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Prognostic value of systemic inflammation response index in patients with persistent human papilloma virus infection
, 1, 1, 2, 1
Affiliations- Afyonkarahisar Health Science University Department of Gynecologic Oncology, Sakarya, Turkey, Türkiye
- Department of Gynecologic Oncology, Sakarya Training and Research Hospital, Turkey
open access
Abstract
Objectives: Persistent human papilloma virus (HPV) infection is a risk factor for the progression of cervical neoplasia into invasive carcinoma. Many inflammatory markers obtaining from hemogram parameters as platelets, monocytes, lymphocytes, and neutrophils or their ratios are still under investigation in recent decades, especially in the oncology era. Indeed, there have not been enough data about the relationship between these parameters and cervical cancer in the literature. Our primary aim was to investigate the possible relationship between the persistent HPV, which is one of the significant risk factors of cervical cancer, and these inflammatory markers. Further, we can add an easy follow-up parameter in women with persistent HPV infection.
Material and methods: The study included patients between 30–65 years old, tested positive for HPV, and afterward had an HPV control test between January 2015 and June 2020.
Results: The study included 114 HPV DNA-positive patients. The mean age was 43 (standard deviation 8.7), and 41 of them (36%) had persistent HPV, but the remaining 73 (64%) did not. The baseline neutrophil/lymphocyte ratio (NLR) value was 2.1, platelet/lymphocyte ratio (PLR) was 133, monocyte/lymphocyte ratio (MLR) was 0.28, and systemic inflammation response index (SIRI) was 0.9. All the parameters were significantly higher in the persistent HPV group compared to the non-persistent group. Patients who had 0.65 and under this had a significantly lower risk of persistent HPV.
Conclusions: Persistent HPV disease can be predicted with an elevated SIRI, NLR, and other hematologic parameters. So, we can closely follow up with these patients with different algorithms to prevent cervical cancer.
Abstract
Objectives: Persistent human papilloma virus (HPV) infection is a risk factor for the progression of cervical neoplasia into invasive carcinoma. Many inflammatory markers obtaining from hemogram parameters as platelets, monocytes, lymphocytes, and neutrophils or their ratios are still under investigation in recent decades, especially in the oncology era. Indeed, there have not been enough data about the relationship between these parameters and cervical cancer in the literature. Our primary aim was to investigate the possible relationship between the persistent HPV, which is one of the significant risk factors of cervical cancer, and these inflammatory markers. Further, we can add an easy follow-up parameter in women with persistent HPV infection.
Material and methods: The study included patients between 30–65 years old, tested positive for HPV, and afterward had an HPV control test between January 2015 and June 2020.
Results: The study included 114 HPV DNA-positive patients. The mean age was 43 (standard deviation 8.7), and 41 of them (36%) had persistent HPV, but the remaining 73 (64%) did not. The baseline neutrophil/lymphocyte ratio (NLR) value was 2.1, platelet/lymphocyte ratio (PLR) was 133, monocyte/lymphocyte ratio (MLR) was 0.28, and systemic inflammation response index (SIRI) was 0.9. All the parameters were significantly higher in the persistent HPV group compared to the non-persistent group. Patients who had 0.65 and under this had a significantly lower risk of persistent HPV.
Conclusions: Persistent HPV disease can be predicted with an elevated SIRI, NLR, and other hematologic parameters. So, we can closely follow up with these patients with different algorithms to prevent cervical cancer.
Keywords
systemic inflammation response index; neutrophil to lymphocyte ratio; platelet to lymphocyte ratio, persistent HPV
About this articleTitle
Prognostic value of systemic inflammation response index in patients with persistent human papilloma virus infection
Journal
Issue
Article type
Research paper
Pages
705-709
Published online
2022-02-01
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4611
Article views/downloads
686
DOI
Pubmed
Bibliographic record
Ginekol Pol 2022;93(9):705-709.
Keywords
systemic inflammation response index
neutrophil to lymphocyte ratio
platelet to lymphocyte ratio
persistent HPV
Authors
Filiz Bilir
Mariam Chkhikvadze
Ayşe Yalçinkaya Yilmaz
Osman Kose
Dagıstan Tolga Arıöz
References (33)- Zhang L, Bi Q, Deng H, et al. Human papillomavirus infections among women with cervical lesions and cervical cancer in Eastern China: genotype-specific prevalence and attribution. BMC Infect Dis. 2017; 17(1): 107.
- Gultekin M, Dundar S, Keskinkilic B, et al. How to triage HPV positive cases: results of four million females. Gynecol Oncol. 2020; 158(1): 105–111.
- Tunç SY, Onan MA, Turp AB, et al. Prevalence and types of cervical human papillomavirus among Turkish women and its relationship with demographic factors in a gynecology outpatient clinic. Eur J Gynaecol Oncol. 2016; 37(1): 53–58.
- Beyazit F, Sılan F, Gencer M, et al. The prevelance of human papillomavirus (HPV) genotypes detected by PCR in women with normal and abnormal cervico-vaginal cytology. Ginekol Pol. 2018; 89(2): 62–67.
- Demirtas D, Bilir C, Demirtas AO, et al. The effects of zoledronic acid on ECG: a prospective study on patients with bone metastatic cancer. Clin Cases Miner Bone Metab. 2017; 14(1): 35–39.
- Snijders PJF, Steenbergen RDM, Heideman DAM, et al. HPV-mediated cervical carcinogenesis: concepts and clinical implications. J Pathol. 2006; 208(2): 152–164.
- Koshiol J, Lindsay L, Pimenta JM, et al. Persistent human papillomavirus infection and cervical neoplasia: a systematic review and meta-analysis. Am J Epidemiol. 2008; 168(2): 123–137.
