Preoperative neutrophil:lymphocyte and platelet:lymphocyte ratios predict endometrial cancer survival
Menée à partir de données portant sur 605 patientes atteintes d'un cancer de l'endomètre traité par chirurgie (durée de suivi : 5 ans), cette étude met en évidence une association entre le rapport neutrophiles/lymphocytes ou plaquettes/lymphocytes avant traitement et la survie des patientes
Background : Variations in systemic inflammatory response biomarker levels have been associated with adverse clinical outcome in various malignancies. This study determined the prognostic significance of preoperative neutrophil:lymphocyte (NLR), platelet:lymphocyte (PLR) and monocyte:lymphocyte (MLR) ratios in endometrial cancer.
Methods : Clinicopathological and 5-year follow-up data were obtained for a retrospective series of surgically treated endometrial cancer patients (n=605). Prognostic significance was determined for overall (OS) and cancer-specific survival (CSS) using Cox proportional hazards models and Kaplan–Meier analysis. Receiver–operator characteristic and log-rank functions were used to optimise cut-offs. NLR, PLR and MLR associations with clinicopathological variables were determined using non-parametric tests.
Results : Applying cut-offs of greater than or equal to2.4 (NLR), greater than or equal to240 (PLR) and greater than or equal to0.19 (MLR), NLR and PLR (but not MLR) had independent prognostic significance. Combining NLR and PLR scores stratified patients into low (NLR-low and PLR-low), intermediate (NLR-high or PLR-high) and high risk (NLR-high and PLR-high) groups: multivariable hazard ratio (HR) 2.51; P<0.001 (OS); HR 2.26; P<0.01 (CSS) for high vs low risk patients. Increased NLR and PLR were most strongly associated with advanced stage (P<0.001), whereas increased MLR was strongly associated with older age (P<0.001).
Conclusion : Both NLR and PLR are independent prognostic indicators for endometrial cancer, which can be combined to provide additional patient stratification.
British Journal of Cancer , résumé, 2014