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| A study on the association between preoperative NLR and d-NLR and clinical outcome of postoperative colorectal cancer patient |
| CUI Ying-shan, CHEN Xiao-lin, ZHOU Hang-liang, ZHANG Rui-guang
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| Radiotherapy Department of Jinghua Central Hospital, Jinhua,Zhejiang, 321037,China |
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Abstract ObjectiveTo explore the prognostic value of preoperative neutrophil-to-lymphocyte ratio and derived neutrophil-to-lymphocyte ratio in colorectal cancer (CRC) individuals. MethodsThe clinical pathological data and preoperative blood routine test results were collected from medical records, and 5 year follow up was performed in a total of 555 surgically resected CRC cases. Receiver operative curve (ROC) was used to calculate NLR and d-NLR cut-off value, and Kaplan-Meier curve and multiple COX regression were selected to evaluate the influence of preoperative NLR and d-NLR on clinical outcome of CRC cases and prognostic predictive nomogram was established to evaluate the predictive value of NLR and d-NLR. ResultsUsing overall survival (OS) as an endpoint, the optimal cut-off values of NLR and d-NLR were 3.21 (Sensitivity=0.752, specificity=0.753, AUC=0.762) and 2.12 (sensitivity=0.721, specificity=0.683, AUC=0.720), respectively. Preoperative NLR and d-NLR were significantly associated with free-recurrent survival (RFS) and OS(P<0.01). NLR and d-NLR were independent factors for prediction of RFS (HRNLR =2.53, HRd-NLR=1.60) and OS (HRNLR=2.75, HRd-NLR=2.11) in II-III stage preoperative CRC patients. The C-indexes of RFS and OS predictive nomograms including NLR and d-NLR were 0.851 and 0.836, and C-indexes without NLR and d-NLR were 0.801 and 0.793, respectively. ConclusionThis results indicated that RFS and OS of the patients with preoperative high NLR and d-NLR were significantly shorter than those with relative low NLR and d-NLR, and they were independent prognostic predictive factors for RFS and OS, and nomograms including NLR and d-NLR could significantly improve the prognostic predictive efficacy in postoperative CRC individuals.
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Received: 22 September 2015
Published: 07 December 2017
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