Ou Wenting, Zhou Caijin, Zhu Xiaoqing, Lin Lin, Xu Qingwen
Department of Oncology, The Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong 524001, People's Republic of China.
Department of Gastrointestinal Surgery, The Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong 524001, People's Republic of China.
Onco Targets Ther. 2021 Jan 12;14:337-346. doi: 10.2147/OTT.S290234. eCollection 2021.
The inflammatory indexes are attracting increasing attention as a prognostic predictor for colorectal cancer (CRC). However, the prognostic value of the preoperative lymphocyte-to-C-reactive protein ratio (LCR) in patients with non-metastatic CRC remains to be established.
A total of 955 patients from 2010 to 2014 at a single center were included. Receiver operating characteristic curves (ROC) were generated to define the optimal cutoff value of the inflammatory indexes, and the areas under the curve (AUC) were calculated to compare the predictive value among the inflammatory indexes. The Fine and Gray competing risk regression model and Cox proportional hazard model were used to determine the prognostic factors for cancer-specific survival (CSS) and overall survival (OS) by using sub-distribution hazard ratio (SHR) and hazard ratio (HR) as size effects, respectively.
A ratio of 6500 was defined as the optimal cutoff value for LCR for dividing CRC patients into the high (> 6500, n = 528) and low (≤ 6500, n = 427) LCR groups. The LCR had the highest value of prognostic prediction among all inflammation-based scores. Low LCR was significant correlated with several clinicopathological features of tumor invasion and development. The patients with low LCR had poorer CSS and OS as compared to those with high LCR. Multivariate analyses showed that low LCR was independently associated with worse OS (HR = 0.61, 95% CI: 0.53-0.70) and CSS (SHR = 0.55, 95% CI: 0.43-0.71).
Preoperative LCR can be a useful biomarker for prognostic prediction in non-metastatic CRC patients with a better predictive value than other inflammatory indexes.
炎症指标作为结直肠癌（CRC）的预后预测指标正受到越来越多的关注。然而，术前淋巴细胞与C反应蛋白比值（LCR）在非转移性CRC患者中的预后价值仍有待确定。
纳入了2010年至2014年在单一中心的955例患者。生成受试者操作特征曲线（ROC）以确定炎症指标的最佳临界值，并计算曲线下面积（AUC）以比较炎症指标之间的预测价值。采用Fine和Gray竞争风险回归模型以及Cox比例风险模型，分别以亚分布风险比（SHR）和风险比（HR）作为效应量来确定癌症特异性生存（CSS）和总生存（OS）的预后因素。
将6500定义为LCR的最佳临界值，用于将CRC患者分为高LCR组（>6500，n = 528）和低LCR组（≤6500，n = 427）。在所有基于炎症的评分中，LCR具有最高的预后预测价值。低LCR与肿瘤侵袭和发展的几个临床病理特征显著相关。与高LCR患者相比，低LCR患者的CSS和OS较差。多变量分析显示，低LCR与较差的OS（HR = 0.61，95%CI：0.53 - 0.70）和CSS（SHR = 0.55，95%CI：0.43 - 0.71）独立相关。
术前LCR可作为非转移性CRC患者预后预测的有用生物标志物，其预测价值优于其他炎症指标。
