Abstract
BackgroundIn this study, the influence of the neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) on the prognosis of giant cell tumor (GCT) of the extremities were investigated.MethodsThe clinical parameters of 163 patients who were diagnosed with GCT of the extremities between July 2008 and January 2018 were retrospectively analyzed. Optimal cutoff values of NLR and PLR were determined using receiver operating characteristic (ROC) analysis. According to optimal cutoff values, patients were divided into high NLR and low NLR groups or high PLR and low PLR groups. Kaplan-Meier and log-rank methods were used to compare the recurrence-free survival (RFS) between the high and low NLR groups, and between the high and low PLR groups. Univariate analysis was performed to determine the influence of age, gender, neutrophil count, lymphocyte count, platelet count, white blood cell count, tumor size, surgical approach and Campanacci stage on the prognosis of giant cell tumor of bone. The main predictors of RFS were determined by Cox multivariate regression analysis.ResultsThe optimal cutoff value of NLR in giant cell tumor of the extremities was 2.32, which was used to classify patients into high and low NLR groups. The optimal cutoff value of PLR was 116.81, and was used to classify patients into high and low PLR groups. Campanacci stage, tumor maximum diameter, alkaline phosphatase, and C-reactive protein (CRP) were significantly associated with the high NLR and PLR. Cox multivariate regression analysis revealed that the Campanacci stage (HR = 3.28, 95% CI: 1.24~8.69) and NLR (HR = 4.18, 95% CI: 1.83~9.57) were independent prognostic factors for giant cell tumor of the extremities.ConclusionAs a novel inflammatory index, NLR has some predictive power for the prognosis of patients with giant cell tumor of the extremities.
Highlights
In this study, the influence of the neutrophil-to-lymphocyte ratio (NLR) and the platelet-tolymphocyte ratio (PLR) on the prognosis of giant cell tumor (GCT) of the extremities were investigated
The inclusion criteria comprised the following: (1) All patients with histopathological diagnosis of giant cell tumor of the extremities were classified according to the Campanacci method [1]; (2) All patients underwent expanded curettage or extensive resection according to standard surgical procedures; (3) All inflammatory markers were measured before anti-tumor therapy, such as surgery; (4) No blood disease, infection, or fever; (5) No chronic diseases, such as diabetes and chronic obstructive pulmonary disease; (6) All patients were treated for the first time in our hospital
This study showed that both NLR and PLR influenced the recurrence of giant cell tumor of the extremities based on univariate analysis
Summary
The influence of the neutrophil-to-lymphocyte ratio (NLR) and the platelet-tolymphocyte ratio (PLR) on the prognosis of giant cell tumor (GCT) of the extremities were investigated. Many cytokines produced during tumor growth, such as interleukins (ILs), vascular endothelial growth factor (VEGF) and tumor necrosis factor (TNF), stimulate the production of granulocytes and platelets [18,19,20,21]. These cytokines are associated with cell proliferation, invasion, migration, angiogenesis and metastasis. Activated platelets release large amounts of growth factors that modulate inflammatory responses and promote tumor growth and metastasis [23]. Neutrophils inhibit cytotoxic T cells and lymphokine-activated anti-tumor cells thereby causing immune tolerance of tumor antigen, allowing tumors to escape the immune system [26]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
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 callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
