Pre-treatment lymphopenia as a prognostic biomarker in colorectal cancer patients receiving chemotherapy

Cézé, Nicolas; Thibault, Gilles; Goujon, Gaël; Viguier, Jérôme; Watier, Hervé; Dorval, Étienne; Lecomte, Thierry

doi:10.1007/s00280-011-1610-3

Cited by 107 publications

(81 citation statements)

References 40 publications

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“…Although neutrophils are considered to be the first line of defense against infections, lymphocytes have been reported to play a crucial role in tumor defense by inducing cytotoxic cell death and inhibiting tumor cell proliferation and migration in the tumor microenvironment [28]. In addition, the prognostic value of lymphopenia has been demonstrated in nonhematopoietic malignancies, including pancreatic cancer, esophageal cancer, colorectal cancer, and renal cell carcinoma [29-32]. In fact, the present study demonstrated that DCC patients with low lymphocyte count, high NLR, high PLR, and low LMR tended to have worse prognosis, indicating a direct influence of lymphopenia on tumor progression.…”

Section: Discussionmentioning

confidence: 99%

Association of Preoperative Platelet-to-Lymphocyte Ratio with Poor Outcome in Patients with Distal Cholangiocarcinoma

et al. 2019

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Background: Several preoperative systemic inflammatory parameters, such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and Glasgow Prognostic Score, have been reported to be associated with the prognosis of solid tumors. However, there are conflicting survival data regarding these parameters in cholangiocarcinoma. Objectives: In this study, we performed a retrospective cohort analysis of patients with distal cholangiocarcinoma (DCC) who underwent surgical resection to evaluate the prognostic value of a cluster of preoperative hematological inflammatory parameters for survival. Method: Fifty-three patients with DCC who underwent pancreaticoduodenectomy with curative intent were enrolled. The optimal cutoff values of hematological inflammatory parameters, including the absolute lymphocyte count, NLR, PLR, and LMR, were determined by time-dependent receiver operating characteristic analysis. Results: The univariate analysis for overall survival (OS) of conventional factors and hematological inflammatory parameters identified that portal vein invasion and PLR had p values of ≤0.1. The univariate analysis for disease-free survival (DFS) identified that lymph node metastasis, PLR, lymphocyte count, and number of positive lymph nodes (≥3) had p values of ≤0.1. These factors were incorporated into the full model and variables were selected using the backward stepwise method. The multivariate analysis identified portal vein invasion and high PLR as independent prognostic factors for OS (p = 0.033 and 0.039, respectively) and high PLR and number of positive lymph nodes (≥3) as independent prognostic factors for DFS (p = 0.016 and 0.004, respectively). Conclusions: Preoperative PLR assessment may be useful for detecting high-risk DCC patients undergoing surgical resection for aggressive adjuvant therapy.

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Section: Discussionmentioning

confidence: 99%

Association of Preoperative Platelet-to-Lymphocyte Ratio with Poor Outcome in Patients with Distal Cholangiocarcinoma

et al. 2019

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“…The median preoperative lymphocyte count was 1,690/mm 3 (range, 432-3,891), and 1,000 mm 3 was set as the cut-off value, in accordance with previous studies (15). Following the lymphocyte count, 171 patients were placed into the high-lymphocyte group and 18 patients into the low-lymphocyte group.…”

Section: Survival Analysis According To the Lymphocyte/monocyte Countmentioning

confidence: 99%

“…Previous studies have demonstrated a correlation between lymphopenia and poor prognosis of patients with various types of cancer (15,19). Lymphocytes induce cytotoxic cell death and produce cytokines that inhibit cancer cell proliferation and metastatic activity (4,20,21).…”

Section: Univariate Analysis Multivariate Analysis ------------------mentioning

confidence: 99%

“…Lymphocytes induce cytotoxic cell death and produce cytokines that inhibit cancer cell proliferation and metastatic activity (4,20,21). The absolute peripheral lymphocyte count is assumed to reflect the degree of responsiveness of the entire immune system of a patient (15,22). Therefore, a low peripheral lymphocyte count may result in a weak and insufficient immunological reaction to the tumor, thus promoting tumor progression and metastasis (23).…”

