Inflammatory Markers May Predict Mesothelioma Prognosis

Researchers say they have identified several signs of inflammation in patients with malignant mesothelioma that might be used to predict how patients will respond to treatment.

Doctors from the Department of Chest Diseases at Dicle University collected data on 155 patients at the time of their mesothelioma diagnosis and compared it to their survival. The information collected included the extent of each patient’s exposure to asbestos, the histological subtype of their mesothelioma, and other laboratory measures.

The mean survival time for all mesothelioma patients in the study was 13.9 months. When the researchers considered one potential prognostic factor at a time, they found that being 60 years old or over and having a neutrophil-to-lymphocyte ratio (NLR) of 3 or more were each associated with significantly shorter median survival.

When more than one variable was considered at a time (multivariate analysis), having a non-epithelial variety of mesothelioma, an NLR of 3 or over, and a red cell distribution width (RDW) of 20% or higher were also associated with poor survival. RDW is a measurement of the variation in size of red blood cells in a blood sample. Certain disorders, including cancers, can cause a significant variation in blood cell size. Higher RDW indicates a greater variation in size.

RDW was found to be such an important indicator of prognosis that mesothelioma patients with levels higher than 20% had a 2.77-fold increase in mortality. NLR levels of 3 or higher produced a 1.67-fold increase in mortality and patients with non-epithelial mesothelioma had a 1.52-fold increase. Just having non-epithelial mesothelioma, as well as having higher white blood cell counts and platelet-to-lymphocyte ratios of 300 or higher at baseline, was associated with higher NLR value.

In an article in the Journal of International Medical Research, the authors concluded, “The neutrophil-to-lymphocyte ratio and the red cell distribution width were significant predictive factors for malignant mesothelioma prognosis.” Prognostic factors can play an important role in treatment planning for mesothelioma, an aggressive cancer caused by asbestos exposure.


Abakay, O, “The value of inflammatory parameters in the prognosis of malignant mesothelioma”, February 26, 2014, Journal of International Medical Research, Epub head of print.

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