Abstract
BackgroundThe neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR), two low cost, routinely available inflammatory indices, have been found to be associated with risk of death in patients with solid cancer, in both general population and HIV-positive subjects. However, no study investigated the role of NLR and PLR as predictive of cancer incidence so far.MethodsThe aim of our study was to assess the association of PLR and NLR with risk of developing solid non-AIDS defining cancer (NADC) in HIV-infected subjects. We conducted a multicenter Italian cohort study from 2000 to 2012 including HIV-infected subjects naïve at antiretroviral treatment at enrollment. The associations of NLR and PLR with NADC incidence were evaluated by univariate and multivariate analyses using both time independent and time dependent Cox proportional hazard models.ResultsThirteen thousand five hundred fifty-nine patients (73.3 % males) with a mean age of 36.0 years (SD 10.0) were included. The median (inter-quartile range) of NLR and PLR at baseline were 1.47 (1.03–2.17) and 109.9 (79.6–155.3), respectively. During a median follow-up of 3.9 years, 337 subjects had a first diagnosis of solid NADC. The crude and age- and gender-standardized incidence rates were 3.57 and 3.91 per 1000 person-years, respectively. No statistically significant association was found between NLR and PLR and NADC incidence, using multivariate models, including also time-dependent Cox models with a cubic-spline for NLR and PLR.ConclusionThis study does not sustain the hypothesis that NRL and PLR may be useful for predicting the risk of cancer in HIV positive subjects.Electronic supplementary materialThe online version of this article (doi:10.1186/s13027-015-0032-y) contains supplementary material, which is available to authorized users.
Highlights
Chronic inflammation is thought to be a key mediator of cancer through the mobilization of transcription factors and inflammatory mediators, as recruitment of inflammatory cells, including neutrophils and megakaryocytes, causes neutrophilia and thrombocytosis on the cancer site, leading to tumor promotion, invasion, and metastasis [1]
In HIV infected subjects, the incidence of non-AIDS related chronic disorders, cancer, has increased in last decade, even in those with long-term antiretroviral therapy (ART), and it is higher than the general population [5, 6], possibly due to residual chronic immune activation and inflammation [7,8,9,10]
The neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are low cost, routine available, inflammatory indices, which have been demonstrated useful for predicting risk of death in patients with solid cancer in the general population, independently of tumor characteristics [13,14,15]
Summary
Chronic inflammation is thought to be a key mediator of cancer through the mobilization of transcription factors and inflammatory mediators, as recruitment of inflammatory cells, including neutrophils and megakaryocytes, causes neutrophilia and thrombocytosis on the cancer site, leading to tumor promotion, invasion, and metastasis [1]. Higher levels of several inflammatory biomarkers have been found to be associated with increased risk of AIDS and non-AIDS events, including cancer in these patients [11, 12]. The neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are low cost, routine available, inflammatory indices, which have been demonstrated useful for predicting risk of death in patients with solid cancer in the general population, independently of tumor characteristics [13,14,15]. The neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR), two low cost, routinely available inflammatory indices, have been found to be associated with risk of death in patients with solid cancer, in both general population and HIV-positive subjects. No study investigated the role of NLR and PLR as predictive of cancer incidence so far
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
