Neutrophil-to-lymphocyte ratio is an independent predictor for survival outcomes in cervical cancer: a systematic review and meta-analysis

Zou, Peijun; Yang, Eun Jung; Li, Zhengyu

doi:10.1038/s41598-020-79071-x

Cited by 28 publications

(21 citation statements)

References 47 publications

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“…[29][30][31] A meta-analysis of 14 studies comprising 6041 patients with cervical cancer (SCC and adenocarcinoma) demonstrated that an elevated NLR was associated with short PFS and OS. 32 Our study showed that a high NLR was associated with short PFS and OS. Although the mechanism underlying the poorer outcomes of increased NLR has not been clarified, neutrophils have been shown to suppress the activity of lymphocytes and T cell response.…”

Section: Discussionmentioning

confidence: 51%

PD‐L1 expression and immune stromal features in HPV‐independent cervical adenocarcinoma

Song

Meng

et al. 2021

Histopathology

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Human papilloma virus (HPV)-independent cervical adenocarcinoma (CA) is usually diagnosed at an advanced stage, while the therapeutic options are limited. Therefore, effective treatment options are required. The programmed cell death 1 (PD-1) inhibitor pembrolizumab has been approved for the treatment of patients with recurrent or metastatic cervical squamous cell carcinoma expressing PD-ligand 1 (PD-L1). However, no data regarding PD-L1 expression in HPV-independent CA are available. Thus, we evaluated the association between PD-L1 expression and the clinicopathological characteristics and survival of patients with HPV-independent CA. Methods: We evaluated PD-L1, mismatch repair (MMR) protein expression and the immune stromal features of 44 patients with HPV-independent CA. PD-L1 expression was defined as a combined positive score (CPS) ≥1 and a tumour proportion score (TPS) ≥1%.Results: PD-L1 expression was observed in 14 cases (31.8%) with CPS ≥1 and 12 cases (27.3%) with TPS ≥1%. PD-L1 expression, based on either the CPS or the TPS, was associated with a high tumourinfiltrating lymphocyte percentage (CPS = P < 0.001; TPS = P < 0.001). Patients with a PD-L1 CPS ≥1 showed worse progression-free survival and overall survival than PD-L1-negative patients (P = 0.004 and P = 0.023, respectively). Forty-two cases demonstrated intact MMR expression and two cases demonstrated loss of MSH2/MSH6. Conclusions: Our data demonstrated that PD-L1 was expressed in HPV-independent CA, especially in clear cell carcinoma, and that PD-L1 expression is a negative prognostic marker. Our data support the role of PD-L1 in HPV-independent CA and its potential as an immunotherapeutic target.

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Section: Discussionmentioning

confidence: 51%

PD‐L1 expression and immune stromal features in HPV‐independent cervical adenocarcinoma

Song

Meng

et al. 2021

Histopathology

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“…NLR and PLR can be easily calculated from the routine blood cell count and are more stable and predictive than each parameter alone. Similar to NLR, PLR served as a novel marker of systemic inflammation, and both biomarkers were shown to be independently related to other inflammatory markers [ 16 ] and composite adverse outcomes in various diseases, such as chronic obstructive pulmonary disease [ 17 ], metastatic renal cell carcinoma [ 18 ], non-small-cell lung cancer [ 19 ], and cervical cancer [ 20 ]. Furthermore, NLR and PLR could also predict the presence of proteinuria [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

High Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio Are Associated with Poor Survival in Patients with Hemodialysis

Zhang

Wang

et al. 2021

BioMed Research International

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Background. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are markers for systemic inflammation condition. Although NLR has emerged as a risk factor for poor survival in end-stage renal disease (ESRD) patients, the relationship between PLR and mortality is still unknown. We aimed to explore the interaction of NLR and PLR in predicting mortality in hemodialysis (HD) patients. Method. We enrolled 360 HD patients for a 71-month follow-up. The endpoint was all-cause and cardiovascular (CV) mortality. Pearson correlation analysis was conducted to evaluate the relationship between factors and NLR or PLR. Kaplan-Meier curves and Cox proportional analysis were used to assess the prognostic value of NLR and PLR. Results. NLR was positively correlated with neutrophil and negatively correlated with lymphocyte, hemoglobin, and serum albumin. PLR was positively correlated with neutrophil and platelet and negatively correlated with lymphocyte and hemoglobin. In multivariate Cox regression, a higher NLR level was independently associated with all-cause mortality (OR 2.011, 95% CI 1.082-3.74, p = 0.027 ), while a higher PLR level might predict CV mortality (OR 2.768, 95% CI 1.147-6.677, p = 0.023 ) in HD patients. Conclusion. NLR and PLR are cheap and reliable biomarkers for all-cause and CV mortality to predict survival in HD patients.

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“…Tumor-induced neutrophilia and thrombocytosis, which may be considered a sign of systemic inflammation, and relative lymphocytopenia, which occurs as part of the antitumor immune response, are frequently observed [47]. In a meta-analysis, an elevated pretreatment neutrophil to lymphocyte ratio was confirmed as an independent predictor of a decreased OS and PFS, regardless of stage or primary treatment [48]. In addition, a systemic immune inflammation index based on peripheral neutrophil, lymphocyte and platelet counts was established in cervical cancer patients after primary surgery.…”

Section: Hematological Parametersmentioning

confidence: 98%

Molecular Markers to Predict Prognosis and Treatment Response in Uterine Cervical Cancer

Fleischmann

Chatzikonstantinou

Fokas

et al. 2021

Cancers

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Uterine cervical cancer is one of the leading causes of cancer-related mortality in women worldwide. Each year, over half a million new cases are estimated, resulting in more than 300,000 deaths. While less-invasive, fertility-preserving surgical procedures can be offered to women in early stages, treatment for locally advanced disease may include radical hysterectomy, primary chemoradiotherapy (CRT) or a combination of these modalities. Concurrent platinum-based chemoradiotherapy regimens remain the first-line treatments for locally advanced cervical cancer. Despite achievements such as the introduction of angiogenesis inhibitors, and more recently immunotherapies, the overall survival of women with persistent, recurrent or metastatic disease has not been extended significantly in the last decades. Furthermore, a broad spectrum of molecular markers to predict therapy response and survival and to identify patients with high- and low-risk constellations is missing. Implementation of these markers, however, may help to further improve treatment and to develop new targeted therapies. This review aims to provide comprehensive insights into the complex mechanisms of cervical cancer pathogenesis within the context of molecular markers for predicting treatment response and prognosis.

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Neutrophil-to-lymphocyte ratio is an independent predictor for survival outcomes in cervical cancer: a systematic review and meta-analysis

Cited by 28 publications

References 47 publications

PD‐L1 expression and immune stromal features in HPV‐independent cervical adenocarcinoma

PD‐L1 expression and immune stromal features in HPV‐independent cervical adenocarcinoma

High Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio Are Associated with Poor Survival in Patients with Hemodialysis

Molecular Markers to Predict Prognosis and Treatment Response in Uterine Cervical Cancer

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