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Prognostic Model Built on Blood-based Biomarkers in Patients with Metastatic Colorectal Cancer

  • He, Wen-Zhuo (Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine) ;
  • Jiang, Chang (Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine) ;
  • Yin, Chen-Xi (Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine) ;
  • Guo, Gui-Fang (Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine) ;
  • Rong, Ru-Ming (Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine) ;
  • Qiu, Hui-Juan (Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine) ;
  • Chen, Xu-Xian (Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine) ;
  • Zhang, Bei (Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine) ;
  • Xia, Liang-Ping (Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine)
  • Published : 2014.09.15

Abstract

Background: We had previously showed that the neutrophil lymphocyte ratio (NLR), ${\gamma}$-glutamyl transpeptidase (GGT) and carcinoembryonic antigen (CEA) are prognostic factors for metastatic colorectal cancer (mCRC) patients. In this study we developed a prognostic model based on these three indices. Materials and Methods: A total of 243 patients who were initially diagnosed as mCRC between 2005 and 2010 in the Sun Yat-sen University Cancer Center were studied. The endpoint was overall survival (OS). Results: NLR>3, elevated GGT and elevated CEA were confirmed as independent risk factors which could predict poor prognosis. Patients could be divided into three groups according to the number of risk factors they had. Those with two or three were defined as the high risk group, individuals with one risk factor as the modest risk group and patients without risk factor as the low risk group. The OS values for these three groups were 16.2 months (2.80~68.8), 24.2 months (4.07~79.0), and 37.2 months (12.6~87.8), respectively (p<0.001). Conclusions: We developed a simple but useful model based on NLR, GGT and CEA to provide prognostic information to clinical practice in highly selected mCRC patients. Further prospective and multi-center studies are warranted to test our model.

