Vinicius J Campos1,2, Guilherme S Mazzini3,4, José F Juchem3, Richard R Gurski3,4. 1. Department of Gastrointestinal Surgery, Hospital de Clínicas de Porto Alegre, 2350 Ramiro Barcellos Street, Porto Alegre, RS, 90035-003, Brazil. viniciusjcampos@gmail.com. 2. Postgraduate Program in Medicine: Surgical Sciences, Federal University of Rio Grande do Sul, 2400 Ramiro Barcelos Street, Porto Alegre, RS, 90035-007, Brazil. viniciusjcampos@gmail.com. 3. Department of Gastrointestinal Surgery, Hospital de Clínicas de Porto Alegre, 2350 Ramiro Barcellos Street, Porto Alegre, RS, 90035-003, Brazil. 4. Postgraduate Program in Medicine: Surgical Sciences, Federal University of Rio Grande do Sul, 2400 Ramiro Barcelos Street, Porto Alegre, RS, 90035-007, Brazil.
Abstract
BACKGROUND: Immune imbalance and inflammation have been suggested as key factors of Barrett's esophagus (BE) pathway towards adenocarcinoma. The neutrophil-lymphocyte ratio (NLR) indirectly reflects the relation between innate and adaptive immune systems and has been studied in premalignant conditions as a biomarker for cancer diagnosis. Our aim was to investigate if increasing values of NLR correlated with advancing stages of BE progression to dysplasia and neoplasia. METHODS: We retrospectively analyzed data of patients with biopsies reporting BE between 2013 and 2017 and with a complete blood count within 6 months from the endoscopy, as well as patients with esophageal adenocarcinoma (EAC). NLR was calculated as neutrophil count/lymphocyte count. Cases (n = 113) were classified as non-dysplastic BE (NDBE, n = 72), dysplastic BE (DBE, n = 11) and EAC (n = 30). RESULTS: NLR progressively increased across groups (NDBE, 1.92 ± 0.7; DBE, 2.92 ± 1.1; EAC 4.54 ± 2.9), with a significant correlation between its increasing value and the presence of dysplasia or neoplasia (r = 0.53, p < 0.001). NLR > 2.27 was able to diagnose EAC with 80% sensitivity and 71% specificity (area under the curve = 0.8). CONCLUSION: NLR correlates with advancing stages of BE progression, a finding that reinforces the role of immune imbalance in EAC carcinogenesis and suggests a possible use of this marker for risk stratification on surveillance strategies.
BACKGROUND: Immune imbalance and inflammation have been suggested as key factors of Barrett's esophagus (BE) pathway towards adenocarcinoma. The neutrophil-lymphocyte ratio (NLR) indirectly reflects the relation between innate and adaptive immune systems and has been studied in premalignant conditions as a biomarker for cancer diagnosis. Our aim was to investigate if increasing values of NLR correlated with advancing stages of BE progression to dysplasia and neoplasia. METHODS: We retrospectively analyzed data of patients with biopsies reporting BE between 2013 and 2017 and with a complete blood count within 6 months from the endoscopy, as well as patients with esophageal adenocarcinoma (EAC). NLR was calculated as neutrophil count/lymphocyte count. Cases (n = 113) were classified as non-dysplasticBE (NDBE, n = 72), dysplasticBE (DBE, n = 11) and EAC (n = 30). RESULTS: NLR progressively increased across groups (NDBE, 1.92 ± 0.7; DBE, 2.92 ± 1.1; EAC 4.54 ± 2.9), with a significant correlation between its increasing value and the presence of dysplasia or neoplasia (r = 0.53, p < 0.001). NLR > 2.27 was able to diagnose EAC with 80% sensitivity and 71% specificity (area under the curve = 0.8). CONCLUSION: NLR correlates with advancing stages of BE progression, a finding that reinforces the role of immune imbalance in EACcarcinogenesis and suggests a possible use of this marker for risk stratification on surveillance strategies.
Authors: Elizabeth D Kantor; Lynn Onstad; Patricia L Blount; Brian J Reid; Thomas L Vaughan Journal: Cancer Epidemiol Biomarkers Prev Date: 2012-01-12 Impact factor: 4.254
Authors: E Jabłońska; M Kiluk; W Markiewicz; L Piotrowski; Z Grabowska; J Jabłoński Journal: Arch Immunol Ther Exp (Warsz) Date: 2001 Impact factor: 4.291
Authors: Graeme J K Guthrie; Kellie A Charles; Campbell S D Roxburgh; Paul G Horgan; Donald C McMillan; Stephen J Clarke Journal: Crit Rev Oncol Hematol Date: 2013-04-17 Impact factor: 6.312
Authors: Sheetal Hardikar; Lynn Onstad; Xiaoling Song; Angela M Wilson; Thomas J Montine; Mario Kratz; Garnet L Anderson; Patricia L Blount; Brian J Reid; Emily White; Thomas L Vaughan Journal: Cancer Epidemiol Biomarkers Prev Date: 2014-08-08 Impact factor: 4.254
Authors: Ksenia S Maslyonkina; Alexandra K Konyukova; Darya Y Alexeeva; Mikhail Y Sinelnikov; Liudmila M Mikhaleva Journal: Cancer Med Date: 2021-12-06 Impact factor: 4.452