Section: Univariate Analysis Multivariate Analysis ------------------mentioning

confidence: 99%

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Prognostic significance of the preoperative lymphocyte-to-monocyte ratio in patients with colorectal cancer

et al. 2016

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Abstract.A correlation between the lymphocyte-to-monocyte ratio (LMR) and the survival of patients with hematological malignancies has been reported previously. However, there have been few studies investigating the prognostic significance of LMR in patients with solid tumors. The aim of the present study was to evaluate the prognostic significance of preoperative LMR in patients with colorectal cancer (CRC). A total of 189 patients undergoing potentially curative surgery for CRC were enrolled. The LMR was calculated from preoperative blood samples by dividing absolute lymphocyte count by absolute monocyte count. A cut-off value of 4.8 was set based on the receiver operating characteristic curve; 116 patients were classified as high-LMR, and 73 patients classified as low-LMR. The high-LMR group exhibited significantly better relapse-free survival (P=0.0018) and overall survival (P=0.0127) rates than the low-LMR group. According to the multivariate analysis of survival, preoperative LMR was identified as an independent prognostic factor for relapse-free survival (P=0.041) and overall survival (P=0.031). Therefore, preoperative LMR is a useful prognostic marker in patients with CRC. IntroductionColorectal cancer (CRC) is the third most common cancer and fourth leading cause of cancer-associated mortality worldwide (1). Despite advances in surgical procedures and adjuvant chemotherapy, 20-25% of patients still experience relapse following curative surgery (2). The Union for International Cancer Control (UICC) tumor node metastasis (TNM) staging system (3) is currently the most reliable indicator of patient prognosis and is widely used amongst practitioners. However, there are differences in patient prognosis even within the same TNM stage. Therefore, more reliable markers are required to improve predictions of cancer recurrence and patient survival.It has previously been reported that inflammation is important in determining cancer progression (4,5). Inflammation-based indices, such as the C-reactive protein level, Glasgow prognostic score, and neutrophil-to-lymphocyte ratio; are useful for predicting the prognosis of patients with CRC as well as various other types of cancer (6-9). Recent studies investigating various types of malignancies have demonstrated a correlation between the lymphocyte-to-monocyte ratio (LMR), which also reflects the degree of systemic inflammation, and patient survival (10-14). However, the prognostic value of the LMR has mainly been investigated in patients with hematological malignancies, with few reports focusing on patients with solid tumors. Therefore, the aim of this retrospective study was to evaluate the prognostic significance of preoperative LMR in patients with CRC who are able to undergo potentially curative surgery. Materials and methods Patients.A total of 189 patients with CRC were enrolled. All patients underwent potentially curative surgery for CRC in the Department of Surgical Oncology, Osaka City University, between January 2007 and December 2009. Patients who received ...

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“…16,17 More generally, T cell lymphopenia has been shown to be a grave prognostic indicator in multiple types of cancers. [18][19][20][21][22][23] Recently, digital PCR platforms have been developed that offer advantages over real time qPCR including the capability to obtain absolute quantification without external references and to be highly robust to variations in PCR efficiency, thus improving assay precision. [25][26][27] Digital PCR is based on limiting dilution of a sample into a large number of separate PCR reactions.…”

Section: Introductionmentioning

confidence: 99%

A comparison of DNA methylation specific droplet digital PCR (ddPCR) and real time qPCR with flow cytometry in characterizing human T cells in peripheral blood

et al. 2014

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Quantitating the copy number of demethylated CpG promoter sites of the CD3Z gene can be used to estimate the numbers and proportions of T cells in human blood and tissue. Quantitative methylation specific PCR (qPCR) is useful for studying T cells but requires extensive calibration and is imprecise at low copy numbers. Here we compared the performance of a new digital PCR platform (droplet digital PCR or ddPCR) to qPCR using bisulfite converted DNA from 157 blood specimens obtained from ambulatory care controls and patients with primary glioma. We compared both ddPCR and qPCR with conventional flow cytometry (FACS) evaluation of CD3 positive T cells. Repeated measures on the same blood sample revealed ddPCR to be less variable than qPCR. Both qPCR and ddPCR correlated significantly with FACS evaluation of peripheral blood CD3 counts and CD3/total leukocyte values. However, statistical measures of agreement showed that linear concordance was stronger for ddPCR than for qPCR and the absolute values were closer to FACS for ddPCR. Both qPCR and ddPCR could distinguish clinically significant differences in T cell proportions and performed similarly to FACS. Given the higher precision, greater accuracy, and technical simplicity of ddPCR, this approach appears to be a superior DNA methylation based method than conventional qPCR for the assessment of T cells.

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Pre-treatment lymphopenia as a prognostic biomarker in colorectal cancer patients receiving chemotherapy

Cited by 107 publications

References 40 publications

Association of Preoperative Platelet-to-Lymphocyte Ratio with Poor Outcome in Patients with Distal Cholangiocarcinoma

Association of Preoperative Platelet-to-Lymphocyte Ratio with Poor Outcome in Patients with Distal Cholangiocarcinoma

Prognostic significance of the preoperative lymphocyte-to-monocyte ratio in patients with colorectal cancer

A comparison of DNA methylation specific droplet digital PCR (ddPCR) and real time qPCR with flow cytometry in characterizing human T cells in peripheral blood

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