Utility of Neutrophil–Lymphocyte Ratio, Platelet–Lymphocyte Ratio, Mean Platelet Volume–Platelet Count Ratios: Diagnostic and Prognostic Markers in Patients with Hepatocellular Carcinoma, Prostate Carcinoma, Stomach Carcinoma, and Aplastic Anemia

V S Srikanth; M Gopala Krishna Pillai; Cinzia Keechilot; Ashwin Rajkumar; Tushar Tatineni

doi:10.4103/ijmpo.ijmpo_10_18

Indian Journal of Medical and Paediatric Oncology, Inhaltsverzeichnis

CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2019; 40(03): 396-401
DOI: 10.4103/ijmpo.ijmpo_10_18

Original Article

Utility of Neutrophil–Lymphocyte Ratio, Platelet–Lymphocyte Ratio, Mean Platelet Volume–Platelet Count Ratios: Diagnostic and Prognostic Markers in Patients with Hepatocellular Carcinoma, Prostate Carcinoma, Stomach Carcinoma, and Aplastic Anemia

V S Srikanth

Department of General Medicine, Amrita Institute of Medical Sciences and Research Centre AIMS, Affiliated to Amrita Vishwa Vidyapeetham, Ponekkara, Kochi, Kerala, India

,

M Gopala Krishna Pillai

Department of General Medicine, Amrita Institute of Medical Sciences and Research Centre AIMS, Affiliated to Amrita Vishwa Vidyapeetham, Ponekkara, Kochi, Kerala, India

,

Cinzia Keechilot

Department of General Medicine, Amrita Institute of Medical Sciences and Research Centre AIMS, Affiliated to Amrita Vishwa Vidyapeetham, Ponekkara, Kochi, Kerala, India

,

Ashwin Rajkumar

Department of General Medicine, Amrita Institute of Medical Sciences and Research Centre AIMS, Affiliated to Amrita Vishwa Vidyapeetham, Ponekkara, Kochi, Kerala, India

,

Tushar Tatineni

Department of Radiation Oncology, Amrita Institute of Medical Sciences and Research Centre AIMS, Affiliated to Amrita Vishwa Vidyapeetham, Ponekkara, Kochi, Kerala, India

› Institutsangaben

Abstract

Introduction: The purpose of the study is to study the potential role of neutrophil–lymphocyte ratio (NLR), platelet–lymphocyte ratio (PLR), and mean platelet volume (MPV)–platelet ratio as diagnostic and prognostic markers in patients with hepatocellular carcinoma (HCC), prostate cancer, stomach cancer, and aplastic anemia. Materials and Methods: We have conducted the present study by screening 208,486 patients who have got admitted during January 2013–June 2017 as in patients in our hospital. The data collected were analyzed for NLR, PLR, and MPV–platelet ratio. Inclusion Criteria: Patients admitted with a diagnosis of HCC, prostate cancer, stomach cancer, and aplastic anemia irrespective of the age and gender. Exclusion Criteria: Patients with multiple malignancies, the presence of secondary infection, and any source of sepsis. SPSS tool was used for statistical analysis. Results: Cost-effective predictive and prognostic biomarkers identified in the study are – NLR for liver cancer, prostate cancer, and stomach cancer; PLR for prostate and stomach cancer; MPV/plate ratio can be used in addition to NLR for liver cancer. These ratios were not significant in aplastic anemia. Conclusion: From our study, we conclude that NLR and PLR are better cost-effective predictor and prognostic markers of HCC, prostate cancer, and stomach cancer. These ratios can be used at the primary health-care level as it can be derived from a simple complete blood count/peripheral smear. Early identification of carcinoma is possible using these potential markers along with the respective clinical presentations and symptoms. These ratios will reduce the financial burden on the patients from rural and low socioeconomic background and will aid in better management of the disease process.

Keywords

Carcinoma - neutrophil–lymphocyte ratio - platelet–lymphocyte ratio - and mean platelet volume/platelet ratio

