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. 2025 Sep 8;60(3):s00451810032.
doi: 10.1055/s-0045-1810032. eCollection 2025 Jun.

High Levels of Systemic Inflammatory Markers Associated with Metastasis Incidence in Osteosarcoma

I Gede Eka Wiratnaya  1 , Mohamad Dimas Ismail  1 , Risang Haryo Raditya  1 , I Putu Dema Prasetya  1
Affiliations

High Levels of Systemic Inflammatory Markers Associated with Metastasis Incidence in Osteosarcoma

I Gede Eka Wiratnaya et al. Rev Bras Ortop (Sao Paulo). .

Abstract
in English, Portuguese

Objective: The present study explores the association between these inflammatory markers and metastasis in osteosarcoma patients.

Methods: We conducted a retrospective analysis of osteosarcoma patients at our center between January 2022 and August 2024. We collected the clinical and laboratory data of the patients, including white blood cell differential count, C-reactive protein (CRP) levels, erythrocyte sedimentation rate (ESR), neutrophil-to-lymphocyte ratio (NLR), alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) levels. Statistical correlation between these markers and metastasis was assessed using the Pearson's Chi-squared test, the Fisher's exact test, and logistic regression.

Results: A total of 40 osteosarcoma patients were included. Elevated levels of neutrophil count ( p = 0.024; odds ratio [OR] = 12.667; 95%CI = 1.402-114.419), CRP ( p < 0.001; OR = 17.000; 95%CI = 3.464-83.436), ESR ( p = 0.009; OR = 19.000; 95%CI = 2.119-170.383), NLR ( p = 0.006; OR = 7.429; 95%CI = 1.778-31.040), and LDH ( p = 0.009; OR = 9.333; 95%CI = 2.180-39.962) were significantly associated with the presence of metastasis.

Conclusion: The neutrophil count, ESR, NLR, and the levels of CRP and LDH are significantly associated with metastasis in osteosarcoma, and they may serve as valuable prognostic markers. Future research should focus on elucidating the mechanisms underlying this relationship and exploring therapeutic interventions targeting inflammation to mitigate metastasis.

Objetivo: Este estudo explora a associação entre esses marcadores inflamatórios e metástase em pacientes com osteossarcoma.

Métodos: Realizamos uma análise retrospectiva de pacientes com osteossarcoma de nosso centro entre janeiro de 2022 e agosto de 2024. Coletamos dados clínicos e laboratoriais dos pacientes, incluindo contagem diferencial de leucócitos, níveis de proteína C reativa (PCR), velocidade de hemossedimentação (VHS), razão neutrófilo-linfócito (RNL) e concentrações de fosfatase alcalina (FA) e lactato desidrogenase (LDH). A correlação estatística entre esses marcadores e metástase foi avaliada por meio dos teste do Qui-quadrado de Pearson, exato de Fisher e regressão logística.

Resultados: O estudo incluiu 40 pacientes com osteossarcoma. Níveis altos de contagem de neutrófilos ( p = 0,024; razão de chances [RC] = 12,667; IC95% = 1,402–114,419) de PCR ( p < 0,001; RC = 17,000; IC95% = 3,464–83,436), VHS ( p = 0,009; RC = 19,000; IC95% = 2,119–170,383), RNL ( p = 0,006; RC = 7,429; IC95% = 1,778–31,040) e LDH ( p = 0,009; RC = 9,333; IC95% = 2,180–39,962) foram significativamente associados à presença de metástase.

Conclusão: A contagem de neutrófilos, a VHS, a RNL e os níveis de PCR e LDH estão significativamente associados à metástase em osteossarcoma, e podem ser marcadores prognósticos valiosos. Pesquisas futuras devem se concentrar em elucidar os mecanismos subjacentes a essa relação e explorar intervenções terapêuticas direcionadas à inflamação para mitigar a metástase.

Keywords: C-reactive protein; L-lactate dehydrogenase; blood sedimentation; bone neoplasms; osteosarcoma.

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Conflict of interest statement

Conflict of Interests The authors have no conflict of interests to declare.

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