Stem Jonathan, Yang Qiuyu, Carchman Evie, Striker Robert, Sanger Cristina B
Department of Surgery, University of North Carolina at Chapel Hill School of Medicine, Campus Box 7081, Chapel Hill, NC, 27599-7211, USA.
Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Int J Colorectal Dis. 2022 May;37(5):983-988. doi: 10.1007/s00384-022-04123-9. Epub 2022 Mar 25.
People living with HIV (PLWH) are at an elevated risk for developing anal cancer. As screening is invasive, markers predicting those at highest risk for anal cancer could guide individualized screening. Neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), and prognostic nutritional index (PNI) are surrogate inflammatory/immune markers known to correlate with cancer outcomes. This study aims to assess whether these markers correlate with anal cancer risk in PLWH.
This is a retrospective single-institution cohort study of PLWH at a single academic medical center who were diagnosed with or screened for anal dysplasia between 2001 and 2019. Aforementioned markers collected within one year of diagnosis were recorded. Regression modeling was used to estimate odds of anal cancer. Receiver operating characteristic analysis was utilized to determine optimal cutoff for screening values.
Five-hundred-fourteen patients were included. NLR and PNI were significantly associated with cancer risk on univariate (p = 0.03, p = 0.001) and multivariate analyses (p = 0.03, p = 0.01). NLR increased across all grades of dysplasia. PLR was not associated with cancer risk. A NLR of ≥ 1.64 can be utilized to capture 76% of cancer patients in our cohort.
NLR values in patients living with HIV correlate with risk of anal cancer and increasing grades of dysplasia. A cutoff NLR of ≥ 1.64 can be used to help capture those at risk. NLR is a promising marker of risk of anal cancer and progression of anal dysplasia in patients with HIV infection and could be used to risk-stratify screening and surveillance intervals.
人类免疫缺陷病毒感染者（PLWH）患肛门癌的风险较高。由于筛查具有侵入性，预测肛门癌高危人群的标志物可指导个体化筛查。中性粒细胞淋巴细胞比值（NLR）、血小板淋巴细胞比值（PLR）和预后营养指数（PNI）是已知与癌症预后相关的替代炎症/免疫标志物。本研究旨在评估这些标志物是否与PLWH患肛门癌的风险相关。
这是一项在单一学术医疗中心对2001年至2019年间被诊断为肛门发育异常或接受肛门发育异常筛查的PLWH进行的回顾性单机构队列研究。记录诊断后一年内收集的上述标志物。采用回归模型估计患肛门癌的几率。利用受试者工作特征分析确定筛查值的最佳临界值。
纳入514例患者。在单因素分析（p = 0.03，p = 0.001）和多因素分析（p = 0.03，p = 0.01）中，NLR和PNI与癌症风险显著相关。NLR在所有发育异常等级中均升高。PLR与癌症风险无关。NLR≥1.64可用于在我们的队列中识别76%的癌症患者。
HIV感染者的NLR值与肛门癌风险及发育异常等级增加相关。临界NLR≥1.64可用于帮助识别高危人群。NLR是HIV感染患者肛门癌风险和肛门发育异常进展的一个有前景的标志物，可用于风险分层筛查和监测间隔。
