The preoperative platelet to neutrophil ratio and lymphocyte to monocyte ratio are superior prognostic indicators compared with other inflammatory biomarkers in ovarian cancer

Qian Song; Song-Xiao Xu; Jun-Zhou Wu; Lin Ling; Sheng Wang; Xin-Hua Shu; Dan-Ni Ying; Wang-Wei Pei; Yu-Chen Wu; Su-Fang Sun; Yi-Ning Zhang; Si-Hang Zhou; Zhu-Yan Shao

doi:10.3389/fimmu.2023.1177403

The preoperative platelet to neutrophil ratio and lymphocyte to monocyte ratio are superior prognostic indicators compared with other inflammatory biomarkers in ovarian cancer

Front Immunol. 2023 Jun 30:14:1177403. doi: 10.3389/fimmu.2023.1177403. eCollection 2023.

Authors

Affiliations

¹ Department of Clinical Laboratory, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, Zhejiang, China.
² Cancer Research Institute, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, Zhejiang, China.
³ Department of Gynaecology, Haining People's Hospital, Haining, Zhejiang, China.
⁴ Department of Gynecological Oncology, Zhejiang Cancer Hospital, The Key Laboratory of Zhejiang Province for Aptamers and Theranostics, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, Zhejiang, China.

Abstract

Background: Previous studies have suggested that the ratios of immune-inflammatory cells could serve as prognostic indicators in ovarian cancer. However, which of these is the superior prognostic indicator in ovarian cancer remains unknown. In addition, studies on the prognostic value of the platelet to neutrophil ratio (PNR) in ovarian cancer are still limited.

Methods: A cohort of 991 ovarian cancer patients was analyzed in the present study. Receiver operator characteristic (ROC) curves were utilized to choose the optimal cut-off values of inflammatory biomarkers such as neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR), platelet to lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and PNR. The correlation of inflammatory biomarkers with overall survival (OS) and relapse-free survival (RFS) was investigated by Kaplan-Meier methods and log-rank test, followed by Cox regression analyses.

Results: Kaplan-Meier curves suggested that LMR<3.39, PLR≥181.46, and PNR≥49.20 had obvious associations with worse RFS (P<0.001, P=0.018, P<0.001). Multivariate analysis suggested that LMR (≥3.39 vs. <3.39) (P=0.042, HR=0.810, 95% CI=0.661-0.992) and PNR (≥49.20 vs. <49.20) (P=0.004, HR=1.351, 95% CI=1.103-1.656) were independent prognostic indicators of poor RFS. In addition, Kaplan-Meier curves indicated that PLR≥182.23 was significantly correlated with worse OS (P=0.039).

Conclusion: Taken together, PNR and LMR are superior prognostic indicators compared with NLR, PLR, and SII in patients with ovarian cancer.

Keywords: lymphocyte to monocyte ratio; neutrophil to lymphocyte ratio; ovarian cancer; platelet to lymphocyte ratio; platelet to neutrophil ratio; prognosis; systemic immune-inflammation index.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Biomarkers
Female
Humans
Inflammation
Lymphocytes
Monocytes*
Neoplasm Recurrence, Local
Neutrophils
Ovarian Neoplasms* / diagnosis
Prognosis

Substances

Biomarkers

Grants and funding

This study was funded by National Natural Science Foundation of China (contract/grant number: 82202602), Zhejiang Provincial Natural Science Foundation of China (contract/grant number: LQ21H200001), Social Development Project of Public Welfare Technology Research in Zhejiang Province (contract/grant number: LGF21H160008), Zhejiang Provincial Public Welfare Technology Applied Research Program (contract/grant number: LGF19H040002), and General research program of Health Department of Zhejiang Province (contract/grant number: 2020KY480).