The Prognostic Role Of Systemic Inflammation Response (SIR) Parameters In Patients With Resectable Colorectal Cancers

Background: Systemic inflammatory response(SIR)plays an important role in the development of cancer.The aim of this study was to evaluate the impact of SIR-related parameters,including albumin(ALB),globulin(GLB),lactate dehydrogenase(LDH),platelet to lymphocyte ratio(PLR),neutrophil to lymphocyte ratio(NLR)and ALB to GLB ratio(AGR)on the prognosis of resectable colorectal cancer patients.Methods: This study collected 153 cases of resectable CRC patients from June 2006 to July 2016 in the First Affiliated Hospital of Soochow University,including 70 males and 83 females.?56 years old in 81 cases,>56 years old in 72 cases,mean age 56 years(range 27-85 years),each group of patients before treatment fasting 12 h,collecting elbow venous blood collected before and after surgery or chemotherapy.The clinical data of ALB,GLB,LDH,PLR,NLR,AGR and OS before and after surgery plus chemotherapy were collected,and the clinical information such as tumor size,depth of invasion,lymph node metastasis and TNM / AJCC stage were also collected.The patients with CRC were then divided into low ALB,GLB,LDH,NLR,PLR and AGR groups and high ALB,GLB,LDH,NLR,PLR and AGR groups according to the corresponding median values.Patient history data and corresponding survival rate were statistically analyzed.The Kaplan-Meier curves were constructed.The influence of each parameter level on survival was analyzed,and the log rank test was used for statistical analysis.Through ?2 test to explore the relationship between blood parameters and clinical pathological features.The t-test was used to assess the changes in blood parameters before and after surgery or chemotherapy.Univariate and multivariate logistic regression models were used to analyze independent risk factors associated with resectable CRC.They were considered statistically significant for values of P<0.05.Results: 1.Low pre-treatment ALB and AGR levels,as well as high pre-treatment GLB and LDH levels were correlated with worse outcomes.2.Surgery significantly increased the value of GLB,and decrease the values of NLR,PLR and AGR,whereas had no significant impact on the value of ALB or LDH.3.Adjuvant chemotherapy significantly increased the values of ALB,LDH,NLR and AGR,whereas had no significant impact on the value of GLB or PLR.4.Whole course of treatment(surgery plus adjuvant chemotherapy)significantly increased the values of ALB,GLB and LDH,whereas had no significant impact on the value of NLR,PLR or AGR.5.Overall survival of patients with elevated LDH decreased after the end of treatment,However,changes in the ratio of ALB,GLB,NLR,PLR,and AGR before and after treatment had no effect on OS.6.The gender(female),larger tumor size,more lymphonodus metastases,low pre-treatment ALB and AGR,high pre-treatment LDH,as well as increased post/pre-treatment LDH ratio were independent risk factors affecting OS.Conclusion: Pre-treatment ALB,AGR,GLB and LDH levels,as well as post-/pre-treatment LDH ratio may provide valuable informations in predicting prognosis of resectable colorectal cancers.