Oh Seung Yeop, Kim Young Bae, Suh Kwang Wook
Department of Surgery, Ajou University School of Medicine, Suwon, Korea.
Department of Pathology, Ajou University School of Medicine, Suwon, Korea.
J Surg Res. 2017 Feb;208:158-165. doi: 10.1016/j.jss.2016.08.100. Epub 2016 Sep 9.
It is considered that stage II colorectal cancers have heterogeneous oncological outcomes. It remains to be determined whether inflammatory markers can predict survival after curative surgery in these patients. The aim of this study was to investigate the prognostic impact of preoperative inflammatory markers after curative surgery in stage II colorectal cancers.
Two hundred sixty-one patients with stage II colorectal cancers who underwent curative surgery between January 2006 and December 2011 were reviewed. Oncologic outcomes were analyzed with neutrophil count, lymphocyte count, monocyte count, neutrophil to lymphocyte ratio (NLR), and lymphocyte to monocyte ratio.
Univariate analysis showed that high NLR (hazard ratio (HR), 3.506; 95% confidence interval [CI], 1.415-8.688; P = 0.007) and low LMR (HR, 2.436; 95% CI, 1.010-5.880; P = 0.048) were associated with worse disease-free survival (DFS), and high NLR (HR, 2.834; 95% CI, 1.419-5.662; P = 0.003) and low LMR (HR, 2.374; 95% CI, 1.188-4.742; P = 0.014) were associated with worse overall survival (OS) in stage II colorectal cancer. Cox multivariate analysis demonstrated that high NLR was independently associated with worse DFS (HR, 3.163; 95% CI, 1.058-9.455; P = 0.004) and OS (HR, 3.018; 95% CI, 1.467-6.207; P = 0.003) in stage II colorectal cancer.
Among the systemic inflammatory markers, NLR is a strong predictor of worse DFS and OS in stage II colorectal cancer.
人们认为Ⅱ期结直肠癌具有不同的肿瘤学结局。炎症标志物能否预测这些患者根治性手术后的生存情况仍有待确定。本研究的目的是探讨Ⅱ期结直肠癌根治性手术后术前炎症标志物的预后影响。
回顾了2006年1月至2011年12月期间接受根治性手术的261例Ⅱ期结直肠癌患者。采用中性粒细胞计数、淋巴细胞计数、单核细胞计数、中性粒细胞与淋巴细胞比值（NLR）和淋巴细胞与单核细胞比值分析肿瘤学结局。
单因素分析显示，高NLR（风险比[HR]，3.506；95%置信区间[CI]，1.415 - 8.688；P = 0.007）和低LMR（HR，2.436；95% CI，1.010 - 5.880；P = 0.048）与Ⅱ期结直肠癌患者较差的无病生存期（DFS）相关，高NLR（HR，2.834；95% CI，1.419 - 5.662；P = 0.003）和低LMR（HR，2.374；95% CI，1.188 - 4.742；P = 0.014）与较差的总生存期（OS）相关。Cox多因素分析表明，高NLR与Ⅱ期结直肠癌患者较差的DFS（HR，3.163；95% CI，1.058 - 9.455；P = 0.004）和OS（HR，3.018；95% CI，1.467 - 6.207；P = 0.003）独立相关。
在全身炎症标志物中，NLR是Ⅱ期结直肠癌患者DFS和OS较差的有力预测指标。
