The relationship of systemic inflammatory biomarkers and cardiac parameters with malignancy in patients with soft tissue tumors located in the extremity

Abstract

Objectives In this study, we aimed to investigate the contribution of systemic inflammatory biomarkers to the diagnosis and to examine the relationship between cardiac parameters and malignancy in patients with extremity soft tissue sarcomas (STSs). Patients and methods Between January 2011 and December 2020, a total of 256 patients (155 males, 101 females; median age: 50 years; range, 18 to 87 years) who were diagnosed with benign and malignant soft tissue tumors were retrospectively analyzed. The control group consisted of a total of 150 age- and sex-matched healthy individuals (83 males, 67 females; median age: 52 years; range 19 to 76 years) with complete blood count analysis and having no STS. Demographic characteristics, laboratory parameters, and echocardiographic data of the patients were obtained from the hospital database. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were calculated. Results Of a total of 256 patients included, 99 were diagnosed with benign tumors and 157 with malignant tumors. Lipoma was observed with the highest frequency of 40.4% among benign tumors, while malignant mesenchymal tumor (35.0%) was the most common tumor in the malignant group. There was no significant difference between the control and benign groups (p=0.198 and p=0.553, respectively), while the NLR and PLR of the malignant group were higher than both the control and benign groups, indicating a statistical significance (p<0.001). Total cholesterol, albumin, and ejection fraction (EF) levels of patients in the malignant group were significantly lower than the benign group (p=0.01, p<0.001, and p=0.046, respectively). According to the receiver operating characteristic curve, a cut-off value of 2.17 for NLR (sensitivity=64.1%, specificity=72%) and a cut-off value of 138.2 for PLR (sensitivity=60.9%, specificity=60.7%) were determined to distinguish malignant patients from healthy individuals. To distinguish malignant patients from the benign group, the cut-off values of NLR and PLR were 2.24 (sensitivity=62.8%, specificity=67.7%) and 137.9 (sensitivity=61%, specificity= 59.6%), respectively. Conclusion Our study results suggest that NLR and PLR can be used as diagnostic markers in malignant soft tissue tumors located in the extremities. In addition, total cholesterol, albumin, and EF values are lower than normal in malignant soft tissue tumors.

Does the preoperative neutrophil-to-lymphocyte ratio have a prognostic value in aneurysmal bone cysts?

“…Hematological parameters such as NLR, PLR, and LMR have been shown to be altered by systemic inflammatory response and are not only being used comprehensively in musculoskeletal tumors, but also in the diagnosis and evaluation of prognosis in hip fractures and many other tumors. [14][15][16][17][18] Recently, these hematological parameters have also been used as prognostic factors in musculoskeletal tumors such as soft tissue sarcomas, [19] pigmented villonodular synovitis, [20] and osteosarcoma. [10,11,21,22] In a study including patients with osteosarcoma, pre-treatment NLR and PLR values were related to survival and, particularly, NLR was concluded to be a good predictor of overall survival and progression-free survival.…”