The platelet-lymphocyte ratio improves the predictive value of serum CA19-9 levels in determining patient selection for staging laparoscopy in suspected periampullary cancer

Smith, Roger; Bosonnet, L.; Ghaneh, Paula; Sutton, Robert; Evans, Julian; Healey, Priya; Garvey, C.J.; Hughes, Monica A.; Raraty, Michael; Campbell, Fiona; Neoptolemos, John P.

doi:10.1016/j.surg.2007.12.014

Cited by 107 publications

(99 citation statements)

References 33 publications

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“…Recently, thrombocytosis and lymphocytopenia have been reported as a marker in host systemic inflammation. In the same study, it was emphasized that PLR is a novel marker for inflammation, which incorporates both hematological factors (Smith et al, 2008). In addition, an association between PLR and uterine malign lesions was demonstrated (Acmaz et al, 2014).…”

Section: Discussionmentioning

confidence: 92%

Could the Platelet-to-Lymphocyte Ratio be a Novel Marker for Predicting Invasiveness of Cervical Pathologies?

Köse

Çelik²,

Köse³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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Asian Pac J Cancer Prev, 16 (3), 923-926 IntroductionThe term preinvasive disease of the cervix (PCD) was first defined in 1947 (Pund, 1947). Despite the fact that epithelial changes give the appearance of invasive cancer on the cervix, lesions confined to the epithelium are to be noted in PCD. After PCD is defined, some studies have shown that if these lesions did not treat cervical dysplasia, it progresses to cervical cancer (Koss et al., 1963). Therefore, when the preinvasive lesions could be diagnosed before the stage of the invasive cervical cancer, this early detection allows easy treatment (Richart & Sciarra, 1968).Cervical cancer (CC) is still one of the most frequent malignancies in women worldwide (Siegel, Naishadham & Jemal, 2013). In CC, like the other cancers, the host response to malignant tumors comprises not only changes in the microenvironment, but also systemic alterations (Tavares-Murta et al., 2010). One of the important systemic alterations is inflammation. Inflammation is a nonspecific feature of cancer and plays an important role in various aspects of cancer involving cancer initiation, promotion, progression, metastasis and clinical features (Babu et al., 2012). Therefore, inflammatory markers were studied in various cancer types as indicators of invasion (Acmaz et al., 2014).The platelet-lymphocyte ratio (PLR) is an inflammatory marker and has been studied in uterine cancer and uterine cancer precursor lesions (Acmaz et al., 2014). The aim of

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Section: Discussionmentioning

confidence: 92%

Could the Platelet-to-Lymphocyte Ratio be a Novel Marker for Predicting Invasiveness of Cervical Pathologies?

Köse

Çelik²,

Köse³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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“…17 . There are some studies about PLR and periampullary cancer in the literature but reports are not satisfactory 18,19 . There are valuable results in the studies about the role of PLR in terms of prognosis of the patients with breast and gynaecological malignancies 12,13,20,21 .…”

Section: Resultsmentioning

confidence: 99%

Platelet to Lymphocyte Ratio and Acute Appendicitis

Kahramanca¹,

Özgehan²,

Kaya³

et al. 2017

Kafkas J Med Sci

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“…The addition of platelet/lymphocyte ratio to the CA19.9 measurement has been useful in determining which patients should undergo laparoscopy. 35,36 18 Fluorine-2-fluoro-2-deoxy-D-glucose positron emission tomography in pancreatic cancer Positron emission tomography (PET) is a functional imaging technology that enables visualisation, characterisation and quantification of biological processes in vivo. By using positron-emitting radiotracers, PET provides unique information about the molecular and metabolic changes associated with disease.…”

Section: Standard Diagnostic Practicementioning

confidence: 99%

PET-PANC: multicentre prospective diagnostic accuracy and health economic analysis study of the impact of combined modality 18fluorine-2-fluoro-2-deoxy-d-glucose positron emission tomography with computed tomography scanning in the diagnosis and management of pancreatic cancer