Keywords

References

  1. An X, Ding PR, Li YH, et al (2010). Elevated neutrophil to lymphocyte ratio predicts survival in advanced pancreatic cancer. Biomarkers, 15, 516-22. https://doi.org/10.3109/1354750X.2010.491557
  2. Baba Y, Nosho K, Shima K, et al (2010). HIF1A overexpression is associated with poor prognosis in a cohort of 731 colorectal cancers. Am J Pathol, 176, 2292-301. https://doi.org/10.2353/ajpath.2010.090972
  3. Cao D, Hou M, Guan YS, et al (2009). Expression of HIF-1alpha and VEGF in colorectal cancer: association with clinical outcomes and prognostic implications. BMC Cancer, 9, 432. https://doi.org/10.1186/1471-2407-9-432
  4. Chiang SF, Hung HY, Tang R, et al (2012). Can neutrophil-tolymphocyte ratio predict the survival of colorectal cancer patients who have received curative surgery electively? Int J Colorectal Dis, 27, 1347-57. https://doi.org/10.1007/s00384-012-1459-x
  5. Cohen SJ, Punt CJ, Iannotti N, et al (2008). Relationship of circulating tumor cells to tumor response, progression-free survival, and overall survival in patients with metastatic colorectal cancer. J Clin Oncol, 26, 3213-21. https://doi.org/10.1200/JCO.2007.15.8923
  6. Farias IL, Farias JG, Rossato L, et al (2011). Correlation between TBARS levels and glycolytic enzymes: the importance to the initial evaluation of clinical outcome of colorectal cancer patients. Biomed Pharmacother, 65, 395-400. https://doi.org/10.1016/j.biopha.2011.04.026
  7. Franzini M, Corti A, Lorenzini E, et al (2006). Modulation of cell growth and cisplatin sensitivity by membrane gammaglutamyltransferase in melanoma cells. Eur J Cancer, 42, 2623-30. https://doi.org/10.1016/j.ejca.2006.04.016
  8. Franzini M, Bramanti E, Ottaviano V, et al (2008). A high performance gel filtration chromatography method for gamma-glutamyltransferase fraction analysis. Anal Biochem, 374, 1-6. https://doi.org/10.1016/j.ab.2007.10.025
  9. Franzini M, Corti A, Fornaciari I, et al (2009). Cultured human cells release soluble gamma-glutamyltransferase complexes corresponding to the plasma b-GGT. Biomarkers, 14, 486-92. https://doi.org/10.3109/13547500903093757
  10. Goldstein MJ, Mitchell EP (2005). Carcinoembryonic antigen in the staging and follow-up of patients with colorectal cancer. Cancer Invest, 23, 338-51. https://doi.org/10.1081/CNV-58878
  11. He W, Yin C, Guo G, et al (2013). Initial neutrophil lymphocyte ratio is superior to platelet lymphocyte ratio as an adverse prognostic and predictive factor in metastatic colorectal cancer. Med Oncol, 30, 439. https://doi.org/10.1007/s12032-012-0439-x
  12. He WZ, Guo GF, Yin CX, et al (2013). Gamma-glutamyl transpeptidase level is a novel adverse prognostic indicator in human metastatic colorectal cancer. Colorectal Dis, 15, 443-52. https://doi.org/10.1111/codi.12258
  13. Kemal Y, Yucel I, Ekiz K, et al (2014). Elevated serum neutrophil to lymphocyte and platelet to lymphocyte ratios could be useful in lung cancer diagnosis. Asian Pac J Cancer Prev, 15, 2651-4. https://doi.org/10.7314/APJCP.2014.15.6.2651
  14. Koukourakis MI, Giatromanolaki A, Sivridis E, Gatter KC, Harris AL (2006). Lactate dehydrogenase 5 expression in operable colorectal cancer: strong association with survival and activated vascular endothelial growth factor pathway--a report of the tumour angiogenesis research group. J Clin Oncol, 24, 4301-8. https://doi.org/10.1200/JCO.2006.05.9501
  15. Kwon HC, Kim SH, Oh SY, et al (2012). Clinical significance of preoperative neutrophil-lymphocyte versus plateletlymphocyte ratio in patients with operable colorectal cancer. Biomarkers, 17, 216-22. https://doi.org/10.3109/1354750X.2012.656705
  16. Noike T, Miwa S, Soeda J, Kobayashi A, Miyagawa S (2008). Increased expression of thioredoxin-1, vascular endothelial growth factor, and redox factor-1 is associated with poor prognosis in patients with liver metastasis from colorectal cancer. Hum Pathol, 39, 201-8. https://doi.org/10.1016/j.humpath.2007.04.024
  17. Ozdemir Y, Akin ML, Sucullu I, Balta AZ, Yucel E (2014). Pretreatment neutrophil/lymphocyte ratio as a prognostic aid in colorectal cancer. Asian Pac J Cancer Prev, 15, 2647-50. https://doi.org/10.7314/APJCP.2014.15.6.2647
  18. Pompella A, De Tata V, Paolicchi A, Zunino F (2006). Expression of gamma-glutamyltransferase in cancer cells and its significance in drug resistance. Biochem Pharmacol, 71, 231-8. https://doi.org/10.1016/j.bcp.2005.10.005
  19. Saif MW, Alexander D, Wicox CM (2005). Serum alkaline phosphatase level as a prognostic tool in colorectal cancer: a study of 105 patients. J Appl Res, 5, 88-95.
  20. Shiono S, Ishii G, Nagai K, et al (2006). Immunohistochemical prognostic factors in resected colorectal lung metastases using tissue microarray analysis. Eur J Surg Oncol, 32, 308-9. https://doi.org/10.1016/j.ejso.2005.12.003
  21. Tokarz P, Blasiak J (2012). The role of microRNA in metastatic colorectal cancer and its significance in cancer prognosis and treatment. Acta Biochim Pol, 59, 467-74.
  22. Xie Y, Wei ZB, Duan XW (2014). Prognostic value of pretreatment serum alkaline phosphatase in nasopharyngeal carcinoma. Asian Pac J Cancer Prev, 15, 3547-53. https://doi.org/10.7314/APJCP.2014.15.8.3547
  23. Yang XQ, Chen C, Wang FB, Peng CW, Li Y (2011). Preoperative serum carcinoembryonic antigen, carbohydrate antigen19-9 and carbohydrate antigen 125 as prognostic factors for recurrence-free survival in colorectal cancer. Asian Pac J Cancer Prev, 12, 1251-6.

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