The Relationship Between Preoperative Neutrophil To Lymphocyte Ratio,Lymphocyte And Monocyte Ratio And Platelet And Lymphocyte Ratio And The Prognosis Of Patients With Stage Ii And Iii Colon Cancer

Objective:The relationship between the ratio of neutrophils to lymphocyte(NLR),the ratio of lymphocyte to monocyte(LMR)and the ratio of platelet to lymphocyte(PLR)and clinicopathological data in the peripheral blood of patients with stage II and III stage colon cancer were investigated.The impact on the prognosis.Methods:A retrospective analysis of the clinical data of 92 patients with colon cancer who underwent radical resection of colon cancer from January 1st to December 31 st,2013 in gastroenterological Surgery in our hospital.The clinical data included age,sex,tumor location,tumor size,operation mode,TNM staging,degree of tissue differentiation,nerve and vascular infiltration,etc.All the postoperative pathological changes were colon adenocarcinoma,and TNM staging was stage II and stage III.All patients began chemotherapy(XELOX regimen)within 4 weeks after operation.The absolute value of neutrophils,the absolute value of lymphocyte and the absolute value of mononuclear cells were counted,and NLR,LMR and PLR were calculated.According to the receiver operating characteristic curve,the respective cut-off values were calculated,and then the patients were divided into two groups.Patients or family members were followed up by telephone to understand their current living status.The relationship between each group of patients and clinical data was analyzed,and the five year survival rate of each group was analyzed and compared.COX regression was used to analyze the prognostic factors of colon cancer.A risk scoring system for predicting the prognosis of colon cancer was established,and the five year survival rate of patients with different risk levels was analyzed by Kaplan-Meier.ResultsResults: 1.The cut-off values of NLR,LMR and PLR are 2.43,4.47 and 144.04,respectively.According to this,the patients were divided into high NLR group(HN group)/ low NLR group(LN group),high LMR group(HL group)/ low LMR group(LL group)and high PLR group(HP group)/ low PLR group(LP group).2.HN group,LL group and HP group had multiple tumors in the right colon,and had a deeper invasion.The positive rate of nerve / vessel invasion was higher.HN group had larger tumor and poorer differentiation.LL group had higher positive rate of lymph node metastasis,and HP group had poorer differentiation.3.The five year overall survival rate of HN group,LL group and HP group were significantly lower than those of LN group,HL group and LP group(P < 0.05).4.Tumor location,tumor differentiation,lymph node metastasis,and preoperative NLR and LMR levels are independent risk factors for postoperative survival in colon cancer patients.5.The five year survival rate of patients with low risk score(0-50 points)was significantly higher than that of high-risk score group(50-100 points)(P < 0.05).The risk score model can be used to predict the survival of patients.Conclusion: 1.The pre-operative levels of NLR,LMR and PLR in patients with colon cancer may be related to the size of the tumor,the degree of differentiation,the location of the tumor,the depth of infiltration,and the presence of lymph node metastasis and nerve / vascular invasion.2.Tumor location,nerve / vascular invasion,and preoperative NLR and LMR levels are independent risk factors for postoperative survival in colon cancer patients.3.The five year survival rate of patients with risk score of low risk(2.35-6.21 points)was significantly higher than that of high-risk patients(6.22-12.27 points)(P < 0.05).The risk score model can better predict the survival of patients.