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Mide kanseri nüksü ve mortalitesinin bir belirteci olarak pan-immün inflamasyon değeri

Year 2024, , 63 - 69, 28.03.2024
https://doi.org/10.18663/tjcl.1403742

Abstract

Amaç: Bu çalışma, pan-immün-inflamasyon değerinin (PIV), mide kanseri nüksü ve mortalitesi için yeni bir prognostik belirteç olarak hizmet edip etmediğini incelemekte ve bunun tümör mikroçevresinin immün-inflamatuar durumu ile etkileşimini değerlendirmektedir.
Gereç ve Yöntemler: 1 Ocak 2020 ile 1 Ocak 2023 tarihleri arasında, mide adenokarsinomu için total ve subtotal gastrektomi uygulanan hastalar üzerinde geriye dönük bir çalışma yapılmıştır (n: 141). 'PIV = Nötrofil x Trombosit x Monosit / Lenfosit' olarak hesaplanan Periferik İnflamasyon Değeri (PIV), klinik parametreler, immün hücre alt grupları, sitokinler ve akut faz reaktanları ile birlikte değerlendirilmiştir. Çeşitli klinikopatolojik faktörler, hastalık nüksü, mortalite ve diğer kritik klinik sonuçlar arasındaki ilişkileri keşfetmeyi amaçlayan çok değişkenli regresyon modelleri kullanılarak istatistiksel analiz gerçekleştirilmiştir.
Bulgular: İki yıllık takip süresince hastaların %48'i hastalık nüksü yaşamış, %50'si ise mortalite ile karşılaşmıştır. Yüksek PIV değerlerinin hastalık nüksü ve mortalite riskini artırdığını gösteren istatistiksel olarak anlamlı bir ilişki tespit edilmiştir. Lenfo-vasküler ve perinöral invazyon (LVI, PNI) nüksle ilişkili faktörler olarak belirlenmiştir. CA 19-9 ve CEA seviyelerinin yüksek olması mortalitenin bağımsız prediktörleri olarak tanımlanmıştır. Ayrıca, düşük albümin seviyeleri mortalite riski ile ilişkilendirilmiştir.
Sonuçlar: Bu çalışma, mide kanserinde PIV'nin potansiyel prognostik önemini vurgulamaktadır. Yüksek PIV, nüks riskini arttırmış, peritümöral immün yanıtın ilerleme ve metastazdaki rolünü vurgulamıştır. PIV'yi klinikopatolojik faktörlerle birleştirmek, risk sınıflandırmasını artırabilir ve kişiselleştirilmiş tedavileri bilgilendirebilir. PIV'nin klinik kullanılabilirliğini ve mide kanserindeki temel mekanizmalarını doğrulamak için daha büyük prospektif çalışmalara ihtiyaç vardır.

Ethical Statement

Çalışma, Helsinki Bildirisi'ne uygun olarak planlanmış olup, bu çalışma için onay, HİTİT Üniversitesi Tıp Fakültesi Etik Komitesi'nden alınmıştır (numara: 2022/87, tarih: 26/10/2022).

Thanks

Çalışmaya olan katkılarından dolayı Dr. Mehmet Berksun Tutan'a teşekkür ediyoruz.

