There is relationship between PET-CT metabolic parameters and NLR in SCLC. Highest correlation was found with NLR and MTV, WBMTV, and WBTLG, and evaluation of NLR together with these parameters predicts survival times and tumor biology more clearly in SCLC.
Purpose The aim of this study was to evaluate the prognostic and predictive value of neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (DNLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR) in soft tissue sarcoma (STS) cases treated with pazopanib. Materials and methods The study population included 26 STS cases treated with pazopanib for at least 3 months. NLR, DNLR, LMR, and PLR were evaluated at baseline, and at third month of therapy and also compared with response to pazopanib. Median measurements were taken as cutoff for NLR (4.8), DNLR (3.1), LMR (3.6), and PLR (195). The associations between these cutoff values and survival times (progression-free survival [PFS] and overall survival [OS]) were assessed by Kaplan–Meier curves and Cox proportional models. Results Patients with low pretreatment NLR and DNLR had longer OS ( P =0.022, P =0.018), but low PLR was found to be associated only with longer OS. Additionally, decrease in NLR and DNLR after 3 months of therapy as compared with pretreatment measurements was found to be associated with an advantage for OS ( P =0.021, P =0.010, respectively) and PFS ( P =0.005, P =0.001, respectively). Response to pazopanib; changes in NLR, DNLR, LMR, and PLR; and >3 metastatic sites were found to be independent risk factors in univariate analysis, but NLR was the only independent risk factor in multivariate analysis. Conclusion Low pretreatment and decrease in NLR and DNLR values, and regression/stable disease after 3 months of pazopanib are predictive factors for longer OS and PFS.
Amaç: Kemik iliği infiltrasyonu (Kİİ), lenfoma evresini, sağkalımı ve tedaviyi etkiler. Lenfoma hastalarında Kİİ' ni saptamada kemik iliği biyopsisi (KİB) ve positron emisyon tomografi-bilgisayarlı tomografi (PET/BT)' nin performanslarını değerlendirmek istedik. Gereç veYöntemler: 269 non-Hodgkin lenfoma (NHL) ve 110 hodgkin lenfoma (HL) hastası retrospektif olarak değerlendirildi. Kİİ' ni saptamada PET/BT ve KİB için duyarlılık, negatif prediktif değer (NPD) ve doğruluk hesaplandı. Bulgular: NHL olgularında Kİİ' ni saptamada PET/BT için duyarlılık, NPD ve doğruluk sırasıyla %65, %78 ve %84.4 iken KİB için %55, %73.4 ve %79.9 idi. Diffüz büyük B hücreli lenfoma ve folliküler lenfoma için PET/BT performansı KİB' den daha iyi iken; mantle-cell lenfoma, burkitt's lenfoma ve primer mediastinal B hücreli lenfomada KİB performansı daha iyiydi. HL olgularında PET/BT için duyarlılık, NPD ve doğruluk sırasıyla %91.3, %97.75 ve %98.18 iken KİB için %56.52, %89.69 ve %90.91 idi. KİB yapılması ile NHL grubunda 43 (%15.9), HL grubunda ise 2 (%1.8) olgunun düşük evrelenmesinden korunmuş olundu. Sonuç: Kİİ' ni saptamada NHL alt tiplerine göre değişmekle birlikte PET/BT ve KİB birbirini tamamlayıcı yöntemlerdir. HL' de ise Kİİ' ni saptamak için PET/BT önemli bir tanı aracıdır ve KİB olguların önemli kısmında gerekli değildir. Anahtar Sözcükler: Lenfoma, kemik iliği infiltrasyonu, PET/BT, kemik iliği biyopsisiObjective: Bone marrow infiltration (BMI) affects the stage of lymphoma, survey, and treatment. We aimed to evaluate the performance of bone marrow biopsy (BMB) and positron emission tomography-computed tomography (PET/CT) in detecting bone marrow infiltration in lymphoma patients. Materials and Methods: 269 non-Hodgkin's lymphoma (NHL) and110 Hodgkin's lymphoma (HL) patients were evaluated retrospectively. Sensitivity, negative predictive value (NPV) and accuracy were calculated for PET/CT and BMB in detecting BMI.Results: Sensitivity, NPV and accuracy for PET/CT in detecting BMI in NHL cases were 65%, 78% and 84.4%, respectively, while 55%, 73.4% and 79.9% for BMB. PET/CT