Department of Oncology, The First Affiliated Hospital of Kunming Medical University, Kunming, China.
J Cancer Res Ther. 2022 Apr;18(2):438-444. doi: 10.4103/jcrt.jcrt_1807_21.
To investigate whether systemic inflammation-based predictors can predict tumor response to neoadjuvant chemoradiotherapy (CRT) in patients with locally advanced rectal cancer (LARC).
Totally, 205 LARC patients undergoing neoadjuvant CRT and curative surgery between 2008 and 2017 were analyzed. After propensity score matching, 132 patients were included in the study. Hematological parameters were collected, and their relationship with tumor response was investigated.
After propensity score matching, patients in good response group before CRT displayed significantly lower neutrophil-lymphocyte-ratio (NLR) and platelet-lymphocyte-ratio (PLR) than those in poor response group, while there were no significant differences in all hematological characteristics between the two groups after CRT. The cutoff values of pre-CRT NLR and pre-CRT PLR after receiver operating characteristic analysis were 3.10 and 198.7, respectively. Multivariate analysis revealed that while there was no association between pre-CRT PLR and tumor response, pre-CRT NLR ≥3.1 was identified as the predictor of poor tumor response (P = 0.007).
An increased NLR before CRT can serve as a hematological factor for predicting a poor tumor response in LARC.
探讨基于全身炎症的预测因子是否能预测局部晚期直肠癌（LARC）患者新辅助放化疗（CRT）的肿瘤反应。
回顾性分析 2008 年至 2017 年间接受新辅助 CRT 及根治性手术的 205 例 LARC 患者。经过倾向评分匹配后，共有 132 例患者纳入研究。收集血液学参数，并探讨其与肿瘤反应的关系。
在 CRT 前，反应良好组患者的中性粒细胞-淋巴细胞比值（NLR）和血小板-淋巴细胞比值（PLR）明显低于反应不良组，而 CRT 后两组间所有血液学特征均无显著差异。ROC 分析得出的 CRT 前 NLR 和 PLR 的截断值分别为 3.10 和 198.7。多因素分析显示，CRT 前 PLR 与肿瘤反应无关，而 CRT 前 NLR≥3.1 是肿瘤反应不良的预测因子（P=0.007）。
CRT 前 NLR 升高可作为预测 LARC 肿瘤反应不良的血液学因素。