References

  • Duchon R, Bernadic Jr M, Pindak D. Impact of the anatomical location and the number of metastatic lymph nodes on gastric cancer patient's survival. Bratisl Lek Listy 2020; 121(4): 253-258.
  • Bakos, M, Jankovic T, Durdik S, Danihel L. Radical gastrectomy with D2 lymph node dissection after neoadjuvant therapy. Bratisl Lek Listy 2022; 123(11): 777-784.
  • Gunderson LL, Sosin H. Adenocarcinoma of the stomach: areas of failure in a re-operation series (second or symptomatic look) clinicopathologic correlation and implications for adjuvant therapy. Int J Radiat Oncol Biol Phys 1982; 8: 1–11.
  • Qiu Y, Zhang Z, Chen Y. Prognostic value of pretreatment systemic immune-inflammation index in gastric cancer: A meta-analysis. Front Oncol 2021; 11: 537140.
  • Baba Y, Nakagawa S, Toihata T et al. Pan-immune-inflammation value and prognosis in patients with esophageal cancer. Ann Surg. Open 2022; 3: 113.
  • Chow MT, Möller A, Smyth MJ. Inflammation and immune surveillance in cancer. Semin. Cancer Biol 2012; 22: 23–32.
  • Dunn GP, Bruce AT, Ikeda H, Old LJ, Schreiber RD. Cancer immunoediting: from immunosurveillance to tumor escape. Nat Immunol 2002; 3: 991–998.
  • Vesely MD, Kershaw MH, Schreiber RD, Smyth MJ. Natural innate and adaptive immunity to cancer. Annu Rev Immunol 2011; 29: 235–271.
  • Pandya PH, Murray ME, Pollok KE, Renbarger JL. The Immune System in Cancer Pathogenesis: Potential Therapeutic Approaches. J Immunol Res 2016; 2016: 4273943.
  • Fucà G, Guarini V, Antoniotti C, Morano F, Moretto R, Corallo S, et al. The Pan-Immune-Inflammation Value is a new prognostic biomarker in metastatic colorectal cancer: Results from a pooled analysis of the Valentino and TRIBE first-line trials. Br J Cancer 2020; 123: 403–409.
  • Guven DC, Sahin TK, Erul E, Kilickap S, Gambichler T, Aksoy S. The association between the pan-immune-inflammation value and cancer prognosis: a systematic review and meta-analysis. Cancers (Basel) 2022; 14: 2675.
  • Gabrilovich DI, Nagaraj S. Myeloid-derived suppressor cells as regulators of the immune system. Nat Rev Immunol 2009; 9: 162–174.
  • Ostrand-Rosenberg S, Sinha P. Myeloid-derived suppressor cells: linking inflammation and cancer. J Immunol 2009; 182: 4499–4506.
  • Murdoch C, Muthana M, Coffelt SB, Lewis CE. The role of myeloid cells in the promotion of tumour angiogenesis. Nat Rev Cancer 2008; 8: 618–631.
  • Bingle L, Brown NJ, Lewis CE. The role of tumor-associated macrophages in tumour progression: implications for new anticancer therapies. The Journal of Pathology: A Journal of the Pathological Society of Great Britain and Ireland 2002; 196(3): 254-226.
  • Zou Y, Kamada N, Seong SY, Seo SU. (2023). CD115− monocytic myeloid-derived suppressor cells are precursors of OLFM4 high polymorphonuclear myeloid-derived suppressor cells. Communications biology 2023; 6(1): 272.
  • Zhang F, Chen H, Luo D, Xiong Z, Li X, Yin S, et al. Lymphovascular or perineural invasion is associated with lymph node metastasis and survival outcomes in patients with gastric cancer. Cancer Med 2023; 12: 9401-9408.
  • Pérez-Martelo M, González-García A, Vidal-Ínsua Y et al. Clinical significance of baseline PanImmune-Inflammation Value and its dynamics in metastatic colorectal cancer patients under first-line chemotherapy. Sci Rep 2022; 12: 6893.
  • Takahashi Y, Takeuchi T, Sakamoto J et al. Tumor Marker Committee: The usefulness of CEA and/or CA19-9 in monitoring for recurrence in gastric cancer patients: a prospective clinical study. Gastric Cancer 2003; 6: 142–145.
  • Choi SR, Jang JS, Lee JH et al. Role of serum tumor markers in monitoring for recurrence of gastric cancer following radical gastrectomy. Dig Dis Sci 2006; 51: 2081–2086.

Pan-immune-inflammation value as a marker of gastric cancer recurrence and mortality

Year 2024, , 63 - 69, 28.03.2024
https://doi.org/10.18663/tjcl.1403742

Abstract

Aim: This study investigates whether the pan-immune-inflammation value (PIV) can serve as a novel prognostic marker for gastric cancer recurrence and mortality by assessing its interaction with the tumor microenvironment's immune-inflammatory status.
Marerial and Methods: Between January 1, 2020, and January 1, 2023, a retrospective study was conducted on patients who had undergone total and subtotal gastrectomy for gastric adenocarcinoma (n:141). Peripheral Inflammation Value (PIV), calculated as 'PIV=Neutrophil x Platelet x Monocyte / Lymphocyte,' was assessed alongside clinical parameters, immune cell subsets, cytokines, and acute-phase reactants. Statistical analysis, employing multivariate regression models, aimed to explore the relationships between PIV and critical clinical outcomes, including disease recurrence, mortality, and various clinicopathological factors.
Results: During the two-year follow-up, 48% of the patients experienced disease recurrence, while 50% faced mortality. A statistically significant correlation was observed, indicating that higher PIV values were associated with an increased risk of disease recurrence and mortality. Lymphovascular and perineural invasion (LVI, PNI) were identified as factors related to recurrence. Elevated levels of CA 19-9 and CEA were independent predictors of mortality. Furthermore, lower albumin levels were associated with an increased risk of mortality.
Conclusion: This study highlights PIV's potential prognostic significance in gastric cancer. Elevated PIV reduced recurrence risk, emphasizing peritumoral immune response's role in progression and metastasis. Combining PIV with clinicopathological factors may enhance risk stratification and inform personalized treatments. Larger prospective studies are needed to validate PIV's clinical utility and its underlying mechanisms in gastric cancer.

