Preoperative Neutrophil-to-Lymphocyte Ratio (NLR) On The Prognosis Of Patients With Colorectal Cancer

Background and objective: With the global changes in lifestyle andeconomic development, the incidence of colorectal cancer increased year byyear. There is no large changes in the mortality rate of patients with colorectalcancer in the past10years.5-year survival rate remained at60%-70%.Neutrophil to lymphocyte ratio (NLR) as an inflammatory response evaluationhas been considered as the prognostic factors for a variety of malignant tumors.Clinical data was collected from resection of colorectal cancer in China-JapanUnion Hospital of Jilin University from September2000to September2005.Toinvestigate the relationship between the preoperative neutrophil cells andlymphocyte ratio (NLR) and prognosis in patients with colorectal cancer.Methods:362patients with colorectal cancer were collected, including213male and149female. All the patients were treated with radical surgery. Weanalyzed the patient’s gender, age, platelet count, tumor location, tumor size,depth of invasion, metastasis, lymph node metastasis, Ducks staging, and thetumor differentiation. NLR value was analyzed by rank sum test to explore therelationship between preoperative NLR and clinical factors on prognosis. Weestablished the1-year,3-years,5-year disease-free survival by following-up.Patients were divided into low NLR group (NLR＜3) and high NLR group(NLR≥3) according to the peripheral venous blood in the preoperative NLRsize. We analyze the NLR with the respective tumor-free survival time.213cases of male patients preoperative NLR is2.88±2.02with the female2.86±2.66. The average age is61.24years old between24-95years old. Thereare20cases of patients under the age of40years with preoperative NLR of2.72±1.71, and patients from20to40years old with the preoperative NLR of 2.52±1.26.199cases of patients over60years of age have the NLR of3.02±2.72.Results:Preoperative NLR number in TNM I is2.45±1.97, TNMⅡ is3.00±2.32, TNMⅢ is3.17±2.18. Preoperative NLR difference in3groups hasstatistics significance (P=0.0441). With the advances in preoperative Ducksstaging, NLR value rise gradually.The NLR in patients with preoperative platelet count＜350×109is2.81±2.25,and in patients with preoperative platelet count≥350×109is3.63±2.86. Preoperative NLR difference between2groups has statisticssignificance (P=0.0114).Low NLR group (NLR＜3)1-year,3-years,5-year tumor-free survivalrate is97%,83%and78%,and the difference between the three groups wasstatistically significant (P<0.01). Cox regression suggests the preoperative NLR,lymph node staging, TNM stage is the independent factor for prognosis ofpatients with resection.Conclusion:1. Colorectal preoperative NLR and platelet count or TNM stage arerelated.2. Prognosis in patients with preoperative NLR≥3is worse than patientswith NLR＜3. The higher in NLR, the poorer in prognosis.