Abstract
Introduction Stage IIB cervical cancer (CC) is an advanced stage CC with poor prognosis. Inflammatory response plays a crucial role in the development of CC, and systemic inflammatory indexes were related to the prognosis in several cancers. The objective of the study was to determine the prognostic value of platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), basophil-to-lymphocyte ratio (BLR), and systemic inflammation response index (SIRI) as inflammatory indexes in patients with stage IIB CC. Materials and Methods A retrospective study was performed in 260 patients with stage IIB CC. PLR, NLR, MLR, BLR, and SIRI were obtained from routine blood tests. Prognosis information of the patients was acquired from regular clinical follow-up. Recurrence and response to therapy were determined through electronic medical records (EMRs). Correlations of the inflammatory indexes with overall survival (OS), progression-free survival (PFS), recurrence, and response to therapy were analyzed using SPSS version 26.0 software. Results Receiver operating characteristic (ROC) curve analyses suggested that NLR, MLR, and SIRI had better predictive value than PLR as well as BLR in the prognosis and recurrence risk. Both univariate and multivariate survival analyses showed that higher NLR and MLR were significantly associated with shorter OS as well as PFS, whereas SIRI was not an independent predictive factor of PFS. Chi-square test results revealed that increased NLR was significantly correlated with higher recurrence rate (P=0.046), and increased MLR showed significant correlation with elevated recurrence risk (P=0.002). Univariate and binary logistic regression analyses for response to therapy indicated that elevated NLR was associated with decreased complete remission (CR) rate (P=0.031), and the P value lost statistical significance while being adjusted by tumor size (P=0.108). Conclusions For patients with stage IIB CC, both NLR and MLR are independent prognostic factors as well as risk factors for recurrence; NLR serves as a potential marker for therapeutic response.
Highlights
Stage IIB cervical cancer (CC) is an advanced stage CC with poor prognosis
There were numerous published studies that had demonstrated the prognostic value of inflammatory indexes (PLR, neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), basophil-to-lymphocyte ratio (BLR), and systemic inflammation response index (SIRI)) for CC patients [17, 37,38,39,40,41,42,43], whether the inflammatory indexes serve as predictive factors for prognosis, recurrence, and therapeutic response in patients with stage IIB cervical cancer remains unknown. e aim of the study is to investigate the inflammatory indexes including platelet-to-lymphocyte ratio (PLR), BLR, NLR, MLR, and SIRI as the biomarkers in predicting clinical outcome in patients with stage IIB CC
(3) Blood transfusion within one week prior to the therapy. 353 candidate patients with stage IIb CC were selected from electronic medical records (EMRs) in the hospital; 260 patients with stage IIb CC were included in accordance with the inclusion and exclusion criteria (Figure 1)
Summary
Cervical cancer (CC) is one of the most common female cancers, with the high mortality among women suffering from cancers, especially in developing countries [1]. Erefore, systemic inflammatory factors, such as platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and basophil-to-lymphocyte ratio (BLR), have been increasingly studied on the connection with cancer prognosis [13,14,15,16,17]. There were numerous published studies that had demonstrated the prognostic value of inflammatory indexes (PLR, NLR, MLR, BLR, and SIRI) for CC patients [17, 37,38,39,40,41,42,43], whether the inflammatory indexes serve as predictive factors for prognosis, recurrence, and therapeutic response in patients with stage IIB cervical cancer remains unknown. E aim of the study is to investigate the inflammatory indexes including PLR, BLR, NLR, MLR, and SIRI as the biomarkers in predicting clinical outcome in patients with stage IIB CC There were numerous published studies that had demonstrated the prognostic value of inflammatory indexes (PLR, NLR, MLR, BLR, and SIRI) for CC patients [17, 37,38,39,40,41,42,43], whether the inflammatory indexes serve as predictive factors for prognosis, recurrence, and therapeutic response in patients with stage IIB cervical cancer remains unknown. e aim of the study is to investigate the inflammatory indexes including PLR, BLR, NLR, MLR, and SIRI as the biomarkers in predicting clinical outcome in patients with stage IIB CC
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