Assessment of the relationship between neutrophil lymphocyte ratio and prognostic factors in non-metastatic colorectal cancer
INTRODUCTIONColorectal cancer is the third most common malignancy worldwide. The number of deaths from colorectal cancer is 15.9 per 100,000 individuals per year. Approximately 4.7% of men and women are diagnosed with colon and rectal cancer at some point during their lifetime (1). Estimated preoperative prognosis for colorectal cancer patients will help the choice and modality of the surgical and medical treatment.An improved lifespan has been shown with an intensive lymphocytic infiltration in localized tumors in the colorectal cancer patients (2-4). Additionally, some parameters, such as C-reactive protein and hypoalbuminemia, which show a poor prognostic association between systemic inflammatory response and colorectal cancer have been discussed (5, 6). Systemic inflammation has been reported to be an independent determining factor for prognosis in colorectal patients after surgery (5). A high neutrophillymphocyte ratio (NLR) has been reported to estimate poor outcomes in colorectal cancer patients who are exposed to primary resection (7). Ding (8) reported that a high NLR may establish the risk groups and in such patients NLR may be a marker in response at adjuvant cancer therapy.Considering the histopathology of colorectal diseases, it is known that lymphovascular and perineural invasion have an adverse effect on prognosis. The most important prognostic variable in colorectal carcinoma is the presence or absence of lymph node metastases. In a study of more than 1000 operative specimens, Morson and Dawson (9) found regional venous involvement in 35% of cases. Submucosal venous spread occurred in 10% of cases, and there was an evidence of permeation of extramural vessels in 25% cases. In the former cases, there was little or no effect on prognosis; however, extramural venous involvement reduced five-year survival rates from 55% to approximately 30%.Perineural invasion (PNI) has been shown to have a detrimental effect on the prognosis (10). Its presence may be a part of overall penetration of the bowel wall. The relationship between PNI and the advanced colorectal cancer patients was reported in 1981 (11). Krasna et al. (12) found that the three-year survival rate decreased from 57.7% in patients without neural invasion to 29.6% in patients with neural invasion. Objective: Neutrophil-lymphocyte ratio still has a limited clinical use due to many non-cancer factors affecting neutrophils or lymphocytes in the present time. We aimed to evaluate the association between preoperative neutrophillymphocyte ratio and poor prognostic factors after curative elective colorectal surgery.
Material and Methods:This clinical retrospective study was initiated with 95 patients, who had a curative surgical resection between 2003 and 2013. The patients were divided into two groups based on the preoperative neutrophillymphocyte ratio cut-off value above and below 3. The groups were compared for tumor locali...
Cyclin D1 is an important positive regulator of the G1/S phase of the cell cycle. We investigated the association between the CCND1 G870A polymorphism and susceptibility to papillary thyroid cancer in Turkish people. This study covered 102 patients with papillary thyroid cancer and 174 healthy controls. CCND1 genotyping was determined by the PCR-RFLP method. We found that the A allele frequency was higher in the cases than in the controls (p=0.042). On stratification analysis, papillary thyroid cancer risk was significantly elevated in individuals older than 45 years with the A allele (OR=1.91, 95% CI, 1.09-3.35, p=0.024) and in females with the A allele (OR=1.73, 95% CI, 1.06-2.84, p=0.029), compared to the G allele. According to the subject age, there was an increased papillary thyroid cancer risk for the individuals older than 45 years with the AA genotype (OR=2.28, 95% CI, 1.02-5.13, p=0.046) compared to the AG+GG combined genotypes. In conclusion, it is suggested that the CCND1 G870A polymorphism may contribute to the susceptibility to papillary thyroid cancer, especially in those who were older subjects (45≤ years old) and female, in the Turkish population.
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