The Relation Between Serum-based Systemic Inflammatory Biomarkers and Locoregional Lymph Node Metastasis in Clinical Stages I to II Right-sided Colon Cancers: The Role of Platelet-to-Lymphocyte Ratio.
Azmi Lale, Ertugrul Sahin, Ahmet Aslan, Omer Faruk Can, Mehmet Fatih Ebiloglu, Erhan Aygen
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引用次数: 1
Abstract
Background: It aimed to evaluate the relationship between the systemic inflammatory markers and the lymph node metastasis in clinical stages I to II right-sided colon cancers.
Patients and methods: A total of 51 eligible clinical stages I to II right-side located colon cancer patients were included in the study. Complete mesocolic excision and central vascular ligation procedures were performed in all cases. All the patients were divided into 2 main groups, pN - (n = 22) and pN + (n = 29). Demographic parameters, preoperative serum-based inflammatory biomarkers, and histopathological findings were compared between the groups.
Results: The mean age was 61.0 (54 to 71) years. Of the patients, 51.0% (26/51) were females. The open surgical approach was performed on 54.9% (28/51) of the patients and 45.1% (23/51) was performed laparoscopy. The mean total number of retrieved lymph nodes was 29.1. The lympho-vascular invasion was significantly higher in the pN + group (89.7% vs 50.0%). There were no significant differences in neutrophil-to-lymphocyte ratio, C-reactive protein-to-albumin ratio, mean platelet volume-to-platelet ratio, hemoglobine-albuminelymphocyte-platelet score, systemic inflammation index, lymphocyte-to-monocyte ratio, neutrophil-to-monocyte ratio, lymphocyte-to-C-reactive protein ratio (LCR), neutrophil-to-albumin ratio, and prognostic nutritional index. However, the mean platelet-to-lymphocyte ratio (PLR) was significantly lower in the pN + group (pN - : 282.1 vs pN + : 218.7, P = 0.048). The cutoff value for PLR was determined as 220 according to receiver operating characteristic analysis, with a 63.6% sensitivity and 65.6% specificity.
Conclusion: Although it has limited sensitivity and specificity, decreased preoperative PLR was significantly associated with lymph node metastasis in patients with clinical stages I to II right-sided colon cancer. It should be considered as a biomarker for nodal involvement when planning treatment strategies.
背景:旨在评估临床I至II期右侧结肠癌的全身炎症标志物与淋巴结转移之间的关系。患者和方法:共有51例符合条件的临床I至II期癌症右侧位结肠癌患者纳入研究。所有病例均行完全性中结肠切除术和中心血管结扎术。所有患者被分为两个主要组,pN-(n=22)和pN+(n=29)。比较两组之间的人口统计学参数、术前基于血清的炎症生物标志物和组织病理学结果。结果:平均年龄61.0岁(54~71岁)。女性占51.0%(26/51)。54.9%(28/51)的患者采用开放式手术入路,45.1%(23/51)采用腹腔镜手术。平均回收的淋巴结总数为29.1个。pN+组的淋巴血管侵袭率显著高于pN+(89.7%vs 50.0%)。中性粒细胞与淋巴细胞的比率、C反应蛋白与白蛋白的比率、平均血小板体积与血小板的比率、血红蛋白-白蛋白-淋巴细胞-血小板评分、全身炎症指数、淋巴细胞与单核细胞的比率、,淋巴细胞与C反应蛋白比率(LCR)、中性粒细胞与白蛋白比率和预后营养指数。然而,pN+组的平均血小板与淋巴细胞比率(PLR)显著降低(pN-:282.1 vs pN+:218.7,P=0.048)。根据受试者操作特征分析,PLR的临界值为220,敏感性为63.6%,特异性为65.6%。结论:尽管其敏感性和特异性有限,但在临床I至II期癌症患者中,术前PLR降低与淋巴结转移显著相关。在规划治疗策略时,应将其视为淋巴结受累的生物标志物。
期刊介绍:
Surgical Laparoscopy Endoscopy & Percutaneous Techniques is a primary source for peer-reviewed, original articles on the newest techniques and applications in operative laparoscopy and endoscopy. Its Editorial Board includes many of the surgeons who pioneered the use of these revolutionary techniques. The journal provides complete, timely, accurate, practical coverage of laparoscopic and endoscopic techniques and procedures; current clinical and basic science research; preoperative and postoperative patient management; complications in laparoscopic and endoscopic surgery; and new developments in instrumentation and technology.