Influence of CA125, platelet count and neutrophil to lymphocyte ratio on the immune system of ovarian cancer patients

Abstract Background Neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS) is the recommended approach in patients with advanced epithelial ovarian cancer (EOC). However, most patients eventually relapse despite the initial high response rate to chemotherapy. Neutrophil-to-lymphocyte ratio is a well-known biomarker that reflects severe inflammation, critical illness, and mortality in various diseases. Chemotherapy response score (CRS) and neutrophil-to-lymphocyte ratio (NLR) have been identified as potential biomarkers of platinum resistance and disease prognosis. We retrospectively evaluated 132 patients with stage IIIc or IV ovarian/fallopian tube/primary peritoneal cancer who had received NACT followed by IDS from 01/01/2003 to 31/12/2018. CRS was assessed on omental specimens collected from IDS according to ICCR guidelines. Results Median age was 64.57 years (SD: 9.72; range 39.2–87.1). Most ovarian tumors were serous epithelial (90.9%; 120/132). An elevated NLR (defined as > 3) was observed in 72% (95/132) of patients in contrast with 28% (37/132) of patients characterized by low NLR status. Median PFS (mPFS) and median overall survival (mOS) were 13.05 months (95% CI: 11.42–14.67)) and 34.69 months (95% CI: 23.26–46.12) respectively. In univariate analysis, CRS3 score was significantly associated with prolonged mPFS (CRS1/2: 12.79 months vs CRS3: 17.7 months; P = 0.008). CRS score was not associated with mOS (P = 0.876). High NLR was not significantly associated with mPFS (P = 0.128), however it was significantly associated with poor mOS (P = 0.012). In multivariate analysis, only performance of surgery maintained its statistical significance with both PFS (P = 0.001) and OS (P = 0.008). Conclusion NLR could serve as a useful predictor of OS but not PFS in ovarian cancer patients receiving NACT. In accordance with our previous study, CRS score at omentum was found to be associated with PFS but not OS in ovarian cancer patients treated with NACT and IDS.

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Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio are predictive of chemotherapeutic response and prognosis in epithelial ovarian cancer patients treated with platinum-based chemotherapy

Cancer Biomarkers ◽

10.3233/cbm-160614 ◽

2016 ◽

Vol 17 (1) ◽

pp. 33-40 ◽

Cited By ~ 36

Author(s):

Yi Miao ◽

Qin Yan ◽

Shuangdi Li ◽

Bilan Li ◽

Youji Feng

Keyword(s):

Ovarian Cancer ◽

Epithelial Ovarian Cancer ◽

Cancer Patients ◽

Neutrophil To Lymphocyte Ratio ◽

Platelet To Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Chemotherapeutic Response ◽

Platinum Based Chemotherapy

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Preoperative neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio can assist in prediction of optimal cytoreduction in epithelial ovarian cancer patients

Gynecologic Oncology ◽

10.1016/j.ygyno.2020.05.199 ◽

2020 ◽

Vol 159 ◽

pp. 145-146

Author(s):

O. Tal ◽

O.D. Feldstein ◽

O. Elyashiv ◽

E. Ben Shem ◽

O. Peled ◽

...

Keyword(s):

Ovarian Cancer ◽

Epithelial Ovarian Cancer ◽

Cancer Patients ◽

Neutrophil To Lymphocyte Ratio ◽

Optimal Cytoreduction ◽

Platelet To Lymphocyte Ratio ◽

Lymphocyte Ratio

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Neutrophil-to-Lymphocyte Ratio in Ovarian Cancer Patients with Low CA125 Concentration

BioMed Research International ◽

10.1155/2019/8107906 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7

Author(s):

Hongyan Zhang ◽

Qianyu Huo ◽

Lunhui Huang ◽

You Cheng ◽

Yunde Liu ◽

...

