Prognostic significance of neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, platelet/neutrophil ratio, and mean platelet volume in patients diagnosed with Hodgkin and Non-Hodgkin Lymphoma

Yıl 2020, , 345 - 353, 30.12.2020

Mesut Göçer , Erdal Kurtoğlu

https://doi.org/10.18663/tjcl.767943

Öz

Aim: We aimed to show whether easily accessible NLR, PLR, PNR and MPV values can be used as prognostic markers in lymphoma subtypes and whether they can contribute to existing prognostic scoring systems.
Material and Methods: The records of all lymphoma patients between 2005-2019 were reviewed retrospectively. NLR, PLR, PNR and MPV values at the time of diagnosis were compared with Progression-Free Survival (PFS) and Overall Survival (OS) durations.
Results: PLR and NLR values in Marginal Zone Lymphoma (MZL) and PNR and MPV values in Diffuse Large B-cell Lymphoma (DLBCL) were found to be associated with prognosis and to have a direct effect on PFS and OS. Except for these parameters, we found that lactate dehydrogenase (LDH), MPV, age, stage and histological subtype had an effect on prognosis for all patients.
Conclusion: It has been concluded that PLR and NLR can be used as prognostic factors in MZL, whereas PNR and MPV can be used as prognostic factors in DLBCL, and that these values can be used as easily accessible methods in disease prognosis scores.

Anahtar Kelimeler

Lymphoma, prognostic score, pnr, mpv, pfs, os

Hodgkin ve Non-Hodgkin Lenfoma tanılı hastalarda nötrofil/lenfosit oranı, trombosit/lenfosit oranı, trombosit/nötrofil oranı ve ortalama trombosit hacminin prognostik önemi

Öz

Amaç: Kolay ulaşılabilir NLR, PLR, PNR ve MPV değerlerinin lenfoma alt tiplerinde prognostik belirteç olarak kullanılıp kullanılamayacağını ve mevcut prognostik skorlama sistemlerine ek katkı sağlayıp sağlayamayacağını göstermeyi amaçladık.
Gereç ve Yöntemler: 2005-2019 tarihleri arasında ki tüm lenfoma hastalarının kayıtları retrospektif olarak incelenmiştir. Tanı anında ki NLR, PLR, PNR ve MPV değerleri ile PFS ve OS süreleri karşılaştırılmıştır.
Bulgular: Marjinal zone lenfomada PLR ve NLR değerleri ve DBBHL’da da PNR ve MPV değerlerinin prognoz ile ilişkili olduğu, PFS ve OS üzerine doğrudan etkisi olduğu saptandı. Bu parametreler dışında tüm hasta grubu için LDH, MPV, yaş, evre ve histolojik alt tipin prognoz üzerinde etkili olduğunu saptadık.
Sonuçlar: Sonuç olarak PLR ve NLR Marjinal Zone lenfomada, PNR ve MPV’de DBBHL da prognostik faktör olarak kullanabilir. Hastalık prognoz skorlarında kolay ulaşılabilir yöntemler olarak yerlerini alabilirler.

