Altıntaş Yunus Emre, Bilici Ahmet, Yıldız Özcan, Kınıkoğlu Oğuzcan, Ölmez Ömer Fatih
Department of Medical Oncology, Faculty of Medicine, Istanbul Medipol University, 34000 Istanbul, Türkiye.
Medicina (Kaunas). 2025 May 8;61(5):865. doi: 10.3390/medicina61050865.
: This study aimed to investigate the predictive and prognostic value of pre-treatment systemic inflammatory markers in patients with locally advanced rectal cancer (RC) undergoing neoadjuvant chemoradiotherapy (CRT) or radiotherapy (RT) alone. : A total of 79 patients with biopsy-confirmed locally advanced RC treated at a single tertiary center between 2011 and 2017 were retrospectively analyzed. Pre-treatment blood-based inflammatory indices, including neutrophil-to-lymphocyte ratio (NLR), derived NLR, platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and hemoglobin levels, were recorded. Tumor response was assessed using the Ryan tumor regression grade (TRG), and associations between laboratory parameters, treatment response, and recurrence-free survival (RFS) were evaluated. : Among 79 patients (mean age: 55.9 ± 11.98 years; 67.1% male), 57 received neoadjuvant CRT and 22 underwent short-course RT. Complete pathological response (pCR) was observed in 10 patients (12.7%). No statistically significant associations were found between baseline inflammatory markers and TRG, tumor differentiation, or pCR. ROC analysis revealed that none of the markers demonstrated significant discriminatory power for predicting tumor response or recurrence. However, a weak but statistically significant inverse correlation was identified between poor TRG response and higher baseline values of NLR, derived NLR, and PLR ( < 0.05). : Inflammatory biomarkers such as NLR, PLR, and LMR, while easily accessible and cost-effective, did not demonstrate strong predictive or prognostic value in this cohort of RC patients receiving neoadjuvant therapy. These findings suggest that reliance solely on systemic inflammatory indices may be insufficient for predicting treatment outcomes, emphasizing the need for integrative models incorporating molecular and pathological markers.
本研究旨在探讨治疗前全身炎症标志物对接受新辅助放化疗（CRT）或单纯放疗（RT）的局部晚期直肠癌（RC）患者的预测和预后价值。对2011年至2017年在单一三级中心接受活检确诊的79例局部晚期RC患者进行回顾性分析。记录治疗前基于血液的炎症指标，包括中性粒细胞与淋巴细胞比值（NLR）、衍生NLR、血小板与淋巴细胞比值（PLR）、淋巴细胞与单核细胞比值（LMR）以及血红蛋白水平。使用Ryan肿瘤消退分级（TRG）评估肿瘤反应，并评估实验室参数、治疗反应和无复发生存期（RFS）之间的关联。在79例患者（平均年龄：55.9±11.98岁；67.1%为男性）中，57例接受了新辅助CRT，22例接受了短程RT。10例患者（12.7%）观察到完全病理缓解（pCR）。在基线炎症标志物与TRG、肿瘤分化或pCR之间未发现统计学上的显著关联。ROC分析显示，没有一个标志物对预测肿瘤反应或复发具有显著的鉴别能力。然而，在TRG反应较差与较高的NLR、衍生NLR和PLR基线值之间发现了微弱但具有统计学意义的负相关（<0.05）。炎症生物标志物如NLR、PLR和LMR虽然易于获取且成本效益高，但在接受新辅助治疗的这组RC患者中并未显示出强大的预测或预后价值。这些发现表明，仅依靠全身炎症指标可能不足以预测治疗结果，强调需要纳入分子和病理标志物的综合模型。
