Neutrophil-to-Lymphocyte Ratio (NLR) as a Poor Predictive Biomarker for Pathological Response to Neoadjuvant Chemoradiation in Locally Advanced Rectal Cancer: A Prospective Study

Abstract

Background:The literature is inconsistent for the role of neutrophil-to-lymphocyte ratio (NLR) obtained before neoadjuvant therapy (pre-NLR) in predicting pathological response to neoadjuvant chemoradiation (neoCRT) in patients with locally advanced rectal cancer (LARC). In the present cohort study, we explored the predictive role of pre-NLR in this setting. Methods: We prospectively included patients with LARC who were candidates for neoCRT at the Shohada-e-Hafte Tir Hospital (Tehran, Iran) between Mar 2018 and Feb 2020. The pre-NLR was obtained through a peripheral blood smear before CRT. We used the AJCC system for evaluating tumor regression grade (TRG). The TRGs were categorized into: response-group 1 (TRG 0-1 vs. 2-3), response-group 2 (TRG 0 vs. 1-3), and responsegroup 3 (TRG 0-2 vs. 3). We applied receiver operating characteristic (ROC) analysis to assess the predictive value of pre-NLR. Results: Of the 86 screened patients with rectal cancer, 30 patients who fulfilled the inclusion criteria were included in the study. In total, 63.3% were responsive, and 23.3% had complete pathologic response. Pre-NLR could not predict the pathologic response in response-group 1 (area under the ROC curve [AUC]: 0.45, 95%CI 0.23-0.66) and response-group 2 (AUC: 0.36, 95%CI 0.13-0.59). Nevertheless, it had a poor predictive value in response-group 3 (AUC: 0.55, CI%95 0.33-0.75) with an optimal NLR cutoff value of 2.94. Conclusions: Pre-NLR could not predict the pathological response to neoCRT in our cohort of patients with LARC.

Correlation between rs1800871, rs1800872 and rs1800896 Polymorphisms at IL-10 Gene and Lung Cancer Risk

“…In the current meta-analysis, a significant heterogeneity existed for -819T>C and -1082A>G polymorphisms under almost genetic models in overall, but not for IL-10 -592A>C. After subgroup analyses by ethnicity, the heterogeneity was not decreased by ethnicity, suggesting that other factors such as gene-environment factors or histological type cause the heterogeneity. In the meta-analysis, publication bias was analyzed by Begg’s funnel plots and the Egger’s test and no significant publication bias was detected, suggesting the reliability of our results [ 73 - 75 ]. Our results showed a publication bias for IL-10 -1082A>G polymorphism under the heterozygote model.…”

Lack of Association between TP73 G4C14-A4T14 Polymorphism and Cervical Cancer Risk in Overall and Asian Women: A Meta-Analysis

“…It is well known that single nucleotide polymorphisms (SNPs) are the most common sources of human genetic variation, which may contribute to an individual’s susceptibility to cancer [ 50 , 11 , 28 ]. Here, we have carried out a meta-analysis based on 10 case-control studies with 1804 cases and 2433 controls to obtain a more conclusive result on relationship between TP73 G4C14-A4T14 polymorphism and cervical cancer.…”

“…However, it seems that prevalence of this cancer in Iran is less than that of western countries [ 9 , 10 ]. A retrospective cohort study by using data of Iranian National Cancer Registry System from 2008 to 2014 showed that the mean age of the cervical cases was 51.91 years and their 5- and 10-year survival rates were 58% and 50%, respectively [ 11 , 12 ].…”

Advances in Precision Medicine Approaches for Colorectal Cancer: From Molecular Profiling to Targeted Therapies

“…Microsatellite instability (MSI) and DNA mismatch repair deficiency (dMMR) represent another group of predictive biomarkers in colorectal cancer. Tumors with high levels of MSI or dMMR are more likely to respond to immune checkpoint inhibitors, such as programmed cell death protein 1 (PD-1) inhibitors. , This is because these tumors tend to have a higher mutational load and increased levels of immune cell infiltration, making them more susceptible to immunotherapies. The identification of MSI or dMMR status helps select patients who are most likely to benefit from immunotherapy, highlighting the importance of these biomarkers in treatment decisions.…”