The utility of pre-treatment inflammation markers as associative factors to the adverse outcomes of vulvar cancer: a study on staging, nodal involvement, and metastasis models
Author(s)
Winarto, Hariyono
Habiburrahman, Muhammad
Anggraeni, Tricia Dewi
Nuryanto, Kartiwa Hadi
Julianti, Renny Anggia
Type
Journal Article
Abstract
BACKGROUND: Given the role of inflammation in carcinogenesis, this study investigated the utility of pre-treatment inflammatory markers as associative indicators for advanced-stage disease, lymph node metastasis (LNM), and distant metastasis (DM) in vulvar cancer (VC). METHODS: A cross-sectional study was conducted on 86 women with VC in a single centre in Jakarta, Indonesia. The laboratory data was based on C-reactive protein (CRP), procalcitonin, the erythrocyte sedimentation rate (ESR) and fourteen derived, recorded and calculated ratios: leukocyte-to-platelet (LPR), neutrophil-to-lymphocyte (NLR), derived neutrophil-to-lymphocyte (dNLR), neutrophil-to-monocyte (NMR), platelet-to-monocyte (PLR), lymphocyte-to-monocyte (LMR), basophil-to-monocyte (BLR), systemic immune-inflammation index (SII), body mass index, albumin, and NLR (BAN) score, haemoglobin-to-platelet (HPR), prognostic nutritional index (PNI), modified Glasgow Prognostic Score (mGPS), CRP-to-albumin, and CRP-to-procalcitonin. The optimal cut-off for each marker was determined using receiver operating characteristic (ROC) curve analysis, and their diagnostic indicator performances were assessed. The utility of these ratios as associative factors for three endpoints was further evaluated in multivariate regression models. RESULTS: Investigated inflammatory markers exhibited specific performances for individual adverse outcomes, proving a fair to excellent ability in case finding and screening. After adjustment, the BAN score ≤ 334.89 (OR 9.20, p = 0.001) and ESR ≥ 104 (OR 4.18, p = 0.048) become two advanced-stage associative factors with AUC: 0.769. LNM was solely determined by higher NLR ≥ 2.83 (OR 4.15, p = 0.014) with AUC: 0.615. Meanwhile, BLR ≥ 0.035 (OR 5.67, p = 0.001) and ESR ≥ 84 (OR 6.01, p = 0.003) were contributing factors for DM, with AUC: 0.765. CONCLUSIONS: Inflammatory markers are crucial for identifying the deleterious outcomes of VC. Accordingly, yielded models require external validation.
Date Issued
2023-01
Date Acceptance
2022-12-19
Citation
Journal of Clinical Medicine, 2023, 12 (1)
ISSN
2077-0383
Publisher
MDPI AG
Journal / Book Title
Journal of Clinical Medicine
Volume
12
Issue
1
Copyright Statement
© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
License URL
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/36614896
Subjects
advanced stage
albumin
basophil-to-monocyte
body-mass-index
complete blood count
derived ratios
distant metastasis
inflammatory markers
lymph node metastasis
neutrophil-to-lymphocyte
vulvar cancer
Publication Status
Published
Coverage Spatial
Switzerland
Article Number
96
Date Publish Online
2022-12-22