Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jun 29;13(13):3256.
doi: 10.3390/cancers13133256.

Comparison of Selected Immune and Hematological Parameters and Their Impact on Survival in Patients with HPV-Related and HPV-Unrelated Oropharyngeal Cancer

Affiliations

Comparison of Selected Immune and Hematological Parameters and Their Impact on Survival in Patients with HPV-Related and HPV-Unrelated Oropharyngeal Cancer

Adam Brewczyński et al. Cancers (Basel). .

Abstract

Several immune and hematological parameters are associated with survival in patients with oropharyngeal cancer (OPC). The aim of the study was to analyze selected immune and hematological parameters of patients with HPV-related (HPV+) and HPV-unrelated (HPV-) OPC, before and after radiotherapy/chemoradiotherapy (RT/CRT) and to assess the impact of these parameters on survival. One hundred twenty seven patients with HPV+ and HPV- OPC, treated with RT alone or concurrent chemoradiotherapy (CRT), were included. Patients were divided according to HPV status. Confirmation of HPV etiology was obtained from FFPE (Formalin-Fixed, Paraffin-Embedded) tissue samples and/or extracellular circulating HPV DNA was determined. The pre-treatment and post-treatment laboratory blood parameters were compared in both groups. The neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), monocyte/lymphocyte ratio (MLR), and systemic immune inflammation (SII) index were calculated. The impact of these parameters on overall (OS) and disease-free (DFS) survival was analyzed. In HPV+ patients, a high pre-treatment white blood cells (WBC) count (>8.33 /mm3), NLR (>2.13), SII (>448.60) significantly correlated with reduced OS, whereas high NLR (>2.29), SII (>462.58) significantly correlated with reduced DFS. A higher pre-treatment NLR and SII were significant poor prognostic factors for both OS and DFS in the HPV+ group. These associations were not apparent in HPV- patients. There are different pre-treatment and post-treatment immune and hematological prognostic factors for OS and DFS in HPV+ and HPV- patients. The immune ratios could be considered valuable biomarkers for risk stratification and differentiation for HPV- and HPV+ OPC patients.

Keywords: Human Papillomavirus (HPV); hematological parameters; immune status; oropharyngeal cancer; radiotherapy.

PubMed Disclaimer

Conflict of interest statement

The authors have no conflict of interest to declare.

Figures

Figure 1
Figure 1
Flowchart diagram for the study.
Figure 2
Figure 2
Comparison of overall survival (OS) and disease-free survival (DFS) between Human Papilloma Virus (HPV)− and HPV+ groups.

References

    1. Huang S.H., Waldron J., Milosevic M., Shen X., Ringash J., Su J., Tong L., Perez-Ordonez B., Weinreb I., Bayley A.J., et al. Prognostic value of pretreatment circulating neutrophils, monocytes, and lymphocytes in oropharyngeal cancer stratified by human papillomavirus status. Cancer. 2014;121:545–555. doi: 10.1002/cncr.29100. - DOI - PubMed
    1. Takahashi H., Sakakura K., Tada H., Kaira K., Oyama T., Chikamatsu K. Prognostic significance and population dynamics of peripheral monocytes in patients with oropharyngeal squamous cell carcinoma. Head Neck. 2019;41:1880–1888. doi: 10.1002/hed.25625. - DOI - PubMed
    1. Meshman J., Velez M.A., Wang P.-C., Abemayor E., John M.S., Wong D., Bhuta S., Chen A.M. Immunologic mediators of outcome for irradiated oropharyngeal carcinoma based on human papillomavirus status. Oral Oncol. 2019;89:121–126. doi: 10.1016/j.oraloncology.2018.11.030. - DOI - PubMed
    1. Yamashita Y., Ikegami T., Hirakawa H., Uehara T., Deng Z., Agena S., Uezato J., Kondo S., Kiyuna A., Maeda H., et al. Staging and prognosis of oropharyngeal carcinoma according to the 8th Edition of the American Joint Committee on Cancer Staging Manual in human papillomavirus infection. Eur. Arch. Oto. Rhino. Laryngol. 2019;276:827–836. doi: 10.1007/s00405-018-05263-x. - DOI - PMC - PubMed
    1. Mallen-St Clair J., Ho A.S. American Joint Committee on Cancer 8th edition staging-an improvement in prognostication in HPV-associated oropharyngeal cancer? Ann. Transl. Med. 2019;7(Suppl. 1):S10. - PMC - PubMed