Volltext

Referenzen

References
1 Mallath MK, Taylor DG, Badwe RA, Rath GK, Shanta V, Pramesh CS. et al. The growing burden of cancer in India: Epidemiology and social context. Lancet Oncol 2014; 15: e205-12
2 Cancer report 2014 and Cancer Fact sheet. http://www.who.int/mediacentre/factsheets/fs297/en/ Available from: [Last accessed on 2017 Feb 23]
3 Proctor MJ, Talwar D, Balmar SM, O'Reilly DS, Foulis AK, Horgan PG. et al. The relationship between the presence and site of cancer, an inflammation-based prognostic score and biochemical parameters. Initial results of the Glasgow inflammation outcome study. Br J Cancer 2010; 103: 870-6
4 Szkandera J, Gerger A, Liegl-Atzwanger B, Absenger G, Stotz M, Samonigg H. et al. Validation of the prognostic relevance of plasma C-reactive protein levels in soft-tissue sarcoma patients. Br J Cancer 2013; 109: 2316-22
5 Gomez D, Morris-Stiff G, Toogood GJ, Lodge JP, Prasad KR. Impact of systemic inflammation on outcome following resection for intrahepatic cholangiocarcinoma. J Surg Oncol 2008; 97: 513-8
6 Coussens LM, Werb Z. Inflammation and cancer. Nature 2002; 420: 860-7
7 Balkwill F, Mantovani A. Inflammation and cancer: Back to Virchow?. Lancet 2001; 357: 539-45
8 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
9 McMillan DC, Canna K, McArdle CS. Systemic inflammatory response predicts survival following curative resection of colorectal cancer. Br J Surg 2003; 90: 215-9
10 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
11 Aliustaoglu M, Bilici A, Ustaalioglu BB, Konya V, Gucun M, Seker M. et al. The effect of peripheral blood values on prognosis of patients with locally advanced gastric cancer before treatment. Med Oncol 2010; 27: 1060-5
12 Cho H, Hur HW, Kim SW, Kim SH, Kim JH, Kim YT. et al. Pre-treatment neutrophil to lymphocyte ratio is elevated in epithelial ovarian cancer and predicts survival after treatment. Cancer Immunol Immunother 2009; 58: 15-23
13 Walsh SR, Cook EJ, Goulder F, Justin TA, Keeling NJ. Neutrophil-lymphocyte ratio as a prognostic factor in colorectal cancer. J Surg Oncol 2005; 91: 181-4
14 Halazun KJ, Aldoori A, Malik HZ, Al-Mukhtar A, Prasad KR, Toogood GJ. 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
15 Templeton AJ, Pezaro C, Omlin A, McNamara MG, Leibowitz-Amit R, Vera-Badillo FE. et al. Simple prognostic score for metastatic castration-resistant prostate cancer with incorporation of neutrophil-to-lymphocyte ratio. Cancer 2014; 120: 3346-52
16 Templeton AJ, McNamara MG, Šeruga B, Vera-Badillo FE, Aneja P, Ocaña A. et al. Prognostic role of neutrophil-to-lymphocyte ratio in solid tumors: A systematic review and meta-analysis. J Natl Cancer Inst 2014; 106: dju124
17 Mittal S, El-Serag HB. Epidemiology of hepatocellular Carcinoma: Consider the population. J Clin Gastroenterol 2013; 47 Suppl S2-6
18 Xiao WK, Chen D, Li SQ, Fu SJ, Peng BG, Liang LJ. et al. Prognostic significance of neutrophil-lymphocyte ratio in hepatocellular carcinoma: A meta-analysis. BMC Cancer 2014; 14: 117
19 Liao W, Zhang J, Zhu Q, Qin L, Yao W, Lei B. et al. Preoperative neutrophil-to-lymphocyte ratio as a new prognostic marker in hepatocellular carcinoma after curative resection. Transl Oncol 2014; 7: 248-55
20 Cho SY, Yang JJ, You E, Kim BH, Shim J, Lee HJ. et al. Mean platelet volume/platelet count ratio in hepatocellular carcinoma. Platelets 2013; 24: 375-7
21 Yin X, Xiao Y, Li F, Qi S, Yin Z, Gao J. et al. Prognostic role of neutrophil-to-lymphocyte ratio in prostate cancer: A systematic review and meta-analysis. Medicine (Baltimore) 2016; 95: e2544
22 Langsenlehner T, Pichler M, Thurner EM, Krenn-Pilko S, Stojakovic T, Gerger A. et al. Evaluation of the platelet-to-lymphocyte ratio as a prognostic indicator in a European cohort of patients with prostate cancer treated with radiotherapy. Urol Oncol 2015; 33: 201.e9-16
23 Hu ZD, Huang YL, Qin BD, Tang QQ, Yang M, Ma N. et al. Prognostic value of neutrophil to lymphocyte ratio for gastric cancer. Ann Transl Med 2015; 3: 50
24 Sun J, Chen X, Gao P, Song Y, Huang X, Yang Y. et al. Can the neutrophil to lymphocyte ratio be used to determine gastric cancer treatment outcomes? A systematic review and meta-analysis. Dis Markers 2016; 2016: 7862469
25 Dogan M, Eren T, Ozdemir N, Cigirgan CL, Zengin N. The relationship between platelet-lymphocyte ratio, neutrophil-lymphocyte ratio, and survival in metastatic gastric cancer on firstline modified docetaxel and cisplatinum plus 5 Fluorourasil Regimen: A single institute experience. Saudi J Gastroenterol 2015; 21: 320-4
26 Matowicka-Karna J, Kamocki Z, Polińska B, Osada J, Kemona H. Platelets and inflammatory markers in patients with gastric cancer. Clin Dev Immunol 2013; 2013: 401623