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Abstract
Introduction. Due to the fact that the treatment algorithm for gastrointestinal neuroendocrine tumors (GI NETs) is determined only by the localization of neoplasia and is focused on classification by the degree of differentiation, the search for additional prognostic markers is an urgent task.
Aim. The purpose of the study is to determine unfavorable prognosis factors in patients with GI NETs to improve the effectiveness of treatment for cancer patients.
Materials and methods. At the initial stage, the clinical and morphological features of 298 patients with GI NETs were analyzed. The subsequent phase of the study involved an investigation into the impact of peripheral blood parameters, systemic inflammatory factors and the proliferation index (Ki-67) on the progression of GI NETs (71 patients). The prognostic significance of type 2 diabetes mellitus, pre-treatment glucose level, body mass index and carcinoid syndrome were also assessed (34 patients with type 2 diabetes mellitus and 30 patients in the control group).
Results. Factors associated with an adverse prognosis and early progression of GI NETs were identified, including Ki-67 > 5 %, relative neutrophil count > 58.30 %, relative lymphocyte count ≤ 30 % and neutrophil-lymphocyte index (NLI) > 1.85. The optimal threshold value of the number of adverse prognostic factors at the cut-off point was 2: having 2 or more adverse prognostic factors at the time of the initial assessment negatively affected the progression-free survival (PFS) time of patients. The presence of more than 2 adverse prognostic factors in a patient increased the risk of disease progression by 67 %: p = 0.0013; OR = 1.67, 95 % CI 1.05-1.78.
Conclusion. Factors of unfavorable prognosis for the course and early progression of GI NETs were identified.
References
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