Correlation Analysis Of Inflammatory Response And Postoperative Survival Rate Of Rectal Cancer

Objective:A series of prognostic cell indices in inflammatory response,namely neutrophil to lymphocyte ratio(NLR),derived neutrophil to lymphocyte ratio(D-NLR),platelet to lymphocyte ratio(PLR),Lymphocyte to monocyte ratio(LMR),combined platelet count and neutrophil to lymphocyte ratio(COP-NLR),and prognostic nutritional index(PNI),the correlation of these cell indices to the prognosis of multiple malignancies.This article explores the prognostic effects of these six inflammatory scores in patients with rectal cancer.Methods:A retrospective cohort was used to analyze the patients who underwent radical resection of rectal cancer from August 2008 to January 2013 in the Affiliated Hospital of Chengde Medical College in Hebei Province.The follow-up deadline was January 2018.A total of 678 patients were enrolled.Peripheral venous blood routine and liver function on the second day after admission,the inflammation scores-NLR,D-NLR,PLR,LMR,COP-NLR and PNI were calculated in turn,based on widely accepted inflammatory prognosis scores.(IPS),which calculates their respective scores in turn.The 5-year survival time was used as the endpoint of the inflammatory prognostic score(IPS).The index of the index(ROC)was used as the cut-off point for predicting the 5-year survival time of the preoperative inflammatory prognostic score(IPS).According to the threshold,the patients were divided into high-inflammation prognostic score(IPS)group and low-inflammation prognosis score(IPS)group.The surgical methods,tumor TNM stage,tumor size and morphology,and invasion were compared between the two groups.And the relationship between the depth,the distance of the tumor from the anal margin,and other indicators.Then,the COX proportional hazard regression model was used to analyze the factors that constitute the inflammatory prognostic score(IPS)by univariate and multivariate analysis.Results: 1.Baseline clinical situation of two groups of patients: ROC curve was used to determine the critical value of inflammation score in this study,taking sensitivity and specificity into consideration.The cut-off point with the largest Youden index was selected as the critical point,and IPS=2.5 was selected as the cut-off point for evaluation.2.The sensitivity was 54.7 %,the specificity was 94.3 %,and the area under the curve was 0.781.The IPS is divided into high IPS group and low IPS group with the boundary value of 2.5.There was no significant difference between the high IPS group and the low IPS group in gender,age,tumor size,distance between tumor and anal margin,presence or absence of complications,ulcer type and infiltration type in tumor general classification,and there was significant difference between the two groups in tumor general classification and TNM classification period(P < 0.05).3.The IPS is divided into a high IPS group and a low IPS group with a threshold of 2.5.There was a significant difference in the survival rate of patients after rectal cancer on high IPS group and low IPS group.There were no statistically significant differences in gender,age,tumor size,tumor distance from the anal margin,presence or absence of complications,and ulcer type and invasive type in the general classification of the tumor.There was a statistically significant difference between the two groups in the mass type and TNM of the tumor.3.1 In the multivariate COX risk regression model,male,NLR score,D-NLR score,and COP-NLR score were considered as risk factors,and HR were 1.489,4.027,2.208,and 2.188,respectively,that is,patients with gender males had worse risk events than female patients.The incidence increased by 1.489 times;the NLR score increased by 1 point,the incidence of adverse risk events increased by 4.027 times;the D-NLR score increased by 1 point,the incidence of adverse risk events increased by 2.208 times;each COP-NLR score increased by 1 point,adverse risk events The incidence increased by 2.188 times.3.2 The LMR score was a protective factor with an HR of 0.559,which is an increase of 1 point in the LMR score and a 0.559-fold decrease in the incidence of adverse risk events.Conclusion: 1.Preoperative inflammatory response is associated with postoperative survival in patients with rectal cancer.2.High Inflammatory prognostic score(IPS)suggests a poor prognosis.3.IPS can be used as an indicator to assess the survival of rectal cancer.