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Global Translational Medicine Blood parameters for SCLC and AC relapse prognosis

risk of relapse. It has been previously shown that cellular of monocytes (64.9%), and the highest for lymphocytes
ratios such as N/L, P/L, and L/M, as well as the level of CRP, expressing CXCR1 receptor (75.3%).
were known as indicators of the inflammatory reaction Three parameters in patients with SCLC (proportions of
associated with tumor development. At the same time, lymphocytes expressing the CXCR1 receptor, monocytes
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elevated levels of CRP, N/L, and P/L ratios, along with a expressing the CXCR2 receptor, and CYFRA 21-1 level) and
decreased L/M ratio, have been associated with a poor three parameters in patients with AC (CYFRA 21-1 level,
prognosis in NSCLC. The prognostic value of the N/L ratio lymphocytes expressing the CXCR1 receptor, and the E/M
was higher compared to P/L ratio. Conversely, findings ratio) were included in the regression analysis to construct
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from other studies suggest that the prognosis of NSCLC the equation. The resulting equations were expected to
is associated with the cellular ratio of P/L rather than the exhibit higher sensitivity and specificity in stratifying
N/L ratio. 17,18 Similar inconsistency of results has also been patients with Stage III AC based on the duration of relapse-
found in the assessment of the prognostic value of CRP. 19 free survival. Utilizing a combination of parameters or
The findings of our investigation demonstrated that markers is a common technique for improving prognostic
in Stage III SCLC, only the proportion of lymphocytes accuracy. 25-30 The convenience of the regression equation
expressing the CXCR1 receptor, monocytes expressing lies in its ability to combine several markers into a single
the CXCR2 receptor, and the CYFRA 21-1 level showed numerical value, streamlining prognostic analysis.
significant differences between patients with high and low All the prognostic characteristics (sensitivity, specificity
risk of relapse-free survival. For the high-risk group of etc.) were much higher than when using each indicator
AC recurrence, the absolute concentrations of monocytes, separately for a similar prognostic purpose. For Stage III
eosinophilic leukocytes, eosinophilic-to-monocyte ratio, SCLC, the prognostic accuracy in predicting relapse-free
the proportion of lymphocytes expressing the CXCR1 survival (Y > 0.417) was 87.7%.
receptor, and the CYFRA 21-1 level, are significantly
higher than in the low-risk group. In contrast, other For patients with Stage III AC, the optimal threshold
parameters, including SII, IPI, and SIRI indices, the levels value for distinguishing between low- and high-risk groups
of HIF-1α, CXCL5, CXCL8, TuM2 PK, and CXCR1, of tumor recurrence was 0.597. Specifically, if the value of
did not demonstrate significant differences between the Z > 0.597, the patient has an 89.6% probability of high
high- and low-risk groups of patients. tumor recurrence, while for value of Z ≤ 0.597, 84.4% of
patients are correctly predicted to have a low risk of tumor
Therefore, only different parameters were used in the recurrence. The use of the logistic equation significantly
Cox proportional hazards models, which show their equal improved the probability in accurately predicting a low or
significance for patient survival. Besides, the results of the high risk of tumor recurrence, reaching an overall accuracy
multivariate analysis confirmed the results of the univariate of 89.0% (with sensitivity of 85.7%, and specificity of 94.8%).
analysis, establishing a connection between the selected As illustrated, all these indicators were notably higher than
set of parameters and relapse-free survival. This approach those achieved when using individual parameters for the
validated the identification of the selected parameters same prognostic purpose.
as prognostic markers and assessed their influence on The distribution of relapse-free survival into relatively
prognosis in terms of odds ratios.
high and low, according to the results of logistic equation,
However, the generally accepted criteria for the aligns to the results of TNM stratification. In patients with
diagnostic and prognostic value of a specific marker Stage III SCLC, the relapse-free survival at the end of the
include threshold value, diagnostic sensitivity, specificity, first year for those at low risk of tumor recurrence is 79%
efficiency, etc. The results of the ROC analysis for the according to TNM stratification and 77% when selected
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selected indicators showed that the proportion of blood blood parameters are included in the regression equation.
lymphocytes expressing the CXCR1 receptor demonstrated For patients with a high risk of tumor recurrence, survival
the highest prognostic efficiency (75.3%) for predicting at the end of the 1 year after treatment is 49% and 48%,
st
relapse-free survival in patients with stage III SCLC. For respectively. Another notable observation is that a clear
Stage III AC, the highest specificity (84.4%) was observed difference between the high and low survival curves
for the relative proportion of lymphocytes expressing the occurs as early as the 1 month after the treatment, with
st
CXCR1, while the diagnostic sensitivity of this indicator this difference subsequently increasing. In contrast, the
did not exceed 66.2%. The diagnostic sensitivity values differences in the high and low relapse-free survival curves
of other selected indicators were in the range of 62.3% to constructed based on TNM appear only two months after
76.6%. As a result, the diagnostic efficiency in predicting the treatment. In subsequent studies, further verification
relapse-free survival was the lowest for the concentration of the proposed prognostic model is needed, not only to

Volume 3 Issue 4 (2024) 11 doi: 10.36922/gtm.4865