Aydin İsa Caner, Subasi Ismail Ege, Sunar Ahmet Orhan, Ademoglu Serkan, Gulmez Selcuk, Dincer Mursit, Duman Mustafa, Polat Erdal
University of Health Sciences, Kartal Kosuyolu Training and Research Hospital, Gastroenterologic Surgery Department, Istanbul, Turkey.
University of Health Sciences, Van City Hospital Gastroenterologic Surgery Department, Van, Turkey.
Int J Gen Med. 2024 May 22;17:2361-2369. doi: 10.2147/IJGM.S463769. eCollection 2024.
Colorectal cancer remains a significant health concern, necessitating reliable prognostic indicators for effective management. This study explores the preoperative prognostic significance of the Glucose/Lymphocyte Ratio (GLR) in colorectal cancers.
The study retrospectively analyzed records of patients who underwent surgery for elective colorectal cancers between January 1, 2013, and December 31, 2021, at the Koşuyolu Training and Research Hospital Gastroenterologic Surgery Department. Demographic, clinicopathological, and follow-up data were comprehensively assessed. A cutoff was established from GLR ratios and patients were divided into two groups for prognosis analysis.
The study enrolled 222 eligible patients, examining variables such as age, sex, ASA score, neoadjuvant treatment, lymphovascular and perineural invasion, tumor grade, TNM stage, and GLR. The groups consisted of 128 patients with low GLR and 94 patients with high GLR. Statistical analyses revealed relations between GLR levels (p ≤ 0.001) and various prognostic factors such as age (p = 0.034), Perineural Invasion (PNI) (p = 0.002), tumor grade (p = 0.017), TNM stage (p = 0.003), and surgery time (p = 0.029), individuals with GLR ≥ 3.04 were observed to show higher mortality rates (p = 0.001). Above GLR cutoff point of 3.04 patients showed better overall survival rates. All survival related parameters were related with prognosis in univariant Cox regression tests. In multivariant cox regression tests GLR ≥ 3.04 significantly increased mortality by 2.9 times. (p = 0.003).
This study demonstrates that GLR, calculated from preoperative glucose and lymphocyte values serves as an independent prognostic factor in colorectal cancers. The findings suggest potential applications for GLR in survival analyses, with significant associations identified in age, PNI, tumor grade, TNM stage, and surgery time. Further investigations are warranted in homogeneous patient populations.
结直肠癌仍是一个重大的健康问题，需要可靠的预后指标以进行有效管理。本研究探讨了葡萄糖/淋巴细胞比值（GLR）在结直肠癌中的术前预后意义。
该研究回顾性分析了2013年1月1日至2021年12月31日在科叙约卢培训与研究医院胃肠外科接受择期结直肠癌手术患者的记录。对人口统计学、临床病理和随访数据进行了全面评估。根据GLR比值确定了一个临界值，并将患者分为两组进行预后分析。
该研究纳入了222例符合条件的患者，检查了年龄、性别、美国麻醉医师协会（ASA）评分、新辅助治疗、淋巴管和神经周围侵犯、肿瘤分级、TNM分期和GLR等变量。分组包括128例低GLR患者和94例高GLR患者。统计分析揭示了GLR水平（p≤0.001）与年龄（p = 0.034）、神经周围侵犯（PNI）（p = 0.002）、肿瘤分级（p = 0.017）、TNM分期（p = 0.003）和手术时间（p = 0.029）等各种预后因素之间的关系，观察到GLR≥3.04的个体死亡率较高（p = 0.001）。GLR高于临界值3.04的患者总体生存率较好。在单变量Cox回归试验中，所有与生存相关的参数均与预后相关。在多变量Cox回归试验中，GLR≥3.04显著使死亡率增加2.9倍（p = 0.003）。
本研究表明，根据术前葡萄糖和淋巴细胞值计算得出的GLR可作为结直肠癌的独立预后因素。研究结果表明GLR在生存分析中具有潜在应用价值，在年龄、PNI、肿瘤分级、TNM分期和手术时间方面发现了显著关联。在同质患者群体中需要进一步研究。
