Elevated Preoperative NMPR Predicts an Unfavorable Chance of Survival in Resectable Esophageal Squamous Cell Carcinoma
<i>Background and objectives</i>: Combined peripheral neutrophil–platelet indexes reflecting the systemic inflammatory status have been reported to predict the clinical outcome in patients with various types of cancer. However, the prognostic value of combined neutrophil–platelet indexes...
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MDPI AG
2022-12-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/58/12/1808 |
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| author | Meng-Ying Peng Zhi-Gang Zuo Feng-Jun Cao Yuan-Dong Yu Xiao-Jun Cai Guo-Xing Wan |
| author_facet | Meng-Ying Peng Zhi-Gang Zuo Feng-Jun Cao Yuan-Dong Yu Xiao-Jun Cai Guo-Xing Wan |
| author_sort | Meng-Ying Peng |
| collection | DOAJ |
| description | <i>Background and objectives</i>: Combined peripheral neutrophil–platelet indexes reflecting the systemic inflammatory status have been reported to predict the clinical outcome in patients with various types of cancer. However, the prognostic value of combined neutrophil–platelet indexes in operable esophageal squamous cell carcinoma (ESCC) remains unclear. The study introduced a novel combined neutrophil–meanplateletvolume–platelet ratio (NMPR) index and investigated its clinical and prognostic value in patients with operable ESCC receiving curative surgery. <i>Materials and Methods</i>: A retrospective analysis of the clinicopathologic data of 277 consecutive ESCC patients who received curative resection at Zhejiang Cancer Hospital in China between January 2007 and December 2010 was conducted (the training cohort). In addition, the clinicopathologic data of 101 resectable ESCC patients at Renmin Hospital of Hubei University of Medicine between December 2018 and June 2021 were collected (the external validation cohort). The optimal cutoff value of NMPR concerning overall survival (OS) in the training cohort was determined by X-tile software. Univariate and multivariate Cox regression analyses were used to evaluate the prognostic value of NMPR along with other variables in the training cohort, which was further validated with the same cutoff value in the external validation cohort. Significant predictors of OS were used to construct the nomogram, of which the discrimination and calibration was evaluated by concordance index (C-index) and calibration plots. <i>Results</i>: With a cutoff value of 16.62, the results from both the training and external validation cohorts supported the association of high NMPR (>16.62) with increased tumor length and advanced T stage but not with other variables. In the training cohort, a significant association between shorter OS and high NMPR (<i>p</i> = 0.04) as well as high CRP (<i>p</i> < 0.001), poor tumor differentiation (<i>p</i> = 0.008), advanced T stage (<i>p</i> = 0.006), advanced N stage (<i>p</i> < 0.001) and high CEA (<i>p</i> = 0.007) was revealed. Additionally, the high NMPR was verified to independently predict unfavorable OS (<i>p</i> = 0.049) in the external validation cohort. The C-index of the OS nomogram cooperating significant predictors in the training cohort was 0.71 and the calibration plots of the OS nomogram fitted well. <i>Conclusions</i>: The present study demonstrates that high NMPR is an independent predictor of unfavorable OS in resectable ESCC patients without neoadjuvant therapy. |
| first_indexed | 2024-03-09T16:07:28Z |
| format | Article |
| id | doaj.art-8e91664003944cd0a4baa0f74a2ff1c1 |
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| language | English |
| last_indexed | 2024-03-09T16:07:28Z |
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| spelling | doaj.art-8e91664003944cd0a4baa0f74a2ff1c12023-11-24T16:33:05ZengMDPI AGMedicina1010-660X1648-91442022-12-015812180810.3390/medicina58121808Elevated Preoperative NMPR Predicts an Unfavorable Chance of Survival in Resectable Esophageal Squamous Cell CarcinomaMeng-Ying Peng0Zhi-Gang Zuo1Feng-Jun Cao2Yuan-Dong Yu3Xiao-Jun Cai4Guo-Xing Wan5Graduate Student Training Base, Graduate School of Jinzhou Medical University, Jinzhou 121004, ChinaDepartment of Oncology, Renmin Hospital, Hubei University of Medicine, Shiyan 442000, ChinaDepartment of Oncology, Renmin Hospital, Hubei University of Medicine, Shiyan 442000, ChinaDepartment