Abstract
The association between leukocytosis and poor disease prognosis has been reported in several types of cancer. However, to date, the potential mechanism of this predictive model has not been presented. Objective. To examine the correlation between the level of NETosis markers and white blood cell (WBC) count in the blood plasma of gynecologic oncology patients before treatment and the role of these indicators in predicting the course of disease. Patients and methods. This retrospective single-center non-randomized study included 212 patients hospitalized for surgical treatment and chemotherapy between 2016 and 2020: 58 with ovarian cancer, 44 with cervical cancer, 56 with breast cancer, and 54 with uterine cancer. Upon hospitalization, all patients had their WBC counts and other blood counts determined and recorded in a unified database. NETosis markers (citH3 and MPO:Ag concentrations) were determined in patients’ frozen plasma samples. Results. The WBC count of >7·109/L before treatment was noted in patients with later stages of disease according to the TNM (tumor–node–metastasis) staging system. Patients with higher WBC counts had significantly higher MPO:Ag concentrations. The overall survival and progression-free survival rates were significantly worse in patients with WBC >7·109/L and elevated concentrations of NETosis markers before treatment. Conclusion. The results obtained indicate that preoperative leukocytosis is associated with NETosis activation and is observed in patients with advanced stages of disease and poor prognosis. Key words: white blood cells, neutrophil extracellular traps, leukocytosis, NETosis, myeloperoxidase, citrullinated histone
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