Evaluation of Neutrophil-Lymphocyte Ratio and Platelet-Lymphocyte Ratio on Predicting Responsiveness to Neoadjuvant Chemoradiotherapy in Locally Advanced Rectal Cancer Patients

Abstract

Objective. Neutrophil-lymphocyte ratio (NLR) and Platelet-lymphocyte ratio (PLR) have been proposed as prognostic biomarkers in multiple cancers. However, the implications of NLR and PLR in the responsiveness to neoadjuvant chemoradiotherapy (nCRT) remain to be clarified in locally advanced rectal cancer (LARC) patients. This retrospective study investigated the prognostic value of NLR and PLR in nCRT responsiveness of LARC patients. Methods. A total number of 86 patients diagnosed with LARC and treated with nCRT and total mesorectal excision were retrospectively followed from 2013 to 2016. Receiver operating characteristic (ROC) curve was used to determine the cutoff values of NLR and PLR, and the patients were divided into NLR elevation and NLR decrease groups, or PLR elevation and PLR decrease groups. The correlation between NLR and PLR changes, and clinicopathological factors were analyzed. The relationship between NLR and PLR changes and the curative responsiveness towards nCRT were further evaluated. Results. NLR and PLR changes after nCRT were significantly correlated with the distance of tumors to the anus and BMI (body mass index) ( P < 0.05 ). The clinical remission rate of patients with NLR reduction was 72.09% (31/43), which was significantly higher than that in patients with NLR increment (22/43, 51.16%). There was no significant difference in the clinic remission rate between the patients with PLR reduction and those with PLR increment ( P > 0.05 ). However, the pathological responsiveness rate was significantly higher in patients with PLR reduction (21/43, 48.84%) when compared to the ones with PLR increment (9/43, 20.9%) ( P = 0.036 ). Conclusion. Our data indicate that in LARC patients with nCRT, the reduction of NLR and the reduction of PLR could serves as predictors for the clinic remission rate and pathological responsiveness rate, respectively. The combination of NLR and PLR changes may be employed as a simple and effective prognostic parameter to predict the treatment outcome of nCRT in LARC.

Incidence of neurological complications following pediatric heart surgery and its association with neutrophil‐to‐lymphocyte ratio

“…In the first day the difference among the two groups were more pronounced that second day; however, both associations were not significant ( p = 0.099 & p = 0.824). This finding in our study contradicts some of the other studies to date 7,9,10,17,24 . Furthermore, we did not discover any relationship between the sex of the patients and the presence of neurological symptoms.…”

“…This finding in our study contradicts some of the other studies to date. 7 , 9 , 10 , 17 , 24 Furthermore, we did not discover any relationship between the sex of the patients and the presence of neurological symptoms. Notably, we observed that younger children were more susceptible to present with neurological complications.…”

“…It also discusses its association with sex, weight, age, and neutrophil to lymphocyte ratio (NLR). We chose NLR, because it has been shown to be prognostic in many acute conditions such as cancer, 7,8 sepsis, [9][10][11][12][13] surgery, [14][15][16] and even Covid-19. 17…”

Prognostic Value of Systemic Immune-Inflammation Index (SII) in Patients with Glioblastoma: A Comprehensive Study Based on Meta-Analysis and Retrospective Single-Center Analysis

“…The probability of benefit from an ICI is significantly higher in the NLR low/TMB high group compared to the NLR high/TMB low group. Moreover, Liu et al [54] reported that the reduction in the NLR and PLR could predict the clinic remission rate and pathological responsiveness rate, respectively, in patients with rectal cancer. These findings suggest that these peripheral inflammatory indicators may be suitable candidates for a cost-effective and widely accessible biomarker.…”

Neutrophil-lymphocyte ratio: an independent predictor of the herpes zoster risk in rheumatoid arthritis patients treated with tofacitinib

“…NLR indicates a patient's inflammatory state (neutrophil count) and adaptive immunity(lymphocyte count), which is determined from the number of neutrophils to lymphocytes measured in the peripheral blood. NLR is a straightforward and reliable biomarker for patient survival and surgical prognosis in a variety of disorders, including serious cardiac disease and numerous cancers [20][21][22].…”