The clinical value of peripheral immune cell counts in pancreatic cancer

Abstract

Background Elevated neutrophil-lymphocyte ratio (NLR) is linked to poor overall survival (OS) in pancreatic cancer. We aim to investigate the association of the various hematologic markers, in particular NLR among others, with distant metastases, a common feature in pancreatic cancer. Methods Clinical data from 355 pancreatic cancer patients managed at King Hussein Cancer Center (Amman-Jordan) have been reviewed. We examined the relationship between absolute neutrophil count (ANC), absolute lymphocyte count (ALC), absolute eosinophilic count (AEC), absolute monocytic count (AMC), NLR, monocyte to lymphocyte ratio (MLR) and platelet to lymphocyte ratio (PLR) with the presence of baseline distant metastases and OS. Receiver Operating Characteristic (ROC) curve analysis was plotted to identify the NLR optimum cutoff value indicative of its association with distant metastases. Results On univariate and multivariate analyses patients whom on presentation had high NLR (�3.3) showed more baseline distant metastases compared to patients with low NLR (<3.3), (p-value: <0.0001 and <0.0001, respectively). Patients with high baseline ANC (�5500/μL), AMC (�600/μL), MLR (�0.3) had more baseline distant metastases in comparison to patients with lower values (p-value: 0.

The Predictive Value of Peripheral Immune Cell Counts for the Presence of Brain Metastases in Stage IV Non-Small-Cell Lung Cancer (NSCLC)

“…Neutrophil–lymphocyte ratio (NLR), absolute neutrophil count (ANC), and absolute lymphocyte count (ALC) were found to have a negative impact on the survival outcomes in various tumors including NSCLC. 7 8 9 10 11 One study showed that high NLR is an independent predictive factor of baseline presence and subsequent development of brain metastasis in stage IV NSCLC. 12 However, that study included only 260 patients and the results were likely limited by the patient population comprised of only Korean lung cancer patients historically known to have higher rates of epidermal growth factor receptor (EGFR) mutations.…”

The clinical potential of circulating immune cell counts in primary gastric lymphoma

“…Several studies reported the correlation of NLR with poor prognosis in multiple cancer types, including gastric and pancreatic cancer, with NLR cutoff values ranging from 2.3 to 5, and sample sizes ranging from 65 to 502 patients (12,14,34). The variation in the NLR value reported could be attributed to the varying demographic characteristics of the patients, in addition to their race (29,35) as well as to possible concurrent infections.…”

“…Inflammation mediated by dysregulated levels of circulating immune cells and pro-inflammatory cytokines is associated with tumorigenesis, distant metastases, and overall patient survival in various cancer types (11,12). Nevertheless, the immediate linkage between inflammation and the pathophysiology of metastases is not completely understood.…”

Very high and very low levels of preoperative absolute monocyte count indicate poor long-term survival outcomes in patients with pancreatic adenocarcinoma. A preliminary study

“…As the rationale comes from AMC translation into the general anticancer immunity state, in our opinion it is justified to read them in context with each other, independently from the studied malignancy type. Until now there was only one study discussing this issue in PC patients (cut-off 0.6, p = 0.23) [5]. The approach of other authors was either dichotomic, or trichotomic, depending on the number Cox proportional hazard model survival function according to resectability and AMC status p = 0.0002 non-resectable, non-optimal AMC non-resectable, optimal AMC resectable, non-optimal AMC r esectable, optimal AMC Where k is the cut-off point set for the particular study group, so it is kind of an unfavourable balance between white blood cell type counts in peripheral blood.…”

“…Some cancers can secrete GM-CSF and G-CSF, influencing directly the white blood cell counts, but this phenomenon has not been explored in cases of PC [4]. High pretreatment absolute monocyte count (AMC) generally drives poor prognosis factors in many cancers, including PC [5]. There is significant evidence that monocytes may influence the course of PC, but their role cannot be easily translated into simple hypothesis linking them to pancreatic cancer.…”