Keyword(s):

Ovarian Cancer ◽

Cancer Screening ◽

Physical Examination ◽

Cancer Patients ◽

False Negative ◽

Neutrophil To Lymphocyte Ratio ◽

Healthy Controls ◽

Ovarian Cancer Screening ◽

Lymphocyte Ratio ◽

Routine Physical Examination

Ovarian cancer cases with low CA125 concentration are problematic and increase the high false negative results ratio during routine physical examination testing. Unfortunately, patients without early discovery have very low survival rates. In our study, we investigated the possible role of differential leukocyte counts and the neutrophil-to-lymphocyte ratio (NLR) in ovarian cancer patients to identify an additional discriminative marker to avoid missing diagnoses in normal physical examinations. One hundred seventy-three patients with epithelial ovarian cancer and 70 healthy controls were involved in our study. Based on the results, compared with the healthy controls, NLR was significantly different both in the low CA125 concentration group and in the complete patient group, indicating that NLR could be an effective marker for ovarian cancer screening. According to ROC, sensitivity, specificity, and NPV results, CA125 >35 U/ml is a good indicator for cancer in routine physical examination. However, in patients with low CA125 concentration, the CA125>7.65 U/ml and NLR >1.72 group yielded increased sensitivity with appropriate specificity and higher NPV results than the CA125 >35 U/ml group. We believe CA125>7.65 U/ml and NLR >1.72 should be effective makers for patients with low CA125 concentration. As a more sensitive and cost-effective strategy, this method could be conducted during routine ovarian cancer screening.

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944P The prognostic role of COP-NLR score (combination of platelet count and neutrophil to lymphocyte ratio) in locally advanced nasopharyngeal cancer patients

Annals of Oncology ◽

10.1016/j.annonc.2020.08.1059 ◽

2020 ◽

Vol 31 ◽

pp. S673

Author(s):

A.F. Achmad ◽

J. Kurnianda ◽

S.H. Hutajulu

Keyword(s):

Platelet Count ◽

Cancer Patients ◽

Locally Advanced ◽

Nasopharyngeal Cancer ◽

Neutrophil To Lymphocyte Ratio ◽

Prognostic Role ◽

Lymphocyte Ratio ◽

Score Combination

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Neutrophil-to-Lymphocyte Ratio and Chemotherapy Response Score as prognostic markers in ovarian cancer patients treated with Neoadjuvant Chemotherapy

10.21203/rs.3.rs-667991/v1 ◽

2021 ◽

Author(s):

Michalis Liontos ◽

Angeliki Andrikopoulou ◽

Konstantinos Koutsoukos ◽

Christos Markellos ◽

Efthymia Skafida ◽

...

Keyword(s):

Ovarian Cancer ◽

Cancer Patients ◽

Statistical Significance ◽

Univariate Analysis ◽

High Response Rate ◽

Neutrophil To Lymphocyte Ratio ◽

Platinum Resistance ◽

Chemotherapy Response ◽

Lymphocyte Ratio ◽

Response Score

Abstract BackgroundNeoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS) is the recommended approach in patients with advanced epithelial ovarian cancer (EOC). However, most patients eventually relapse despite the initial high response rate to chemotherapy. Chemotherapy response score (CRS) and neutrophil-to-lymphocyte ratio (NLR) have been identified as potential biomarkers of platinum resistance and disease prognosis. We retrospectively evaluated 132 patients with stage IIIc or IV ovarian/fallopian tube/primary peritoneal cancer who had received NACT followed by IDS from 01/01/2003 to 31/12/2018. CRS was assessed on omental specimens collected from IDS according to ICCR guidelines. ResultsMedian age was 64.57 years (SD: 9.72; range 39.2 - 87.1). Most ovarian tumors were serous epithelial (90.9%; 120/132). An elevated NLR (defined as > 3) was observed in 72% (95/132) of patients in contrast with 28% (37/132) of patients characterized by low NLR status. Median PFS (mPFS) and median overall survival (mOS) were 13.05 months (95% CI: 11.42-14.67)) and 34.69 months (95% CI: 23.26 - 46.12) respectively. In univariate analysis, CRS3 score was significantly associated with prolonged mPFS (CRS1/2: 12.79 months vs CRS3: 17.7 months; P= 0.008). CRS score was not associated with mOS (P=0.876). High NLR was not significantly associated with mPFS (P=0.128), however it was significantly associated with poor mOS (P=0.012). In multivariate analysis, only performance of surgery maintained its statistical significance with both PFS (P=0.001) and OS (P=0.008).ConclusionNLR could serve as a useful predictor of OS but not PFS in ovarian cancer patients receiving NACT. In accordance with our previous study, CRS score at omentum was found to be associated with PFS but not OS in ovarian cancer patients treated with NACT and IDS.

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