scholarly journals Prognostic Value of Inflammatory and Nutritional Markers for Hepatocellular Carcinoma

Author(s):  
Yingying Xu ◽  
Xiuxue Yuan ◽  
Longdi Yao ◽  
Xiaomin Zhang ◽  
Liang Zong

Abstract Background: It is well known that the prognosis of cancer patients after tumor resection is closely related to the patient's autoimmune ability and nutritional status. A large number of studies have shown that the neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and Onodera's prognostic nutritional index (OPNI) are significantly correlated with the prognosis of various tumors. In this study, we analyzed the prognostic value of NLR, PLR and OPNI for hepatocellular carcinoma (HCC) for the first time.Patients and Methods: Data of hepatocellular carcinoma patients undergoing hepatectomy in Changzhi People’s Hospital (Changzhi, China) from 2011 to 2017 were retrospectively analyzed. A total of 286 patients with hepatocellular carcinoma were included in the analysis. The Optimum cut-off values of OPNI, NLR and PLR were determined by using the X-tile program. The overall survival (OS) was analyzed by Kaplan-Meier method and verified by log-rank test. Multivariate analysis was performed using Cox Proportional Hazard Regression model to determine independent prognostic indicators for HCC.Results: Univariate and multivariate analysis showed that OPNI (p<0.001), Treatment (Surgery, p=0.04; Interventional therapy, p=0.002), Postoperative treatment (YES, p=0.004) and Stage can be used as independent prognostic maker for HCC. Comparing the P values and hazard ratios, we found out that the OPNI has greatest influence on prognosis in these preoperative indexes. The optimal cut-off values of NLR, PLR and OPNI were 2.5, 133.3 and 39.5, respectively. Compared with the low OPNI group, the high OPNI group had a better prognosis. In the correlation analysis between OPNI and clinicopathological features, only Age and NLR showed statistical differences, while others did not.Conclusions: OPNI can be used as a simple and effective independent prognostic marker for hepatocellular carcinoma.

2020 ◽  
Author(s):  
Feng Wang ◽  
Tingting Tao ◽  
Heng Yu ◽  
Yingying Xu ◽  
Xuefeng Xia ◽  
...  

Abstract Background Immunoinflammatory and nutritional markers such as peripheral blood neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and onodera’s prognostic nutritional index (OPNI) have gained considerable attention and revealed preliminaryly as prognostic markers in gastrointestinal stromal tumor (GIST). Methods In this study, we firstly investigated the prognostic value of OPNI in GIST treated with or without TKIs based on the propensity score matching (PSM) method. All of the patients had received surgical resection for primary GIST, The data from 2010 to 2018 were initially and retrospectively identified from our gastrointestinal center. Recurrence-free survival (RFS) was calculated by the Kaplan-Meier method and compared by the log-rank test. Results These patients who were treated with TKIs and those who did not were divided into two groups, and we used propensity score matching method to make them have more unified baseline data. Multivariate Cox proportional hazard regression models were applied to identify associations with outcome variables.A total of 563 GISTs were initially chosen and 280 of them were included for analysis under an inclusion criteria. After PSM, there were 200 patients included. Multivariate analyses identified OPNI was an independent prognostic marker, and was associated with primary site, tumor size, mitotic index, tumor rupture, necrosis, and modified NIH risk classification. Low OPNI (< 44.05; HR 0.433; 95% CI 0.236–0.794; P = 0.007) were associated with worse RFS. Conclusions Preoperative OPNI is a novel and useful prognostic marker for GISTs both treated with or without TKIs.


2020 ◽  
Author(s):  
Feng Wang ◽  
Tingting Tao ◽  
Heng Yu ◽  
Yingying Xu ◽  
Zhi Yang ◽  
...  

Abstract Background Immunoinflammatory and nutritional markers such as peripheral blood neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and onodera’s prognostic nutritional index (OPNI) have gained considerable attention and revealed preliminaryly as prognostic markers in gastrointestinal stromal tumor (GIST). Methods In this study, we firstly investigated the prognostic value of OPNI in GIST treated with or without TKIs based on the propensity score matching (PSM) method. All of the patients had received surgical resection for primary GIST, the data from 2010 to 2018 were initially and retrospectively identified from our gastrointestinal center. Recurrence-free survival (RFS) was calculated by the Kaplan-Meier method and compared by the log-rank test. Results These patients who were treated with TKIs and those who did not were divided into two groups, and we used propensity score matching method to make them have more unified baseline data. Multivariate Cox proportional hazard regression models were applied to identify associations with outcome variables. A total of 563 GISTs were initially chosen and 280 of them were included for analysis under an inclusion criteria. After PSM, there were 200 patients included. Multivariate analyses identified OPNI was an independent prognostic marker, and was associated with primary site, tumor size, mitotic index, tumor rupture, necrosis, and modified NIH risk classification. Low OPNI (< 42.6; HR 0.315; P༜0.001) were associated with worse RFS. Conclusions Preoperative OPNI is a novel and useful prognostic marker for GISTs both treated with or without TKIs.


