Systematic Review of Prognostic Role of Blood Cell Ratios in Patients with Gastric Cancer Undergoing Surgery

Schiefer, Sabine; Wirsik, Naita Maren; Kalkum, Eva; Seide, Svenja; Nienhüser, Henrik; Müller, Beat; Billeter, Adrian T.; Büchler, Markus W.; Schmidt, Thomas; Probst, Pascal

doi:10.3390/diagnostics12030593

Cited by 27 publications

(24 citation statements)

References 90 publications

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“…This finding might have been obtained because the subjects of the present study were relatively healthy and patients with early-stage disease were able to receive curative surgical resection and adjuvant treatment. In fact, the mean values of NLR, LMR, and PLR in the present study, which were 1.920 (95% CI 1.824-2.015), 5.184 (95% CI 5.034-5.334), and 128.0 (95% CI 123.7-132.3), respectively, were lower than the reference values suggested by Schiefer et al, which were 4.5, 5.43, and 152, respectively-especially for NLR [23]. Additionally, our values were not significantly different from those of 12,160 healthy Korean populations obtained from the checkup center of a tertiary hospital: NLR of 1.65 (95% CI 0.107-3.193), LMR of 5.31 (95% CI 2.008-8.612), and PLR of 132.40 (95% CI 46.764-218.006) [24].…”

Section: Discussioncontrasting

confidence: 84%

Clinical Significance of Preoperative Hematological Parameters in Patients with D2-Resected, Node-Positive Stomach Cancer

Park

Lim

et al. 2022

Biomedicines

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The purpose of the present study was to investigate the clinical significance of preoperative hematological parameters in patients with advanced stomach cancer, and to explore who might benefit from adjuvant concurrent chemoradiotherapy (CCRT) compared to chemotherapy alone. Among 1032 patients with node-positive stomach cancer who had a confirmed diagnosis after complete D2 resection, and who received adjuvant chemotherapy alone or CCRT, a total of 692 patients was selected using propensity score matching. Among absolute neutrophil count, absolute lymphocyte count (ALC), absolute monocyte count (AMC), platelet count, neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, and platelet-to-lymphocyte ratio, AMC was the most relevant prognostic factor for overall survival and recurrence-free survival (hazard ratio (HR) 1.674, 95% confidence interval (CI) 1.180–2.376; HR 1.908, 95% CI 1.650–2.695, respectively). In a subgroup with a high ALC, patients treated with adjuvant CCRT had a favorable recurrence-free survival (HR 0.620, 95% CI 0.393–0.980) compared to those treated with chemotherapy alone. Further study is needed to confirm our findings and to develop tailored adjuvant treatment.

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Section: Discussioncontrasting

confidence: 84%

Clinical Significance of Preoperative Hematological Parameters in Patients with D2-Resected, Node-Positive Stomach Cancer

Park

Lim

et al. 2022

Biomedicines

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“…The advantage of CXI over Fearon’s criteria is that it includes NLR and serum albumin. Furthermore, previous studies demonstrated that NLR and serum albumin had significant associations with the prognosis in patients with GC [ 32 , 33 , 34 ], which might account for why low CXI, instead of cachexia diagnosed by Fearon’s criteria, was significantly associated with worse OS in this study.…”

Section: Discussionmentioning

confidence: 53%

Cachexia Index as a Prognostic Indicator in Patients with Gastric Cancer: A Retrospective Study

