Prognostic Significance of Inflammatory Markers in Patients with Oral Cavity Cancers

Yıl 2020, , 271 - 277, 25.04.2020

Eda Erdiş , Birsen Yücel

https://doi.org/10.32448/entupdates.696940

Öz

Introduction: In the present study, we aimed to evaluate the relationship between neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) and systemic immune inflammation index (SII) values and overall survival (OS) and disease-free survival (DFS) in patients undergoing radiotherapy with a diagnosis of oral cavity cancer (OCC).
Methods: 58 patients were included who were treated with a diagnosis of OCC who applied to Cumhuriyet University Faculty of Medicine Radiation Oncology Clinic between January 2009 and December 2018. Kaplan-Meier analysis was used to determine OS and DFS. Multivariate Cox regression analysis was also performed to detect independent prognostic factors.
Results: All patients had a squamous cell carcinoma (SCC) of the oral cavity composed of 50 tongue SCC and 8 buccal SCC. Cut-off values in ROC analysis: 954 [Area=0.665 (0.511-0.800), p=0.06] for SII, 174 [Area=0.659 (0.608-0.795), p<.001] for PLR and 3.2 [Area=0.699 (0.556-0.841), p=0.016] for NLR. Prognostic factors affecting OS were SII, PLR, NLR and age. SII, NLR, PLR and grade were statistically significant prognostic factors for DFS. However, SII was an independent prognostic factor.
Conclusion: In this study, high SII value was found to be an indicator of shorter OS and DFS in patients with OCC.

