COMPLETE BLOOD COUNT DERIVED INFLAMMATORY BIOMARKERS IN PATIENTS WITH HEMATOLOGIC MALIGNANCIES.

Inflammation sometimes can be associated with the development of number of diseases, among them cancer. Few studies show prognostic value of different inflammatory markers, such as lymphocyte and monocyte count, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and others in some types of blood cancers. There is further need to investigate easy measurable diagnostic and prognostic novel biomarkers in hematologic malignancies. Our aim was to investigate the role of inflammatory markers: NLR, PLR, platelet-monocyte ratio (PMR), hemoglobin-platelet ratio (HPR), hemoglobin-lymphocyte ratio (HLR), lymphocyte-monocyte ratio (LMR), systemic immune-inflammation index (SII) and derived neutrophil-lymphocyte ratio (dNLR), which were used alone or in combination, in early diagnoses of hematologic malignancies. The counts for total white blood cells, neutrophils, lymphocytes, platelets, monocyte and hemoglobin as well as systemic inflammatory factors, such as NLR, PLR, PMR, HPR, HLR, LMR, SII and dNLRwere analysed from patients with hematologic malignancies and their age-matched controls. The area under the curve (AUC), sensitivity, specificity and cut-off values, as well as correlations between these inflammatory markers were analyzed. The patients with hematologic malignancies have significantly increased level of inflammatory markers: NLR, PLR, PMR, HLR, SII and dNLR in comparison with age-matched controls. NLR and PLR positively correlate with each other and SII and negatively correlate with HGB. Additionally, PLR has positive correlation with HLR. dNLR has the highest AUC score. For diagnosing hematologic malignancies the AUC of the ROC curve for dNLR was 0.810 with a 95% CI of 0.646-0.975. However, combining these six markers - NLR, PLR, PMR, HLR, SII and dNLR reached the best AUC score - 0.923 with a 95% of CI of 0.778-1.000. Results indicate that NLR, PLR, PMR, HLR, SII and dNLR, which are easily detectable laboratory parameters and reflect systemic inflammatory response can be predictive factors for hematologic malignancies.

HEPATOCELLULAR CARCINOMA: CURRENT AND PROSPECTIVE IMMUNOTHERAPEUTIC STRATEGIES.

Hepatocellular carcinoma (HCC) is a highly lethal and the most common primary liver cancer with increasing worldwide incidence. Pathogenesis of HCC is immune mediated, however, not completely understood. Chronic low-grade inflammation alters both innate and adaptive immune responses. As a result tolerogenic environment is established in damaged organ. Up to date, incomplete understanding of HCC pathogenesis and the extend of biomarker variability among patients represent the major obstacle for early diagnosis and for the choice of effective treatment. Among current treatment options for HCC, thermal ablation strategy, which in addition to cancer eradication provides adjuvant/"danger"signal to the patient's immune cells, has demonstrated its active immunotherapeutic effect. In ongoing phase I/II clinical trials, tumor antigen loaded dendritic cell (DC)-based vaccines as well as tumor-specific cytotoxic T cells are being tested. Genetically redirected T cell therapy and more refined autologous vaccines are still awaiting approaches in HCC. The topic of this review focuses on current and bench-to-bedside immunotherapeutic strategies for HCC and discusses their advantages and limitations in clinic. We also weight up several prospective immunotherapeutic approaches which in theory have the potential for further implication in HCC. Combination of the induction of effective antitumor immunity with the inhibition of the mechanisms of tumor-induced immunosuppression ought to be a key objective in these future developments.