2021 ◽  
Author(s):  
Feng Wang ◽  
Tingting Tao ◽  
Heng Yu ◽  
Yingying Xu ◽  
Zhi Yang ◽  
...  

Abstract Background Immunoinflammatory and nutritional markers such as peripheral blood neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and onodera’s prognostic nutritional index (OPNI) have gained considerable attention and revealed preliminaryly as prognostic markers in gastrointestinal stromal tumor (GIST). Methods In this study, we firstly investigated the prognostic value of OPNI in GIST treated with or without TKIs based on the propensity score matching (PSM) method. All of the patients had received surgical resection for primary GIST, the data from 2010 to 2018 were initially and retrospectively identified from our gastrointestinal center. Recurrence-free survival (RFS) was calculated by the Kaplan-Meier method and compared by the log-rank test. Results These patients who were treated with TKIs and those who did not were divided into two groups, and we used propensity score matching method to make them have more unified baseline data. Multivariate Cox proportional hazard regression models were applied to identify associations with outcome variables. A total of 563 GISTs were initially chosen and 280 of them were included for analysis under an inclusion criteria. After PSM, there were 200 patients included. Multivariate analyses identified OPNI was an independent prognostic marker, and was associated with primary site, tumor size, mitotic index, tumor rupture, necrosis, and modified NIH risk classification. Low OPNI (< 42.6; HR 0.315; P༜0.001) were associated with worse RFS. Conclusions Preoperative OPNI is a novel and useful prognostic marker for GISTs both treated with or without TKIs.


Cancers ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 513
Author(s):  
Riccardo Pravisani ◽  
Federico Mocchegiani ◽  
Miriam Isola ◽  
Dario Lorenzin ◽  
Gian Luigi Adani ◽  
...  

Preoperative inflammatory biomarkers such as the Platelet-to-Lymphocyte Ratio (PLR) and the Neutrophil-to-Lymphocyte Ratio (NLR) strongly predict the outcome in surgically treated patients with hepatocellular carcinoma (HCC), while nutritional biomarkers such as the Controlling Nutritional Status (CONUT) and the Prognostic Nutritional Index (PNI) show an analogue prognostic value in hepatic resection (HR) but not in liver transplant (LT) cases. Data on the impact of LT on the inflammatory and nutritional/metabolic function are heterogeneous. Therefore, we investigated the post-LT trend of these biomarkers up to postoperative month (POM) 12 in 324 HCC patients treated with LT. Inflammatory biomarkers peaked in the early post-LT period but at POM 3 leveled off at values similar (NLR) or higher (PLR) than pre-LT ones. CONUT and PNI worsened in the early post-LT period, but at POM 3 they stabilized at significantly better values than pre-LT. In LT recipients with an overall survival >1 year and no evidence of early HCC recurrence, 1 year post-LT NLR and PNI independently predicted patient overall survival, while 1 year post-LT PLR independently predicted late tumor recurrence. In conclusion, at 1 year post-LT, the nutritional status of liver-transplanted HCC patients significantly improved while their inflammatory state tended to persist. Consequently, post-LT PLR and NLR maintained a prognostic value for LT outcome while post-LT CONUT and PNI acquired it.


2021 ◽  
Author(s):  
feng wang ◽  
Tingting Tao ◽  
Heng Yu ◽  
Yingying Xu ◽  
Zhi Yang ◽  
...  

