Vol 72, No 5 (2022)
Research paper (original)
Published online: 2022-08-22
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
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Nowotwory. Journal of Oncology 2022;72(5):282-287.
Abstract
Introduction.We aimed to assess the prognostic significance of preoperative absolute monocyte count (AMC) in baseline peripheral blood samples among pancreatic cancer (PC) patients as possible manifest signs of non-optimal immunity status.
Material and methods.PC patients who underwent palliative surgical treatment without earlier chemo- or radio-therapy (n = 59).
Results.Median AMC was comparable in each subgroup, showing no significant differences. We have adopted an arbitrary trichotomic AMC division: low (<0.4 G/l, n = 9), medium (>0.4 and ≤0.6 G/l, n = 36) and high (>0.6 G/l, n = 14). Optimal (medium AMC) and non-optimal (both low and high AMC) was independent and a statistically significant predictor of OS. Resectability and optimal AMC constituted best Cox proportional hazard model, being equivalent predictors of OS.
Conclusions.Baseline AMC status may be an independent predictor of OS in this group of patients. Further research is needed to explain the biological nature of this phenomenon more widely.
Keywords: pancreatic cancerimmune systemmonocyteslymphocyte-to-monocyte ratio (LMR)monocyte-tolymphocyte ratio (MLR)
References
- Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA Cancer J Clin. 2018; 68(1): 7–30.
- Cid-Arregui A, Juarez V. Perspectives in the treatment of pancreatic adenocarcinoma. World J Gastroenterol. 2015; 21(31): 9297–9316.
- Xu Z, Pothula SP, Wilson JS, et al. Pancreatic cancer and its stroma: a conspiracy theory. World J Gastroenterol. 2014; 20(32): 11216–11229.
- Matsuda A, Sasajima K, Matsutani T, et al. Aggressive undifferentiated colon carcinoma producing granulocyte-colony stimulating factor: report of a case. Surg Today. 2009; 39(11): 990–993.
- Abu-Shawer O, Abu-Shawer M, Shurman A, et al. The clinical value of peripheral immune cell counts in pancreatic cancer. PLoS One. 2020; 15(6): e0232043.
- Chinen J, Shearer WT. Secondary immunodeficiencies, including HIV infection. J Allergy Clin Immunol. 2010; 125(2 ): S195–S203.
- De Filippo E, Marra M, Alfinito F, et al. Hematological complications in anorexia nervosa. Eur J Clin Nutr. 2016; 70(11): 1305–1308.
- Gordon D, Drescher M, Shiber S. Security Hunger-Strike Prisoners in the Emergency Department: Physiological and Laboratory Findings. J Emerg Med. 2018; 55(2): 185–191.
- Guan M, Shinde AM, Hendifar AE. Frailty and Sarcopenia—Onset, Development and Clinical Challenges. IntechOpen Limited, London 2017.
- Herishanu Y, Kay S, Sarid N, et al. Absolute monocyte count trichotomizes chronic lymphocytic leukemia into high risk patients with immune dysregulation, disease progression and poor survival. Leuk Res. 2013; 37(10): 1222–1228.
- Bruckner HW, Lavin PT, Plaxe SC, et al. Absolute granulocyte, lymphocyte, and moncyte counts. Useful determinants of prognosis for patients with metastatic cancer of the stomach. JAMA. 1982; 247(7): 1004–1006.
- Wilcox RA, Ristow K, Habermann TM, et al. The absolute monocyte count is associated with overall survival in patients newly diagnosed with follicular lymphoma. Leuk Lymphoma. 2012; 53(4): 575–580.
- Irigoín V, Oliver C, López S, et al. Absolute monocyte count as a prognostic parameter in diffuse large B cell lymphoma. Rev Med Chil. 2019; 147(12): 1553–1560.
- Tadmor T, Fell R, Polliack A, et al. Absolute monocytosis at diagnosis correlates with survival in diffuse large B-cell lymphoma-possible link with monocytic myeloid-derived suppressor cells. Hematol Oncol. 2013; 31(2): 65–71.
- de Pádua Covas Lage LA, Hamasaki DT, Moreira FR, et al. Absolute monocyte count is a predictor of overall survival and progression-free survival in nodal peripheral T cell lymphoma. Ann Hematol. 2019; 98(9): 2097–2102.
- Sasaki A, Iwashita Y, Shibata K, et al. Prognostic value of preoperative peripheral blood monocyte count in patients with hepatocellular carcinoma. Surgery. 2006; 139(6): 755–764.
- Donskov F, von der Maase H. Impact of immune parameters on long-term survival in metastatic renal cell carcinoma. J Clin Oncol. 2006; 24(13): 1997–2005.
- Eo WK, Kwon BSu, Kim KiH, et al. Monocytosis as a prognostic factor for survival in stage IB and IIA cervical cancer. J Cancer. 2018; 9(1): 64–70.
- Leitch EF, Chakrabarti M, Crozier JEM, et al. Comparison of the prognostic value of selected markers of the systemic inflammatory response in patients with colorectal cancer. Br J Cancer. 2007; 97(9): 1266–1270.
- Schmidt H, Bastholt L, Geertsen P, et al. Elevated neutrophil and monocyte counts in peripheral blood are associated with poor survival in patients with metastatic melanoma: a prognostic model. Br J Cancer. 2005; 93(3): 273–278.
- Hu RJ, Ma JY, Hu G. Lymphocyte-to-monocyte ratio in pancreatic cancer: Prognostic significance and meta-analysis. Clin Chim Acta. 2018; 481: 142–146.
- Stotz M, Szkandera J, Stojakovic T, et al. The lymphocyte to monocyte ratio in peripheral blood represents a novel prognostic marker in patients with pancreatic cancer. Clin Chem Lab Med. 2015; 53(3): 499–506.
- Sierzega M, Lenart M, Rutkowska M, et al. Preoperative Neutrophil-Lymphocyte and Lymphocyte-Monocyte Ratios Reflect Immune Cell Population Rearrangement in Resectable Pancreatic Cancer. Ann Surg Oncol. 2017; 24(3): 808–815.
- Li GJ, Xu HW, Ji JJ, et al. Prognostic value of preoperative lymphocyte-to-monocyte ratio in pancreatic adenocarcinoma. Onco Targets Ther. 2016; 9: 1085–1092.
- Qi Q, Geng Y, Sun M, et al. Clinical implications of systemic inflammatory response markers as independent prognostic factors for advanced pancreatic cancer. Pancreatology. 2015; 15(2): 145–150.
- Wang L. Lymphocyte-to-monocyte ratio for predicting gemcitabine containing chemotherapy outcomes in pancreatic cancer patients. Journal of Clinical Oncology Conference. 2016; 34.
- 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.
- Xue P, Hang J, Huang W, et al. Validation of Lymphocyte-to-Monocyte Ratio as a Prognostic Factor in Advanced Pancreatic Cancer: An East Asian Cohort Study of 2 Countries. Pancreas. 2017; 46(8): 1011–1017.
- Kenig J, Richter P. Pancreatoduodenectomy due to cancer in the older population. Nowotwory. Journal of Oncology. 2021; 71(5): 321–327.
- Kiczmer P, Seńkowska AP, Szydło B, et al. Assessing the merits of existing pancreatic cancer biomarkers. Nowotwory. Journal of Oncology. 2017; 67(3): 201–205.