C-reactive protein/albumin ratio and Glasgow prognostic score are associated with prognosis and infiltration of Foxp3+ or CD3+ lymphocytes in colorectal liver metastasis

Abstract

Background Inflammatory indices and tumor-infiltrating lymphocytes (TILs) have prognostic value in many cancer types. This study aimed to assess the prognostic value of inflammatory indices and evaluate their correlation with survival and presence of TILs in patients with colorectal liver metastasis (CRLM). Methods Medical records of 117 patients who underwent hepatectomy for CRLM were retrospectively reviewed. We calculated inflammatory indices comprising the neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, C-reactive protein/albumin ratio (CAR), and Glasgow prognostic score (GPS). Furthermore, we evaluated the relationship between these ratios and the GPS and survival rates and immunohistochemical results of tumor-infiltrating CD3+, CD8+, and Foxp3+ lymphocytes. Results The patients with low CAR values and low GPS had significantly better overall survival as per the log-rank test (p = 0.025 and p = 0.012, respectively). According to the multivariate analysis using the Cox proportional hazard model, the CAR (hazard ratio [HR], 0.57; 95% confidence interval [CI], 0.33–0.99; p = 0.048) and GPS (HR, 0.40; 95% CI, 0.19–0.83; p = 0.013) were independent prognostic factors. Additionally, Foxp3+ lymphocytes were more common in samples from the patients with a low CAR (p = 0.041). Moreover, the number of CD3+ TILs was significantly higher in the patients with a low GPS (p = 0.015). Conclusions The CAR and GPS are simple, inexpensive, and objective markers associated with predicting survival in patients with CRLM. Moreover, they can predict the presence of Foxp3+ and CD3+ lymphocytes in the invasive margin of a tumor. Trial registration Retrospectively registered. https://www.kurume-u.ac.jp/uploaded/attachment/14282.pdf.

Rifaximin Improves Liver Functional Reserve by Regulating Systemic Inflammation

“…In addition, increasing levels of inflammatory cytokines such as interleukin (IL)-6 and tumor necrosis factor-alpha (TNF-α) trigger the inflammatory immune response and predispose patients with cirrhosis to infectious complications such as sepsis [ 16 ]. Thus, systemic inflammation and immune function are inextricably linked, and serological inflammation-based markers that reflect them have been developed; furthermore, their association with prognosis in various diseases has been reported [ 17 , 18 ]. In addition, several inflammation-based markers, such as C-reactive protein (CRP) and neutrophil-to-lymphocyte ratio (NLR), can predict outcomes in patients with cirrhosis [ 19 , 20 ].…”