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Prognostic Value of Inflammation Biomarkers for Survival of Patients with Neuroblastoma

Authors Zheng C, Liu S, Feng J, Zhao X

Received 11 January 2020

Accepted for publication 18 March 2020

Published 1 April 2020 Volume 2020:12 Pages 2415—2425

DOI https://doi.org/10.2147/CMAR.S245622

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Antonella D'Anneo


Chen Zheng,* Shuaibin Liu,* Jiexiong Feng, Xiang Zhao

Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Xiang Zhao
Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, People’s Republic of China
Email zhaoxiang8609@163.com

Purpose: The prognostic significance of inflammation-based biomarkers for neuroblastoma (NB) has not been investigated before. The aim of this study was to evaluate the prognostic value of pre-treatment inflammation biomarkers in children patients with NB.
Patients and Methods: Patients diagnosed with NB from 2008 to 2016 in our institution were enrolled in this study. The clinical data and survival outcomes were retrospectively reviewed. Inflammation biomarkers or scores including C-reactive protein (CRP), albumin (ALB), Glasgow Prognostic Score (GPS), modified Glasgow Prognostic Score (mGPS), high-sensitivity modified Glasgow Prognostic Score (Hs-mGPS), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), lymphocyte to monocyte ratio (LMR) and system inflammation index (SII) were tested in this study. Univariate and multivariate survival analyses were performed to assess the prognostic value of these inflammation indicators for overall survival (OS) of children with NB. Kaplan–Meier survival curves were also conducted.
Results: A total of 70 children diagnosed with neuroblastoma were enrolled in this study. NLR, PLR, LMR and SII were found to be not predictive of OS for NB patients. However, CRP, ALB, GPS and CAR were significantly associated with OS of NB patients. Multivariate analysis adjusting for age, sex, histology, tumor size, tumor stage and metastasis revealed that ALB, CAR, GPS and Hs-mGPS were significantly associated with OS of NB patients. Receiver operating characteristic (ROC) curves and Akaike Information Criterion (AIC) analyses revealed that Hs-mGPS is superior to other inflammation biomarkers in predicting OS of NB patients. Subgroup survival analysis for immature NB patients revealed similar results.
Conclusion: Hs-mGPS is an effective prognostic factor for OS of patients with NB and is promising to be used as a factor for risk stratification and an indicator for more aggressive therapy.

Keywords: inflammation, neuroblastoma, biomarker, Glasgow Prognostic Score, survival
 

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