AbstractObjective To evaluate the prognostic value of combined detection of platelet‐to‐lymphocyte ratio (PLR), neutrophil‐to‐lymphocyte ratio (NLR) and squamous cell carcinoma antigen (SCC) for patients with advanced cervical squamous cell carcinoma undergoing radical radiotherapy. Methods Clinical data of 127 patients with advanced cervical squamous cell carcinoma who received radical radiotherapy in the Affiliated Tumor Hospital of Nantong University from January 2016 to February 2019 were analyzed retrospectively. The enrolled cases were divided into the survival group and death group according to the survival at the end of 3 years after treatment. The laboratory indexes of peripheral blood were collected before treatment, PLR and NLR were calculated, and the differences of clinical parameters were compared between two groups. The prediction model was established, and the prediction efficiency of PLR, NLR and SCC alone and combined prediction models for 3‐year overall survival (OS) in patients with advanced cervical squamous cell carcinoma was compared through the ROC curve. Univariate and multivariate analyses of prognosis were carried out by binary logistic regression model. Results A total of 127 patients with advanced cervical squamous cell carcinoma were included in the study. There were 96 cases in the survival group and 31 cases in the death group. There were significant differences between two groups in FIGO stage, longest diameter of tumor, lymph node metastasis, PLR, NLR and SCC (all P<0.05). The area under ROC curve (AUC) of PLR, NLR and SCC was 0.660, 0.712 and 0.700, respectively. The AUC of PLR+NLR+SCC combined prediction model was increased to 0.784. Logistic multivariate analysis showed that FIGO Ⅲ, FIGO Ⅳ, lymph node metastasis, PLR≥205.555, NLR≥3.060 and SCC≥6.950 ng/ml were the independent risk factors for 3‐year OS in patients with advanced cervical squamous cell carcinoma (all P<0.05). Conclusions PLR, NLR and SCC have good value in predicting the 3‐year OS of patients with advanced cervical squamous cell carcinoma, and the combined prediction model of PLR+NLR+SCC has higher prediction value.
Fund:Scientific Research Project of Nantong Health Committee (QA2019027); Scientific Research Project of Nantong Health Committee (MA2021022)
Corresponding Authors:
He Aiqin, Email: HAQ0118@163.com
Cite this article:
Shao Jia,He Aiqin,Zhang Can et al. Prognostic value of combined detection of three indexes in patients with advanced cervical squamous cell carcinoma[J]. Chinese Journal of Radiation Oncology, 2022, 31(10): 904-909.
Shao Jia,He Aiqin,Zhang Can et al. Prognostic value of combined detection of three indexes in patients with advanced cervical squamous cell carcinoma[J]. Chinese Journal of Radiation Oncology, 2022, 31(10): 904-909.
[1] 杜银萍, 贾雪梅. 常规放疗与调强放射治疗对中晚期宫颈癌患者复发率及转移率的影响[J].临床与病理杂志,2022,42(1):73-80. DOI: 10.3978/j.issn.2095-6959.2022.01.011. Du YP, Jia XM.Influence of conventional radiotherapy and intensity modulated radiotherapy on recurrence rate and metastasis rate of patients with intermediate to advanced cervical cancer[J].Inter J Pathol Clinic Med,2022,42(1):73-80. DOI: 10.3978/j.issn.2095-6959.2022.01.011. [2] Sung H, Ferlay J, Siegel RL, et al.Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2021,71(3):209-249. DOI: 10.3322/caac.21660. [3] 周晖, 刘昀昀, 罗铭, 等. 《2022 NCCN子宫颈癌临床实践指南(第1版)》解读[J].中国实用妇科与产科杂志,2021,37(12):1220-1226. DOI: 10.19538/j.fk2021120112. Zhou H, Liu YY, Luo M, et al.Interpretation of 2022 NCCN Clinical Practice Guidelines for Cervical Cancer (1st Edition)[J].Chin J Pract Gynecol Obstet, 2021,37(12):1220-1226. DOI: 10.19538/j.fk2021120112. [4] Huang Z, Fu Z, Huang W, et al.Prognostic value of neutrophil-to-lymphocyte ratio in sepsis: a meta-analysis[J]. Am J Emerg Med, 2020,38(3):641-647. DOI: 10.1016/j.ajem.2019.10.023. [5] Cupp MA, Cariolou M, Tzoulaki I, et al.Neutrophil to lymphocyte ratio and cancer prognosis: an umbrella review of systematic reviews and meta-analyses of observational studies[J]. BMC Med, 2020,18(1):360. DOI: 10.1186/s12916-020- 01817-1. [6] Wang J, Li H, Xu R, et al.The MLR, NLR, PLR and D-dimer are associated with clinical outcome in lung cancer patients treated with surgery[J]. BMC Pulm Med, 2022,22(1):104. DOI: 10.1186/s12890-022-01901-7. [7] Wang D, Bai N, Hu X, et al.Preoperative inflammatory markers of NLR and PLR as indicators of poor prognosis in resectable HCC[J]. PeerJ, 2019,7:e7132. DOI: 10.7717/peerj.7132. [8] de Jong MC, Mihai R, Khan S. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) as possible prognostic markers for patients undergoing resection of adrenocortical carcinoma[J]. World J Surg, 2021,45(3):754-764. DOI: 10.1007/s00268-020-05868-6. [9] 冯未萍, 王俊华. 调强放疗治疗宫颈癌术后阴道残端复发及其对生存率的影响[J].航空航天医学杂志,2019,(8)DOI: 10.3969/j.issn.2095-1434.2019.08.023. Feng WP, Wang JH.Intensity‐modulated radiotherapy for recurrent vaginal stump after cervical cancer surgery and its influence on survival rate[J]. Journal of Aerospace Medicine,2019,(8)DOI: 10.3969/j.issn.2095-1434.2019.08.023. [10] Beharee N, Shi Z, Wu D, et al.Diagnosis and treatment of cervical cancer in pregnant women[J]. Cancer Med, 2019,8(12):5425-5430. DOI: 10.1002/cam4.2435. [11] 邓宇, 李镰, 唐洁, 等. 宫颈癌同步放化疗后疗效的预测模型构建与效能检验[J].现代妇产科进展,2022,31(2):102-106. DOI: 10.13283/j.cnki.xdfckjz.2022.02.005. Deng Y, Li L, Tang J.Prediction model construction and efficacy test of concurrent chemoradiotherapy for cervical cancer[J]. Prog Obstet Gynecol,2022,31(2):102-106. DOI: 10.13283/j.cnki.xdfckjz.2022.02.005. [12] 张静, 单单单, 尹红梅, 等. NLR、MLR、PLR水平对胃癌术后短期复发及转移的预测价值[J].实用癌症杂志,2022,37(3):396-398,403. DOI: 10.3969/j.issn.1001-5930.2022.03.012. Zhang J, Shan DD, Yin HM.Predictive value of early NLR,MLR and PLR in short-term recurrence and metastasis of gastric cancer after operation[J].The Practical Journal of Cancer,2022,37(3):396-398,403. DOI: 10.3969/j.issn.1001-5930. 2022.03.012. [13] 孙江宏, 郝明珠, 姜丹, 等. 乳腺炎、良性增生及乳腺癌FFDM鉴别诊断思路[J].实用肿瘤学杂志,2019,(2)DOI: 10. 11904/j. issn. 1002-3070. 2019. 02. 008. Sun JH, Hao MZ, Jiang D, et al.FFDM differential diagnosis of mastitis,benign hyperplasia and breast cancer[J]. Pract Oncol J,2019,(2)DOI: 10. 11904/j. issn. 1002-3070. 2019. 02. 008. [14] Domenici L, Tonacci A, Aretini P, et al.Inflammatory biomarkers as promising predictors of prognosis in cervical cancer patients[J]. Oncology, 2021,99(9):571-579. DOI: 10.1159/000517320. [15] Jiang Y, Gu H, Zheng X, et al.Pretreatment C-reactive protein/albumin ratio is associated with poor survival in patients with 2018 FIGO stage IB-IIA HPV-positive cervical cancer[J]. Pathol Oncol Res, 2021,27:1609946. DOI: 10.3389/pore.2021.1609946. [16] Kim YJ, Kim YS, Shin JW, et al.Prediction scoring system based on clinicohematologic parameters for cervical cancer patients undergoing chemoradiation[J]. Int J Gynecol Cancer, 2020,30(11):1689-1696. DOI: 10.1136/ijgc-2019-001050. [17] Chauhan R, Trivedi V, Rani R, et al.Pre-treatment hematological parameters as a cost effective predictive marker for response to concurrent chemo radiation in locally advanced cervical cancer[J]. Cancer Treat Res Commun, 2022,31:100539. DOI: 10.1016/j.ctarc.2022.100539. [18] Prabawa IPY, Bhargah A, Liwang F, et al. Pretreatment neutrophil‐to‐lymphocyte ratio (NLR) andplatelet‐to‐lymphocyte ratio (PLR) as a predictive value of hematological markers in cervical cancer[J]. Asian Pac J Cancer Prev, 2019,20(3):863‐868. DOI: 10.31557/APJCP. 2019.20.3.863. [19] Han X, Liu S, Yang G, et al.Prognostic value of systemic hemato-immunological indices in uterine cervical cancer: A systemic review, meta-analysis, and meta-regression of observational studies[J]. Gynecol Oncol, 2021,160(1):351-360. DOI: 10.1016/j.ygyno.2020.10.011. [20] Santos Thuler LC, Reis Wariss B, Nogueira-Rodrigues A, et al.The utility of pretreatment systemic inflammatory response biomarkers on overall survival of cervical cancer patients stratified by clinical staging[J]. Eur J Obstet Gynecol Reprod Biol, 2021,264:281-288. DOI: 10.1016/j.ejogrb.2021.07.034.