C‐Reactive Protein to Lymphocyte Ratio (CLR) and Lactate Dehydrogenase to Albumin Ratio (LAR) as Prognostic Biomarkers in Acral Melanoma: Association With Tertiary Lymphoid Structures and Immune Cell Infiltration

ABSTRACT Objective To investigate the correlation between peripheral blood CRP‐to‐lymphocyte ratio (CLR) and lactate dehydrogenase‐to‐albumin ratio (LAR) levels, prognosis, and the tumor microenvironment (TME) in patients with acral melanoma (AM), with a focus on tertiary lymphoid structures (TLS) a...

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Main Authors: Donglin Kang, Xinyu Su, Jiayu Wang, Lianjun Zhao, Rong Huang, Zhengyun Zou
Format: Article
Language:English
Published: Wiley 2025-08-01
Series:Cancer Medicine
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Online Access:https://doi.org/10.1002/cam4.71078
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author Donglin Kang
Xinyu Su
Jiayu Wang
Lianjun Zhao
Rong Huang
Zhengyun Zou
author_facet Donglin Kang
Xinyu Su
Jiayu Wang
Lianjun Zhao
Rong Huang
Zhengyun Zou
author_sort Donglin Kang
collection DOAJ
description ABSTRACT Objective To investigate the correlation between peripheral blood CRP‐to‐lymphocyte ratio (CLR) and lactate dehydrogenase‐to‐albumin ratio (LAR) levels, prognosis, and the tumor microenvironment (TME) in patients with acral melanoma (AM), with a focus on tertiary lymphoid structures (TLS) and immune cell infiltration. Methods A retrospective cohort of 36 patients with acral melanoma was included. Clinical data and hematological parameters were collected. The maturity of TLS, the proportion of immune cells, and their spatial distribution within the TME were assessed using H&E staining and multiplex immunofluorescence. Kaplan–Meier survival curves and Cox regression models were employed to examine the association between these indicators and patient survival. Non‐parametric tests and Spearman's correlation analysis were used to compare CLR and LAR levels across patients with different TLS maturity and immune infiltration statuses. Results Elevated levels of CLR and LAR in the blood are associated with poorer prognosis in patients with acral melanoma. The levels of CLR and LAR vary across patients with TLS of different maturities, and these levels decrease as TLS maturity increases. Additionally, CLR and LAR levels are significantly correlated with the proportions of CD4+ and CD8+ T cells in TME, with higher levels of CLR and LAR being linked to reduced immune cell infiltration. Conclusion Elevated CLR and LAR levels are associated with poorer prognosis in AM patients, and this relationship is closely linked to the maturity of TLS and the extent of immune cell infiltration within the TME.
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spelling doaj-art-8ae1880948bb4fe388fa7ccb84b696df2025-08-20T03:46:34ZengWileyCancer Medicine2045-76342025-08-011415n/an/a10.1002/cam4.71078C‐Reactive Protein to Lymphocyte Ratio (CLR) and Lactate Dehydrogenase to Albumin Ratio (LAR) as Prognostic Biomarkers in Acral Melanoma: Association With Tertiary Lymphoid Structures and Immune Cell InfiltrationDonglin Kang0Xinyu Su1Jiayu Wang2Lianjun Zhao3Rong Huang4Zhengyun Zou5Department of the Comprehensive Cancer Center Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University Nanjing ChinaDepartment of the Comprehensive Cancer Center Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University Nanjing ChinaDepartment of Oncology Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine Nanjing ChinaDepartment of the Comprehensive Cancer Center Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University Nanjing ChinaDepartment of the Comprehensive Cancer Center Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University Nanjing ChinaDepartment of the Comprehensive Cancer Center Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University Nanjing ChinaABSTRACT Objective To investigate the correlation between peripheral blood CRP‐to‐lymphocyte ratio (CLR) and lactate dehydrogenase‐to‐albumin ratio (LAR) levels, prognosis, and the tumor microenvironment (TME) in patients with acral melanoma (AM), with a focus on tertiary lymphoid structures (TLS) and immune cell infiltration. Methods A retrospective cohort of 36 patients with acral melanoma was included. Clinical data and hematological parameters were collected. The maturity of TLS, the proportion of immune cells, and their spatial distribution within the TME were assessed using H&E staining and multiplex immunofluorescence. Kaplan–Meier survival curves and Cox regression models were employed to examine the association between these indicators and patient survival. Non‐parametric tests and Spearman's correlation analysis were used to compare CLR and LAR levels across patients with different TLS maturity and immune infiltration statuses. Results Elevated levels of CLR and LAR in the blood are associated with poorer prognosis in patients with acral melanoma. The levels of CLR and LAR vary across patients with TLS of different maturities, and these levels decrease as TLS maturity increases. Additionally, CLR and LAR levels are significantly correlated with the proportions of CD4+ and CD8+ T cells in TME, with higher levels of CLR and LAR being linked to reduced immune cell infiltration. Conclusion Elevated CLR and LAR levels are associated with poorer prognosis in AM patients, and this relationship is closely linked to the maturity of TLS and the extent of immune cell infiltration within the TME.https://doi.org/10.1002/cam4.71078acral melanomablood biomarkerstertiary lymphoid structuretumor microenvironment
spellingShingle Donglin Kang
Xinyu Su
Jiayu Wang
Lianjun Zhao
Rong Huang
Zhengyun Zou
C‐Reactive Protein to Lymphocyte Ratio (CLR) and Lactate Dehydrogenase to Albumin Ratio (LAR) as Prognostic Biomarkers in Acral Melanoma: Association With Tertiary Lymphoid Structures and Immune Cell Infiltration
Cancer Medicine
acral melanoma
blood biomarkers
tertiary lymphoid structure
tumor microenvironment
title C‐Reactive Protein to Lymphocyte Ratio (CLR) and Lactate Dehydrogenase to Albumin Ratio (LAR) as Prognostic Biomarkers in Acral Melanoma: Association With Tertiary Lymphoid Structures and Immune Cell Infiltration
title_full C‐Reactive Protein to Lymphocyte Ratio (CLR) and Lactate Dehydrogenase to Albumin Ratio (LAR) as Prognostic Biomarkers in Acral Melanoma: Association With Tertiary Lymphoid Structures and Immune Cell Infiltration
title_fullStr C‐Reactive Protein to Lymphocyte Ratio (CLR) and Lactate Dehydrogenase to Albumin Ratio (LAR) as Prognostic Biomarkers in Acral Melanoma: Association With Tertiary Lymphoid Structures and Immune Cell Infiltration
title_full_unstemmed C‐Reactive Protein to Lymphocyte Ratio (CLR) and Lactate Dehydrogenase to Albumin Ratio (LAR) as Prognostic Biomarkers in Acral Melanoma: Association With Tertiary Lymphoid Structures and Immune Cell Infiltration
title_short C‐Reactive Protein to Lymphocyte Ratio (CLR) and Lactate Dehydrogenase to Albumin Ratio (LAR) as Prognostic Biomarkers in Acral Melanoma: Association With Tertiary Lymphoid Structures and Immune Cell Infiltration
title_sort c reactive protein to lymphocyte ratio clr and lactate dehydrogenase to albumin ratio lar as prognostic biomarkers in acral melanoma association with tertiary lymphoid structures and immune cell infiltration
topic acral melanoma
blood biomarkers
tertiary lymphoid structure
tumor microenvironment
url https://doi.org/10.1002/cam4.71078
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