Systemic Inflammatory Response Markers and CA-125 Levels in Ovarian Clear Cell Carcinoma: A Two Center Cohort Study

• Published in: Cancer research and treatment Vol. 48; no. 1; pp. 250 - 258
• Main Authors: Kim, Hee Seung, Choi, Hwa-Young, Lee, Maria, Suh, Dong Hoon, Kim, Kidong, No, Jae Hong, Chung, Hyun Hoon, Kim, Yong Beom, Song, Yong Sang
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Cancer Association 01.01.2016; 대한암학회
• Subjects: Adult; Aged; Aged, 80 and over; CA-125 Antigen - metabolism; Cohort Studies; Female; Humans; Inflammation Mediators - blood; Leukocyte Count; Middle Aged; Odds Ratio; Original; Ovarian Neoplasms - diagnosis; Ovarian Neoplasms - immunology; Ovarian Neoplasms - metabolism; Prognosis; Retrospective Studies; Survival Analysis; 의약학; Blood platelets; Lymphocytes; Ovarian neoplasms; CA-125 antigen; Clear cell adenocarcinoma; Neutrophils
• ISSN: 1598-2998; 2005-9256
• DOI: 10.4143/crt.2014.324

We compared the predictive and prognostic values of leukocyte differential counts, systemic inflammatory (SIR) markers and cancer antigen 125 (CA-125) levels, and identified the most useful marker in patients with ovarian clear cell carcinoma (OCCC). The study included 109 patients with OCCC who did not have any inflammatory conditions except endometriosis, and underwent primary debulking surgery between 1997 and 2012. Leukocyte differential counts (neutrophil, lymphocyte, monocyte, eosinophil, basophil, and platelet), SIR markers including neutrophil to lymphocyte ratio (NLR), monocyte to lymphocyte ratio (MLR), and platelet to lymphocyte ratio (PLR), and CA-125 levels were estimated to select potential markers for clinical outcomes. Among potential markers (neutrophil, monocyte, platelet, NLR, MLR, PLR, and CA-125 levels) selected by stepwise comparison, CA-125 levels were best at predicting advanced stage disease, suboptimal debulking and platinum-resistance (cut-off values, ≥ 46.5, ≥ 11.45, and ≥ 66.4 U/mL; accuracies, 69.4%, 78.7%, and 68.5%) while PLR ≥ 205.4 predicted non-complete response (CR; accuracy, 71.6%) most accurately. Moreover, PLR < 205.4 was an independent factor for the reduced risk of non-CR (adjusted odds ratio, 0.17; 95% confidence interval [CI], 0.04 to 0.69), and NLR < 2.8 was a favorable factor for improved progression-free survival (PFS; adjusted hazard ratio, 0.49; 95% CI, 0.25 to 0.99) despite lack of a marker for overall survival among the potential markers. CA-125 levels may be the most useful marker for predicting advanced-stage disease. Suboptimal debulking and platinum-resistance, and PLR and NLR may be most effective to predict non-CR and PFS in patients with OCCC.