Ghaneh

Hanson

Titman

et al. 2018

Health Technol Assess

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Background Pancreatic cancer diagnosis and staging can be difficult in 10–20% of patients. Positron emission tomography (PET)/computed tomography (CT) adds precise anatomical localisation to functional data. The use of PET/CT may add further value to the diagnosis and staging of pancreatic cancer. Objective To determine the incremental diagnostic accuracy and impact of PET/CT in addition to standard diagnostic work-up in patients with suspected pancreatic cancer. Design A multicentre prospective diagnostic accuracy and clinical value study of PET/CT in suspected pancreatic malignancy. Participants Patients with suspected pancreatic malignancy. Interventions All patients to undergo PET/CT following standard diagnostic work-up. Main outcome measures The primary outcome was the incremental diagnostic value of PET/CT in addition to standard diagnostic work-up with multidetector computed tomography (MDCT). Secondary outcomes were (1) changes in patients’ diagnosis, staging and management as a result of PET/CT; (2) changes in the costs and effectiveness of patient management as a result of PET/CT; (3) the incremental diagnostic value of PET/CT in chronic pancreatitis; (4) the identification of groups of patients who would benefit most from PET/CT; and (5) the incremental diagnostic value of PET/CT in other pancreatic tumours. Results Between 2011 and 2013, 589 patients with suspected pancreatic cancer underwent MDCT and PET/CT, with 550 patients having complete data and in-range PET/CT. Sensitivity and specificity for the diagnosis of pancreatic cancer were 88.5% and 70.6%, respectively, for MDCT and 92.7% and 75.8%, respectively, for PET/CT. The maximum standardised uptake value (SUVmax.) for a pancreatic cancer diagnosis was 7.5. PET/CT demonstrated a significant improvement in relative sensitivity (p = 0.01) and specificity (p = 0.023) compared with MDCT. Incremental likelihood ratios demonstrated that PET/CT significantly improved diagnostic accuracy in all scenarios (p < 0.0002). PET/CT correctly changed the staging of pancreatic cancer in 56 patients (p = 0.001). PET/CT influenced management in 250 (45%) patients. PET/CT stopped resection in 58 (20%) patients who were due to have surgery. The benefit of PET/CT was limited in patients with chronic pancreatitis or other pancreatic tumours. PET/CT was associated with a gain in quality-adjusted life-years of 0.0157 (95% confidence interval –0.0101 to 0.0430). In the base-case model PET/CT was seen to dominate MDCT alone and is thus highly likely to be cost-effective for the UK NHS. PET/CT was seen to be most cost-effective for the subgroup of patients with suspected pancreatic cancer who were thought to be resectable. Conclusion PET/CT provided a significant incremental diagnostic benefit in the diagnosis of pancreatic cancer and significantly influenced the staging and management of patients. PET/CT had limited utility in chronic pancreatitis and other pancreatic tumours. PET/CT is likely to be cost-effective at current reimbursement rates for PET/CT to the UK NHS. This was not a randomised controlled trial and therefore we do not have any information from patients who would have undergone MDCT only for comparison. In addition, there were issues in estimating costs for PET/CT. Future work should evaluate the role of PET/CT in intraductal papillary mucinous neoplasm and prognosis and response to therapy in patients with pancreatic cancer. Study registration Current Controlled Trials ISRCTN73852054 and UKCRN 8166. Funding The National Institute for Health Research Health Technology Assessment programme.

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The platelet-lymphocyte ratio improves the predictive value of serum CA19-9 levels in determining patient selection for staging laparoscopy in suspected periampullary cancer

Cited by 107 publications

References 33 publications

Could the Platelet-to-Lymphocyte Ratio be a Novel Marker for Predicting Invasiveness of Cervical Pathologies?

Could the Platelet-to-Lymphocyte Ratio be a Novel Marker for Predicting Invasiveness of Cervical Pathologies?

Platelet to Lymphocyte Ratio and Acute Appendicitis

PET-PANC: multicentre prospective diagnostic accuracy and health economic analysis study of the impact of combined modality 18fluorine-2-fluoro-2-deoxy-d-glucose positron emission tomography with computed tomography scanning in the diagnosis and management of pancreatic cancer

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