On multivariate analysis, risk for AAD development was associated with perianal location of condyloma (OR 4.39, p = 0.038) and increased time from initial condyloma diagnosis (OR 1.12, p = 0.008). Higher CD4/CD8 ratios were associated with lower risk of AAD (OR 0.15, p = 0.029). Condyloma recurrence and treatment type were not associated with development of AAD. AAD‐free survival was longer in those with intra‐anal only condyloma versus those with either perianal disease alone or combined intra‐anal/perianal disease (mean survival times: 22.8 vs. 8.7 vs. 10.7 years, p = 0.017).ConclusionOur study demonstrates the need for careful, long‐term follow‐up of PLWH and condyloma, particularly in the setting of perianal disease and low CD4/CD8 ratio. Risk of anal disease progression is present even in the setting of condyloma regression following treatment.

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Do immune inflammatory markers correlate with anal dysplasia and anal cancer risk in patients living with HIV?

Cited by 3 publications

References 25 publications

Commonly Drawn Immunologic and Inflammatory Markers as Risk Predictors for Anal Cancer in Veterans Living With HIV

Commonly Drawn Immunologic and Inflammatory Markers as Risk Predictors for Anal Cancer in Veterans Living With HIV

Neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, lymphocyte to monocyte ratio and Systemic Inflammatory Index in sexually transmitted diseases

Risk of developing high‐grade squamous intraepithelial lesions or anal cancer after anal condylomata treatment in people living with HIV

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