The Prognostic Significance of Pretreatment Hematologic Parameters in Patients Undergoing Resection for Colorectal Cancer

Kozak, Margaret M.; Eyben, Rie von; Pai, Jonathan; Anderson, Eric M.; Welton, Mark L.; Shelton, Andrew; Kin, Cindy; Koong, Albert C.; Chang, Daniel T.

doi:10.1097/coc.0000000000000183

Cited by 46 publications

(45 citation statements)

References 32 publications

(26 reference statements)

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“…The cutoff value for LMR varies widely in different studies, from 2.14 (68) to 3.78 (69). Some authors calculated the cutoff value for LMR very close to that of our study (2,28,70,71). The literature data regarding the prognostic value of the PNI index seem to be the most consistent.…”

Section: Discussionsupporting

confidence: 85%

The Importance of Systemic Inflammation Markers in the Survival of Patients with Complicated Colorectal Cancer, Operated in Emergency

Constantin¹,

Firescu²,

Voicu³

et al. 2020

chr

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Introducere: Răspunsul inflamator joacă un rol critic în carcinogeneză. Există scoruri recente bazate pe răspunsul inflamator sistemic, cum ar fi raportul neutrofile/limfocite (NLR), raportul trombocite/limfocite (PLR), raportul limfocite/monocite (LMR), despre care s-a arătat că au valoare prognostică la pacienţii cu cancer. Aceste scoruri permit identificarea pacienţilor care vor avea un răspuns slab la tratament şi o supravieţuire de scurtă durată. Scopul acestui studio este de a evalua rolul prognostic al NLR, PLR, LMR şi PNI în termeni de supravieţuire la distanţă pentru bolnavii cu cancer colorectal, operaţi în urgenţă. Material şi Metode: Am inclus în studiu 391 de pacienţi internaţi şi operaţi pentru cancer colorectal complicat în clinica Chirurgie II a Spitalului Clinic Judeţean de Urgenţă "Sf. Ap. Andrei" din Galaţi, în perioada 2008-2017. Am analizat factorii paraclinici de inflamaţie sistemică NLR, PLR, LMR şi PNI.Ca factori de prognostic, au fost analizate curbele de supravieţuire. Rezultate: La pacienţii din lot, valorile crescute ale NLR, precum şi ale PLR au dus la creşterea riscului de deces (HR=7,581, 95% CI=(6.358,9.039), p value=0.000000, respective HR=1.043, 95% CI=(1.039, 1.047), p value=0.000000), iar valorile crescute ale LMR şi PNI au condus la scăderea acestui risc (HR=0.069, 95%

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Section: Discussionsupporting

confidence: 85%

The Importance of Systemic Inflammation Markers in the Survival of Patients with Complicated Colorectal Cancer, Operated in Emergency

Constantin¹,

Firescu²,

Voicu³

et al. 2020

chr

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“…The majority of reports have shown NLR to be a novel biomarker of survival in primary and metastatic colorectal cancers [30,31,32,33,34,35,36]. A meta-analysis combining results from 49 studies containing 14,282 patients showed that higher values of NLR were associated with poor disease-free [hazard ratio (HR): 1.99; 95% CI = 1.80-2.20; p < 0.001] and overall survival (HR: 1.92; 95% CI = 1.64-2.24; p < 0.001) in solid cancer patients [2].…”

Section: Discussionmentioning

confidence: 99%

The Neutrophil-to-Lymphocyte Ratio as a Marker of Lymph Node Status in Patients with Rectal Cancer

Khan

Akritidis²,

Pring³

et al. 2016

Oncology

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Aim: The aim of the study was to investigate the role of the neutrophil-to-lymphocyte ratio (NLR) as a prognostic marker of rectal cancers. Methods: We undertook a retrospective review of patients with rectal cancer. Pre-treatment NLR was assessed for association and predictive values against clinicopathological staging and post-treatment outcomes. Results: A total of 140/180 cases were included in the final analysis [male:female 2:1; mean age 68 years (interquartile range 58-75)]. The pre-operative mean NLR was 5.4 ± 6.8. There was a strong positive correlation between NLR and C-reactive protein (Spearman's rho 64.3%, p < 0.001). A high NLR was associated with a positive nodal status on MRI (5.2 vs. 3.8, p = 0.03) and histopathological (4.8 vs. 3.8, p = 0.02) assessment. The NLR showed an average value for predicting MRI and pathological nodal status on receiver operating characteristic analysis [area under the curve = 0.72 (95% CI = 0.54-0.91), p = 0.031 and area under the curve = 0.64 (95% CI = 0.52-0.077), p = 0.021, respectively]. On multivariate analysis, the total lymph node retrieved at operation was the best predictor of pathological nodal involvement; NLR did not show any predictive value. Patients with an NLR >4 showed reduced recurrence-free (60 vs. 86 months, p = 0.52) and overall survival (57 vs. 84 months, p = 0.40) without statistical significance. Conclusion: Raised pre-treatment NLR may indicate nodal involvement in patients with rectal cancer.

