Jonathan Stem1, Qiuyu Yang2, Evie Carchman2,3, Robert Striker3,4, Cristina B Sanger2,3. 1. Department of Surgery, University of North Carolina at Chapel Hill School of Medicine, Campus Box 7081, Chapel Hill, NC, 27599-7211, USA. Jonathan_Stem@med.unc.edu. 2. Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA. 3. William S. Middleton Memorial Veteran's Hospital, Madison, WI, USA. 4. Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Abstract
PURPOSE: People living with HIV (PLWH) are at an elevated risk for developing anal cancer. As screening is invasive, markers predicting those at highest risk for anal cancer could guide individualized screening. Neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), and prognostic nutritional index (PNI) are surrogate inflammatory/immune markers known to correlate with cancer outcomes. This study aims to assess whether these markers correlate with anal cancer risk in PLWH. METHODS: This is a retrospective single-institution cohort study of PLWH at a single academic medical center who were diagnosed with or screened for anal dysplasia between 2001 and 2019. Aforementioned markers collected within one year of diagnosis were recorded. Regression modeling was used to estimate odds of anal cancer. Receiver operating characteristic analysis was utilized to determine optimal cutoff for screening values. RESULTS: Five-hundred-fourteen patients were included. NLR and PNI were significantly associated with cancer risk on univariate (p = 0.03, p = 0.001) and multivariate analyses (p = 0.03, p = 0.01). NLR increased across all grades of dysplasia. PLR was not associated with cancer risk. A NLR of ≥ 1.64 can be utilized to capture 76% of cancer patients in our cohort. CONCLUSIONS: NLR values in patients living with HIV correlate with risk of anal cancer and increasing grades of dysplasia. A cutoff NLR of ≥ 1.64 can be used to help capture those at risk. NLR is a promising marker of risk of anal cancer and progression of anal dysplasia in patients with HIV infection and could be used to risk-stratify screening and surveillance intervals.
PURPOSE: People living with HIV (PLWH) are at an elevated risk for developing anal cancer. As screening is invasive, markers predicting those at highest risk for anal cancer could guide individualized screening. Neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), and prognostic nutritional index (PNI) are surrogate inflammatory/immune markers known to correlate with cancer outcomes. This study aims to assess whether these markers correlate with anal cancer risk in PLWH. METHODS: This is a retrospective single-institution cohort study of PLWH at a single academic medical center who were diagnosed with or screened for anal dysplasia between 2001 and 2019. Aforementioned markers collected within one year of diagnosis were recorded. Regression modeling was used to estimate odds of anal cancer. Receiver operating characteristic analysis was utilized to determine optimal cutoff for screening values. RESULTS: Five-hundred-fourteen patients were included. NLR and PNI were significantly associated with cancer risk on univariate (p = 0.03, p = 0.001) and multivariate analyses (p = 0.03, p = 0.01). NLR increased across all grades of dysplasia. PLR was not associated with cancer risk. A NLR of ≥ 1.64 can be utilized to capture 76% of cancer patients in our cohort. CONCLUSIONS: NLR values in patients living with HIV correlate with risk of anal cancer and increasing grades of dysplasia. A cutoff NLR of ≥ 1.64 can be used to help capture those at risk. NLR is a promising marker of risk of anal cancer and progression of anal dysplasia in patients with HIV infection and could be used to risk-stratify screening and surveillance intervals.
Authors: Antoine Schernberg; Alexandre Escande; Eleonor Rivin Del Campo; Michel Ducreux; France Nguyen; Diane Goere; Cyrus Chargari; Eric Deutsch Journal: Radiother Oncol Date: 2016-12-24 Impact factor: 6.280
Authors: Andrea Casadei-Gardini; Francesco Montagnani; Chiara Casadei; Francesca Arcadipane; Kalliopi Andrikou; Deborah Aloi; Alessandra Anna Prete; Maria Giulia Zampino; Antonella Argentiero; Giuseppe Pugliese; Stefania Martini; Giuseppe Carlo Iorio; Mario Scartozzi; Massimiliano Mistrangelo; Lorenzo Fornaro; Paola Cassoni; Giorgia Marisi; Veronica Dell'Acqua; Paola Simona Ravenda; Sara Lonardi; Nicola Silvestris; Berardino De Bari; Umberto Ricardi; Stefano Cascinu; Pierfrancesco Franco Journal: Cancer Manag Res Date: 2019-04-26 Impact factor: 3.989