The Impact of Neutrophil to Lymphocytic Ratio (NLR) as a Predictor of Treatment Outcomes in Rectal Carcinomas: A Retrospective Cohort Study

Abstract

Background and aim: The prognostic role of neutrophil to lymphocyte ratio (NLR) has been shown in many solid tumors included in a recent meta-analysis of one hundred studies. We aimed to evaluate the prognostic value of neutrophil to lymphocyte ratio in treatment outcomes; response and survival of patients with different stages of rectal cancers. Patients and methods: All patients with pathologically confirmed cancer rectum presented to our department during the period from January 2012 to the end of 2014 were included in this retrospective study, these recruited patients were evaluated through their files to determine different objectives of our study. Results: The median overall survival was 31 ± 4.676 months while disease free survival was 40 ± 2.346 for the whole study group; neutrophil to lymphocyte ratio was negatively correlated with overall survival with r = −0.743, P < 0.001, also with disease free survival with r = −0.717, P < 0.0001. Neutrophil to lymphocyte ratio was positively correlated with the number of positive lymph nodes dissected to total number of lymph nodes dissected ratio with r = +0.254, P = 0.028. Roc curve was used to find the accurate cut point of NLR for these patients and was found to be of 4.5. Conclusion: Elevated pre-treatment NLR is an independent predictor of shorter survival in patients with rectal cancer. This parameter is a simple, easily accessible laboratory test for identifying patients with poorer prognosis.

Effects of Tripterygium wilfordii extracts on the hematological parameters of solid Ehrlich carcinoma bearing mice

“…High NLR and MLR values indicate an unjustified immune reaction, which diminishes the predictability of anti-tumor resolution. As systemic inflammation leads to changes in the circulatory blood leukocytes, it is suggested that NLR and MLR values can be considered as an indicator for forecasting malignancy invasion and severity [38]. The results of the current study revealed a remarkable, significant decrease in NLR, MLR, and PLR values in the TW extract treated mice.…”