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“…This finding may be related to the presence of chronic inflammation that is associated with decreased cell growth control capacity, which leads to genomic destabilization by the production of reactive oxygen species (hydrogen peroxide (H 2 O 2 ), singlet dioxygen (1O 2 ), and hydroxyl radical (HO)) and nitrogen compounds (molecules derived from nitric oxide (NO) and superoxide (O 2 2)) due to the action of phagocytic cells. 6,34,46 The significant association between gene expression and DNA repair proteins and expression of inflammatory markers (IL-2 and TNF-a genes) reinforced the idea that chronic inflammation plays a decisive role in Table 5. Association between the expression of inflammatory marker genes-mRNA-(TNF-a, IL-2, and IL-10) with the expression of MMR genes-mRNA-(hMLH1, hMSH2, hMSH6, and PMS2) in patients with colorectal carcinoma.…”

Section: Discussionmentioning

confidence: 86%

“…4,5 A previous study showed that inflammation alters immunity and normal cell proliferation, which can result in the loss of cellular growth control capacity, favoring genomic destabilization and consequent development of neoplasms. 6 Malignant neoplasms, such as colorectal adenocarcinoma, arise in association with chronic inflammation, which induces irreversible and persistent somatic changes in DNA in normal colonic tissue. 2,4,7 This state remains until a second stimulation occurs after colon cells are exposed to chronic inflammation, which then recruits inflammatory cells, induces cell proliferation, and produces reactive oxygen species.…”

Section: Introductionmentioning

confidence: 99%

Association of expression of inflammatory response genes and DNA repair genes in colorectal carcinoma

et al. 2019

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Inflammation is an important etiological factor of colorectal carcinoma and may be related to colorectal carcinoma growth and proliferation. This study aimed to verify whether the presence of chronic inflammation represented by tumor necrosis factor-a, interleukin-2, interleukin-6, and interleukin-10 gene expression is related to hMLH1, hMSH2, hMSH6, and PMS2 gene expression and the corresponding protein levels of these genes from the DNA repair system. A total of 83 patients were operated on for curative or palliative colorectal carcinoma. Expression of the inflammatory response genes tumor necrosis factor-a, interleukin-2, interleukin-6, and interleukin-10 as well as expression of the hMLH1, hMSH2, hMSH6, and PMS2 genes of the DNA repair system (mismatch repair) and the expression levels of the corresponding mismatch repair proteins were measured in neoplastic tissue by reverse transcription polymerase chain reaction and immunohistochemistry, respectively. Associations were observed between hMSH6 mRNA expression and interleukin-2 mRNA expression (p = 0.026) as well as between hMLH1 and hMSH2 gene expression and tumor necrosis factor-a gene expression (p = 0.042). Higher tissue levels of interleukin-2 and tumor necrosis factor-a gene expression were associated with lower hMSH6, hMLH1, and hMSH2 gene expression.

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The Prognostic Significance of Pretreatment Hematologic Parameters in Patients Undergoing Resection for Colorectal Cancer

Abstract: Pretreatment lymphopenia, thrombocytosis, a decreased lymphocyte-to-monocyte ratio, and an elevated neutrophil-to-lymphocyte ratio independently predict for worse OS in patients with CRC.

Cited by 46 publications

References 32 publications

The Importance of Systemic Inflammation Markers in the Survival of Patients with Complicated Colorectal Cancer, Operated in Emergency

The Importance of Systemic Inflammation Markers in the Survival of Patients with Complicated Colorectal Cancer, Operated in Emergency

The Neutrophil-to-Lymphocyte Ratio as a Marker of Lymph Node Status in Patients with Rectal Cancer

Association of expression of inflammatory response genes and DNA repair genes in colorectal carcinoma

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