Association between Systemic Inflammation and Clinicopathological Characteristics in Patients with Colorectal Cancer
Iraqi Postgraduate Medical Journal,
2021, Volume 20, Issue 3, Pages 285-291
Colorectal cancer is a major cause of mortality and morbidity. The interplay between systemic inflammation and the local immune response was recognized as the seventh hallmark of cancer, and it has been demonstrated to be involved in the initiation, development, and progression of several types of malignancies. systemic immune-inﬂammation index, was reported as prognostic factors in some malignant tumors, including Colorectal cancer.
AIM OF STUDY:
To investigate the relationship between systemic immune-inﬂammation index and clinicopathological characteristics (sex, age, site of tumor, T stage, N stage, M stage, Clinical (TNM) stage, Duke stage, Grade, Lympho-Vascular Invasion and Carcino-Embryonic Antigen level) of colorectal cancer.
cross-sectional study was conducted, involving seventy patients with Colorectal cancer who were diagnosed by histopathological proof, to evaluate the relationship by dividing the patients into two groups depending on cut-off values: (1) those with high marker level, (2) those with low marker level.
The study involved 70 patients who are 38 males and 32 females. Their mean age was 53 years. Tumor site was in 40% of them in the left colon. The majority (67.1%) of patients have no metastasis and moderately differentiated tumors, 22 of 38 patients (58%) have positive lymphovascular invasion. Only 53 patients (75%) have a recorded pretreatment Carcino-Embryonic Antigen level and the mean was 13.07 ng/ml. There was a statistically significant association between systemic immune inflammation index and T stage and presence of metastasis, thereby clinical and Duke stages, as the value of systemic immune inflammation index is higher in advanced stages. Higher values of systemic immune inflammation index were associated with higher grade and with positive lymphovascular invasion also.
Elevated systemic immune-inflammation index is associated with higher stages and with lympho-vascular invasion of colorectal cancer. It is furtherly associated with higher grade of disease. Systemic immune inflammation index is easily accessible, and its association with poor prognostic indicators (like stage or presence of metastasis) warrant further investigation.
- Richards CH, Flegg KM, SD Roxburgh C, Going JJ, Mohammed Z, Horgan PG et al. The relationships between cellular components of the peritumoural inflammatory response, clinicopathological characteristics and survival in patients with primary operable colorectal cancer. Br J Cancer 2012; 106:2010–5. https://doi.org/10.1038/bjc.2012.211.
- Roxburgh CSD, McMillan DC. Role of systemic inflammatory response in predicting survival in patients with primary operable cancer. Future Oncol 2010;6:149–63. http://www.ncbi.nlm.nih.gov/pubmed/20021215.
- Mantovani A, Allavena P, Sica A, Balkwill F. Cancer-related inflammation. Nature 2008;454:436-44. https://doi.org/10.1038/nature07205
- Lin W-W, Karin M. A cytokine-mediated link between innate immunity, inflammation, and cancer. J Clin Invest 2007; 117:1175–83.http://www.ncbi.nlm.nih.gov/pubmed/17476347
- Ammirante M, Luo J-L, Grivennikov S, Nedospasov S, Karin M. B-cell-derived lymphotoxin promotes castration-resistant prostate cancer. Nature 2010;464:302–5. http://www.ncbi.nlm.nih.gov/pubmed/20220849
- Dunn GP, Old LJ, Schreiber RD. The immunobiology of cancer immunosurveillance and immunoediting. Immunity 2004; 21:137–48. http://www.ncbi.nlm.nih.gov/pubmed/15308095
- Hu B, Yang X-R, Xu Y, Sun Y-F, Sun C, Guo W Et al. Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma. Clin Cancer Res 2014; 20:6212–22.http://www.ncbi.nlm.nih.gov/pubmed/25271081
- Coupland LA, Parish CR. Platelets, selectins, and the control of tumor metastasis. Semin Oncol 2014; 41:422–34. http://www.ncbi.nlm.nih.gov/pubmed/25023359
10. Chen J-H, Zhai E-T, Yuan Y-J, Wu K-M, Xu J-B, Peng J-J Et al. Systemic immune-inflammation index for predicting prognosis of colorectal cancer. World J Gastroenterol 2017; 23:6261–72.http://www.ncbi.nlm.nih.gov/pubmed/28974892.
11. Cheng CK-W, Chan J, Cembrowski GS, van Assendelft OW. Complete blood count reference interval diagrams derived from NHANES III: stratification by age, sex, and race. Lab Hematol 2004; 10:42–53. http://www.ncbi.nlm.nih.gov/pubmed/15070217
12. Qiao R, Yang S, Yao B, Wang H, Zhang J, Shang H. Complete blood count reference intervals and age- and sex-related trends of North China Han population. Clin Chem Lab Med 2014; 52:1025–32.http://www.ncbi.nlm.nih.gov/pubmed/24497225
13. Schisterman EF, Perkins NJ, Liu A, Bondell H. Optimal cut-point and its corresponding Youden Index to discriminate individuals using pooled blood samples. Epidemiology 2005; 16:73–81.http://www.ncbi.nlm.nih.gov/pubmed/15613948.
14. MacDonald N. Cancer cachexia and targeting chronic inflammation: a unified approach to cancer treatment and palliative/supportive care. J Support Oncol 2007; 5:157-62; discussion 164-6, 183.http://www.ncbi.nlm.nih.gov/pubmed/17500503.
15. Maltoni M, Caraceni A, Brunelli C, Broeckaert B, Christakis N, Eychmueller S Et al. Prognostic factors in advanced cancer patients: evidence-based clinical recommendations--a study by the Steering Committee of the European Association for Palliative Care. Journal of Clinical Oncology 2005; 23:6240–8.http://www.ncbi.nlm.nih.gov/pubmed/16135490
16. Yang J, Xu H, Guo X, Zhang J, Ye X, Yang Y Et al. Pretreatment Inflammatory Indexes as Prognostic Predictors for Survival in Colorectal Cancer Patients Receiving Neoadjuvant Chemoradiotherapy. Sci Rep 2018; 8:3044. http://www.ncbi.nlm.nih.gov/pubmed/29445100 .
- Article View: 50
- PDF Download: 45