| Objective:The neutrophil-to-lymphocyte(NLR)ratio has been widely reported to be associated with the prognosis of a variety of malignancies,including colorectal cancer.Different tumor locations also have an impact on the prognosis,but previous studies have included patients with colorectal cancer in the analysis,which may reduce the accuracy of the prognosis assessment.This study will further confirm the relationship between preoperative NLR and tumor prognosis in patients with non-metastatic colon cancer,and compare the influence of NLR level in different locations of colon cancer on prognosis,so as to systematically explore the clinical value of NLR in the occurrence and development of non-metastatic colon cancer.Methods:The clinical pathology and survival follow-up data of 132 patients with nonmetastatic colon cancer who underwent radical resection of colon cancer from January 2008 to December 2014 were retrospectively analyzed in the department of gastrointestinal oncology,Fujian Cancer Hospital affiliated to Fujian Medical University.Collecting patients in the routine blood neutrophil count and lymphocyte count is used for calculation of the ratio of neutrophils and lymphocytes(neutrophil-to-lymphocyte,NLR),ROC curve is used to determine the optimal threshold,according to the results the patients were divided into high NLR group and low NLR,single factor and multiple factors analysis its correlation with prognosis,and stratified according to tumor location and comparative NLR prognostic value in the difference between right and left half colon cancer.Results:1.ROC was used to determine the critical value,and NLR=2.46 was taken as the cut-off point according to the results.At this time,the sensitivity was 64.0%,the specificity was 72.0%,and the area under the curve was 0.705.According to the results,the patients were divided into preoperative low NLR group: 86 cases(65.2%)with NLR ≦ 2.46.NLR group: 46(34.8%)with NLR ﹥ 2.46.The clinical data of the two groups were compared and analyzed,and it was found that there was no significant difference in age,gender,tumor site,surgical method,postoperative pathological stage and vascular invasion.(P>0.05).The differentiation degree of tumor tissue in the high NLR group was lower than that in the low NLR group,and the difference was statistically significant(P<0.05).2.The 5-year survival rates of colon cancer patients in the low NLR group and the high NLR group were 89.5% and 61.7%,the difference was significant(P<0.05).Univariate analysis showed that high NLR,late clinical stage,poor differentiation,and vascular invasion were prognostic risk factors for colon cancer(P<0.05).Multivariate prognostic analysis confirmed that NLR,clinical staging,and vascular invasion were independent risk factors affecting the prognosis of colon cancer patients(P<0.05).3.Compared with patients with left colon cancer and those with tumors in the right colon,the difference in prognosis between the high NLR group and the low NLR group was more significant.The results of univariate analysis suggested that the prognosis of patients with left colon cancer was affected by pathological staging and vascular invasion.In patients with right colon cancer,pathological staging,degree of differentiation,vascular invasion and NLR are prognostic risk factors.Multivariate analysis confirmed that vascular invasion was an independent risk factor for prognosis in patients with left colon cancer.In patients with right colon cancer,late pathological staging and high NLR were independent risk factors for prognosis..Conclusion:1.Preoperative NLR in peripheral blood can be used as a prognostic indicator for patients with colon cancer,especially for patients with right colon cancer.Those with high NLR have poor prognosis.2.Pathological staging,vascular invasion and NLR level are independent risk factors affecting the prognosis of right colon cancer. |
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