of Oncology, Renmin Hospital, Hubei University of Medicine, Shiyan 442000, ChinaDepartment of Oncology, Renmin Hospital, Hubei University of Medicine, Shiyan 442000, ChinaDepartment of Oncology, Renmin Hospital, Hubei University of Medicine, Shiyan 442000, China<i>Background and objectives</i>: Combined peripheral neutrophil–platelet indexes reflecting the systemic inflammatory status have been reported to predict the clinical outcome in patients with various types of cancer. However, the prognostic value of combined neutrophil–platelet indexes in operable esophageal squamous cell carcinoma (ESCC) remains unclear. The study introduced a novel combined neutrophil–meanplateletvolume–platelet ratio (NMPR) index and investigated its clinical and prognostic value in patients with operable ESCC receiving curative surgery. <i>Materials and Methods</i>: A retrospective analysis of the clinicopathologic data of 277 consecutive ESCC patients who received curative resection at Zhejiang Cancer Hospital in China between January 2007 and December 2010 was conducted (the training cohort). In addition, the clinicopathologic data of 101 resectable ESCC patients at Renmin Hospital of Hubei University of Medicine between December 2018 and June 2021 were collected (the external validation cohort). The optimal cutoff value of NMPR concerning overall survival (OS) in the training cohort was determined by X-tile software. Univariate and multivariate Cox regression analyses were used to evaluate the prognostic value of NMPR along with other variables in the training cohort, which was further validated with the same cutoff value in the external validation cohort. Significant predictors of OS were used to construct the nomogram, of which the discrimination and calibration was evaluated by concordance index (C-index) and calibration plots. <i>Results</i>: With a cutoff value of 16.62, the results from both the training and external validation cohorts supported the association of high NMPR (>16.62) with increased tumor length and advanced T stage but not with other variables. In the training cohort, a significant association between shorter OS and high NMPR (<i>p</i> = 0.04) as well as high CRP (<i>p</i> < 0.001), poor tumor differentiation (<i>p</i> = 0.008), advanced T stage (<i>p</i> = 0.006), advanced N stage (<i>p</i> < 0.001) and high CEA (<i>p</i> = 0.007) was revealed. Additionally, the high NMPR was verified to independently predict unfavorable OS (<i>p</i> = 0.049) in the external validation cohort. The C-index of the OS nomogram cooperating significant predictors in the training cohort was 0.71 and the calibration plots of the OS nomogram fitted well. <i>Conclusions</i>: The present study demonstrates that high NMPR is an independent predictor of unfavorable OS in resectable ESCC patients without neoadjuvant therapy.https://www.mdpi.com/1648-9144/58/12/1808esophageal squamous cell carcinomaneutrophil–mean-platelet-volume–platelet ratioprognosisbiomarker |
| spellingShingle | Meng-Ying Peng Zhi-Gang Zuo Feng-Jun Cao Yuan-Dong Yu Xiao-Jun Cai Guo-Xing Wan Elevated Preoperative NMPR Predicts an Unfavorable Chance of Survival in Resectable Esophageal Squamous Cell Carcinoma Medicina esophageal squamous cell carcinoma neutrophil–mean-platelet-volume–platelet ratio prognosis biomarker |
| title | Elevated Preoperative NMPR Predicts an Unfavorable Chance of Survival in Resectable Esophageal Squamous Cell Carcinoma |
| title_full | Elevated Preoperative NMPR Predicts an Unfavorable Chance of Survival in Resectable Esophageal Squamous Cell Carcinoma |
| title_fullStr | Elevated Preoperative NMPR Predicts an Unfavorable Chance of Survival in Resectable Esophageal Squamous Cell Carcinoma |
| title_full_unstemmed | Elevated Preoperative NMPR Predicts an Unfavorable Chance of Survival in Resectable Esophageal Squamous Cell Carcinoma |
| title_short | Elevated Preoperative NMPR Predicts an Unfavorable Chance of Survival in Resectable Esophageal Squamous Cell Carcinoma |
| title_sort | elevated preoperative nmpr predicts an unfavorable chance of survival in resectable esophageal squamous cell carcinoma |
| topic | esophageal squamous cell carcinoma neutrophil–mean-platelet-volume–platelet ratio prognosis biomarker |
| url | https://www.mdpi.com/1648-9144/58/12/1808 |
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