Abstract Background: Immunoinflammatory and nutritional markers such as peripheral blood neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and onodera’s prognostic nutritional index (OPNI) have gained considerable attention and revealed preliminaryly as prognostic markers in gastrointestinal stromal tumor (GIST).Methods: In this study, we firstly investigated the prognostic value of OPNI in GIST treated with or without TKIs based on the propensity score matching (PSM) method. All of the patients had received surgical resection for primary GIST, the data from 2010 to 2018 were initially and retrospectively identified from our gastrointestinal center. Recurrence-free survival (RFS) was calculated by the Kaplan-Meier method and compared by the log-rank test.Results: These patients who were treated with TKIs and those who did not were divided into two groups, and we used propensity score matching method to make them have more unified baseline data. Multivariate Cox proportional hazard regression models were applied to identify associations with outcome variables. A total of 563 GISTs were initially chosen and 280 of them were included for analysis under an inclusion criteria. After PSM, there were 200 patients included. Multivariate analyses identified OPNI was an independent prognostic marker, and was associated with primary site, tumor size, mitotic index, tumor rupture, necrosis, and modified NIH risk classification. Low OPNI (<42.6; HR 0.409; P<0.001) were associated with worse RFS.Conclusions: Preoperative OPNI is a novel and useful prognostic marker for GISTs both treated with or without TKIs. Higher NLR and PLR have negative effects for RFS.


2021 ◽  
Vol 10 (13) ◽  
pp. 2983
Author(s):  
Kun-Che Lin ◽  
Hau-Chern Jan ◽  
Che-Yuan Hu ◽  
Yin-Chien Ou ◽  
Yao-Lin Kao ◽  
...  

Objectives: This study aimed at investigating the prognostic impact of tumor necrosis and preoperative monocyte-to-lymphocyte ratio (MLR) in patients treated with radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC). Methods: A total of 521 patients with UTUC treated with RNU from January 2008 to June 2019 at our institution were enrolled. Histological tumor necrosis was defined as the presence of microscopic coagulative necrosis. The optimal value of MLR was determined as 0.4 by receiver operating characteristic (ROC) analysis based on cancer-specific mortality. The Kaplan–Meier method with log-rank test and Cox proportional hazards regression models were performed to evaluate the impact of tumor necrosis and MLR on overall (OS), cancer-specific (CSS), and recurrence-free survival (RFS). Furthermore, ROC analysis was used to estimate the predictive ability of potential prognostic factors for oncological outcomes. Results: Tumor necrosis was present in 106 patients (20%), which was significantly associated with tumor location, high pathological tumor stage, lymph node metastasis, high tumor grade, lymphovascular invasion, tumor size, and increased monocyte counts. On multivariate analysis, the combination of tumor necrosis and preoperative MLR was an independent prognosticator of OS, CSS, and RFS (all p < 0.05). Moreover, ROC analyses revealed the predictive accuracy of a combination of tumor necrosis and preoperative MLR for OS, CSS, and RFS with the area under the ROC curve of 0.745, 0.810, and 0.782, respectively (all p < 0.001). Conclusions: The combination of tumor necrosis and preoperative MLR can be used as an independent prognosticator in patients with UTUC after RNU. The identification of this combination could help physicians to recognize high-risk patients with unfavorable outcomes and devise more appropriate postoperative treatment plans.


2021 ◽  
Vol 16 ◽  
pp. 117727192110270
Author(s):  
Gönül Açıksarı ◽  
Mehmet Koçak ◽  
Yasemin Çağ ◽  
Lütfiye Nilsun Altunal ◽  
Adem Atıcı ◽  
...  

Background: The current knowledge about novel coronavirus-2019 (COVID-19) indicates that the immune system and inflammatory response play a crucial role in the severity and prognosis of the disease. In this study, we aimed to investigate prognostic value of systemic inflammatory biomarkers including C-reactive protein/albumin ratio (CAR), prognostic nutritional index (PNI), neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR) in patients with severe COVID-19. Methods: This single-center, retrospective study included a total of 223 patients diagnosed with severe COVID-19. Primary outcome measure was mortality during hospitalization. Multivariate logistic regression analyses were performed to identify independent predictors associated with mortality in patients with severe COVID-19. Receiver operating characteristic (ROC) curve was used to determine cut-offs, and area under the curve (AUC) values were used to demonstrate discriminative ability of biomarkers. Results: Compared to survivors of severe COVID-19, non-survivors had higher CAR, NLR, and PLR, and lower LMR and lower PNI ( P < .05 for all). The optimal CAR, PNI, NLR, PLR, and LMR cut-off values for detecting prognosis were 3.4, 40.2, 6. 27, 312, and 1.54 respectively. The AUC values of CAR, PNI, NLR, PLR, and LMR for predicting hospital mortality in patients with severe COVID-19 were 0.81, 0.91, 0.85, 0.63, and 0.65, respectively. In ROC analysis, comparative discriminative ability of CAR, PNI, and NLR for hospital mortality were superior to PLR and LMR. Multivariate analysis revealed that CAR (⩾0.34, P = .004), NLR (⩾6.27, P = .012), and PNI (⩽40.2, P = .009) were independent predictors associated with mortality in severe COVID-19 patients. Conclusions: The CAR, PNI, and NLR are independent predictors of mortality in hospitalized severe COVID-19 patients and are more closely associated with prognosis than PLR or LMR.


