Acta Oncol Tur.. 2020; 53(3): 402-409 | DOI: 10.5505/aot.2020.38981

Clinical significance of inflammatory indexes in patients with epithelial ovarian cancer

Ali Yýlmaz¹, Salim Baþol Tekin¹, Mehmet Bilici¹, Hatice Yýlmaz^2
1Department Of Medical Oncology, Atatürk University Faculty Of Medicine, Erzurum, Turkey
²Department Of Medical Oncology, Adnan Menderes University Faculty Of Medicine, Aydýn, Turkey

INTRODUCTION: Systemic inflammation and immune response are closely related to cancer prognosis. Systemic immune-inflammation index (SII), prognostic nutritional index (PNI) and C-reactive protein/albumin ratio (CAR) are known to be prognostic in various cancer. However, in epithelial ovarian cancer (EOC) cases, there is little information about inflammatory indexes. Therefore, we investigated the prognostic importance of inflammation-based indexes such as SII, PNI and CAR in EOC patients.
METHODS: Two hundred and seventy three patients with EOC were included in this study retrospectively. Relationship between clinical variables with progression-free survival (PFS) and overall survival (OS) were analyzed via Kaplan–Meier method. The best cut-off points were determined using a receiver operating characteristic (ROC) curve analysis. SII, PNI, and CAR were classified based on cutoff points 1559, 42.1 and 3.11, respectively. Prognostic importance of the variables for OS was determined with the Cox regression model.
RESULTS: Low SII (<1559), high PNI (≥42.1) and low CAR (<3.11), were found to be associated with longer PFS and OS times in patients with EOC. In univariate analysis, age, menopausal status, Eastern Cooperative Oncology Group (ECOG) score, epithelial subtype, stage, SII, PNI and CAR were significantly associated with OS. In multivariate analysis stage, SII and PNI were found to be independent prognostic factors for OS (p <0.001, p <0.024, p<0.006, respectively).
DISCUSSION AND CONCLUSION: Pre-treatment SII and PNI are prognostic biomarkers that can be used to predict OS in patients with EOC.

Keywords: C-reactive protein/albumin ratio, epithelial ovarian cancer, prognostic nutritional index, systemic immune-inflammation index

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Epitelyal over kanserli hastalarda inflamatuar indekslerin klinik önemi

Ali Yýlmaz¹, Salim Baþol Tekin¹, Mehmet Bilici¹, Hatice Yýlmaz^2
1Atatürk Üniversitesi Týp Fakültesi, Týbbi Onkoloji Bilim Dalý, Erzurum
²Adnan Menderes Üniversitesi Týp Fakültesi, Týbbi Onkoloji Bilim Dalý, Aydýn

GÝRÝÞ ve AMAÇ: Sistemik inflamasyon ve immün yanýt kanser prognozu ile yakýndan iliþkilidir. Sistemik immün-inflamasyon indeks (SII), prognostik nutrisyonel indeks (PNI) ve C-reaktif protein / albümin oranýnýn (CAO) çeþitli kanserlerde prognostik olduðu bilinmektedir. Bununla birlikte, epitelyal over kanseri (EOK) vakalarýnda, inflamatuar indeksler hakkýnda çok az bilgi vardýr. Bu nedenle biz bu çalýþmada EOK hastalarýnda SII, PNI ve CAO gibi inflamasyon temelli indekslerin prognostik önemini araþtýrdýk.
YÖNTEM ve GEREÇLER: EOK’lu 273 hasta retrospektif olarak çalýþmaya dahil edildi. Klinik deðiþkenlerle progresyonsuz yaþam süresi (PYS) ve genel saðkalým (GS) arasýndaki iliþki Kaplan – Meier yöntemi ile analiz edildi. En iyi sýnýr deðerler ROC eðrisi analizi kullanýlarak belirlendi. SII, PNI ve CAO sýrasýyla 1559, 42.1 ve 3.11 kesme noktalarýna göre sýnýflandýrýldý. GS için deðiþkenlerin prognostik önemi Cox regresyon modeli ile belirlendi.
BULGULAR: EOK hastalarýnda düþük SII (<1559), yüksek PNI (≥42.1) ve düþük CAO (<3.11) daha uzun PYS ve GS süreleri ile iliþkili bulundu. Tek deðiþkenli analizde yaþ, menopoz durumu, ECOG skoru, epitelyal alt tip, evre, SII, PNI ve CAO’nun GS ile anlamlý iliþkisi vardý. Çok deðiþkenli analizde evre, SII ve PNI, GS için baðýmsýz prognostik faktörler olarak bulundu (p <0.001, p <0.024, p <0.006, sýrasýyla).
TARTIÞMA ve SONUÇ: Tedavi öncesi SII ve PNI, EOK hastalarýnda GS’yi predikte etmek için kullanýlabilecek prognostik biyobelirteçlerdir.

Anahtar Kelimeler: C-reaktif protein/albümin oraný, epitelyal over kanseri, prognostik nutrisyonel indeks, sistemik immün-inflamasyon indeks

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