Department of General Surgery, Faculty of Medicine, Istanbul Medeniyet University, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkey.
ANZ J Surg. 2022 Oct;92(10):2585-2594. doi: 10.1111/ans.17896. Epub 2022 Jul 2.
Stage III colorectal cancer (CRC), which accounts for approximately one third of all CRC cases, is associated with worsened prognosis. The aim of this study was to compare the preoperatively measured systemic inflammatory markers and to define the most significant marker in terms of its prognostic value in stage III CRC.
Surgically treated stage III CRC patients were included. Demographics, preoperatively measured Glasgow prognostic score (GPS), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), lymphocyte/C-reactive protein ratio (LCR) and C-reactive protein/albumin ratio (CAR) values, clinicopathological features, surgical, oncological and survival outcomes were recorded and statistically analysed.
The study group of 102 patients consisted of 65 (63.7%) men and 37 (36.3%) women with a median age of 64 (range: 26-89). The mean follow-up period was 42.8 ± 30.5 (range: 6-107) months. Overall survival (OS) and disease-free survival (DFS) rates were 71.6%, and 67.7%, respectively. Elevated CRP, GPS 2, LCR ≤ 0.530, CAR ≥ 0.080, higher numbers of metastatic lymph nodes and N2b nodal status were detected to impair DFS (P = 0.001, P = 0.015, P = 0.001, P = 0.001, P = 0.001 and P = 0.043, respectively). Variables including GPS 2, PLR≥190.83, CAR≥0.045, LCR≤0.684, surgical site infection and longer hospital stay decreased OS (P = 0.004, P = 0.002, P = 0.005, P = 0.001, P = 0.001 and P = 0.001, respectively). According to multivariate analysis; PLR ≥ 190.83 was associated with three times [HR: 2.892 (95% CI: 1.100-7.602), P = 0.031], and LCR ≤ 0.684 was associated with four times [HR: 3.919 (95% CI: 1.130-13.592), P = 0.031] greater risk of cancer-related mortality.
As an independent prognostic factor, LCR had the highest impact on predicting survival after curative resection for stage III CRC.
III 期结直肠癌（CRC）约占所有 CRC 病例的三分之一，与预后恶化相关。本研究旨在比较术前测量的全身炎症标志物，并确定在 III 期 CRC 中具有最佳预后价值的最显著标志物。
纳入接受手术治疗的 III 期 CRC 患者。记录患者的人口统计学数据、术前测量的格拉斯哥预后评分（GPS）、中性粒细胞/淋巴细胞比值（NLR）、血小板/淋巴细胞比值（PLR）、淋巴细胞/C 反应蛋白比值（LCR）和 C 反应蛋白/白蛋白比值（CAR）值、临床病理特征、手术、肿瘤学和生存结局，并进行统计学分析。
本研究共纳入 102 例患者，其中 65 例（63.7%）为男性，37 例（36.3%）为女性，中位年龄为 64 岁（范围：26-89 岁）。平均随访时间为 42.8±30.5 个月（范围：6-107 个月）。总生存率（OS）和无病生存率（DFS）分别为 71.6%和 67.7%。升高的 CRP、GPS 2、LCR≤0.530、CAR≥0.080、更多的转移性淋巴结和 N2b 淋巴结状态被发现会影响 DFS（P=0.001、P=0.015、P=0.001、P=0.001、P=0.001 和 P=0.043）。包括 GPS 2、PLR≥190.83、CAR≥0.045、LCR≤0.684、手术部位感染和住院时间延长在内的变量降低了 OS（P=0.004、P=0.002、P=0.005、P=0.001、P=0.001 和 P=0.001）。多变量分析显示；PLR≥190.83 与三倍 [HR：2.892（95%CI：1.100-7.602），P=0.031] 和 LCR≤0.684 与四倍 [HR：3.919（95%CI：1.130-13.592），P=0.031] 的癌症相关死亡率增加相关。
作为独立的预后因素，LCR 对预测 III 期 CRC 根治性切除后的生存具有最高的影响。
