The preoperative neutrophil to lymphocyte ratio is a superior indicator of prognosis compared with other inflammatory biomarkers in resectable colorectal cancer.

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  • Additional Information
    • Source:
      Publisher: BioMed Central Country of Publication: England NLM ID: 100967800 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2407 (Electronic) Linking ISSN: 14712407 NLM ISO Abbreviation: BMC Cancer Subsets: MEDLINE
    • Publication Information:
      Original Publication: London : BioMed Central, [2001-
    • Subject Terms:
      Prognosis*; Biomarkers, Tumor/*blood ; Colorectal Neoplasms/*blood ; Inflammation/*blood; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Colorectal Neoplasms/pathology ; Colorectal Neoplasms/surgery ; Disease-Free Survival ; Female ; Humans ; Inflammation/pathology ; Inflammation/surgery ; Kaplan-Meier Estimate ; Lymphocytes/pathology ; Male ; Middle Aged ; Neoplasm Staging ; Neutrophils/pathology ; Platelet Count ; Young Adult
    • Abstract:
      Background: Growing evidence has indicated that some inflammatory markers, including lymphocyte to monocyte ratio (LMR), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and prognostic nutritional index (PNI), can be used as indicators in the prognosis of colorectal cancer (CRC). However, there is controversy concerning what is the best predictor of prognosis in CRC.
      Methods: A cohort of 1744 CRC patients in our institution was analyzed retrospectively. Harrell's concordance index (c-index) and Bayesian information criterion (BIC) were used to determine the optimal cut-off values of inflammatory markers and compare their predictive capacity. The association of inflammatory markers with overall survival (OS) and cancer-specific survival (CSS) was analyzed using Kaplan-Meier methods with log-rank test, followed by multivariate Cox proportional hazards model.
      Results: The multivariate analysis indicated that among these inflammatory markers, NLR (< 2.0 vs. ≥ 2.0) was the only independent prognostic factor for poor OS [hazard ratio (HR) = 0.758, 95% confidence intervals (CI) = 0.598-0.960, P = 0.021)] and CSS (HR = 0.738, 95% CI = 0.573-0.950, P = 0.018). Among these inflammatory markers, the c-index and BIC value for NLR were maximum and minimum for OS, respectively. In addition, the c-index was higher and the BIC value was smaller in TNM staging combined with NLR compared with the values obtained in TNM staging alone.
      Conclusion: NLR is a superior indicator of prognosis compared with LMR, PLR, and PNI in CRC patients, and NLR may serve as an additional indicator based on the current tumor staging system.
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    • Grant Information:
      81372549, 81372550 National Science Foundation of China; 2014CB560712 the Special Prophase Program for National Key Basic Research Program of China; LNCCC-A01-2014 Clinical Capability Construction Project for Liaoning Provincial Hospitals
    • Contributed Indexing:
      Keywords: Colorectal neoplasms; Lymphocyte to monocyte ratio; Neutrophil to lymphocyte ratio; Platelet to lymphocyte ratio; Prognosis; Prognostic nutritional index; TNM staging
    • Accession Number:
      0 (Biomarkers, Tumor)
    • Publication Date:
      Date Created: 20171112 Date Completed: 20180709 Latest Revision: 20220409
    • Publication Date:
      20221213
    • Accession Number:
      PMC5681757
    • Accession Number:
      10.1186/s12885-017-3752-0
    • Accession Number:
      29126400