2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Yuichiro Shimoyama ◽  
Osamu Umegaki ◽  
Noriko Kadono ◽  
Toshiaki Minami

Abstract Objective Sepsis is a major cause of mortality for critically ill patients. This study aimed to determine whether presepsin values can predict mortality in patients with sepsis. Results Receiver operating characteristic (ROC) curve analysis, Log-rank test, and multivariate analysis identified presepsin values and Prognostic Nutritional Index as predictors of mortality in sepsis patients. Presepsin value on Day 1 was a predictor of early mortality, i.e., death within 7 days of ICU admission; ROC curve analysis revealed an AUC of 0.84, sensitivity of 89%, and specificity of 77%; and multivariate analysis showed an OR of 1.0007, with a 95%CI of 1.0001–1.0013 (p = 0.0320).


2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Feng Wang ◽  
Tingting Tao ◽  
Heng Yu ◽  
Yingying Xu ◽  
Zhi Yang ◽  
...  

Abstract Background Immunoinflammatory and nutritional markers, such as the peripheral blood neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and Onodera’s prognostic nutritional index (OPNI), have gained considerable attention and have been preliminarily revealed as prognostic markers of gastrointestinal stromal tumors (GISTs). Methods In this study, we first investigated the prognostic value of OPNI in GISTs treated with or without TKIs based on the propensity score matching (PSM) method. All of the patients had received surgical resection for primary GIST, and data from 2010 to 2018 were initially and retrospectively identified from our gastrointestinal center. Recurrence-free survival (RFS) was calculated by the Kaplan–Meier method and compared by the log-rank test. Results The patients were divided into groups treated and not treated with TKIs, and we used the propensity score matching method to homogenize their baseline data. Multivariate Cox proportional hazard regression models were applied to identify associations with outcome variables. A total of 563 GISTs were initially chosen, and 280 of them were included for analysis under the inclusion criteria. After PSM, there were 200 patients included. Multivariate analyses identified OPNI as an independent prognostic marker that was associated with primary site, tumor size, mitotic index, tumor rupture, necrosis, and modified NIH risk classification. Low OPNI (< 42.6; HR 0.409; P < 0.001) was associated with worse RFS. Conclusions Preoperative OPNI is a novel and useful prognostic marker for GISTs both treated and not treated with TKIs. Higher NLR and PLR have negative effects on RFS.


ESMO Open ◽  
2018 ◽  
Vol 3 (6) ◽  
pp. e000425 ◽  
Author(s):  
Gema Bruixola ◽  
Javier Caballero ◽  
Federica Papaccio ◽  
Angelica Petrillo ◽  
Aina Iranzo ◽  
...  

BackgroundLocally advanced head and neck squamous cell carcinoma (LAHNSCC) is a heterogeneous disease in which better predictive and prognostic factors are needed. Apart from TNM stage, both systemic inflammation and poor nutritional status have a negative impact on survival.MethodsWe retrospectively analysed two independent cohorts of a total of 145 patients with LAHNSCC treated with induction chemotherapy followed by concurrent chemoradiotherapy at two different academic institutions. Full clinical data, including the Prognostic Nutritional Index (PNI), neutrophil to lymphocyte ratio and derived neutrophil to lymphocyte ratio, were analysed in a training cohort of 50 patients. Receiver operating characteristic curve analysis was used to establish optimal cut-off. Univariate and multivariate analyses of prognostic factors for overall survival (OS) were performed. Independent predictors of OS identified in multivariate analysis were confirmed in a validation cohort of 95 patients.ResultsIn the univariate analysis, low PNI (PNI<45) (p=0.001), large primary tumour (T4) (p=0.044) and advanced lymph node disease (N2b-N3) (p=0.025) were significantly associated with poorer OS in the validation cohort. The independent prognostic factors in the multivariate analysis for OS identified in the training cohort were dRNL (p=0.030) and PNI (p=0.042). In the validation cohort, only the PNI remained as independent prognostic factor (p=0.007).ConclusionsPNI is a readily available, independent prognostic biomarker for OS in LAHNSCC. Adding PNI to tumour staging could improve individual risk stratification of patients with LAHNSCC in future clinical trials.


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