Preoperative low absolute lymphocyte count to fibrinogen ratio correlated with poor survival in nonmetastatic colorectal cancer

Abstract

Background Preoperative absolute lymphocyte count (LC) and fibrinogen (FIB) are useful prognostic indicators in colorectal cancer (CRC). However, the prognostic value of the LC to FIB ratio (LFR) has never been addressed. Methods A total of 189 nonmetastatic CRC patients after resection were enrolled retrospectively. The significance of the LFR in predicting disease-free survival (DFS) and overall survival (OS) was estimated by receiver operating characteristic curve analysis, and the prognostic efficacy was compared with individual LC and FIB. Patients were assigned to LFR low or high subgroups. Differences in clinicopathological features among these subgroups were calculated, and the survival differences of these subgroups were determined by the Kaplan-Meier analysis. A Cox proportional hazards model was applied to test the risk factors for survival. Results Taking 0.54 as the optimal cutoff point, the LFR had sensitivities of 79.70% and 86.40% and specificities of 52.30% and 51.00% in predicting the DFS and OS, respectively. A total of 109/189 (57.67%) patients were assigned to the LFR low group, and these patients were more likely to be characterized by criteria such as T3 + T4 (P < 0.01), stage 3 (P < 0.01), tumor deposits (P = 0.01), high CEA (P < 0.01), or CA19-9 levels (P = 0.04). And they also displayed worse DFS (log rank = 18.57, P < 0.01) and OS (log rank = 20.40, P < 0.01) than the high LFR group. Finally, the LFR was independently associated with inferior DFS (HR = 0.32, 95% CI: 0.16–0.61, P < 0.01) and OS (HR = 0.23, 95% CI: 0.09–0.55, P < 0.01). Conclusions The LFR is a useful prognostic indicator in nonmetastatic CRC, and patients with a relatively low LFR had poor survival.

Preoperative Cancer Inflammation Prognostic Index as a Superior Predictor of Short- and Long-Term Outcomes in Patients with Stage I–III Colorectal Cancer after Curative Surgery

“…Two different types of scores have been proposed to track the systemic inflammatory response: those based on protein measurement and those based on inflammatory cell counting. Patients with CRC can have their condition predicted by counting these differentiated cells individually or collectively [ 46 , 47 , 48 , 49 , 50 ]. Studies evaluating the relationship between NLR and various cancers have shown that it was a strong prognostic factor [ 51 , 52 ].…”

Postoperative serum interleukin-6 levels correlate with survival in stage I-III colorectal cancer

“…Routine laboratory tests and the method to measure blood cell fractions were performed as described previously [ 19 , 20 ]. The CRP (reference: 0-0.5 mg/dl) was measured by using turbidimetric inhibition immunoassay with the CRPL3 kit (Roche Diagnostics GmbH, Mannheim, Germany) according to the manufacturer’s manual with the automatic analysis system (Cobas e 501, Roche, Switzerland).…”

Combined preoperative prognostic nutritional index and D-dimer score predicts outcome in colorectal cancer

“…Cases meeting any one of the following criteria were excluded: 1. any preoperative anticancer therapies; 2. suspected distant lesions identified by imaging examinations; 3. complications that require long-term administration of anticoagulant drugs, such as aspirin and Plavix; 4. lack of preoperative laboratory tests, such as DD; 5. absence of postoperative pathological TNM message; and 6. follow-up problems. Parameters including age, sex, tumor location and others were also recorded as previously described [ 35 , 36 ]. The study was approved by the ethics committee of Hainan Hospital of Chinese PLA General Hospital (ID: 301HLFYLS15), and informed consent was obtained from the patients or their authorized relatives.…”

“…Routine blood tests were conducted in the departmental clinical laboratory as previously described [ 35 ]. The reference was 35–50 g/L for serum albumin, 1.75–7.00 × 10 9 /L for peripheral absolute lymphocyte counts, and 0–500 ng/mL for DD levels.…”

“…The reference was 35–50 g/L for serum albumin, 1.75–7.00 × 10 9 /L for peripheral absolute lymphocyte counts, and 0–500 ng/mL for DD levels. All tests were performed within one week before curative surgery as previously described [ 35 , 36 ]. The PNI was calculated as previously described [ 37 ], and patients were divided into PNI-low or -high and DD-low or -high subgroups based on the optimal cutoff points described in the statistical results below.…”