References

  • Duchon R, Bernadic Jr M, Pindak D. Impact of the anatomical location and the number of metastatic lymph nodes on gastric cancer patient's survival. Bratisl Lek Listy 2020; 121(4): 253-258.
  • Bakos, M, Jankovic T, Durdik S, Danihel L. Radical gastrectomy with D2 lymph node dissection after neoadjuvant therapy. Bratisl Lek Listy 2022; 123(11): 777-784.
  • Gunderson LL, Sosin H. Adenocarcinoma of the stomach: areas of failure in a re-operation series (second or symptomatic look) clinicopathologic correlation and implications for adjuvant therapy. Int J Radiat Oncol Biol Phys 1982; 8: 1–11.
  • Qiu Y, Zhang Z, Chen Y. Prognostic value of pretreatment systemic immune-inflammation index in gastric cancer: A meta-analysis. Front Oncol 2021; 11: 537140.
  • Baba Y, Nakagawa S, Toihata T et al. Pan-immune-inflammation value and prognosis in patients with esophageal cancer. Ann Surg. Open 2022; 3: 113.
  • Chow MT, Möller A, Smyth MJ. Inflammation and immune surveillance in cancer. Semin. Cancer Biol 2012; 22: 23–32.
  • Dunn GP, Bruce AT, Ikeda H, Old LJ, Schreiber RD. Cancer immunoediting: from immunosurveillance to tumor escape. Nat Immunol 2002; 3: 991–998.
  • Vesely MD, Kershaw MH, Schreiber RD, Smyth MJ. Natural innate and adaptive immunity to cancer. Annu Rev Immunol 2011; 29: 235–271.
  • Pandya PH, Murray ME, Pollok KE, Renbarger JL. The Immune System in Cancer Pathogenesis: Potential Therapeutic Approaches. J Immunol Res 2016; 2016: 4273943.
  • Fucà G, Guarini V, Antoniotti C, Morano F, Moretto R, Corallo S, et al. The Pan-Immune-Inflammation Value is a new prognostic biomarker in metastatic colorectal cancer: Results from a pooled analysis of the Valentino and TRIBE first-line trials. Br J Cancer 2020; 123: 403–409.
  • Guven DC, Sahin TK, Erul E, Kilickap S, Gambichler T, Aksoy S. The association between the pan-immune-inflammation value and cancer prognosis: a systematic review and meta-analysis. Cancers (Basel) 2022; 14: 2675.
  • Gabrilovich DI, Nagaraj S. Myeloid-derived suppressor cells as regulators of the immune system. Nat Rev Immunol 2009; 9: 162–174.
  • Ostrand-Rosenberg S, Sinha P. Myeloid-derived suppressor cells: linking inflammation and cancer. J Immunol 2009; 182: 4499–4506.
  • Murdoch C, Muthana M, Coffelt SB, Lewis CE. The role of myeloid cells in the promotion of tumour angiogenesis. Nat Rev Cancer 2008; 8: 618–631.
  • Bingle L, Brown NJ, Lewis CE. The role of tumor-associated macrophages in tumour progression: implications for new anticancer therapies. The Journal of Pathology: A Journal of the Pathological Society of Great Britain and Ireland 2002; 196(3): 254-226.
  • Zou Y, Kamada N, Seong SY, Seo SU. (2023). CD115− monocytic myeloid-derived suppressor cells are precursors of OLFM4 high polymorphonuclear myeloid-derived suppressor cells. Communications biology 2023; 6(1): 272.
  • Zhang F, Chen H, Luo D, Xiong Z, Li X, Yin S, et al. Lymphovascular or perineural invasion is associated with lymph node metastasis and survival outcomes in patients with gastric cancer. Cancer Med 2023; 12: 9401-9408.
  • Pérez-Martelo M, González-García A, Vidal-Ínsua Y et al. Clinical significance of baseline PanImmune-Inflammation Value and its dynamics in metastatic colorectal cancer patients under first-line chemotherapy. Sci Rep 2022; 12: 6893.
  • Takahashi Y, Takeuchi T, Sakamoto J et al. Tumor Marker Committee: The usefulness of CEA and/or CA19-9 in monitoring for recurrence in gastric cancer patients: a prospective clinical study. Gastric Cancer 2003; 6: 142–145.
  • Choi SR, Jang JS, Lee JH et al. Role of serum tumor markers in monitoring for recurrence of gastric cancer following radical gastrectomy. Dig Dis Sci 2006; 51: 2081–2086.
There are 20 citations in total.

