INTERACTION BETWEEN LOCAL AND SYSTEMIC INFLAMMATORY RESPONSE IN
INTERACTION BETWEEN LOCAL AND SYSTEMIC INFLAMMATORY RESPONSE IN COLORECTAL CARCINOMA: TWO FACES OF JANUS PAPER ID 23482 Inese Drike 1, Sandra Cipkina 2, Fanija Cukure 2 , Ilze Strumfa 1, Janis Gardovskis 3 1 Riga Stradins University, Department of Pathology 2 Riga Stradins University, Faculty of Medicine 3 Riga Stradins University, Department of Surgery INTRODUCTION RESULTS High-grade peritumorous inflammation is associated with better prognosis in many cancers (Wang et al. , 2016). In contrast, marked systemic inflammatory response (SIR) is linked to worse survival (Krenn-Pilko et al. , 2014). The study comprised 182 colorectal carcinomas, including 101 (55. 5% [95% confidence interval: 48. 2 – 62. 5]) cases featuring low-grade inflammation and 81 (44. 5% [37. 5 – 51. 8]) tumours showing highgrade local inflammation. Spearman test confirmed statistically significant association between the intensity of local inflammation and NLR (p=0. 04) as well as PLR (p=0. 03). In patients presenting with low-grade local inflammation, the median NLR was 2. 4 (interquartile range (IQR): 1. 7 – 4. 0) and PLR: 166. 0 (IQR: 118. 5 – 244. 0), contrasting with NLR of 3. 1 (IQR: 2. 3 – 4. 6) and PLR of 224. 0 (145. 5 – 281. 5) in those having highgrade peritumourous inflammation. LMR (p=0. 11) and NMR (p=0. 12) lacked statistically significant association with the intensity of local inflammation. Figure 1. Colorectal cancer within operation material AIM The aim of our study was to evaluate the local inflammatory reaction in relation to SIR in colorectal cancer. MATERIALS AND METHODS The study was designed as a retrospective morphological and laboratory assessment of consecutive primary colorectal carcinoma cases subjected to surgical treatment with curative intention. The local inflammatory reaction in tumour tissues was assessed according to Klintrup-Makinen score (Klintrup et al. , 2005). In short, carcinomas were classified by the intensity of inflammation into four groups, which were further re-distributed into two classes: low-grade (no or mild inflammation) vs high-grade (moderate or severe) inflammation. SIR was analyzed by calculating neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), lymphocyte/monocyte ratio (LMR) and neutrophil/monocyte ratio (NMR) using data from preoperative blood counts. Descriptive statistical analysis and Spearman rank correlation test were applied to evaluate the results. . NLR [IQR] PLR [IQR] LMR [IQR] NMR [IQR] Low-grade 2. 4 [1. 7 – 4. 0] 166. 0 [118. 5 – 244. 0] 2. 9 [1. 8 – 4. 1] 7. 0 [6. 2 – 9. 0] Highgrade 3. 1 [2. 3 – 4. 6] 224. 0 [145. 5 – 281. 5] 2. 5 [1. 7 – 3. 2] 8. 0 [6. 4 – 10. 4] p value 0. 04 0. 03 0. 11 0. 12 Inflammation Figure 2. Inflammatory infiltrate within colorectal hematoxylin-eosin stain, original magnification 400 x cancer, CONCLUSIONS In colorectal carcinoma, high-grade local inflammation is associated with higher NLR and PLR. There is no correlation between local inflammation and either LMR or NMR. These associations should be considered when elaborating prognostic algorithms.
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