Prognostic Significance of Neutrophil-Lymphocyte Ratio and Platelet-Lymphocyte Ratio in Metastatic Colorectal Cancer

Abstract

There are many studies on biomarkers for prognosis in the treatment of metastatic colorectal cancer.Neutrophil-lymphocyte radio (NLR) and Platelet-lymphocyte radio (PLR) are of interest with studies revealing the relationship between in ammatory biomarkers and cancer. Our study is a retrospective le study and the contribution of NLR and PLR to progression-free survival (PFS) and overall survival(OS) before rst line chemotherapy was investigated regardless treatment. The cut off values of NLR and TLR were determined using ROC curve analysis. NLR and PLR was divided into two groups according to the cut-off points. OS and PFS associated with NLR and TLR were performed by Kaplan-Meier method. In our study, we could not demonstrate the prognostic potential of pre-treatment NLR and PLR in patients with mCRC treated with rst-line chemotherapy. Our study was showed that the use of these biomarkers in mCRC is limited. Introduction:Colorectal cancer (CRC) is the third most common cancer worldwide. While the incidence and the mortality rate of colorectal cancer has decreased due to effective cancer screening, CRC is still the second most common cause of cancer-related deaths in the Western world (1) and 20% of patients with CRC have metastases at time of diagnosis (2).Advances in CRC therapy as combination of chemotherapy with targeted agents and supportive care have led to signi cant improvement in survival rates for CRC patients. However, metastatic colorectal cancer (mCRC) remains to have poor prognosis with with an approximately 2-year survival (3). A multitude of factors at diagnosis, including clinical parameters (age, performance status, comorbidities), biological properties of the tumor (local growth, distant metastasis, sidedness), molecular factors (KRAS, NRAS, and BRAF mutations) and biochemical markers such as carcinoembryonic antigen, lactate dehydrogenase, platelets, leucocytes, hemoglobin, alkaline phosphatase, albumin have important prognostic impact for outcome in mCRC (4,5). In recent decades, studies provided de nitive evidence about the association between in ammation and cancer development (6,7).The in ammation is essential for tumor microenvironment, and in ammatory cells can affect tumor proliferation, angiogenesis, metastasis, and genetic instability. Lymphocytes, macrophages, and granulocytes are involved in the anti-cancer battle (8). The main cell population in anti-cancer immune response is the population of cytotoxic T lymphocytes (CTLs) (9). Neutrophils may play a crucial role in in ammation driven tumorigenesis (10). Neutrophil population consists of pro-and antitumor subpopulations (11). It is controversy that neutrophil abundance correlates with a better prognosis. (12).Platelets release some tumor growth factors which play a signi cant role in cancer growth, progression, and metastasizing (13). In previous studies, elevated pretreatment neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in peripheral blood were identi ed as independent prognostic factors. As a resul...

Prognostic Value of Inflammatory Markers in Nasopharyngeal Carcinoma Patients in the Intensity-Modulated Radiotherapy Era

“…9 For decades, numerous studies have confirmed that inflammation plays an important role in cancer initiation, progression and metastasis. 10 Furthermore, inflammatory markers, such as neutrophil-to-lymphocyte ratio (NLR), platelet-tolymphocyte ratio (PLR), systemic immune inflammation index (SII), and systemic inflammation response index (SIRI), have been employed to predict the prognosis of breast, 11 lung, 12 pancreatic, 13 and cervical 14 cancers, among others. Previous studies have also suggested that high NLR, PLR, SII, and SIRI are significantly associated with poor prognosis in various malignancies.…”

Potential impact of platelet-to-lymphocyte ratio on prognosis in patients with colorectal cancer: A systematic review and meta-analysis

“…Twenty-five of the included records reported that overall survival (OS) of CRC patients with high PLR levels was significantly shorter than for those with low PLR levels ( 11 – 15 , 17 , 19 – 27 , 29 – 31 , 34 , 35 , 46 – 50 ). Pooled analysis of OS revealed significant differences and moderate heterogeneity between the high and low PLR groups in the random-effect model (HR = 1.40, 95% CI = 1.21–1.62, P < 0.00001, Figure 2A ).…”

“…However, the relationship between the PLR and CRC remains controversial. Some studies reported that an elevated PLR was an independent adverse prognostic factor in patients with CRC (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23), yet others showed that the PLR could not be a related prognostic biomarker of CRC (11,(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35).…”

The Ratio of Platelets to Lymphocytes Predicts the Prognosis of Metastatic Colorectal Cancer: A Review and Meta-Analysis

“…Ultimately, 12 articles including 1452 patients published between 2014 and 2021 were included in this meta-analysis. The characteristics of the included studies are summarized in Table 1 [ 21 – 32 ]. All included literatures are retrospective studies.…”