Abstract
The role of systemic inflammation-based markers remains uncertain in advanced or metastatic neuroendocrine tumours (nets). Systemic inflammatory factors, such as levels of circulating white blood cells and other blood components, were combined to yield inflammation-based prognostic scores [high-sensitivity inflammation-based Glasgow prognostic score (hsgps), neutrophil:lymphocyte ratio (nlr), platelet:lymphocyte ratio (plr), high-sensitivity inflammation-based prognostic index (hspi), and prognostic nutritional index (pni)], whose individual values as prognostic markers were retrospectively determined. Univariate and multivariate analyses were used to examine the association of inflammatory markers with overall survival (os). The study included 135 patients. Univariate analysis revealed that elevated white blood cell count, elevated neutrophil count, low serum albumin, elevated high-sensitivity C-reactive protein, and elevated hspi, hsgps, and nlr scores were significantly associated with worse os. Multivariate analyses demonstrated that, apart from pathology grade and original site of the tumour, elevated hspi (p = 0.004) was an independent prognostic factor for worse os. In the present study, elevated pretreatment hspi was observed to be an independent predictor of shorter os in patients with inoperable advanced or metastatic net. The hspi might thus provide additional guidance for therapeutic decision-making in such patients.
Highlights
Neuroendocrine tumours constitute a heterogeneous group of malignancies that originate from cells of the endocrine system, most commonly the gastrointestinal tract[1]
Study findings suggest that systemic inflammation–based scores—and, in particular, an elevated pretreatment hs-pi score—are independent predictors of shorter os in patients with inoperable advanced or metastatic net
Because the relationship between crp-based systemic inflammation–related prognostic scores and advanced or metastatic nets has not been examined, we further considered the individual markers of crp, lymphocyte count, wbc count, neutrophil count, and the combined markers of gps, hs-pi, pni, nlr, and plr, analyzing their correlation with os and clinicopathologic parameters
Summary
Neuroendocrine tumours (nets) constitute a heterogeneous group of malignancies that originate from cells of the endocrine system, most commonly the gastrointestinal tract[1]. Because these tumours have been regarded as relatively rare, their biology and molecular characteristics, and the optimal treatment strategy for affected patients, are far from clear[2,3,4]. Tumour grade, and site of tumour origin are well established prognostic factors for patients with nets[6]. Even within the same classification of those factors, response to treatment and survival vary from patient to patient[7]. The role of systemic inflammation–based markers remains uncertain in advanced or metastatic neuroendocrine tumours (nets)
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