Evaluating the prognostic significance of the pre-treatment neutrophil-to-lymphocyte and monocyte-to-lymphocyte ratios in ¹⁷⁷Lu-DOTATATE PRRT treated patients with advanced metastatic neuroendocrine tumors.

IF 3.7 3区医学 Q2 Medicine

Endocrine Pub Date : 2025-03-25 DOI:10.1007/s12020-025-04212-z

Mahesh K Padwal, Amir K Nazar, Rahul V Parghane, Sandip Basu, Bhakti Basu

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引用次数: 0

Abstract

Purpose: This study aimed to investigate the role of pre-treatment neutrophil-to-lymphocyte ratio (NLR) and monocyte-to-lymphocyte ratio (MLR) in the prognosis assessment of ¹⁷⁷Lu-DOTATATE Peptide Receptor Radionuclide Therapy (PRRT) treated patients with advanced metastatic neuroendocrine tumors (NETs).

Methods: Eligible PRRT-treated patients (n = 247, 2010-2019) were included. Pre-PRRT NLR and MLR were calculated from complete blood count data. Data on tumor characteristics, response to PRRT, progression-free survival (PFS), and overall survival (OS) were evaluated using COXPH analyses.

Results: In NET patients, median values of NLR and MLR were 2.21 (IQR = 1.66-3.00) and 0.14 (IQR = 0.06-0.24), respectively. NLR showed significant positive association with G3 tumors (median = 3.64, IQR = 2.1-4.26, p = 0.022) and high ¹⁸F-FDG avidity (SUVmax>5) (median = 2.5, IQR = 1.82-3.56, p = 0.003). MLR was significantly associated with high disease burden (median = 0.18, IQR = 0.08-0.29, p = 0.0083). MLR distinguished between the PRRT non-responders with progressive disease and responders with complete/partial response (median 0.19 versus 0.12, p = 0.043) or responders with stable disease (median 0.19 versus 0.14, p = 0.045). The ratios independently correlated with disease progression and OS. Patients in NLR^high (>3.5) group displayed significantly shorter median PFS and OS (48 and 58 months) compared to NLR^low (≤3.5) group (108 and 96 months) (p < 0.01). Patients in MLR^high (>0.25) group displayed significantly shorter median PFS and OS (40 and 52 months) compared to MLR^low (≤0.25) group (108 and 102 months) (p < 0.01).

Conclusion: Pre-treatment NLR and MLR had an independent prognostic impact on disease progression and OS in PRRT-treated NET patients. This routine, inexpensive CBC-based test in the standard pre-PRRT workup demonstrates the prognostic value and may aid clinicians in the risk stratification of NET patients.

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评价177Lu-DOTATATE PRRT治疗晚期转移性神经内分泌肿瘤患者治疗前中性粒细胞/淋巴细胞及单核细胞/淋巴细胞比值的预后意义

目的：本研究旨在探讨治疗前中性粒细胞与淋巴细胞比值（NLR）和单核细胞与淋巴细胞比值（MLR）在177Lu-DOTATATE肽受体放射性核素疗法（PRRT）治疗晚期转移性神经内分泌肿瘤（NETs）患者预后评估中的作用。方法：纳入符合条件的prrt治疗患者（n = 247, 2010-2019）。根据全血细胞计数数据计算prrt前NLR和MLR。使用COXPH分析评估肿瘤特征、对PRRT的反应、无进展生存期（PFS）和总生存期（OS）的数据。结果：NET患者NLR和MLR的中位值分别为2.21 （IQR = 1.66-3.00）和0.14 （IQR = 0.06-0.24）。NLR与G3肿瘤呈显著正相关（中位数= 3.64,IQR = 2.1 ~ 4.26, p = 0.022）， 18F-FDG高贪婪度（SUVmax>5）（中位数= 2.5,IQR = 1.82 ~ 3.56, p = 0.003）。MLR与高疾病负担显著相关（中位数= 0.18,IQR = 0.08-0.29, p = 0.0083）。MLR区分疾病进展的PRRT无应答者、完全/部分应答者（中位数0.19 vs 0.12, p = 0.043）或疾病稳定应答者（中位数0.19 vs 0.14, p = 0.045）。这些比率与疾病进展和OS独立相关。与NLRlow（≤3.5）组（108个月和96个月）相比，NLRhigh（>3.5）组患者的中位PFS和OS（48个月和58个月）显著缩短(p高（>0.25）组（108个月和102个月）。（p结论：治疗前NLR和MLR对prrt治疗NET患者的疾病进展和OS有独立的预后影响。）在标准的prrt前检查中，这种常规的、廉价的基于cbc的检测显示了预后价值，并可能帮助临床医生对NET患者进行风险分层。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Endocrine 医学-内分泌学与代谢

CiteScore

6.40

自引率

5.40%

发文量

期刊介绍： Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology. Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted. Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.