Gong

Wan

Zhao

et al. 2022

Cancers

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The current diagnostic criteria for cancer cachexia are inconsistent, and the prognostic value of cachexia in gastric cancer (GC) is controversial. This study aimed to investigate the prognostic value of the cachexia index (CXI) in patients with GC. We calculated the CXI as skeletal muscle index (SMI) × serum albumin/neutrophil-lymphocyte ratio (NLR), and a total of 161 and 163 patients were included in the high and low CXI groups, respectively. Low CXI was significantly associated with a more advanced tumor–node–metastasis (TNM) stage, a higher level of serum C-reactive protein, serum interleukin-6, and NLR, but also a decreased level of serum prealbumin and albumin. In addition, patients in the low CXI group were more likely to have postoperative pulmonary infections (9.8% vs. 3.7%, p = 0.03). Cox proportional analyses indicated that patients with low CXI (HR 0.45, 95% CI 0.29 to 0.69; p < 0.001) or TNM stage III+IV (HR 4.38, 95% CI 2.54 to 7.55; p < 0.001) had a significantly poorer overall survival (OS). Kaplan–Meier survival curves suggested that patients with low CXI had a significantly decreased OS, which was not affected by subgroup analyses of different sex, age, cachexia, body mass index (BMI), and TNM stage. Furthermore, low CXI combined with cachexia, low BMI, or TNM stage III+IV caused the worst OS in each subgroup analysis, respectively. Our study demonstrated that CXI had a good prognostic value in GC. Greater attention should be paid to patients with low CXI, particularly those combined with cachexia, low BMI, or TNM stage III+IV.

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“…Routine hematological parameters have been used in recent years as indicators of systemic inflammation. Among these simple parameters, the proportions of circulating inflammatory cells, including the white blood cell (WBC) count, lymphocyte count, neutrophil count, platelet count (PLTs), mean platelet volume (MPV), and levels of hemoglobin (Hb) and serum CRP, have been screened ( 208 , 209 ). Analyte-based scores or ratios of some of these parameters have been reported to assess systemic inflammation, and their correlation with the prognosis of numerous pathologies, including cancer, has been described.…”

Section: Parameters To Assess Systemic Immune-inflammatory Markersmentioning

confidence: 99%

The systemic-level repercussions of cancer-associated inflammation mediators produced in the tumor microenvironment

et al. 2022

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The tumor microenvironment is a dynamic, complex, and redundant network of interactions between tumor, immune, and stromal cells. In this intricate environment, cells communicate through membrane–membrane, ligand–receptor, exosome, soluble factors, and transporter interactions that govern cell fate. These interactions activate the diverse and superfluous signaling pathways involved in tumor promotion and progression and induce subtle changes in the functional activity of infiltrating immune cells.The immune response participates as a selective pressure in tumor development. In the early stages of tumor development, the immune response exerts anti-tumor activity, whereas during the advanced stages, the tumor establishes mechanisms to evade the immune response, eliciting a chronic inflammation process that shows a pro-tumor effect.The deregulated inflammatory state, in addition to acting locally, also triggers systemic inflammation that has repercussions in various organs and tissues that are distant from the tumor site, causing the emergence of various symptoms designated as paraneoplastic syndromes, which compromise the response to treatment, quality of life, and survival of cancer patients. Considering the tumor–host relationship as an integral and dynamic biological system, the chronic inflammation generated by the tumor is a communication mechanism among tissues and organs that is primarily orchestrated through different signals, such as cytokines, chemokines, growth factors, and exosomes, to provide the tumor with energetic components that allow it to continue proliferating. In this review, we aim to provide a succinct overview of the involvement of cancer-related inflammation at the local and systemic level throughout tumor development and the emergence of some paraneoplastic syndromes and their main clinical manifestations. In addition, the involvement of these signals throughout tumor development will be discussed based on the physiological/biological activities of innate and adaptive immune cells. These cellular interactions require a metabolic reprogramming program for the full activation of the various cells; thus, these requirements and the by-products released into the microenvironment will be considered. In addition, the systemic impact of cancer-related proinflammatory cytokines on the liver—as a critical organ that produces the leading inflammatory markers described to date—will be summarized. Finally, the contribution of cancer-related inflammation to the development of two paraneoplastic syndromes, myelopoiesis and cachexia, will be discussed.

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Systematic Review of Prognostic Role of Blood Cell Ratios in Patients with Gastric Cancer Undergoing Surgery

Cited by 27 publications

References 90 publications

Clinical Significance of Preoperative Hematological Parameters in Patients with D2-Resected, Node-Positive Stomach Cancer

Clinical Significance of Preoperative Hematological Parameters in Patients with D2-Resected, Node-Positive Stomach Cancer

Cachexia Index as a Prognostic Indicator in Patients with Gastric Cancer: A Retrospective Study

The systemic-level repercussions of cancer-associated inflammation mediators produced in the tumor microenvironment

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