Kozak Margaret M, von Eyben Rie, Pai Jonathan S, Anderson Eric M, Welton Mark L, Shelton Andrew A, Kin Cindy, Koong Albert C, Chang Daniel T
*Department of Radiation Oncology, Stanford Cancer Institute †Department of Surgery, Stanford University Medical Center, Stanford, CA.
Am J Clin Oncol. 2017 Aug;40(4):405-412. doi: 10.1097/COC.0000000000000183.
The prognostic value of several hematologic parameters, including platelet, lymphocyte, and neutrophil counts, has been studied in a variety of solid tumors. In this study, we examined the significance of inflammatory markers and their prognostic implications in patients with colorectal cancer (CRC).
Patients with stage I-III CRC who underwent surgical resection at the Stanford Cancer Institute between 2005 and 2009 were included. Patients were excluded if they did not have preoperative complete blood counts performed within 1 month of surgical resection, underwent preoperative chemotherapy or radiation, had metastatic disease at diagnosis, or had another previous malignancy. We included 129 eligible patients with available preoperative complete blood counts in the final analysis.
A preoperative neutrophil-to-lymphocyte ratio of>3.3 was significantly associated with worse disease-free (DFS) and overall survival (OS) (P=0.009, 0.003), as was a preoperative lymphocyte-to-monocyte ratio of ≤2.6 (P=0.01, 0.002). Preoperative lymphopenia (P=0.002) was associated with worse OS but not DFS (P=0.09). In addition, preoperative thrombocytosis was associated with worse DFS (P=0.006) and OS (P=0.010). Preoperative leukocytosis was associated with worse OS (P=0.048) but not DFS (P=0.49). Preoperative hemoglobin was neither associated with OS (P=0.24) or DFS (P=0.15).
Pretreatment lymphopenia, thrombocytosis, a decreased lymphocyte-to-monocyte ratio, and an elevated neutrophil-to-lymphocyte ratio independently predict for worse OS in patients with CRC.
在多种实体瘤中已对包括血小板、淋巴细胞和中性粒细胞计数在内的多种血液学参数的预后价值进行了研究。在本研究中，我们检测了炎症标志物在结直肠癌（CRC）患者中的意义及其预后影响。
纳入2005年至2009年间在斯坦福癌症研究所接受手术切除的I - III期CRC患者。如果患者在手术切除前1个月内未进行术前全血细胞计数、接受术前化疗或放疗、诊断时已有转移性疾病或曾患其他恶性肿瘤，则将其排除。最终分析纳入了129例有术前全血细胞计数数据的合格患者。
术前中性粒细胞与淋巴细胞比值>3.3与无病生存期（DFS）和总生存期（OS）较差显著相关（P = 0.009，0.003），术前淋巴细胞与单核细胞比值≤2.6也与之相关（P = 0.01，0.002）。术前淋巴细胞减少与较差的OS相关（P = 0.002），但与DFS无关（P = 0.09）。此外，术前血小板增多与较差的DFS（P = 0.006）和OS（P = 0.010）相关。术前白细胞增多与较差 的OS相关（P = 0.048），但与DFS无关（P = 0.49）。术前血红蛋白与OS（P = 0.24）或DFS（P = 0.15）均无关。
预处理时的淋巴细胞减少、血小板增多、淋巴细胞与单核细胞比值降低以及中性粒细胞与淋巴细胞比值升高可独立预测CRC患者较差的OS。
