Pretreatment neutrophil to lymphocyte and platelet to lymphocyte ratios as predictive factors for the survival of cervical adenocarcinoma patients

Our study assessed the clinical utility and prognostic value of pretreatment hematological parameters and calculated coefficients including the platelet to lymphocyte ratio (PLR), neutrophil to lymphocyte ratio (NLR), and monocyte to lymphocyte ratio (MLR) in patients with cervical adenocarcinoma (C...

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Bibliographic Details
Published in:Cancer management and research 2018-01, Vol.10, p.6029-6038
Main Authors: Jonska-Gmyrek, Joanna, Gmyrek, Leszek, Zolciak-Siwinska, Agnieszka, Kowalska, Maria, Fuksiewicz, Malgorzata, Kotowicz, Beata
Format: Article
Language:English
Subjects:
Adenocarcinoma
Blood
Blood platelets
Cancer patients
Cancer screening
Cancer therapies
Cervical adenocarcinoma
Cervical cancer
chemoradiotherapy
Diagnosis
Health aspects
hematological parameters
Histopathology
Inflammation
inflammatory parameters
Lung cancer
Lymphatic system
Lymphocytes
Medical prognosis
Neutrophils
Obstetrics
Oncology
Original Research
Prognosis
Radiation therapy
Risk factors
Studies
surgery
Systematic review
White blood cell count
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Summary:Our study assessed the clinical utility and prognostic value of pretreatment hematological parameters and calculated coefficients including the platelet to lymphocyte ratio (PLR), neutrophil to lymphocyte ratio (NLR), and monocyte to lymphocyte ratio (MLR) in patients with cervical adenocarcinoma (CA). Among 738 cervical cancer patients with International Federation of Gynecology and Obstetrics (FIGO) stages IA-IV treated at our institution, 96 (13%) presented with CA histology. The blood samples, collected within 10 days before treatment, were analyzed using a Sysmex XN-2000 system. The statistical tests included Mann-Whitney -tests, log-rank tests, and Cox regression models. The cutoff points for the calculated hematological coefficients (NLR, PLR, and MLR) were determined using the MedCalc statistical program. The prognostic factor for overall survival (OS) and recurrence-free survival (RFS) in CA was clinical stage according to FIGO classification (FIGO IIB-IV vs I-IIA) ( =0.0001; =0.002). Among patients with FIGO stage IIB-IV treated with radiotherapy/chemoradiotherapy, an elevated PLR was a negative prognostic factor for OS ( =0.017; HR: 2.96; 95% CI: 2.069-3.853). Among all patients, an elevated pretreatment NLR was a poor prognostic factor for OS ( =0.014; HR: 2.85; 95% CI: 2.011-3.685) and RFS ( =0.049; HR: 4.0; 95% CI: 2.612-5.392). The white blood cell count (WBC) before treatment was significantly higher in patients who died during follow-up ( =0.009). Elevated NLR values before treatment may be associated with a shorter time of RFS and OS, while PLR index may have prognostic significance for OS in patients with advanced disease (FIGO IIB-IV). Both indexes and WBC may be a cost-effective biomarker that can be used conveniently for stratification of recurrence risk and death.
ISSN:1179-1322
1179-1322
DOI:10.2147/CMAR.S178745