Neutrophil to apolipoprotein A‐I ratio as an independent indicator of locally advanced nasopharyngeal carcinoma

Abstract

Purpose: To explore the peripheral blood cells (neutrophil/monocyte/lymphocyte/ platelet) to apolipoprotein AI or high-density lipoprotein-cholesterol ratio (NAR, MAR, LAR, PAR, NHR, MHR, LHR, and PHR) as independent prognostic indicators for stage III nasopharyngeal carcinoma (NPC).Patients and methods: Between 2009 and 2014, 562 patients diagnosed with stage III NPC who were treated with a concomitant chemotherapy and intensitymodulated radiotherapy with cumulative cisplatin dose ≥200 mg/m 2 were included in this retrospective study. Routine blood and biochemical variables and baseline clinical characteristics (T and N stage, age, sex, and induction chemotherapy) were collected. After inserting 19 hematological parameters into a set, we applied the least absolute shrinkage and selection operator (LASSO) algorithm and restricted cubic splines regression to select valuable parameters for predicting 5-year overall survival (OS). Subsequently, univariate and multivariate survival analyses were used to assess independent indicators of 5-year OS, distant metastasis survival, regional recurrence-free survival (RRFS), and disease-free survival.Results: NAR, MAR, serum lactated dehydrogenase (LDH), and Epstein-Barr virus (EBV)-DNA were selected using LASSO regression, and the optimal cut-off values for NAR, MAR, EBV-DNA, and, LDH were 4.39, 0.3, 1590 copies/mL, and 218.4 IU/L, respectively. In multivariate survival analysis, higher NAR was associated with both poor 5-year OS and RRFS (hazard ratio [HR], 1.88; 95% confidence interval [CI],

Predictive value of neutrophil-to-apolipoprotein A1 ratio in all-cause and cardiovascular death in elderly non-valvular atrial fibrillation patients

“…NAR has a predictive value for long-term tumour disease prognosis [ 15 , 35 ]. However, data on NAR’s impact on the long-term prognosis of AF patients are limited.…”

“…The neutrophil-to-apolipoprotein A1 (NAR) ratio is a composite inflammation and lipid metabolism marker that can exert anti-inflammatory and antithrombotic effects [ 12 , 13 , 14 ]. NAR can be used as a prognostic indicator of the five-year overall survival of nasopharyngeal carcinoma patients [ 15 ]. Nevertheless, the relationship between NAR and all-cause and cardiovascular mortality in elderly AF patients remains unclear.…”

Development and validation of a risk prediction model for overall survival in patients with nasopharyngeal carcinoma: a prospective cohort study in China

“…Li etc. concluded that NLR could be an attractive indicator for evaluating the 5-year OS in NPC patients with stage III [ 22 ]. High PLR was associated with poor OS in NPC patients [ 23 ].…”

The Prognostic Value of Serum Apolipoprotein A-I Level and Neutrophil-to-Lymphocyte Ratio in Colorectal Cancer Liver Metastasis

“…Our analyses revealed that high ApoA-I level was significantly associated with prolonged OS. Li et al discovered that elevated ApoA-I inhibits the movement and invasion of neutrophils at tumor sites rich in chronic inflammatory factors, thereby reducing the number of neutrophils infiltrating tumor tissue and ultimately increasing the survival rate [ 12 ]. Increasing ApoA-I levels by ApoA-I transgenic mice expression inhibited lymphocyte activation, decreased germinal center B cell numbers at length, and ameliorated glomerulonephritis [ 13 ].…”

“…Some studies have discussed the anti-inflammatory and antitumor properties of ApoA-I, neutrophils, and lymphocytes. For instance, it was discovered that neutrophils would adhere to tumor cells if they overexpressed CD11b and intercellular adhesion molecule 1, but that ApoA-I would remove these molecules [ 12 ]. ApoA-I can also inhibit inflammation in hypercholesterolemic mice by reducing cholesterol accumulation in lymphocytes [ 13 ].…”