Relationship Between Preoperative Neutrophils To Lymphocyte Ratio Of Peripheral Blood And The Prognosis Of Rectal Carcinoma

Objective: the study aims to explore the relationship between the preoperative Neutrophil Lymphocyte Ratio(NLR) and the prognosis factors and clinical factors of the patients undergoing rectal cancer. Methods: the study collected a series of medical records of the rectal cancer patients treated with radical correction from January 2008 to January 2010, in the Department of Colon and Rectal Surgery of Xinjiang People’s Hospital and then analyzed the relationship between the preoperative NLR and the age, gender, size of tumor, tumor invasion depth, lymphatic metastasis and TNM staging of the 172 cases of patients. And then it divided all the patients cases into High NLR group and Low NLR respectively according to the optimum intercept points of preoperative NLR, which were obtained by drawing ROC curve. After that, it conducted a comparison of every clinical factor between the groups to check whether there existed statistical significance and mapped the survival curve. At last, it conducted COX regression analysis for the factors affecting the prognosis of rectal cancer. Results: among the 172 patients cases, male patients accounted for 59.9%, representing 103 cases, with an average preoperative NLR of 2.76±1.82; and female patients 40.1%, representing 69 cases, with an average preoperative NLR 2.63 ±2.14. The average age of them was 61.6, with the oldest 85 and youngest 25. In the group of patients aged not more than 40, there were 16 cases with an average preoperative NLR 2.91±1.23; between 40-60, there were 42 cases, with an average preoperative NLR 2.82 ±1.41; and above 60, there were 114 cases, with an average preoperative NLR 2.87 ±1.32. In terms of sizes of tumors, there were 68 patients with tumor not less than 5cm, while 104 cases below 5cm. In terms of invasion depth of tumors, the cases numbered 4, 16, 78 and 74 according to the degrees T1~T4 respectively. There were 88 patients free of lymphatic metastasis(N0), while cases of patients with lymphatic metastasis N1 numbered 46, N2(≥4) 38. In the cases, 88 patients were in the TNM stage II, and 84 in TNM stage III. The pathological results suggested 39 patients were well-differentiated, with an average preoperative NLR 2.71±1.19, 120 patients were moderately-differentiated, with an average preoperative NLR 2.60±1.13, and 13 patients poorly-differentiated, with an average preoperative NLR 3.01±1.12. With ROC curve, it was confirmed that the optimum intercept point for the prognosis of patients when NLR=2.51.The five-year survival rates prior to operation in the Low NLR group(NLR<2.51)and high NLR group(NLR≥2.51)were 75.6% and 51.2% respectively, and the relative differences between the two groups is statistically significant(P<0.05). Prior to operation, the survival rates of patients with NLR<2.51 were remarkably better that those with NLR ≥2.51, and the prognosis of patients in the High NLR group had worse effects than those in the Low NLR group. The Cox regression analysis showed that preoperative NLR was a prognosis factor in judging patients suffering rectal cancer, while lymphatic metastasis and TNM staging were the prognosis factors of the patients with rectal cancer. Conclusions: preoperative NLR, lymphatic metastasis, tumor invasion depth, differentiation degrees of tumor and TNM staging are factors affecting the prognosis of rectal cance and clinicians ought to attach importance to these elements in developing clinical treatment plans as well as judging prognosis.