open access

Ahead of Print
Research paper
Published online: 2020-11-19
Get Citation

The analysis of the prognostic value of the neutrophil/ lymphocyte ratio and the platelet/lymphocyte ratio among advanced endometrial cancer patients

Konrad Piotr Muzykiewicz, Ewa Iwanska, Maja Janeczek, Izabela Glanowska, Kaziemierz Karolewski, Pawel Blecharz
DOI: 10.5603/GP.a2020.0164

open access

Ahead of Print
ORIGINAL PAPERS Gynecology
Published online: 2020-11-19

Abstract

Objectives: About 20% of endometrial cancer (EC) patients have advanced disease (FIGO III & IV) at the moment of diagnosis.
An attempt to evaluate the prognostic value of biochemical markers of inflammation and classic endometrial cancer
prognostic factors in the group of advanced EC (aEC) patients has been made in this study.
Material and methods: Records of 266 patients treated in the Maria Sklodowska-Curie Memorial Cancer Centre and Institute
of Oncology, Cracow Branch between the year 2006 and 2018 were included in the study. Follow-up ranged from 1 to
138 months. Progression free survival (PFS) and overall survival (OS) have been set as endpoints. Tests such as: chi-squared,
Fisher, log-rank, Mann-Whitney, Kruskal-Wallis and Cox proportional hazard ratio were used in the statistical analyses.
Results: In the analysed group high total platelet count (PLT) before operative treatment and high levels of white blood cells
(WBC), PLT, neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) before adjuvant therapy (AT) have been
significantly associated with shorter PFS and OS. After setting the cut-off values of NLR and PLR a statistically significant
correlation between those parameters and PFS as well as OS has been shown. Multivariate analysis has indicated that NLR
is an independent prognostic factor of the course of aEC.
Conclusions: NLR and PLR correlate significantly with OS and PFS in aEC. NLR is an independent prognostic factor in this
group. It is possible to distinguish 3 risk groups, among aEC patients, based on NRL and PLR.

Abstract

Objectives: About 20% of endometrial cancer (EC) patients have advanced disease (FIGO III & IV) at the moment of diagnosis.
An attempt to evaluate the prognostic value of biochemical markers of inflammation and classic endometrial cancer
prognostic factors in the group of advanced EC (aEC) patients has been made in this study.
Material and methods: Records of 266 patients treated in the Maria Sklodowska-Curie Memorial Cancer Centre and Institute
of Oncology, Cracow Branch between the year 2006 and 2018 were included in the study. Follow-up ranged from 1 to
138 months. Progression free survival (PFS) and overall survival (OS) have been set as endpoints. Tests such as: chi-squared,
Fisher, log-rank, Mann-Whitney, Kruskal-Wallis and Cox proportional hazard ratio were used in the statistical analyses.
Results: In the analysed group high total platelet count (PLT) before operative treatment and high levels of white blood cells
(WBC), PLT, neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) before adjuvant therapy (AT) have been
significantly associated with shorter PFS and OS. After setting the cut-off values of NLR and PLR a statistically significant
correlation between those parameters and PFS as well as OS has been shown. Multivariate analysis has indicated that NLR
is an independent prognostic factor of the course of aEC.
Conclusions: NLR and PLR correlate significantly with OS and PFS in aEC. NLR is an independent prognostic factor in this
group. It is possible to distinguish 3 risk groups, among aEC patients, based on NRL and PLR.

Get Citation

Keywords

advanced endometrial cancer; NLR; PLR; adjuvant treatment

About this article
Title

The analysis of the prognostic value of the neutrophil/ lymphocyte ratio and the platelet/lymphocyte ratio among advanced endometrial cancer patients

Journal

Ginekologia Polska

Issue

Ahead of Print

Article type

Research paper

Published online

2020-11-19

DOI

10.5603/GP.a2020.0164

Keywords

advanced endometrial cancer
NLR
PLR
adjuvant treatment

Authors

Konrad Piotr Muzykiewicz
Ewa Iwanska
Maja Janeczek
Izabela Glanowska
Kaziemierz Karolewski
Pawel Blecharz

