Evoked from asbestos-induced inflammation, pleural mesothelioma represents a fatal diagnosis. Therapy ranges from nihilism to aggressive multimodality regimens. However, it is still unclear who ultimately benefits from which treatment. We aimed to re-challenge inflammatory-related biomarkers’ prognostic value in times of modern immune-oncology and lung-sparing surgery. The biomarkers (leukocytes, hemoglobin, platelets, neutrophils, lymphocytes, monocytes, neutrophil–lymphocyte ratio (NLR), lymphocyte–monocyte ratio (LMR), platelet–lymphocyte ratio (PLR), C-reactive protein (CRP)) and clinical characteristics (age, sex, histology, therapy) of 98 PM patients were correlated to overall survival (OS). The median OS was 19.4 months. Significant OS advantages (Log-Rank) were observed in multimodal treatment vs. others (26.1 vs. 7.2 months,p< 0.001), surgery (pleurectomy/decortication) vs. no surgery (25.5 vs. 3.8 months,p< 0.001), a high hemoglobin level (cut-off 12 g/dL, 15 vs. 24.2 months,p= 0.021), a low platelet count (cut-off 280 G/L, 26.1 vs. 11.7 months,p< 0.001), and a low PLR (cut-off 194.5, 25.5 vs. 12.3 months,p= 0.023). Histology (epithelioid vs. non-epithelioid,p= 0.002), surgery (p= 0.004), CRP (cut-off 1 mg/dL,p= 0.039), and platelets (p= 0.025) were identified as independent prognostic variables for this cohort in multivariate analysis (Cox regression, covariates: age, sex, histology, stage, CRP, platelets). Our data verified the previously shown prognostic role of systemic inflammatory parameters in patients treated with lung-sparing surgery within multimodality therapy.
胸膜间皮瘤由石棉引发的炎症所诱发，是一种致命性疾病。其治疗策略从消极保守到积极的多模式综合方案不等。然而，目前仍不清楚哪些患者最终能从何种治疗中获益。本研究旨在现代免疫肿瘤学和保留肺功能手术时代，重新评估炎症相关生物标志物的预后价值。我们分析了98例胸膜间皮瘤患者的生物标志物（白细胞、血红蛋白、血小板、中性粒细胞、淋巴细胞、单核细胞、中性粒细胞-淋巴细胞比值、淋巴细胞-单核细胞比值、血小板-淋巴细胞比值、C反应蛋白）及临床特征（年龄、性别、组织学类型、治疗方案）与总生存期的相关性。中位总生存期为19.4个月。多模式治疗较其他方案（26.1 vs. 7.2个月，p<0.001）、手术（胸膜切除/剥脱术）较非手术治疗（25.5 vs. 3.8个月，p<0.001）、高血红蛋白水平（截断值12 g/dL，15 vs. 24.2个月，p=0.021）、低血小板计数（截断值280 G/L，26.1 vs. 11.7个月，p<0.001）以及低血小板-淋巴细胞比值（截断值194.5，25.5 vs. 12.3个月，p=0.023）均显示出显著的总生存期优势（Log-Rank检验）。多变量分析（Cox回归，协变量：年龄、性别、组织学类型、分期、C反应蛋白、血小板）显示，组织学类型（上皮样 vs. 非上皮样，p=0.002）、手术（p=0.004）、C反应蛋白（截断值1 mg/dL，p=0.039）和血小板（p=0.025）是该队列的独立预后变量。我们的数据验证了既往研究提示的全身炎症参数在多模式治疗中接受保留肺功能手术患者的预后作用。
Validation of Inflammatory Prognostic Biomarkers in Pleural Mesothelioma
肿瘤(癌症)患者之家