Prognostic significance of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio in uterine carcinosarcoma.

IF 2.4 3区 医学 Q3 ONCOLOGY International Journal of Clinical Oncology Pub Date : 2025-01-08 DOI:10.1007/s10147-024-02687-w
Azusa Sakurai, Ken Yamaguchi, Kentaro Ishida, Naoki Horikawa, Eri Kawai, Yasushi Kotani, Takaaki Yoshida, Naoya Kishimoto, Keiji Tatsumi, Minami Okudate, Yoko Iemura, Yukiko Taga, Megumi Aki, Yukiko Ando, Akihiro Yanai, Koji Yamanoi, Mana Taki, Ryusuke Murakami, Junzo Hamanishi, Masaki Mandai
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Abstract

Introduction: Uterine carcinosarcoma (UCS) and uterine sarcomas (US) are rare but aggressive cancer with poor prognoses. The prognostic value of systemic inflammatory response (SIR) indicators, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR), in predicting outcomes of UCS and US remains unclear. This study investigated the prognostic significance of SIR indicators for UCS and US.

Materials and methods: Clinicopathological data from 237 patients diagnosed with UCS or US across 14 hospitals from January 2008 to December 2017 were retrospectively analyzed. NLR, PLR, and MLR values were calculated from preoperative blood counts. Prognostic impact was evaluated using Kaplan-Meier survival analysis, Cox regression models, and receiver operating characteristic (ROC) curve analysis.

Results: Elevated NLR, PLR, and MLR were associated with poorer progression-free survival (PFS) in UCS. Additionally, a high NLR also indicated worse overall survival (OS) in UCS. In patients with US, only PLR was significantly associated with poorer PFS. Combining SIR indicators provided a stronger prognostic prediction for UCS compared to individual indicators. Multivariate analysis revealed that high levels of SIR indicators were an independent poor prognostic factor for both PFS and OS in UCS.

Conclusion: SIR indicators, particularly when combined, are valuable prognostic markers in UCS, reflecting the inflammatory status and aiding in stratifying patients for tailored therapeutic strategies. These findings support the incorporation of SIR indicators into clinical practice for better management of patients with UCS.

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中性粒细胞与淋巴细胞比值、血小板与淋巴细胞比值、单核细胞与淋巴细胞比值在子宫癌肉瘤中的预后意义。
子宫癌肉瘤(UCS)和子宫肉瘤(US)是一种罕见的恶性肿瘤,预后较差。系统性炎症反应(SIR)指标,包括中性粒细胞与淋巴细胞比率(NLR)、血小板与淋巴细胞比率(PLR)和单核细胞与淋巴细胞比率(MLR),在预测UCS和US预后方面的预后价值尚不清楚。本研究探讨SIR指标对UCS和US的预后意义。材料和方法:回顾性分析2008年1月至2017年12月14家医院237例诊断为UCS或US的患者的临床病理资料。NLR、PLR和MLR值根据术前血球计数计算。采用Kaplan-Meier生存分析、Cox回归模型和受试者工作特征(ROC)曲线分析评估预后影响。结果:升高的NLR、PLR和MLR与UCS较差的无进展生存期(PFS)相关。此外,高NLR也表明UCS的总生存期(OS)较差。在US患者中,只有PLR与较差的PFS显著相关。与单个指标相比,SIR指标的结合对UCS的预后预测更强。多因素分析显示,高水平的SIR指标是UCS患者PFS和OS的独立不良预后因素。结论:SIR指标,尤其是联合使用时,是有价值的UCS预后指标,反映了炎症状态,有助于对患者进行分层,以制定量身定制的治疗策略。这些发现支持将SIR指标纳入临床实践,以更好地管理UCS患者。
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来源期刊
CiteScore
6.80
自引率
3.00%
发文量
175
审稿时长
2 months
期刊介绍: The International Journal of Clinical Oncology (IJCO) welcomes original research papers on all aspects of clinical oncology that report the results of novel and timely investigations. Reports on clinical trials are encouraged. Experimental studies will also be accepted if they have obvious relevance to clinical oncology. Membership in the Japan Society of Clinical Oncology is not a prerequisite for submission to the journal. Papers are received on the understanding that: their contents have not been published in whole or in part elsewhere; that they are subject to peer review by at least two referees and the Editors, and to editorial revision of the language and contents; and that the Editors are responsible for their acceptance, rejection, and order of publication.
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