Anahtar Kelimeler

lenfoma, prognoz skoru, pnr, mpv, pfs, os

Kaynakça

• 1. Armitage JO, Weisenburger DD. New approach to classifying non-Hodgkin’s lymphomas: clinical features of the major histologic subtypes. Non-Hodgkin’s lymphoma classification project. J Clin Oncol 1998; 16: 2780-95.
• 2. Swerdlow SH, Campo E, Pileri SA et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood 2016; 127: 2375-90.
• 3. Wang J, Zhou M, Xu JY et al. MYC and BCL-2 adjusted-International Prognostic Index (A-IPI) is a better predictor of outcome than the standard IPI for patients with diffuse large B-cell lymphoma treated with R-CHOP. Histol Histopathol 2016; 31: 285–92.
• 4. Serrano CV, Mattos FR, Pitta FG et al. Association between Neutrophil-Lymphocyte and Platelet-Lymphocyte Ratios and Coronary Artery Calcification Score among Asymptomatic Patients: Data from a Cross-Sectional Study. Mediators Inflamm 2019; 2019: 6513847
• 5. Kirlioglu SS, Balcioglu YH, Kalelioglu T, Erten E, Karamustafalioglu N. Comparison of the complete blood count-derived inflammatory markers in bipolar patients with manic and mixed episodes. Bratisl Lek Listy 2019; 120: 195-9.
• 6. Zahorec R. Ratio of neutrophil to lymphocyte counts--rapid and simple parameter of systemic inflammation and stress in critically ill. Bratisl Lek Listy 2001; 102: 5-14.
• 7. Jiang Y, Zang M, Li S. Serum PLR and LMR in Behçet's disease: Can they show the disease activity? Medicine (Baltimore) 2017; 96: 6981
• 8. Szor DJ, Dias AR, Pereira MA et al. Prognostic Role of Neutrophil/Lymphocyte Ratio in Resected Gastric Cancer: A Systematic Review and Meta-analysis. Clinics 2018; 73: 360
• 9. Temur I, Gulec UK, Paydas S et al. Prognostic value of pre-operative neutrophil/lymphocyte ratio, monocyte count, mean platelet volume, and platelet/lymphocyte ratio in endometrial cancer. European Journal of Obstetrics & Gynecology and Reproductive Biology 2018; 226: 25–9.
• 10. 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.
• 11. Kang MH, Go SI, Song HN et al. The prognostic impact of the neutrophil- to-lymphocyte ratio in patients with small-cell lung cancer. Br J Cancer 2014; 111: 452-60.
• 12. Proctor MJ, Morrison DS, Talwar D et al. A comparison of inflammation-based prognostic scores in patients with cancer. A Glasgow Inflammation Outcome Study. Eur J Cancer 2011; 47: 2633-41.
• 13. Dow RB. The Clinical and laboratory utility of trombosit volume parameters. Jnl Medical Science 1994; 15: 1-15.
• 14. Suh DH, Kim HS, Chung HH et al. Pre-operative systemic inflammatory response markers in predicting lymph node metastasis in endometrioid endometrial adenocarcinoma. Eur J Obstet Gynecol Reprod Biol 2012; 162: 206-10.
• 15. Lee SF, Luque-Fernandez MA. Prognostic value of lymphocyte-to-monocyte ratio and neutrophil-to lymphocyte ratio in follicular lymphoma: a retrospective cohort study. BMJ Open 2017; 7: 017904.
• 16. Go S, Kim JH, Kim HR et al. A new prognostic model using the NCCN-IPI and neutrophil-to-lymphocyte ratio in diffuse large B-cell lymphoma. Tumori 2018 ;104: 292-9.
• 17. Reddy JP, Hernandez M, Gunther JR et al. Pre-treatment neutrophil/lymphocyte ratio and platelet/lymphocyte ratio are prognostic of progression in early stage classical Hodgkin lymphoma Br J Haematol 2018; 180: 545-9.
• 18. Zhou S, Ma Y, Shi Y et al. Mean platelet volume predicts prognosis in patients with diffuse large B‐cell lymphoma. Hematological Oncology. 2017; 1–6.
• 19. Wang J, Zhou M, Xu JY et al. Prognostic role of pretreatment neutrophil lymphocyte ratio in patients with diffuse large B-cell lymphoma treated with RCHOP. Medicine 2016; 95: 38.
• 20. Moore MM, Chua W, Charles KA, Clarke SJ. Inflammation and cancer: causes and consequences. Clin Pharmacol Ther 2010; 87: 504-8.
• 21. Shalapour S, Karin M. Immunity, inflammation, and cancer: an eternal fight between good and evil. J Clin Invest 2015; 125: 3347-55.
• 22. Jackson JR, Seed MP, Kircher CH, Willoughby DA, Winkler JD. The codependence of angiogenesis and chronic inflammation. FASEB J 1997; 11: 457-65.
• 23. Mizunuma M, Yokoyama Y, Futagami M, Aoki M, Takai Y, Mizunuma H. The pretreatment neutrophil-to-lymphocyte ratio predicts therapeutic response to radiation therapy and concurrent chemoradiation therapy in uterine cervical cancer. Int J Clin Oncol 2015; 20: 989-96.
• 24. Romano A, Parrinello NL, Vetro C et al. Prognostic meaning of neutrophil to lymphocyte ratio (NLR) and lymphocyte to monocyte ration (LMR) in newly diagnosed Hodgkin lymphoma patients treated upfront with a PET-2 based strategy. Ann Hematol 2018; 97: 1009-18
• 25. Kelkitli E, Atay H, Cilingir F et al Predicting survival for multiple myeloma patients using baseline neutrophil/lymphocyte ratio. Ann Hematol 2014; 93: 841–6.
• 26. Ho CL, Lu CS, Chen JH, Chen YG, Huang TC, Wu YY. Neutrophil/Lymphocyte Ratio, Lymphocyte/Monocyte Ratio, and Absolute Lymphocyte Count/Absolute Monocyte Count Prognostic Score in Diffuse Large B-Cell Lymphoma Useful Prognostic Tools in the Rituximab Era. Medicine (Baltimore) 2015; 94: 993
• 27. Seo J, Kim WS, Kim JS et al. Platelet to lymphocyte ratio (PLR) retains independent prognostic significance in advanced stage marginal zone lymphoma patients treated with rituximab, cyclophosphamide, vincristine, and prednisone combination chemotherapy (R-CVP): Consortium for Improving Survival of Lymphoma trial. Blood Res 2017; 52: 200-6.
• 28. Ni J, Wang YQ, Zhang YP et al. Value of Neutrophil/Lymphocyte Ratio and Platelet/Lymphocyte Ratio for Prognostic Evaluation of Diffuse Large B-cell Lymphoma. Zhongguo Shi Yan Xue Ye Xue Za Zhi 2016; 24: 427-32
• 29. Mercier J, Voutsadakis IA. The platelets-neutrophils to lymphocytes ratio: a new prognostic marker in metastatic colorectal cancer J Gastrointest Oncol 2018; 9: 478-86.
• 30. Choi M, Lee JO, Jung J et al. Prognostic Value of Platelet Count in Patients with Peripheral T Cell Lymphoma. Acta Haematol 2019; 141: 176–86.
• 31. Rupa-Matysek J, Gil L, Kroll-Balcerzak R, Barańska M, Komarnicki M. Mean platelet volume as a predictive marker for venous thromboembolism and mortality in patients treated for diffuse large B-cell lymphoma. Hematol Oncol. 2017; 35: 456-64
• 32. Meng X, Chang Q, Liu Y et al. Determinant roles of gender and age on SII, PLR, NLR, LMR and MLR and their reference intervals defining in Henan, China: A posteriori and big-data-based. J Clin Lab Anal 2018; 32: 22228.