Neutrophil-Lymphocyte Ratio as a Marker of Progression from Non-Dysplastic Barrett’s Esophagus to Esophageal Adenocarcinoma: a Cross-Sectional Retrospective Study

Campos, Vinícius Jardim; Mazzini, Guilherme S.; Juchem, José Felipe; Gurski, Richard R

doi:10.1007/s11605-019-04456-x

Cited by 13 publications

(17 citation statements)

References 51 publications

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“…In these studies, the cutoffs of NLR ranged from 1.7 to 5 [26,27], making our results within the margins of previous studies. In addition, in one small retrospective study evaluating the utility of NLR in progression to EAC in patients with BE, the AUC was 0.8, and an NLR of ≥ 2.3 was associated with progression, with a sensitivity of 80 % and a specificity of 71 % [28]. These findings correlate well with the results of our large prospective cohort and validate our findings.…”

Section: Discussionsupporting

confidence: 89%

Neutrophil to lymphocyte ratio and risk of neoplastic progression in patients with Barrett’s esophagus

et al. 2020

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Background and aims: Patient’s with Barrett’s esophagus (BE) are at risk of progression to esophageal adenocarcinoma (EAC). Neutrophil to lymphocyte ratio (NLR) was found to be a predictor of poor prognosis in patients with EAC, however its performance in premalignant esophageal lesions is vague. We aim to evaluate the utility of NLR as a predictor of histologic progression in patients with BE. Methods: A prospective cohort of patients with proven BE in a tertiary referral center was retrospectively analyzed. All biopsies were reviewed by an expert GI pathologist. The discriminatory capacity of NLR was evaluated by Area under the Receiver Operating Curve (AUC) analysis and Cox regression analysis. Results: 324 patients were part of the final cohort, 241 (74.4%) were males, with mean age of 62.3 years. Thirteen patients demonstrated histologic progression to neoplasia over a mean follow up of 3.7 years (annual progression risk of 1.0% per year). The AUC of NLR for progression to high grade dysplasia (HGD) or EAC was 0.88 (95% CI 0.83-0.96), and baseline NLR was associated with 3-fold increase of progression to HGD and EAC during follow up (HR 3.2, 95% CI 1.5-5.8, p<0.001). Notably, in a subgroup analysis of patients with non-dysplastic BE (NDBE) at presentation, NLR was also a risk factor of histologic progression (HR 2.4, 95% CI 1.7-3.4, p<0.001). Conclusion: NLR predicts histologic progression in patients with BE. Patients with NDBE and NLR above 2.4 can be considered for specific surveillance programs with shorter intervals between sessions.

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Section: Discussionsupporting

confidence: 89%

Neutrophil to lymphocyte ratio and risk of neoplastic progression in patients with Barrett’s esophagus

et al. 2020

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“…More recently, the high level of technology of our era paved the way for novel substances that can be applied to the early detection of EC, providing insights into novel blood tests for screening and early diagnosis of EC (Table 1). Antibody against amino acid L-proline, ketone body 3-hydroxybutyrate, carbohydrate D-mannose ESCC/EAC [4] anti-p53, anti-HSP70, anti-p16, anti-cyclin B1, anti c-Myc, anti-LY6K Blood cells EAC [26,27] Neutrophil-lymphocyte ratio Erythrocyte mutant frequency Abbreviations: miRNA, micro-RNA; lncRNA, long non-coding RNA; ESCC, esophageal squamous cell carcinoma; EAC, esophageal adenocarcinoma.…”

Section: Blood Biomarkers Of Esophageal Cancer: a Liquid Biopsymentioning

confidence: 99%

“…As immune imbalance and inflammation seem to play a role in the progression from BE to EAC, Campos et al [26] investigated the neutrophil-lymphocyte ratio (NLR) in BE and EAC patients. The authors found that NLR progressively increased and significantly correlated with the presence of dysplasia or neoplasia (p < 0.001).…”

Section: Blood Biomarkers Of Esophageal Adenocarcinomamentioning

confidence: 99%

Modern Diagnosis of Early Esophageal Cancer: From Blood Biomarkers to Advanced Endoscopy and Artificial Intelligence

Visaggi

Barberio

Ghisa

et al. 2021

Cancers

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Esophageal cancer (EC) is the seventh most common cancer and the sixth cause of cancer death worldwide. Histologically, esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EAC) account for up to 90% and 20% of all ECs, respectively. Clinical symptoms such as dysphagia, odynophagia, and bolus impaction occur late in the natural history of the disease, and the diagnosis is often delayed. The prognosis of ESCC and EAC is poor in advanced stages, being survival rates less than 20% at five years. However, when the diagnosis is achieved early, curative treatment is possible, and survival exceeds 80%. For these reasons, mass screening strategies for EC are highly desirable, and several options are currently under investigation. Blood biomarkers offer an inexpensive, non-invasive screening strategy for cancers, and novel technologies have allowed the identification of candidate markers for EC. The esophagus is easily accessible via endoscopy, and endoscopic imaging represents the gold standard for cancer surveillance. However, lesion recognition during endoscopic procedures is hampered by interobserver variability. To fill this gap, artificial intelligence (AI) has recently been explored and provided encouraging results. In this review, we provide a summary of currently available options to achieve early diagnosis of EC, focusing on blood biomarkers, advanced endoscopy, and AI.

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“…NLR >2.27 was able to diagnose EAC with 80% sensitivity and 71% specificity (area under the curve = 0.8). 244 RNA-Seq and the genomic cellular analysis tool xCell revealed a linear increase in Th1, Th2, Treg, and pro-B cell populations in EAC compared with precancerous lesions (dysplastic BE and NDBE) as well as a linear increase in M1 and M2 macrophages between HGD and EAC. 245 Although multiplex IHC showed that immune cell populations tended to increase in a stepwise fashion from BE to LGD to HGD, followed by a decline in all evaluated immune cell populations in EAC tissues that coincided with increased PD-L1 expression.…”

Section: Markers In Progression To Barrett 'S Adenocarcinomamentioning

confidence: 97%

Barrett's esophagus: The pathomorphological and molecular genetic keystones of neoplastic progression

et al. 2021

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Barrett's esophagus is a widespread chronically progressing disease of heterogeneous nature. A life threatening complication of this condition is neoplastic transformation, which is often overlooked due to lack of standardized approaches in diagnosis, preventative measures and treatment. In this essay, we aim to stratify existing data to show specific associations between neoplastic transformation and the underlying processes which predate cancerous transition. We discuss pathomorphological, genetic, epigenetic, molecular and immunohistochemical methods related to neoplasia detection on the basis of Barrett's esophagus. Our review sheds light on pathways of such neoplastic progression in the distal esophagus, providing valuable insight into progression assessment, preventative targets and treatment modalities. Our results suggest that molecular, genetic and epigenetic alterations in the esophagus arise earlier than cancerous transformation, meaning the discussed targets can help form preventative strategies in at-risk patient groups.

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Neutrophil-Lymphocyte Ratio as a Marker of Progression from Non-Dysplastic Barrett’s Esophagus to Esophageal Adenocarcinoma: a Cross-Sectional Retrospective Study

Cited by 13 publications

References 51 publications

Neutrophil to lymphocyte ratio and risk of neoplastic progression in patients with Barrett’s esophagus

Neutrophil to lymphocyte ratio and risk of neoplastic progression in patients with Barrett’s esophagus

Modern Diagnosis of Early Esophageal Cancer: From Blood Biomarkers to Advanced Endoscopy and Artificial Intelligence

Barrett's esophagus: The pathomorphological and molecular genetic keystones of neoplastic progression

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