Correlation Study Of Neutrophil Lymphocyte Ratio And Platelet Lymphocyte Ratio With Lymph Node Metastasis In Colorectal Cancer Patients

ObjectiveThe purpose of this study was to investigate the relationship between neutrophil lymphocyte ratio(NLR)and platelet lymphocyte ratio(PLR)with lymph node metastasis in colorectal cancer patients so as to developing guideline for surgeons on the dissection of lymph nodes.It also provided a new basis and thought for the clinical diagnosis,treatment and prevention of patients.MethodsThis study selected colorectal cancer patients who were hospitalized in the department of gastrointestinal surgery in Shandong Provincial Hospital Affiliated to Shandong University for radical surgical treatment from November 1,2016 to October 31,2017 according to the inclusion and exclusion criterions.A total of 396 patients were included,consisting of 230 males(58.1%)and 166 females(41.9%),with an average age of 60 years old(24-88 years old).The study collected relevant clinical data of patients,including basic information,medical history,surgical records,routine laboratory results of peripheral blood within one week before operation and pathological reports of postoperative specimens,and then calculated data for retrospective analysis.The receiver operator characteristic(ROC)curves of NLR and PLR relating to lymph node metastasis were drawn,subsequently the best critical value was found.The cases were separately grouped according to the levels of NLR and PLR.We analyzed the correlation between the levels of NLR and PLR and clinical features and calculated the lymph node metastatic rates of different groups.Single factor analysis was performed with the related factors that might affect lymph node metastasis and screened out statistically significant variables.Multiple factors analysis was carried out to determine whether NLR or PLR was independent risk factors for lymph node metastasis in colorectal cancer patients.Results1.After drawing the ROC curves of NLR and PLR relating to lymph node metastasis,the best critical value of NLR was obtained according to the maximum of Youden's index.The best critical value of NLR was 1.94 and for PLR the value was 125.15.Groups division depended on the values.2.Analysis of the correlation between groups and different clinical features showed that there were significant differences in gender,tumor location,differentiation degree,invasive depth and lymph node staging between high and low NLR groups,but there was no statistical difference in age,tumor size and gross type.There were significant differences in invasive depth and lymph node staging between high and low PLR groups,but there was no statistical difference in age,gender.tumor size,tumor location,gross type and differentiation degree.3.The lymph node metastatic rates of patients with colorectal cancer were calculated and the results-showed that there was no significant difference in lymph node metastatic rates between NLR and PLR groups.4.The differentiation degree,invasive depth,NLR level and PLR level were confirmed to be related with lymph node metastasis after single factor analysis.5.The differentiation degree,invasive depth,NLR level and PLR level were included in the multivariate logistic regression analysis after the collinearity diagnostics excluded multicollinearity.The results showed that PLR level,degree of differentiation and depth of invasion might be independent risk factors for lymph node metastasis in colorectal cancer patients.Conclusion1.The levels of NLR in colorectal cancer patients might be related to gender,tumor location,differentiation degree and invasive depth,while PLR levels might be interrelated with the invasive depth of tumor.2.The high levels of NLR or PLR could not indicate high lymph node metastasis rates in colorectal cancer patients.3.The levels of NLR and PLR were associated with lymph node metastasis,and PLR level might be an independent risk factor of lymph node metastasis in patients with colorectal cancer.