Optimal cutpoint of preoperative neutrophil-lymphocyte ratio and associated postoperative prognosis in colorectal cancer patients.

IF 2.3 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY International Journal of Colorectal Disease Pub Date : 2025-02-26 DOI:10.1007/s00384-025-04839-4

Tai-Jan Chiu, Ting-Ting Liu, Ching-Di Chang, Wan-Hsiang Hu

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Abstract

Purpose: As the role of systemic inflammation in cancer progression, the neutrophil-to-lymphocyte ratio (NLR) is easily evaluated and predicts prognosis in solid cancers. However, the optimal cutpoint for NLR in colorectal cancer patients remains unclear.

Methods: This retrospective cohort study was based on the Chang Gung Research Database. Participants included colorectal cancer patients who received operation and preoperative complete blood counts with differentiation from 2007 to 2017. The cutpoint of NLR was calculated by SAS macro (%FINGCUT).

Results: A total of 16,990 colorectal patients were included, and 4961 (29.1%) were identified as the high NLR group (≥ 3.59). Poor clinical characteristics were significantly predominant in the patients with high NLR. The patients with high NLR were associated with worse 5-year disease-free survival and overall survival (p < 0.0001). Multivariate Cox regression survival analysis still showed poor 5-year disease-free survival (HR = 1.319, p < 0.0001) and overall survival (HR = 1.611, p < 0.0001) in the high NLR group after adjustment. Patients with high NLR and hypoalbuminemia had the worst disease-free survival and overall survival (p < 0.0001). In subgroup analysis, stage II colon cancer patients with low NLR had better survival than those with high NLR (p < 0.0001). The hazard ratios of without chemotherapy in disease-free survival and overall survival were higher in the patients with high NLR.

Conclusions: High NLR was associated with worse clinical characteristics and an independent predictor of poor survival. After adjuvant chemotherapy for stage II colon cancer, more benefits of improving survival were demonstrated in the patients with high NLR.

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结直肠癌患者术前中性粒细胞与淋巴细胞比值的最佳切点与术后预后。

目的：作为全身炎症在肿瘤进展中的作用，中性粒细胞与淋巴细胞比值（NLR）在实体癌中易于评估和预测预后。然而，结直肠癌患者NLR的最佳切入点仍不清楚。方法：本回顾性队列研究基于常庚研究数据库。参与者包括2007年至2017年接受手术和术前全血细胞计数有分化的结直肠癌患者。用SAS宏（%FINGCUT）计算NLR切点。结果：共纳入16990例结直肠患者，其中4961例（29.1%）为高NLR组（≥3.59）。高NLR患者的临床特征明显较差。高NLR患者的5年无病生存期和总生存期较差(p)。结论：高NLR与较差的临床特征相关，是较差生存期的独立预测因子。II期结肠癌辅助化疗后，高NLR患者的生存率提高更明显。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Colorectal Disease 医学-外科

CiteScore

4.90

自引率

3.60%

发文量

206

审稿时长

3-8 weeks

期刊介绍： The International Journal of Colorectal Disease, Clinical and Molecular Gastroenterology and Surgery aims to publish novel and state-of-the-art papers which deal with the physiology and pathophysiology of diseases involving the entire gastrointestinal tract. In addition to original research articles, the following categories will be included: reviews (usually commissioned but may also be submitted), case reports, letters to the editor, and protocols on clinical studies. The journal offers its readers an interdisciplinary forum for clinical science and molecular research related to gastrointestinal disease.