Clinical Value of Platelet-to-Lymphocyte Ratio in Predicting Liver Metastasis and Lymph Node Positivity of Colorectal Cancer Patients

Abstract

Amaç: Kolon kanserine bağlı mortalite azalsa da hala yüksektir. Kolonoskopinin artan kullanımı, cerrahi teknolojide ilerlemeler, kemoradyoterapi protokollerinin standardizasyonu metastatik olgularda sağkalımı arttırmıştır. Enflamasyon, birçok kanserin gelişiminde önemli rol oynar. Plateletlenfosit oranı (PLO) gibi birçok belirteç kanserde kötü prognoz ile ilişkilendirilmiştir. Çalışmamızda preoperatif bakılan PLO'nun kolon kanserli hastalarda karaciğer metastazını ve lenf nodu pozitifliğini öngörebilirliğini saptamayı amaçladık. Yöntem: Mart 2010 ve Eylül 2016 tarihleri arasında kolorektal kanser tanısı konularak operasyona alınan hastaların dosyaları retrospektif olarak incelendi. Hastaların demografik verileri, preoperatif PLO, intraoperatif bulgular ve postoperatif tümör-nod-metastaz evrelemesine göre histopatoloji raporları kaydedildi. Hastalar karaciğer metastazı saptananlar grup 1a ve saptanmayanlar grup 1b olarak 2 gruba ayrıldı. Aynı şekilde lenf nodu pozitifliği saptananlar grup 2a ve saptanmayanlar grup 2b olarak alt gruba ayrıldı. Sonuçlar SPSS programı ile analiz edildi. Bulgular: Yüz elli iki hastada erkek/kadın oranı 1,53 idi. En sık rektosigmoid bölgede kanser tespit edildi. Sekiz hastada ailesel kolorektal kanser, 66 hastada komorbid hastalık tespit edildi. Postoperatif 30 günlük dönemde sekiz hastada erken mortalite gözlendi. Otuz bir hastada karaciğer metastazı mevcuttu. PLO'nun gruplar arası karşılaştırmasında, metastaz saptanan grupta PLO değeri, anlamlı şekilde yüksekti (p<0,001). Yaş, cinsiyet ÖZ ABSTRACTAim: Colorectal cancer related mortality is still high. The widespread use of colonoscopy, surgical advancements, and standardized use of chemotherapeutic agents has increased survival rates in metastatic cases. Inflammation is the main etiological factor in a variety of cancers. Plateletto-lymphocyte ratio (PLR), one the most studied biochemical parameters, has been shown as a poor prognostic factor. In this study, our aim was to determine the predictive value of PLR on liver metastasis and lymph node positivity in colorectal patients. Method: The data of patients who were diagnosed with colorectal cancer and underwent surgery between March 2010 and September 2016 were analyzed retrospectively. Demographic characteristics, preoperative PLR, intraoperative findings, and tumor-node-metastasis stages were recorded. Patients with liver metastasis comprised group 1a and those without liver metastasis were group 1b; patients were also sorted into groups 2a and 2b based on lymph node positivity or negativity, respectively. Results: A total of 152 patients were included in the study and the male/female ratio was 1.53. Most of patients had rectosigmoid junction tumors. Eight patients had familial history of colorectal cancer and 66 patients had comorbid conditions. Eight patients had early 30-day mortality. Thirty-one patients had liver metastasis. Patients with liver metastasis (group 1a) had significantly higher PLR values when compared to group 1b (p<0.001). When age, gender and comorbid disease...

Receiver Operating Characteristic Prediction for Classification: Performances in Cross-Validation by Example

“…A small number of articles reported the threshold for the investigated inflammatory ratios on patients with colorectal cancer regarding metastasis as the outcome. Anuk and Yıldırım reported a cut-off value for PLR equal to 194.7 for liver metastasis (Se = 74.5.%, Sp = 72.7%) and of 163.95 (Se = 56.8%, Sp = 56.3%) for lymph node tumour cells invasion [62] on a sample of 152 patients. The thresholds for PLR reported in this study are higher than those reported by Anuk and Yıldırım [62], nonetheless the specificity is higher at the expense of sensitivity (Tables 2 and 6).…”

“…Anuk and Yıldırım reported a cut-off value for PLR equal to 194.7 for liver metastasis (Se = 74.5.%, Sp = 72.7%) and of 163.95 (Se = 56.8%, Sp = 56.3%) for lymph node tumour cells invasion [62] on a sample of 152 patients. The thresholds for PLR reported in this study are higher than those reported by Anuk and Yıldırım [62], nonetheless the specificity is higher at the expense of sensitivity (Tables 2 and 6). In our study we did not devided into the type of metastasis, but the differences in thresholds and Se(s) are important and could be possible explained by the characteristics of the target population.…”