Bumbasirevic Uros, Bojanic Nebojsa, Simic Tatjana, Milojevic Bogomir, Zivkovic Marko, Kosanovic Tijana, Kajmakovic Boris, Janicic Aleksandar, Durutovic Otas, Radovanovic Milan, Santric Veljko, Zekovic Milica, Coric Vesna
Clinic of Urology, University Clinical Center of Serbia, 11000 Belgrade, Serbia.
Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia.
J Pers Med. 2022 May 20;12(5):833. doi: 10.3390/jpm12050833.
Sustained and dysregulated inflammation, concurrent tumor-induced immune suppression, and oxidative stress are profoundly involved in cancer initiation, presentation, and perpetuation. Within this prospective study, we simultaneously analyzed the preoperative indices of systemic inflammatory response and the representative byproducts of oxidative DNA, protein, and lipid damage with the aim of evaluating their clinical relevance among patients diagnosed with testicular germ-cell tumors (GCT). In the analytical cohort (n = 88, median age 34 years), neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (dNLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and C-reactive protein (CRP) were significantly altered in patients with a higher tumor stage (p < 0.05). Highly suggestive correlations were found between NLR, dNLR, and SII and modified nucleoside 8-OHdG. CRP and albumin-to-globulin ratio (AGR) significantly correlated with thiols group level and maximal tumor dimension (p < 0.05). Based on receiver operating characteristic (ROC) curve analyses, all the evaluated pre-orchiectomy inflammation markers demonstrated strong performance in predicting metastatic disease; optimal cut-off points were determined for each indicator. Although further large-scale studies are warranted, inflammatory and redox indices may both complement the established tumor markers and standard clinicopathological prognostic variables and contribute to enhanced personalized risk-assessment among testicular GCT patients.
持续且失调的炎症、同时存在的肿瘤诱导的免疫抑制以及氧化应激在癌症的起始、表现和持续发展中都有着深远的影响。在这项前瞻性研究中，我们同时分析了全身炎症反应的术前指标以及氧化DNA、蛋白质和脂质损伤的代表性副产物，目的是评估它们在诊断为睾丸生殖细胞肿瘤（GCT）的患者中的临床相关性。在分析队列（n = 88，中位年龄34岁）中，肿瘤分期较高的患者中性粒细胞与淋巴细胞比值（NLR）、衍生中性粒细胞与淋巴细胞比值（dNLR）、血小板与淋巴细胞比值（PLR）、淋巴细胞与单核细胞比值（LMR）、全身免疫炎症指数（SII）、全身炎症反应指数（SIRI）和C反应蛋白（CRP）均有显著改变（p < 0.05）。发现NLR、dNLR和SII与修饰核苷8-OHdG之间存在高度提示性的相关性。CRP和白蛋白与球蛋白比值（AGR）与硫醇基团水平和最大肿瘤尺寸显著相关（p < 0.05）。基于受试者工作特征（ROC）曲线分析，所有评估的睾丸切除术前炎症标志物在预测转移性疾病方面表现出强大的性能；为每个指标确定了最佳截断点。尽管需要进一步的大规模研究，但炎症和氧化还原指标可能既可以补充已有的肿瘤标志物和标准临床病理预后变量，也有助于加强睾丸GCT患者的个性化风险评估。
