Search

Purpose Skeletal metastases are a common problem in breast cancer patients. Identifying new prognostic factors can improve survival estimations and guide healthcare professionals in therapeutic decision-making. Our study aimed to determine the prognostic value of inflammatory biomarkers such as neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and C-reactive protein/albumin ratio (CAR) in patients with breast cancer skeletal metastases. Patients and Methods Clinical data from 212 patients with breast cancer skeletal metastases were retrospectively analyzed. The optimal cut-off values of each inflammatory biomarker were extracted from the receiver operating characteristic (ROC) curves. Patients were divided into high-value and low-value groups according to the cut-off values of NLR, LMR, and CAR. We investigated the relationship between inflammatory biomarkers and clinicopathological characteristics. The Kaplan-Meier method was used to measure progression-free survival (PFS) and overall survival (OS). The survival difference was compared by the univariate analysis. Cox multivariate regression analysis was performed to identify independent prognostic factors. Results The median age of the patients was 55 years, and the median follow-up was 45 months. LMR 3 was adverse for PFS. Conclusion LMR

Yu-Cui Liao,1,* Hou-Qun Ying,2,* Ying Huang,3,* Yan-Ran Luo,3 Cui-Fen Xiong,3 Ruo-Wei Nie,3 Xiao-Juan Li,4 Xue-Xin Cheng1 1School of Public Health; Jiangxi Provincial Key Laboratory of Preventive Medicine, Nanchang University, Nanchang, Jiangxi, 330006, People’s Republic of China; 2Department of Nuclear Medicine, Jiangxi Province Key Laboratory of Laboratory Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, People’s Republic of China; 3Jiangxi Medical College, Nanchang University, Nanchang, 330006, People’s Republic of China; 4Department of Clinical Laboratory, Kunming Children’s Hospital, Kunming, Yunnan, 650500, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xue-Xin ChengSchool of Public Health; Jiangxi Provincial Key Laboratory of Preventive Medicine Nanchang University, No. 1 Of Minde Road, Nanchang, People’s Republic of ChinaTel/Fax +86 0791-86297662Email cxxncu@163.comBackground: Cancer-related inflammation is the main cause of the progression of mucinous colorectal adenocarcinoma (MCA). Circulating fibrinogen-to-pre-albumin ratio (FPR) is associated with the clinical outcome in colorectal cancer (CRC). However, the prognostic role of FPR and which is the best inflammatory prognostic biomarker within MCA remain unknown.Methods: We enrolled 157 patients with stage I–III MCA in this study. Kaplan-Meier curve, Cox regression, and time-dependent receiver operation characteristic curve analysis were performed to assess the prognostic value and efficacy of the neutrophil-to-albumin ratio (NAR), neutrophil-to-pre-albumin ratio (NPAR), albumin-to-alkaline phosphatase ratio (AAPR), albumin-to-globulin ratio (AGR), albumin-to-fibrinogen ratio (AFR), and FPR in these patients.Results:: We found that NAR, NPAR, and FPR were significantly associated with unsatisfactory recurrence-free survival (RFS) in patients with stage I–III MCA, and the predicted efficacy of FPR was superior to that of the other two inflammatory biomarkers. Moreover, patients with a high combined TNM-CA199-FPR score had worse outcomes, with a high predicted efficacy of up to 0.779 (0.703– 0.856). Using FPR, the patient was monitored for the recurrence up to two months earlier than that achieved using the common imaging techniques (4 vs 6 median months) in stage I–III MCA patients undergoing radical resection.Conclusion: FPR is the preferred inflammatory biomarker and commonly used for predicting and monitoring recurrence in stage I–III MCA patients. The combined TNM-CA199-FPR score is an economical, simple, effective, and independent prognostic factor for localized disease.Keywords: mucinous colorectal carcinoma, fibrinogen-to-pre-albumin ratio, prognosis, inflammation