老年与非老年子宫内膜癌患者炎症标志物的比较。
The comparison of inflammatory markers in geriatric and nongeriatric endometrial cancers.
机构信息
Obstetrics and Gynecology Department, University of Health Sciences, Hamidiye Medical Faculty, Haydarpaşa Numune Training and Research Hospital, Istanbul, Turkey.
Obstetrics and Gynecology Department, Şişli Kolan International Hospital, Istanbul, Turkey.
出版信息
Cancer Biomark. 2022;34(4):583-590. doi: 10.3233/CBM-210215.
BACKGROUND
The inflammatory markers are associated with adverse clinical outcomes in endometrial cancers (EC), but hematopoietic aging may affect the results.
OBJECTIVE
To compare inflammatory markers in geriatric and nongeriatric EC.
METHODS
This study included 342 women with endometrial cancers (n: 171) and age-matched controls (n: 171). Geriatric (⩾ 65 years old) and nongeriatric women in each group was compared for inflammatory markers, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), mean platelet volume (MPV), and platelet distribution width (PDW).
RESULTS
Geriatric EC had more common nonendometrioid tumors, myometrial invasion, lymph node metastasis, advanced stage, and low overall survival (OS). Nongeriatric EC had low MPV, high NLR, and PDW compared to nongeriatric control. Geriatric EC had low MPV, lymphocyte, and high NLR, PLR compared to geriatric control (p< 0.05). Geriatric EC had significantly low PDW and high NLR, PLR compared to nongeriatric EC in early stages, not in advanced stages. Lymphocyte count was significantly low in geriatric EC with all stages (p< 0.05). In nongeriatric EC, stage was related to platelet count (r: 0.341, p: 0.0019), and PLR (r: 0.252, p: 0.01). OS was negatively related to PLR (r: -0.267, p: 0.007) and NLR (r: -0.353, p: 0.000). In geriatric EC, myometrium invasion was negatively related to lymphocyte count (r: -0.268, p: 0.035). OS was related to neutrophil count (p: 0.352, p: 0.01). MPV was negatively related to stage (r: -0.335, p: 0.01) and OS (r: -0.337, p: 0.02).
CONCLUSIONS
The inflammatory responses of geriatric and nongeriatric EC were different in the early and advanced stages. Geriatric EC had low PDW and high NLR, PLR compared to nongeriatric EC in early stages. Decreased lymphocyte count was the most prominent feature of geriatric EC in the early and advanced stages. These results suggested that decreased lymphocyte count may reflect an aggressive course of disease in the elderlies. Future inflammation studies may direct anticancer treatment strategies in geriatric EC. Further research on inflammaging and geriatric EC is needed to increase our understanding of aging and carcinogenesis.
背景
炎症标志物与子宫内膜癌（EC）的不良临床结局相关，但造血衰老可能会影响结果。
目的
比较老年和非老年 EC 中的炎症标志物。
方法
本研究纳入了 342 名子宫内膜癌患者（n=171）和年龄匹配的对照组患者（n=171）。比较每组中的老年（≥65 岁）和非老年女性的炎症标志物、中性粒细胞/淋巴细胞比值（NLR）、血小板/淋巴细胞比值（PLR）、平均血小板体积（MPV）和血小板分布宽度（PDW）。
结果
老年 EC 中非子宫内膜样肿瘤、肌层浸润、淋巴结转移、晚期和总体生存率（OS）更常见。与非老年对照组相比，非老年 EC 的 MPV 较低，NLR 和 PDW 较高。与老年对照组相比，老年 EC 的 MPV、淋巴细胞和 NLR、PLR 较低（p<0.05）。在早期阶段，老年 EC 的 PDW 较低，NLR 和 PLR 较高，而非老年 EC 则相反，且仅在早期阶段，而不在晚期阶段（p<0.05）。所有阶段的老年 EC 的淋巴细胞计数均明显较低（p<0.05）。在非老年 EC 中，肿瘤分期与血小板计数（r：0.341，p：0.0019）和 PLR（r：0.252，p：0.01）相关。OS 与 PLR（r：-0.267，p：0.007）和 NLR（r：-0.353，p：0.000）呈负相关。在老年 EC 中，肌层浸润与淋巴细胞计数呈负相关（r：-0.268，p：0.035）。OS 与中性粒细胞计数相关（p：0.352，p：0.01）。MPV 与肿瘤分期（r：-0.335，p：0.01）和 OS（r：-0.337，p：0.02）呈负相关。
结论
老年和非老年 EC 的炎症反应在早期和晚期阶段有所不同。在早期阶段，老年 EC 的 PDW 较低，NLR 和 PLR 较高，而非老年 EC 则相反。在早期和晚期阶段，老年 EC 中淋巴细胞计数减少是最显著的特征。这些结果表明，淋巴细胞计数减少可能反映老年人疾病的侵袭性病程。未来的炎症研究可能会指导老年 EC 的抗癌治疗策略。需要进一步研究炎症和老年 EC，以增加我们对衰老和癌变的理解。
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