The Significance Of Preoperative NLR And PLR On Predicting The Distant Metastasis In Colorectal Cancer

Objective To investigate the relationship among preoperative neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR)with distant metastasis of colorectal cancer and its clinical significance.Methods The present study selected 95 patients who underwent CRC surgery with CRC from January 1,2011 to November 30,2018.All patients were confirmed by pathology finally,and 100 cases of healthy adults and 100 case of colorectal cancer of no distant metastasis matched by sex and age were selected as control group.Patients with distant metastasis of colorectal cancer were divided into stage IV A group(Al),stage ⅣB group(A2);CRC patients group(B),healthy adults group(C).Preoperative hematological count was obtained from the first routine blood test after admission,and calculated the NLR and PLR.To analyze the relationship among the NLR.PLR and the distant metastasis of CRC.Results 1.Differences of NLR and PLR in Group A,Group B and Group C were statistically significant(P<0.0001);NLR and PLR are compared each other in Group A,Group B and Group C,differences of NLR were statistically significant(P<0.0001);The difference of PLR between B and C was no statistically significant(P>0.05);The difference of NLR between A1 and A2 was statistically significant(P<0.05);the difference of PLR between A1 and A2 was no statistically significant(P>0.05).2.There was a positive correlation between NLR and PLR in group A(r=0.6173.P<().0001).There was a positive correlation between NLR and PLR in group B(r=0.6231,P<0.0001).3.The area under the ROC curve(AUC)of group A NLR was 0.879(95%CI.0.830-0.928;sensitivity 67.4%,specificity 96.0%;P<0.001),the area under the ROC curve(AUC)of PLR was 0.757(95%CI,0.689-0.825;sensitivity 62.1%,specificity 79.0%;P<0.001).Area under ROC curve of group B NLR was 0.814(95%Cl,0.757-0.872;sensitivity 87.0%,specificity 61.0%;P<0.001).the AUC of group B PLR was 0.595(95%Cl,0.514-0.672;sensitivity 47.0%,specificity 75.0%;P=0.023).4.The AUC of group A1 NLR was 0.913(95%CI.0.857-0.968;sensitivity 81.1%.specificity 88.0%;P<0.001).the AUC of PLR was 0.726(95%CI.0.646-0.807;sensitivity 58.0%.specificity 79.0%;P<0.001).The AUC of group A2 NLR was 0.929(95%CI.0.847-1.000;sensitivity 84.6%,specificity 98.0%;P<0.001),the AUC of PLR was 0.837(95%CI.0.742-0.932;sensitivity 73.1%,specificity 86.0%;P<0.001).Conclusion Preoperative NLR and PLR have certain significance in predicting distant metastasis of colorectal cancer.