Higher Levels of Pre-operative Peripheral Lymphocyte Count Is a Favorable Prognostic Factor for Patients With Stage I and II Rectal Cancer

Abstract

The clinical significance of peripheral blood parameters has been considered to be a potential prognostic indicator for malignancies. In this study, 224 colorectal cancer (CRC; ncolon = 103; nrectal = 121) patients who underwent resection were enrolled, and the pre- and post-operative clinical laboratory data within 1 week, before and after surgery, were collected. The prognostic value of the counts of white blood cell (WBC), neutrophil, lymphocyte and platelet, the neutrophil to lymphocyte ratio (NLR), and systemic immune-inflammation index (SII) were analyzed. Data revealed that pre-operative lymphocyte count (pre-LC) was much higher than that of post-LC (p < 0.001), and only rectal cancer patients with pre-LChigh (>median: 1.61 × 109/L) had a significantly better overall survival (OS) and 5-year survival rate (SR) than those with pre-LClow (OS: 62.3 vs. 49.5 months; SR: 74.0 vs. 43.0%; p = 0.006). Cox's proportional hazard models revealed that pre-LChigh was an independent, favorable prognostic factor for rectal cancer patients (hazard ratio = 0.348; p = 0.003). Moreover, when the disease stages were stratified, the pre-LChigh was significantly associated with better prognosis of rectal cancer patients with stage I + II rectal cancer (n = 65; OS: 67.5 vs. 54.3 months; p = 0.011). Taken together, our study revealed that pre-operative lymphocyte count is an independent prognostic factor for patients with stage I and II rectal cancer.

Prognostic and clinicopathological significance of systemic immune-inflammation index in colorectal cancer: a meta-analysis

“…The 12 eligible studies recruited a total of 3919 patients, with the number of patients in individual studies ranging from 95 to 1383. Eleven studies were conducted in China [9][10][11][12][13][14][15][16][17][18][19] and one in Italy. 8 Eleven studies included patients with CRC, [8][9][10][12][13][14][15][16][17][18][19] and one study with colon cancer.…”

“…Eleven studies were conducted in China [9][10][11][12][13][14][15][16][17][18][19] and one in Italy. 8 Eleven studies included patients with CRC, [8][9][10][12][13][14][15][16][17][18][19] and one study with colon cancer. 11 Eleven studies investigated the relationship between SII and OS, [8][9][10][11][12][13][14][15][17][18][19] eight studies reported the association between SII and PFS, [8][9][10][13][14][15][16][17][18] and nine studies provided data on the correlation of SII and clinicopathological features in CRC.…”

“…Many studies have investigated the prognostic role of SII in patients with CRC, yet the results were inconsistent. [8][9][10][11][12][13][14][15][16][17][18][19] For example, SII was proposed as a significant prognostic factor in several studies, 9,13 whereas the correlation between SII and survival outcomes in CRC was not significant in other studies. 10,14,17 Therefore, we comprehensively searched for relevant studies in the literature and carried out a quantitative meta-analysis to evaluate the potential of SII as a CRC biomarker.…”

The advanced lung cancer inflammation index predicts short and long-term outcomes in patients with colorectal cancer following surgical resection: a retrospective study

“…An increase in NLR leads to neutrophilia or lymphopenia. Neutrophils produce cytokines that inhibit lymphocyte-mediated immune activity, consisting of natural killer T cells or activated T cells, while cytokine releasing lymphocytes play key roles in killing cancer cells, regulating cancer cell proliferation, apoptosis, angiogenesis and metastasis (Eerola, Soini & Pääkkö, 1999;Eerola, Soini & Pääkkö, 2000;Leffers et al, 2009;Ropponen et al, 1998;Zhang et al, 2019). Therefore, NLR may serve as host markers for tumor immune defenses, tumor cell proliferation and invasion of biological activity.…”

Prognostic value of peripheral blood lymphocyte subsets in patients with solid cancers: a retrospective study

“…Peripheral blood lymphocyte subsets in patients with solid cancers, before surgery Twenty-one studies investigated the prognostic value of peripheral blood lymphocyte subsets in patients with different types of cancer before surgery. The analysis included various solid malignancies such as: colorectal cancer -5 studies [20][21][22][23][24] , breast cancer -4 studies [16][17][18][19] , lung cancer -4 studies [25][26][27][28] , kidney cancer -3 studies [31][32][33] , gastric cancer -2 studies [29][30] and esophageal 34 , nasopharyngeal 35 and cervical cancer 36 -one study. Ten studies performed on patients with different types of cancer have shown that peripheral blood lymphocytes values are independent predictors of OS.…”