- Trottier H, Mahmud SM, Lindsay L, et al. GSK HPV-001 Vaccine Study Group. Persistence of an incident human papillomavirus infection and timing of cervical lesions in previously unexposed young women. Cancer Epidemiol Biomarkers Prev. 2009; 18(3): 854–862.
- Chao B, Ju X, Zhang L, et al. A novel prognostic marker Systemic Inflammation Response Index (SIRI) for operable cervical cancer patients. Front Oncol. 2020; 10: 766.
- Geng Y, Shao Y, Zhu D, et al. Systemic immune-inflammation index predicts prognosis of patients with esophageal squamous cell carcinoma: a propensity score-matched analysis. Sci Rep. 2016; 6: 39482.
- Tokunaga R, Sakamoto Y, Nakagawa S, et al. Comparison of systemic inflammatory and nutritional scores in colorectal cancer patients who underwent potentially curative resection. Int J Clin Oncol. 2017; 22(4): 740–748.
- Qi Qi, Zhuang L, Shen Y, et al. A novel systemic inflammation response index (SIRI) for predicting the survival of patients with pancreatic cancer after chemotherapy. Cancer. 2016; 122(14): 2158–2167.
- Darragh TM, Colgan TJ, Thomas Cox J, et al. Members of the LAST Project Work Groups. The lower anogenital squamous terminology standardization project for HPV-associated lesions: background and consensus recommendations from the College of American Pathologists and the American Society for Colposcopy and Cervical Pathology. Int J Gynecol Pathol. 2013; 32(1): 76–115.
- Burd EM. Human papillomavirus and cervical cancer. Clin Microbiol Rev. 2003; 16(1): 1–17.
- Viruses in human cancers. Proc Assoc Am Physicians. 1999; 111(6): 581–587.
- Franco EL. Cancer causes revisited: human papillomavirus and cervical neoplasia. J Natl Cancer Inst. 1995; 87(11): 779–780.
- Walboomers JM, Jacobs MV, Manos MM, et al. Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. J Pathol. 1999; 189(1): 12–19, doi: 10.1002/(SICI)1096-9896(199909)189:1<12::AID-PATH431>3.0.CO;2-F.
- Chen Y, Jiang W, Xi D, et al. Development and validation of nomogram based on SIRI for predicting the clinical outcome in patients with nasopharyngeal carcinomas. J Investig Med. 2019; 67(3): 691–698.
- Huang H, Liu Q, Zhu L, et al. Prognostic value of preoperative systemic immune-inflammation index in patients with cervical cancer. Sci Rep. 2019; 9(1): 3284.
- O'Brien PM, Bäckström T, Brown C, et al. Towards a consensus on diagnostic criteria, measurement and trial design of the premenstrual disorders: the ISPMD Montreal consensus. Arch Womens Ment Health. 2011; 14(1): 13–21.
- Nobbenhuis MA, Walboomers JM, Helmerhorst TJ, et al. Relation of human papillomavirus status to cervical lesions and consequences for cervical-cancer screening: a prospective study. Lancet. 1999; 354(9172): 20–25.
- Cho KM, Park H, Oh DY, et al. Neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and their dynamic changes during chemotherapy is useful to predict a more accurate prognosis of advanced biliary tract cancer. Oncotarget. 2017; 8(2): 2329–2341.
- Hoskin PJ, Rojas AM, Peiris SN, et al. Pre-treatment haemoglobin and peripheral blood lymphocyte count as independent predictors of outcome in carcinoma of cervix. Clin Oncol (R Coll Radiol). 2014; 26(4): 179–184.
- Wu ES, Oduyebo T, Cobb LP, et al. Lymphopenia and its association with survival in patients with locally advanced cervical cancer. Gynecol Oncol. 2016; 140(1): 76–82.
- 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.
- Jayshree RS. The immune microenvironment in human papilloma virus-induced cervical lesions-evidence for estrogen as an immunomodulator. Front Cell Infect Microbiol. 2021; 11: 649815.
- de Vos van Steenwijk PJ, Ramwadhdoebe TH, Goedemans R, et al. Tumor-infiltrating CD14-positive myeloid cells and CD8-positive T-cells prolong survival in patients with cervical carcinoma. Int J Cancer. 2013; 133(12): 2884–2894.
- Hubert P, Caberg JH, Gilles C, et al. E-cadherin-dependent adhesion of dendritic and Langerhans cells to keratinocytes is defective in cervical human papillomavirus-associated (pre)neoplastic lesions. J Pathol. 2005; 206(3): 346–355.
- Dai X, Tohyama M, Murakami M, et al. Epidermal keratinocytes sense dsRNA via the NLRP3 inflammasome, mediating interleukin (IL)-1β and IL-18 release. Exp Dermatol. 2017; 26(10): 904–911.
- Shannon B, Yi TJ, Perusini S, et al. Association of HPV infection and clearance with cervicovaginal immunology and the vaginal microbiota. Mucosal Immunol. 2017; 10(5): 1310–1319.
- Reva IV, Reva GV, Yamamoto T, et al. Distribution of antigen-presenting cells CD68 in papillomavirus infection in the skin. Bull Exp Biol Med. 2014; 157(1): 56–61.
- Bashaw AA, Leggatt GR, Chandra J, et al. Modulation of antigen presenting cell functions during chronic HPV infection. Papillomavirus Res. 2017; 4: 58–65.
- Wentzensen N, Schwartz L, Zuna RE, et al. Performance of p16/Ki-67 immunostaining to detect cervical cancer precursors in a colposcopy referral population. Clin Cancer Res. 2012; 18(15): 4154–4162.
