C-Reactive Protein to Lymphocyte Ratio (CLR) and Lactate Dehydrogenase to Albumin Ratio (LAR) as Prognostic Biomarkers in Acral Melanoma: Association With Tertiary Lymphoid Structures and Immune Cell Infiltration

IF 2.9 2区医学 Q2 ONCOLOGY

Cancer Medicine Pub Date : 2025-07-26 DOI:10.1002/cam4.71078

Donglin Kang, Xinyu Su, Jiayu Wang, Lianjun Zhao, Rong Huang, Zhengyun Zou

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Abstract

Objective

To investigate the correlation between peripheral blood CRP-to-lymphocyte ratio (CLR) and lactate dehydrogenase-to-albumin ratio (LAR) levels, prognosis, and the tumor microenvironment (TME) in patients with acral melanoma (AM), with a focus on tertiary lymphoid structures (TLS) and immune cell infiltration.

Methods

A retrospective cohort of 36 patients with acral melanoma was included. Clinical data and hematological parameters were collected. The maturity of TLS, the proportion of immune cells, and their spatial distribution within the TME were assessed using H&E staining and multiplex immunofluorescence. Kaplan–Meier survival curves and Cox regression models were employed to examine the association between these indicators and patient survival. Non-parametric tests and Spearman's correlation analysis were used to compare CLR and LAR levels across patients with different TLS maturity and immune infiltration statuses.

Results

Elevated levels of CLR and LAR in the blood are associated with poorer prognosis in patients with acral melanoma. The levels of CLR and LAR vary across patients with TLS of different maturities, and these levels decrease as TLS maturity increases. Additionally, CLR and LAR levels are significantly correlated with the proportions of CD4+ and CD8+ T cells in TME, with higher levels of CLR and LAR being linked to reduced immune cell infiltration.

Conclusion

Elevated CLR and LAR levels are associated with poorer prognosis in AM patients, and this relationship is closely linked to the maturity of TLS and the extent of immune cell infiltration within the TME.

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c反应蛋白与淋巴细胞比率（CLR）和乳酸脱氢酶与白蛋白比率（LAR）作为肢端黑色素瘤的预后生物标志物：与三级淋巴结构和免疫细胞浸润的关系

目的探讨肢端黑色素瘤（AM）患者外周血CRP-to-lymphocyte ratio （CLR）、乳酸脱氢酶- To -albumin ratio （LAR）水平与预后、肿瘤微环境（tumor microenvironment， TME）的相关性，重点关注三级淋巴样结构（tertiary lymphoid structures， TLS）和免疫细胞浸润。方法对36例肢端黑色素瘤患者进行回顾性分析。收集临床资料和血液学参数。采用H&；E染色和多重免疫荧光检测TME内TLS的成熟度、免疫细胞比例及空间分布。采用Kaplan-Meier生存曲线和Cox回归模型检验这些指标与患者生存的相关性。采用非参数检验和Spearman相关分析比较不同TLS成熟度和免疫浸润状态患者的CLR和LAR水平。结果血中CLR和LAR水平升高与肢端黑色素瘤患者预后较差相关。不同成熟度TLS患者的CLR和LAR水平不同，并且随着TLS成熟度的增加，这些水平降低。此外，CLR和LAR水平与TME中CD4+和CD8+ T细胞的比例显著相关，CLR和LAR水平升高与免疫细胞浸润减少有关。结论AM患者CLR和LAR水平升高与预后不良相关，且这种关系与TLS的成熟程度和TME内免疫细胞浸润程度密切相关。

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

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.