performance for diffuse large B-cell lymphoma and follicular lymphoma was better than BMB, whereas the performance of BMB was better for mantle-cell lymphoma, Burkitt's lymphoma and primary mediastinal B-cell lymphoma. Sensitivity, NPV and accuracy for PET-CT in HL cases were 91.3%, 97.75% and 98.18%, respectively, while 56.52%, 89.69% and 90.91% for BMB. Due to BMB, 43 (15.9%) patients in the NHL group and 2 (1.8%) patients in the HL group were protected from downstaging. Conclusion:PET/CT and BMB, although their results vary according to the NHL subtypes, are complementary methods in determining the BMI. In HL, PET/CT is an important diagnostic tool for detecting BMI, and BMB is not necessary in a significant proportion of cases. Turk J Hematol 2020;37:220-225 Büyükşimşek et al: Lymphoma and Bone Marrow Infiltration Öz Abstract
Metastatik böbrek hücreli kanser (MBHK) sıklığı giderek artmaktadır ve temel tedavisi antiangiogenik tirozin kinaz inhibitörleridir (TKİ). Sistemik inflamasyonun karsinogenezde önemli bir rollerinden biri de pro-angiogenik faktörlerin salınımını arttırmaktır. Biz de bu yazımızda TKİ tedavisi alan MBHK olgularında sistemik inflamatuar indekslerinden nötrofil lenfosit oranı (NLO), sistemik immun-inflamasyon indeksi (SII), prognostik nutrisyonel indeks (PNI) ve tedavi sürecinde değişen SII değerlerinin prognostik önemini ortaya çıkarmayı amaçladık. YÖNTEM ve GEREÇLER: Çalışmamıza TKİ tedavisi alan 28 MBHK hastası retrospektif olarak dahil edilmiştir. Kaplan-Meier ve log-rank testleri kullanılarak klinikodemografik verilerle yaşam süreleri arasındaki ilişki belirlenmiştir. NLO (2,73), SII (832) ve PNI (39) için en sensitif ve spesifik değerler ROC analizi ile saptanıp prognostik önemleri tekli ve multi faktöriyel analizler yapılarak tespit edilmiştir BULGULAR: Yüksek NLO (≥2,73) ve SII (≥832) ile düşük PNI (<39) daha kısa progresyonsuz yaşam süresi (PYS) ve genel sağkalım (GS) ile ilişkili olup TKI tedavisinin 1. Ayındaki azalmış SII'ye sahip olan hastaların ise daha uzun PYS ve GS'ye sahip olduğu tespit edilmiştir. GS için yapılan univariate analizlerde ECOG performans durumu, NLR, SII, SII değişimi ve PNI prognostik olmakla beraber multifaktöriyel analizlerde sadece SII değişimi bağımsız prognostik faktördür. TARTIŞMA ve SONUÇ: TKI tedavisi alan MBHK hastalarında tedavi ile azalmış SII daha uzun GS için tek bağımsız prognostik faktördür. Anahtar Kelimeler: Böbrek hücreli kanser (BHK), sistemik immun-inflamasyon indeksi (SII), prognostik nutrisyonel indeks (PNI), tirozin kinaz inhibitörü (TKI) ABSTRACT INTRODUCTION: The frequency of metastatic renal cell cancer (RCC) is increasing and main drugs in management are anti-angiogenic tyrosine kinase inhibitors (TKI). Systemic inflammation has an important role in carcinogenesis and increase the secretion of pro-angiogenic factors. Here prognostic significance of neutrophil lymphocyte ratio (NLR), systemic immune-inflammation index (SII), prognostik nutritional index (PNI) and also change in SII during TKI therapy have been evaluated in cases with RCC treated with TKI METHODS: Twenty eight cases with RCC treated with TKI were evaluated retrospectively. Kaplan-Meier and log-rank tests were used to detect the association between clinical/demographic findings and survival times. The most sensitive and specific values were found by ROC analysis: Prognostic significance of NLR (2,73), SII (832), SII changes and PNI (39) were detected. RESULTS: High NLR (≥2,73) and SII (≥832) and low PNI (<39) were found to be associated with shorter PFS and OS. Decreased SII after TKI therapy was found to be associated with longer PFS and OS. In univariate analyses, ECOG performance status, NLR, SII, SII change and PNI were prognostic for OS, whereas in multivariate analyzes only SII change found to be independent factors for OS DISCUSSION AND CONCLUSION: Decreased SII after TKI therapy was th...