Details

Primary Language Turkish
Subjects Oncologic Surgery
Journal Section Research Article
Authors

Bahadır Kartal 0000-0003-1647-9979

Ertugrul Gazi Alkurt 0000-0002-3044-5428

Duygu Tutan 0000-0003-0440-1146

İbrahim Karadağ 0000-0002-2356-6790

Veysel Barış Turhan 0000-0001-5093-4993

Publication Date March 28, 2024
Submission Date December 12, 2023
Acceptance Date January 15, 2024
Published in Issue Year 2024

Cite

APA Kartal, B., Alkurt, E. G., Tutan, D., Karadağ, İ., et al. (2024). Mide kanseri nüksü ve mortalitesinin bir belirteci olarak pan-immün inflamasyon değeri. Turkish Journal of Clinics and Laboratory, 15(1), 63-69. https://doi.org/10.18663/tjcl.1403742
AMA Kartal B, Alkurt EG, Tutan D, Karadağ İ, Turhan VB. Mide kanseri nüksü ve mortalitesinin bir belirteci olarak pan-immün inflamasyon değeri. TJCL. March 2024;15(1):63-69. doi:10.18663/tjcl.1403742
Chicago Kartal, Bahadır, Ertugrul Gazi Alkurt, Duygu Tutan, İbrahim Karadağ, and Veysel Barış Turhan. “Mide Kanseri nüksü Ve Mortalitesinin Bir Belirteci Olarak Pan-immün Inflamasyon değeri”. Turkish Journal of Clinics and Laboratory 15, no. 1 (March 2024): 63-69. https://doi.org/10.18663/tjcl.1403742.
EndNote Kartal B, Alkurt EG, Tutan D, Karadağ İ, Turhan VB (March 1, 2024) Mide kanseri nüksü ve mortalitesinin bir belirteci olarak pan-immün inflamasyon değeri. Turkish Journal of Clinics and Laboratory 15 1 63–69.
IEEE B. Kartal, E. G. Alkurt, D. Tutan, İ. Karadağ, and V. B. Turhan, “Mide kanseri nüksü ve mortalitesinin bir belirteci olarak pan-immün inflamasyon değeri”, TJCL, vol. 15, no. 1, pp. 63–69, 2024, doi: 10.18663/tjcl.1403742.
ISNAD Kartal, Bahadır et al. “Mide Kanseri nüksü Ve Mortalitesinin Bir Belirteci Olarak Pan-immün Inflamasyon değeri”. Turkish Journal of Clinics and Laboratory 15/1 (March 2024), 63-69. https://doi.org/10.18663/tjcl.1403742.
JAMA Kartal B, Alkurt EG, Tutan D, Karadağ İ, Turhan VB. Mide kanseri nüksü ve mortalitesinin bir belirteci olarak pan-immün inflamasyon değeri. TJCL. 2024;15:63–69.
MLA Kartal, Bahadır et al. “Mide Kanseri nüksü Ve Mortalitesinin Bir Belirteci Olarak Pan-immün Inflamasyon değeri”. Turkish Journal of Clinics and Laboratory, vol. 15, no. 1, 2024, pp. 63-69, doi:10.18663/tjcl.1403742.
Vancouver Kartal B, Alkurt EG, Tutan D, Karadağ İ, Turhan VB. Mide kanseri nüksü ve mortalitesinin bir belirteci olarak pan-immün inflamasyon değeri. TJCL. 2024;15(1):63-9.


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