Chirurgia (Bucur). 2023 Aug;118(4):399-409. doi: 10.21614/chirurgia.2023.v.118.i.4.p.399.
Neutrophil to lymphocyte ratio (NLR) is promoted as a marker reflecting the antitumoral inflammatory response. Herein, we aim to assess whether NLR at the time of diagnosis can predict response to neoadjuvant therapy and long-term survival in a matched cohort of rectal cancer patients. This is a case control study on rectal cancer patients who underwent standard oncological treatment and had NLR sampled at each stage. ROC curve was used to establish the cut off value of NLR at diagnosis. Two groups (high and low NLR) were compared. Kaplan Meier overall and disease-free survival (DFS) analysis was done comparatively between two groups of patients: low and high NLR. Pearson and Log Rank tests were used to establish statistical significance. Propensity score matching (PSM) was performed, and all variables were compared again on the matched subgroups. One hundred patients were included and 54 were compared again after PSM. NLR at diagnosis did not correlate with tumor regression grade (p=0.77). High NLR at diagnosis (NLR 2.58) was not found to be significantly associated with worse overall survival (p=0.096) or DFS (p=0.128). Similar results were achieved after PSM, except when stage III subgroups were compared, where higher NLR was associated with worse DFS (p=0.04), while results for OS were borderline (p=0.05). Overall, a pretherapeutic high NLR ( 2.58) was not found to predict survival or response do neoadjuvant therapy in patients with rectal cancer. However, a higher NLR may be associated with worse outcomes in advanced colorectal cancer.
中性粒细胞与淋巴细胞比值（NLR）被认为是反映抗肿瘤炎症反应的标志物。在此，我们旨在评估直肠癌患者的 NLR 是否可以在诊断时预测对新辅助治疗的反应和长期生存。
这是一项关于接受标准肿瘤治疗且在每个阶段均取样 NLR 的直肠癌患者的病例对照研究。ROC 曲线用于建立诊断时 NLR 的截止值。比较两组（高和低 NLR）。对两组患者（低和高 NLR）进行 Kaplan-Meier 总体和无病生存（DFS）分析。使用 Pearson 和对数秩检验来确定统计学意义。进行倾向评分匹配（PSM），并再次比较匹配亚组中的所有变量。
纳入了 100 名患者，其中 54 名患者在 PSM 后再次进行了比较。诊断时的 NLR 与肿瘤消退分级无关（p=0.77）。诊断时 NLR 较高（NLR 2.58）与总体生存率（p=0.096）或 DFS（p=0.128）较差无显著相关性。PSM 后也得出了类似的结果，但当比较 III 期亚组时，较高的 NLR 与较差的 DFS 相关（p=0.04），而 OS 结果则接近（p=0.05）。
总体而言，在直肠癌患者中，治疗前高 NLR（≥2.58）并未预测生存或对新辅助治疗的反应。然而，较高的 NLR 可能与晚期结直肠癌的不良结局相关。