This study aimed to evaluate CD73 and PD-L1 and determine their relationship with each other and with overall survival (OS) in sarcoma patients. The paraffin blocks of 101 patients were analysed. 56.4% were female, and the mean age was 51.39 years. The mean OS was 20.73 months, and the Ki-67 proliferative index was 41.45. A positive correlation was found between CD73 tumour and CD73 tumour-infiltrating lymphocyte (TIL) findings. CD73 tumour and TIL findings were also positively correlated with PD-L1 percentages and PD-L1 intensity. An inverse correlation was detected between OS and CD73 tumour and TIL groups of 5-25%, 25-50%, 50-75%, 75-90%, and > 90%, but no such correlation was found for the ≤ 5% group. There was an inverse correlation between OS and the PD-L1 percentages of <10% and > 50% and the PD-L1 intensity of weak-moderate and strong, but no correlation was found for the negative values. Lastly, an inverse correlation was found between OS and the Ki-67 proliferative index. We found CD73 and PD-L1 positivity to be associated with decreased OS in sarcoma patients and determined a significant correlation between these parameters. This result is promising in terms of achieving better survival and disease control with anti-CD73 and anti-PD-L1 therapy in selected patients.
Aim: In our study, we aimed to determine the clinicopathological factors affecting the pathological response after neoadjuvant chemotherapy in HER2 positive breast cancer. Materials and Methods:A total of 54 HER2 expression positive cases were included in this study. Neoadjuvant chemotherapy regimen containing trastuzumab was applied to all patients. Patients' age, gender, disease stage, tumor size and lymph node status, estrogen and progesterone receptor status, Ki-67 proliferation index, tumor grade, menopausal status and pathological complete response status after neoadjuvant therapy, neoadjuvant treatment regimen and the relationship between the tumor and histological subtype were examined.Results: Grade III tumor, hormone receptor negativity, high Ki-67 score, and the presence of T3 or T4 tumor were found to be better associated with pathological complete response (p=0.036, p=0.033, p=0.021, p=0.048, respectively). High tumor grade, hormone receptor negativity and high Ki-67 score were found as independent risk factors determining pathological complete response (p=0.043, p=0.047, p=0.035, respectively). Conclusion:In this series of 54 cases with HER2 positive breast cancer, the parameters determining pathological complete response after neoadjuvant treatment are high Ki-67 proliferation index, grade III tumor and hormone receptor negativity.
Background: Cancer is a significant health problem for refugees and host countries. Breast cancer is the most common cancer among refugees. The subject of our study is to examine the clinical and pathological features of Syrian refugees with breast cancer and compare them with Turkish patients with breast cancer. Methods: Data of patients with breast cancer between January 2018 and December 2020 were retrospectively reviewed. The clinical and histological features, treatment modalities and overall survival were collected and analyzed. Results: A total number of 338 women with breast cancer were included in this study. Ninety-nine of the 338 (29.3%) patients were Syrian refugees and 239 patients (70.7%) were Turkish. The median follow-up time was significantly lower in Syrian patients (P<0.001). Median OS was 146 months in Turkish and 116 months in Syrian group (P=0.022). Independent risk factors associated with long survival were receiving adjuvant chemotherapy (HR 0.465; 95% CI 0.234–0.926; P=0.029), adjuvant radiotherapy (HR 0.372 95% CI 0.182–0.758; P=0.007), and adjuvant hormonotherapy (HR 0.367; 95% CI 0.201–0.669; P=0.001). The rates of receiving adjuvant chemotherapy, adjuvant radiotherapy, and adjuvant hormonal therapy were significantly lower in the Syrian group (P=0.023, P=0.005, P=0.002, respectively). Conclusion: Syrian refugees with breast cancer are more likely to receive suboptimal treatments. They have inferior survival compared to local patients. Our findings highlight the need for the provision of cancer therapy in such vulnerable populations. We suggest that more attention should be paid to breast cancer, as it is the most common cancer among refugees.
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