Anahtar Kelimeler

Oral cancer, neutrophils, lymphocytes, platelets, inflammation

Kaynakça

• 1. Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics, 2012. CA Cancer J Clin 2015;65:87-108.
• 2. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin. 2019;69:7-34.
• 3. T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü. Türkiye Kanser İstatistikleri 2015. Ankara: 2018. p. 7-14.
• 4. Moore MM, Chua W, Charles KA, Clarke SJ. Inflammation and cancer: causes and consequences. Clin Pharmacol Ther 2010;87:504-8.
• 5. Stotz M, Gerger A, Eisner F, et al. Increased neutrophil-lymphocyte ratio is a poor prognostic factor in patients with primary operable and inoperable pancreatic cancer. Br J Cancer 2013;109:416-21.
• 6. Halazun KJ, Hardy MA, Rana AA, et al. Negative impact of neutrophil-lymphocyte ratio on outcome after liver transplantation for hepatocellular carcinoma. Ann Surg 2009;250:141-51.
• 7. Dan J, Zhang Y, Peng Z, et al. Postoperative neutrophil-to-lymphocyte ratio change predicts survival of patients with small hepatocellular carcinoma undergoing radiofrequency ablation. PLoS One 2013;8:e58184.
• 8. Gomez D, Farid S, Malik HZ, et al. Preoperative neutrophil-to-lymphocyte ratio as a prognostic predictor after curative resection for hepatocellular carcinoma. World J Surg 2008;32:1757-62.
• 9. Halazun KJ, Aldoori A, Malik HZ, et al. Elevated preoperative neutrophil to lymphocyte ratio predicts survival following hepatic resection for colorectal liver metastases. Eur J Surg Oncol 2008;34:55-60.
• 10. Kishi Y, Kopetz S, Chun YS, Palavecino M, Abdalla EK, Vauthey JN. Blood neutrophil-to-lymphocyte ratio predicts survival in patients with colorectal liver metastases treated with systemic chemotherapy. Ann Surg Oncol 2009;16:614-22.
• 11. Zhang Y, Peng Z, Chen M, et al. Elevated neutrophil to lymphocyte ratio might predict poor prognosis for colorectal liver metastasis after percutaneous radiofrequency ablation. Int J Hyperthermia 2012;28:132-40.
• 12. Gasic GJ, Gasic TB, Stewart CC. Antimetastatic effects associated with platelet reduction. Proc Natl Acad Sci U S A 1968;61:46-52.
• 13. Gasic GJ, Gasic TB, Galanti N, Johnson T, Murphy S. Platelet-tumor-cell interactions in mice. The role of platelets in the spread of malignant disease. Int J Cancer 1973;11:704-18.
• 14. Jin DK, Shido K, Kopp HG, et al. Cytokine-mediated deployment of SDF-1 induces revascularization through recruitment of CXCR4+ hemangiocytes. Nat Med 2006;12:557-67.
• 15. Hu B, Yang XR, Xu Y, et al. Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma. Clin Cancer Res 2014;20:6212-22.
• 16. Hong X, Cui B, Wang M, Yang Z, Wang L, Xu Q. Systemic Immune-inflammation Index, Based on Platelet Counts and Neutrophil-Lymphocyte Ratio, Is Useful for Predicting Prognosis in Small Cell Lung Cancer. Tohoku J Exp Med 2015;236:297-304.
• 17. Lolli C, Basso U, Derosa L, et al. Systemic immune-inflammation index predicts the clinical outcome in patients with metastatic renal cell cancer treated with sunitinib. Oncotarget 2016;7:54564-71.
• 18. Lolli C, Caffo O, Scarpi E, et al. Systemic Immune-Inflammation Index Predicts the Clinical Outcome in Patients with mCRPC Treated with Abiraterone. Front Pharmacol 2016;7:376.
• 19. Feng JF, Chen S, Yang X. Systemic immune-inflammation index (SII) is a useful prognostic indicator for patients with squamous cell carcinoma of the esophagus. Medicine (Baltimore) 2017;96:5886.
• 20. Koontongkaew S. The tumor microenvironment contribution to development, growth, invasion and metastasis of head and neck squamous cell carcinomas. J Cancer 2013;4:66-83.
• 21. Curry JM, Sprandio J, Cognetti D, et al. Tumor microenvironment in head and neck squamous cell carcinoma. Semin Oncol 2014;41:217-34.
• 22. Damar M, Dinç AE, Erdem D, et al. Pretreatment Neutrophil-Lymphocyte Ratio in Salivary Gland Tumors Is Associated with Malignancy. Otolaryngol Head Neck Surg 2016;155:988-96.
• 23. Kum RO, Ozcan M, Baklaci D, et al. Elevated neutrophil-to-lymphocyte ratio in squamous cell carcinoma of larynx compared to benign and precancerous laryngeal lesions. Asian Pac J Cancer Prev 2014;15:7351-5.
• 24. Hussain SP, Harris CC. Inflammation and cancer: an ancient link with novel potentials. Int J Cancer 2007;121:2373-80.
• 25. Jaiswal M, LaRusso NF, Burgart LJ, Gores GJ. Inflammatory cytokines induce DNA damage and inhibit DNA repair in cholangiocarcinoma cells by a nitric oxide-dependent mechanism. Cancer Res 2000;60:184-90.
• 26. Waldner M, Schimanski CC, Neurath MF. Colon cancer and the immune system: the role of tumor invading T cells. World J Gastroenterol 2006;12:7233-8.
• 27. Rachidi S, Wallace K, Wrangle JM, Day TA, Alberg AJ, Li Z. Neutrophil- to-lymphocyte ratio and overall survival in all sites of head and neck squamous cell carcinoma. Head Neck 2016;38:1068-74.
• 28. Ozturk K, Akyildiz NS, Uslu M, Gode S, Uluoz U. The effect of preoperative neutrophil, platelet and lymphocyte counts on local recurrence and survival in early-stage tongue cancer. Eur Arch Otorhinolaryngol 2016;273:4425-9.
• 29. Deveci İ, Sürmeli M. Correlation of Systemic Immune-Inflammation Index and Neutrophil-to-Lymphocyte Ratio with Histopathological Findings in Patients with Tongue Cancer. Haydarpasa Numune Med J 2018;58:122-7.
• 30. Chen S, Guo J, Feng C, Ke Z, Chen L, Pan Y. The preoperative platelet-lymphocyte ratio versus neutrophil-lymphocyte ratio: which is better as a prognostic factor in oral squamous cell carcinoma? Ther Adv Med Oncol 2016;8:160-7.
• 31. Ma H, Lin Y, Wang L, et al. Primary lymphoepithelioma-like carcinoma of salivary gland: sixty-nine cases with long-term follow-up. Head Neck 2014;36:1305-12.
• 32. Aziz MH, Sideras K, Aziz NA, et al. The Systemic-immune-inflammation Index Independently Predicts Survival and Recurrence in Resectable Pancreatic Cancer and its Prognostic Value Depends on Bilirubin Levels: a Retrospective Multicenter Cohort Study. Ann Surg 2019;270:139-46.
• 33. Dolan RD, Lim J, McSorley ST, Horgan PG, McMillan DC. The role of the systemic inflammatory response in predicting outcomes in patients with operable cancer: Systematic review and meta-analysis. Sci Rep 2017;7:16717.
• 34. Chen F, Lin L, Yan L, Qiu Y, Cai L, He B. Preoperative Neutrophil-to-Lymphocyte Ratio Predicts the Prognosis of Oral Squamous Cell Carcinoma: A Large-Sample Prospective Study. J Oral Maxillofac Surg 2017;75:1275-82.
• 35. 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;106:124.
• 36. 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;23:1204-12.
• 37. Chovanec M, Cierna Z, Miskovska V, et al. Systemic immune-inflammation index in germ-cell tumours. Br J Cancer 2018;118:831-8.