Preoperative neutrophil-lymphocyte ratio and CEA is associated with poor prognosis in patients with synchronous colorectal cancer liver metastasis

Abstract

Purpose Recently, the neutrophil-to-lymphocyte ratio (NLR), an inflammatory response marker, has been reported to be associated with the prognosis in patients with various type of cancer. However, there have been no studies until now that have explored the prognostic role of combined detection of NLR and CEA in patients with synchronous liver-limited colorectal metastases (sCRLM). Methods Eighty-three patients who histologically diagnosed as sCRLM were selected. Their laboratory and clinical data were collected retrospectively. Using receiver operating characteristic curve analysis, the cutoff value of NLR was calculated based on which patients were assigned to a high NLR (more than 1.94) group and low NLR (less than 1.94) group. A cutoff value of 100 ng/mL for serum CEA level was used in light of the previous literature. Results CEA level and Poorly differentiated histology of colon cancer was significantly correlated with high NLR (P = 0.005 and P = 0.048, respectively). The multivariate analysis identified the high NLR as independent prognostic factors for OS and DFS in all patients (P = 0.010 and P = 0.006, respectively). Patients with both low levels of NLR and CEA had a significantly longer OS and DFS (P = 0.026 and P = 0.009, respectively). Conclusion In conclusion, elevated preoperative NLR is strongly correlated with both survival and recurrence in patients who have been diagnosed with resectable sCRLM. The combination of NLR and CEA level could be a more powerful prognostic marker than NLR alone.

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

“…Hyunjung Kim et al [26] found positive association between high NLR (>1.98) with tumor grade (P = 0.048), and high CEA (≥100 ng/ml, P = 0.005) in patients with CRLM, we agreed with the previous study in that positive correlation between high NLR and high CEA (P = 0.037) was evident in our study.…”

“…Another meta-analysis using a cut-off of 200 ng/mL for CEA to stratify patients into 2 groups, also demonstrated improved survival time with lower CEA level [26]. Consistent with the previous study we declared a negative correlation between OS and high level of CEA.…”

Prognostic value of carcinoembryonic antigen levels before and after curative surgery in colon cancer patients

“…Also, high postoperative CEA levels are associated with residual disease and/or distant metastasis [24,25]. In colon cancer, it is important to predict patient prognosis and detect any early recurrence, thus efforts are being made to identify prognostic factors [22,26,27]. Measurement of serum CEA is simple, fast, inexpensive, and repeatable, thus it is likely to be widely used if the prognostic significance of CEA is established in colon cancer patients [28].…”

Deep learning‐based radiomics predicts response to chemotherapy in colorectal liver metastases

“…CEA is a biomarker of advanced disease and worse long-term survival in patients with CRLM. 38,39 Prediction of short-term response to chemotherapy in CRLM was not comprehensively revealed. Sorbye et al investigated that CEA level was effective for prediction of 3-year progression-free survival in CRLM, because Note: 95% CI: 95% confidence interval; AUC: area under the curve; ACC: accuracy; SENS: sensitivity; SPEC: specificity.…”