References (26)
  1. GLOBOCAN 2018, Cancer Incidence Mortality and Prevalence Worldwide 2018. http://gco.iarc.fr/today.
  2. KRN – Krajowy Rejestr Nowotworów. http://onkologia.org.pl.
  3. Wojciechowska U, Czaderny K, Ciuba A, Olasek P, Didkowska J. Nowotwory złośliwe w Polsce w 2016 roku. Centrum Onkologii Instytut im. M. Skłodowskiej-Curie, Warszawa 2018.
  4. Balkwill F, Mantovani A. Inflammation and cancer: back to Virchow? Lancet. 2001; 357(9255): 539–545.
  5. Balkwill F, Charles KA, Mantovani A. Smoldering and polarized inflammation in the initiation and promotion of malignant disease. Cancer Cell. 2005; 7(3): 211–217.
  6. Coussens LM, Werb Z. Inflammation and cancer. Nature. 2002; 420(6917): 860–867.
  7. Petrie HT, Klassen LW, Kay HD. Inhibition of human cytotoxic T lymphocyte activity in vitro by autologous peripheral blood granulocytes. J Immunol. 1985; 134(1): 230–234.
  8. De Larco JE, Wuertz BRK, Furcht LT. The potential role of neutrophils in promoting the metastatic phenotype of tumors releasing interleukin-8. Clin Cancer Res. 2004; 10(15): 4895–4900.
  9. Mantovani A, Allavena P, Sica A, et al. Cancer-related inflammation. Nature. 2008; 454(7203): 436–444.
  10. Granot Z, Jablonska J. Distinct Functions of Neutrophil in Cancer and Its Regulation. Mediators Inflamm. 2015; 2015: 701067.
  11. Uribe-Querol E, Rosales C. Neutrophils in Cancer: Two Sides of the Same Coin. J Immunol Res. 2015; 2015: 983698.
  12. Thavaramara T, Phaloprakarn C, Tangjitgamol S, et al. Role of neutrophil to lymphocyte ratio as a prognostic indicator for epithelial ovarian cancer. J Med Assoc Thai. 2011; 94(7): 871–877.
  13. Raungkaewmanee S, Tangjitgamol S, Manusirivithaya S, et al. Platelet to lymphocyte ratio as a prognostic factor for epithelial ovarian cancer. J Gynecol Oncol. 2012; 23(4): 265–273.
  14. Ural ÜM, Şehitoğlu İ, Tekin YB, et al. Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in patients with endometrial hyperplasia and endometrial cancer. Obstet Gynaecol Res. 2014; 41(3): 445–448.
  15. Cummings M, Merone L, Keeble C, et al. Preoperative neutrophil:lymphocyte and platelet:lymphocyte ratios predict endometrial cancer survival. Br J Cancer. 2015; 113(2): 311–320.
  16. Gooden MJM, de Bock GH, Leffers N, et al. The prognostic influence of tumour-infiltrating lymphocytes in cancer: a systematic review with meta-analysis. Br J Cancer. 2011; 105(1): 93–103.
  17. Petrie HT, Klassen LW, Kay HD. Inhibition of human cytotoxic T lymphocyte activity in vitro by autologous peripheral blood granulocytes. J Immunol. 1985; 134(1): 230–234.
  18. McCourt M, Wang JH, Sookhai S, et al. Proinflammatory mediators stimulate neutrophil-directed angiogenesis. Arch Surg. 1999; 134(12): 1325–31; discussion 1331.
  19. Di Carlo E, Forni G, Musiani P. Neutrophils in the antitumoral immune response. Chem Immunol Allergy. 2003; 83: 182–203.
  20. Templeton AJ, McNamara MG, Šeruga B, et al. Prognostic role of neutrophil-to-lymphocyte ratio in solid tumors: a systematic review and meta-analysis. J Natl Cancer Inst. 2014; 106(6): dju124.
  21. Ethier JL, Desautels DN, Templeton AJ, et al. Is the neutrophil-to-lymphocyte ratio prognostic of survival outcomes in gynecologic cancers? A systematic review and meta-analysis. Gynecol Oncol. 2017; 145(3): 584–594.
  22. Imai T, Koike K, Kubo T, et al. Interleukin-6 supports human megakaryocytic proliferation and differentiation in vitro. Blood. 1991; 78(8): 1969–1974.
  23. Lippitz BE. Cytokine patterns in patients with cancer: a systematic review. Lancet Oncol. 2013; 14(6): e218–e228.
  24. Templeton AJ, Ace O, McNamara MG, et al. Prognostic role of platelet to lymphocyte ratio in solid tumors: a systematic review and meta-analysis. Cancer Epidemiol Biomarkers Prev. 2014; 23(7): 1204–1212.
  25. Aggarwal BB, Vijayalekshmi RV, Sung B. Targeting inflammatory pathways for prevention and therapy of cancer: short-term friend, long-term foe. Clin Cancer Res. 2009; 15(2): 425–430.
  26. Haruma T, Nakamura K, Nishida T, et al. Pre-treatment neutrophil to lymphocyte ratio is a predictor of prognosis in endometrial cancer. Anticancer Res. 2015; 35(1): 337–343.

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk
tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl