Ciocan Andra, Ciocan Răzvan A, Al Hajjar Nadim, Gherman Claudia D, Bolboacă Sorana D
Department of Medical Informatics and Biostatistics, "Iuliu Hațieganu" University of Medicine and Pharmacy Cluj-Napoca, Louis Pasteur Street, No. 6, 400349 Cluj-Napoca, Romania.
Department of Surgery, "Iuliu Hațieganu" University of Medicine and Pharmacy Cluj-Napoca, Croitorilor Street, No. 19-21, 400162 Cluj-Napoca, Romania.
Diagnostics (Basel). 2021 Mar 21;11(3):566. doi: 10.3390/diagnostics11030566.
Systemic inflammatory status is known as an important factor of colorectal cancer prognosis. Our study aimed to evaluate the performances of inflammation biomarker ratios as classification models of seven outcomes in patients with colorectal cancer.
A retrospective cohort study was conducted on subjects with colorectal cancer over five years at a single center in Transylvania, Romania. Seven derived ratios were calculated based on laboratory data: neutrophil-to-lymphocyte (NLR), derived neutrophil-to-lymphocyte (dNLR), platelet-to-lymphocyte (PLR), lymphocyte-to-monocyte (LMR) and albumin-to-globulin (AGR) ratios, Systemic Immune Inflammation Index (SII) and Prognostic Nutritional Index (PNI). The utility of these ratios as predictors for seven outcomes was further evaluated in multivariable regression models.
Our study shows that the evaluated ratios exhibit specific performances for individual outcomes, proving a fair ability as screening tools (NLR and dNLR for survival, T stage and M stage; NLR and SII for T stage; and PLR for M stage). A dNLR over 3.1 (OR = 2.48, 95% CI (1.421 to 4.331)) shows predictive value for survival. A value of NLR over 3.10 (OR = 1.389, 95% CI (1.061 to 1.817)) is positively associated with an advanced T stage, while LMR is negatively related to the T stage (OR = 0.919, 95% CI (0.867 to 0.975)). NLR over 4.25 (OR = 2.647, 95% CI (2.128 to 3.360)) is positively associated with, while PNI is negatively related (OR = 0.970, 95% CI (0.947 to 0.993)) to, the M stage.
Each of the evaluated ratios possesses prognostic value for certain outcomes considered, but the reported models need external validation to recommend their clinical practice utilization.
全身炎症状态是已知的结直肠癌预后的重要因素。我们的研究旨在评估炎症生物标志物比值作为结直肠癌患者七种预后分类模型的性能。
在罗马尼亚特兰西瓦尼亚的一个单一中心，对五年内的结直肠癌患者进行了一项回顾性队列研究。根据实验室数据计算了七个衍生比值：中性粒细胞与淋巴细胞比值（NLR）、衍生中性粒细胞与淋巴细胞比值（dNLR）、血小板与淋巴细胞比值（PLR）、淋巴细胞与单核细胞比值（LMR）以及白蛋白与球蛋白比值（AGR）、全身免疫炎症指数（SII）和预后营养指数（PNI）。在多变量回归模型中进一步评估了这些比值作为七种预后预测指标的效用。
我们的研究表明，所评估的比值对个体预后表现出特定的性能，证明了其作为筛查工具的一定能力（NLR和dNLR用于生存、T分期和M分期；NLR和SII用于T分期；PLR用于M分期）。dNLR超过3.1（OR = 2.48，95% CI（1.421至4.331））对生存具有预测价值。NLR超过3.10（OR = 1.389，95% CI（1.061至1.817））与晚期T分期呈正相关，而LMR与T分期呈负相关（OR = 0.919，95% CI（0.867至0.975））。NLR超过4.25（OR = 2.647，95% CI（2.128至3.360））与M分期呈正相关，而PNI与M分期呈负相关（OR = 0.970，95% CI（0.947至0.993））。
所评估的每个比值对所考虑的某些预后都具有预后价值，但所报告的模型需要外部验证才能推荐其在临床实践中的应用。
