期刊
CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION
卷 27, 期 10, 页码 1176-1185出版社
AMER ASSOC CANCER RESEARCH
DOI: 10.1158/1055-9965.EPI-18-0408
关键词
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资金
- NIH [P01 CA186866, R01 CA213290, R01 CA188419, R01 AI077283, R01 GM122078, R21 CA209848]
- Hollings Cancer Center's Cancer Center Support Grant [P30 CA138313]
- Abney Foundation
- Hollings Cancer Center
- South Carolina SmartState Center of Excellence
Background: Remarkable discrepancy exists in outcomes between men and women for multiple malignancies. We sought to expose sex differences in using platelet count and neutrophil-to-lymphocyte ratio (NLR) to predict overall survival for select cancer types with focus on head and neck squamous cell carcinoma (HNSCC). Methods: Peripheral blood samples from 9,365 patients seen in a tertiary teaching hospital with nine different primary tumors were retrospectively examined. HNSCC RNA-sequencing data from The Cancer Genome Atlas were analyzed by two computational means [Cell-type Identification By Estimating Relative Subsets Of RNA Transcripts (CIBERSORT) and Estimation of Stromal and Immune cells in Malignant Tumor tissues using Expression data (ESTIMATE)] to extend our observations to the tumor microenvironment. Results: For HNSCC, platelet count was more predictive of overall survival for males [log-rank test: HR = 1.809; 95% confidence interval (CI), 1.461-2.239 vs. HR = 1.287; 95% CI, 0.8901-1.861], whereas NLR was more predictive for females (HR = 2.627; 95% CI, 1.716-4.02 vs. HR = 1.261; 95% CI, 0.998-1.593). For females, lymphocyte count was more associated with survival than neutrophil count (multivariate Cox regression: P = 0.0015 vs. P = 0.7476). Both CIBERSORT (P = 0.0061) and ESTIMATE (P = 0.022) revealed greater immune infiltration in females. High tumor infiltration by T lymphocytes was more strikingly associated with survival in females (HR = 0.20, P = 0.0281) than in males (HR = 0.49, P = 0.0147). Conclusions: This is the first study to comprehensively demonstrate sex bias in the clinical utility of platelet, granulocyte, and lymphocyte counts as biomarkers to prognosticate HNSCC patients. Impact: This work emphasizes the necessity to consider sex in appraising inflammatory markers for cancer risk stratification. (C) 2018 AACR.
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