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术后而非术前炎症相关预后标志物是 III 期结直肠癌患者的预后因素。

Postoperative, but not preoperative, inflammation-based prognostic markers are prognostic factors in stage III colorectal cancer patients.

机构信息

Department of Colorectal Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 1040045, Japan.

Division of Frontier Surgery, The Institute of Medical Science, The University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo, 1088639, Japan.

出版信息

Br J Cancer. 2021 Mar;124(5):933-941. doi: 10.1038/s41416-020-01189-6. Epub 2020 Dec 1.


DOI:10.1038/s41416-020-01189-6
PMID:33257844
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7921100/
Abstract

BACKGROUND: Recent evidence suggests that both preoperative and postoperative inflammation-based prognostic markers are useful for predicting the survival of colorectal cancer (CRC) patients. However, associations between longitudinal changes in inflammation-based prognostic markers and prognosis are controversial. METHODS: The subjects of this study were 568 patients with stage III CRC between 2008 and 2014. Preoperative and postoperative neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), C-reactive protein/albumin ratio (CAR) and lymphocyte-to-C-reactive protein ratio (LCR) were calculated to assess the inflammatory state of subjects. Subjects were stratified into three groups for each marker: preoperatively low inflammatory state (normal group), preoperatively high but postoperatively low inflammatory state (normalised group) and persistently high inflammatory state (elevated group). Multivariable analyses for overall survival (OS) and recurrence-free survival (RFS) were performed to adjust for well-established clinicopathologic factors. RESULTS: For all assessed markers, the normalised group had a significantly better prognosis than the elevated group and a similar prognosis as the normal group for both OS and RFS. CONCLUSIONS: Postoperative, but not preoperative, inflammation-based prognostic markers more accurately predict OS and RFS in patients with stage III CRC.

摘要

背景:最近的证据表明,术前和术后炎症相关预后标志物均有助于预测结直肠癌(CRC)患者的生存情况。然而,炎症相关预后标志物的纵向变化与预后之间的关联仍存在争议。

方法:本研究的对象为 2008 年至 2014 年间的 568 例 III 期 CRC 患者。计算术前和术后中性粒细胞与淋巴细胞比值(NLR)、淋巴细胞与单核细胞比值(LMR)、C 反应蛋白/白蛋白比值(CAR)和淋巴细胞与 C 反应蛋白比值(LCR),以评估受试者的炎症状态。根据每个标志物将受试者分为三组:术前低炎症状态(正常组)、术前高但术后低炎症状态(正常化组)和持续高炎症状态(升高组)。进行多变量分析以调整包括既定临床病理因素在内的总生存期(OS)和无复发生存期(RFS)。

结果:对于所有评估的标志物,正常化组的 OS 和 RFS 预后均明显优于升高组,与正常组相似。

结论:术后而非术前的炎症相关预后标志物更能准确预测 III 期 CRC 患者的 OS 和 RFS。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e288/7921100/f4fdc4a40620/41416_2020_1189_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e288/7921100/8d154bd5bd98/41416_2020_1189_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e288/7921100/84a7c39ae5b0/41416_2020_1189_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e288/7921100/f4fdc4a40620/41416_2020_1189_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e288/7921100/8d154bd5bd98/41416_2020_1189_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e288/7921100/84a7c39ae5b0/41416_2020_1189_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e288/7921100/f4fdc4a40620/41416_2020_1189_Fig3_HTML.jpg

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[3]
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引用本文的文献

[1]
Prognostic impact of persistent postoperative neutrophil-to-lymphocyte ratio elevation 1 year after colorectal cancer surgery.

Updates Surg. 2025-6-25

[2]
Hyperglycemia induces an immunosuppressive microenvironment in colorectal cancer liver metastases by recruiting peripheral blood monocytes through the CCL3-CCR1 axis.

J Immunother Cancer. 2025-6-22

[3]
The prognostic value of the neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and prognostic nutritional index for survival in patients with colorectal cancer.

Open Med (Wars). 2025-6-11

[4]
Not all colon cancer patients with preoperative hyperinflammatory status are at high risk of muscle loss and poor prognosis.

Int J Colorectal Dis. 2025-4-23

[5]
A Novel Definition and Grading Diagnostic Criteria for Tumour-Type-Specific Comprehensive Cachexia Risk.

J Cachexia Sarcopenia Muscle. 2025-4

[6]
Effects of exercise on inflammation, circulating tumor cells, and circulating tumor DNA in colorectal cancer.

J Sport Health Sci. 2025-3-17

[7]
MRI Features and Neutrophil-to-Lymphocyte Ratio (NLR)-Based Nomogram to Predict Prognosis of Microvascular Invasion-Negative Hepatocellular Carcinoma.

J Hepatocell Carcinoma. 2025-2-15

[8]
Longitudinal investigation of albumin-to-globulin ratio for human cancers demonstrates benefit in postoperative serial remeasurement.

NPJ Precis Oncol. 2025-1-24

[9]
A Longitudinal Dynamic Change in LMR Can Be a Biomarker for Recurrence in Fusobacterium Nucleatum-Positive Colorectal Cancer Patients.

J Inflamm Res. 2024-12-25

[10]
Prognostic value of neutrophil-to-lymphocyte ratios pre- and post-surgery in stage III CRC: a study of 2,742 patients.

Int J Colorectal Dis. 2024-12-20

本文引用的文献

[1]
Hallmarks of cancer: the next generation.

Cell. 2011-3-4

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