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High pre-treatment neutrophil-to-lymphocyte ratio in patients with dermatomyositis/polymyositis predicts an increased risk of cancer

  • Clinical Report
  • Published:
European Journal of Dermatology

Abstract

Background

Neutrophil-to-lymphocyte ratio (NLR) is increased and associated with overall survival (OS) in inflammatory diseases including dermatomyositis/polymyositis (DM/PM) and many cancers. The risk of cancer is increased with DM/PM especially in adults > 50 years old.

Objectives

To determine whether high NLR is associated with an increased risk of cancer and OS in DM/PM patients.

Materials and Methods

A retrospective monocentric study was performed in a tertiary care referral centre between 2007 and 2018. Data on patient characteristics included pre-treatment NLR, visceral involvement, treatment, autoantibodies, creatine phosphokinase level, occurrence of cancer, and death. The cut-off value of NLR was determined by receiver operating characteristic curve analysis. Factors associated with risk of cancer and death were estimated by Cox proportional-hazards regression analysis.

Results

In total, 75 patients had a diagnosis of DM/PM (median age: 60 [Q1-Q3: 41.3–70.2] years and median follow-up: 3.5 [Q1-Q3: 1–5.9] years) and 16 patients had cancer. NLR ≥5.5 was associated with occurrence of cancer based on univariate analysis (HR: 3.6; 95% CI: 1.2–10.6) and multivariate analysis (HR: 3.8; 95% CI: 1.2–12.1) adjusted for age (HR: 5.0; 95% CI: 1.1–22.7), as well as corticosteroid intake (p = 0.35) before initial NLR determination.

Conclusion

This is the first study to demonstrate an association between high NLR and risk of cancer in patients with DM/PM. Moreover, analysis was performed with adjustment for potential confounding factors such as corticosteroid intake. High NLR at age ≥ 60 years should prompt investigation for cancer from diagnosis of DM/PM and during follow-up.

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Authors and Affiliations

  1. Department of Dermatology, University Hospital, Tours, France

    Irène Nicoletis & Laurent Machet

  2. Department of Public Health, Clinical Data Centre, EA 1275, Tours, France

    Jeremy Pasco & Leslie Grammatico-Guillon

  3. Department of Epidemiology, University of Tours, Tours, France

    Jeremy Pasco & Leslie Grammatico-Guillon

  4. Department of Internal Medicine, University Hospital, Tours, France

    Francois Maillot

  5. Department of Rheumatology, University Hospital, Tours, France

    Philippe Goupille

  6. Department of Neurology, University Hospital, Tours, France

    Philippe Corcia

  7. UMR Inserm U1253, University of Tours, Tours, France

    Laurent Machet

Authors
  1. Irène Nicoletis
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  2. Jeremy Pasco
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  3. Francois Maillot
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  4. Philippe Goupille
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  5. Philippe Corcia
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  6. Leslie Grammatico-Guillon
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  7. Laurent Machet
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Corresponding author

Correspondence to Laurent Machet.

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Conflicts of interest: none.

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Nicoletis, I., Pasco, J., Maillot, F. et al. High pre-treatment neutrophil-to-lymphocyte ratio in patients with dermatomyositis/polymyositis predicts an increased risk of cancer. Eur J Dermatol 30, 133–139 (2020). https://doi.org/10.1684/ejd.2020.3756

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  • DOI: https://doi.org/10.1684/ejd.2020.3756

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