Cancer Res Treat.  2016 Jan;48(1):250-258. 10.4143/crt.2014.324.

Systemic Inflammatory Response Markers and CA-125 Levels in Ovarian Clear Cell Carcinoma: A Two Center Cohort Study

• Kim HS
• Choi HY
• Lee M
• Suh DH
• Kim K
• No JH
• Chung HH
• Kim YB
• Song YS

• KMID: 2152282
• DOI: http://doi.org/10.4143/crt.2014.324

Abstract

PURPOSE
We compared the predictive and prognostic values of leukocyte differential counts, systemic inflammatory (SIR) markers and cancer antigen 125 (CA-125) levels, and identified the most useful marker in patients with ovarian clear cell carcinoma (OCCC).
MATERIALS AND METHODS
The study included 109 patients with OCCC who did not have any inflammatory conditions except endometriosis, and underwent primary debulking surgery between 1997 and 2012. Leukocyte differential counts (neutrophil, lymphocyte, monocyte, eosinophil, basophil, and platelet), SIR markers including neutrophil to lymphocyte ratio (NLR), monocyte to lymphocyte ratio (MLR), and platelet to lymphocyte ratio (PLR), and CA-125 levels were estimated to select potential markers for clinical outcomes.
RESULTS
Among potential markers (neutrophil, monocyte, platelet, NLR, MLR, PLR, and CA-125 levels) selected by stepwise comparison, CA-125 levels were best at predicting advanced stage disease, suboptimal debulking and platinum-resistance (cut-off values, > or = 46.5, > or = 11.45, and > or = 66.4 U/mL; accuracies, 69.4%, 78.7%, and 68.5%) while PLR > or = 205.4 predicted non-complete response (CR; accuracy, 71.6%) most accurately. Moreover, PLR < 205.4 was an independent factor for the reduced risk of non-CR (adjusted odds ratio, 0.17; 95% confidence interval [CI], 0.04 to 0.69), and NLR < 2.8 was a favorable factor for improved progression-free survival (PFS; adjusted hazard ratio, 0.49; 95% CI, 0.25 to 0.99) despite lack of a marker for overall survival among the potential markers.
CONCLUSION
CA-125 levels may be the most useful marker for predicting advanced-stage disease. Suboptimal debulking and platinum-resistance, and PLR and NLR may be most effective to predict non-CR and PFS in patients with OCCC.

Keyword

Clear cell adenocarcinoma; Ovarian neoplasms; CA-125 antigen; Neutrophils; Blood platelets; Lymphocytes

MeSH Terms

Adenocarcinoma, Clear Cell
Basophils
Blood Platelets
CA-125 Antigen
Cohort Studies*
Disease-Free Survival
Endometriosis
Eosinophils
Female
Humans
Leukocytes
Lymphocytes
Monocytes
Neutrophils
Odds Ratio
Ovarian Neoplasms
CA-125 Antigen

Figure

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  Fig. 1. The receiver operating characteristic curves to determine the best cut-off values of leukocyte differential counts including neutrophil, monocyte and platelet, neutrophil to lymphocyte ratio (NLR), monocyte to lymphocyte ratio (MLR), platelet to lymphocyte ratio (PLR), and cancer antigen 125 (CA-125) levels for predicting International Federation of Gynecology and Obstetrics (FIGO) stage III-IV disease (A), suboptimal debulking (B), platinum-resistance (C), and non-complete response (D) in 109 patients with ovarian clear cell carcinoma.

Reference

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