Prognostic Significance of Preoperative Lymphocyte-to-C-Reactive Protein Ratio in Patients with Non-Metastatic Colorectal Cancer

Ou, Wen‐Ting; Zhou, Caijin; Zhu, Xiang Yang; Lin, Lin; Xu, Qi

doi:10.2147/ott.s290234

Cited by 13 publications

(11 citation statements)

References 28 publications

(31 reference statements)

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“…Human coronavirus disease 2019 (COVID- 19) is caused by a novel respiratory virus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which first emerged in Wuhan, China, in December 2019, before resulting a global pandemic [1]. COVID-19 is now identified as a multi-systemic infection involving the hematological and immunological systems, responsible for a generalized inflammatory response due to the unregulated release of pro-inflammatory cytokines.…”

Section: Introductionmentioning

confidence: 99%

“…The latter two are certainly more specific to inflammation, but can be complex to use in a daily practice [15]. Moreover, CLR was previously identified as a risk factor for severity in cancer and infectious diseases, such as acute or perforated appendicitis [19,20]. Although several authors have found an association between CRP, lymphopenia, severity, and mortality in COVID-19, few have evaluated the CLR in this context [21][22][23].…”

Section: Introductionmentioning

confidence: 99%

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Prognostic Value of C-Reactive Protein to Lymphocyte Ratio (CLR) in Emergency Department Patients with SARS-CoV-2 Infection

Tonduangu

Borgne

Lefèbvre³

et al. 2021

JPM

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(1) Introduction: According to recent studies, the ratio of C-reactive-protein to lymphocyte is more sensitive and specific than other biomarkers associated to systemic inflammatory processes. This study aimed to determine the prognostic value of CLR on COVID-19 severity and mortality at emergency department (ED) admission. (2) Methods: Between 1 March and 30 April 2020, we carried out a multicenter and retrospective study in six major hospitals of northeast France. The cohort was composed of patients hospitalized for a confirmed diagnosis of moderate to severe COVID-19. (3) Results: A total of 1,035 patients were included in this study. Factors associated with infection severity were the CLR (OR: 1.001, CI 95%: (1.000–1.002), p = 0.012), and the lymphocyte level (OR: 1.951, CI 95%: (1.024–3.717), p = 0.042). In multivariate analysis, the only biochemical factor significantly associated with mortality was lymphocyte rate (OR: 2.308, CI 95%: (1.286–4.141), p = 0.005). The best threshold of CLR to predict the severity of infection was 78.3 (sensitivity 79%; specificity 47%), and to predict mortality, was 159.5 (sensitivity 48%; specificity 70%). (4) Conclusion: The CLR at admission to the ED could be a helpful prognostic biomarker in the early screening and prediction of the severity and mortality associated with SARS-CoV-2 infection.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prognostic Value of C-Reactive Protein to Lymphocyte Ratio (CLR) in Emergency Department Patients with SARS-CoV-2 Infection

Tonduangu

Borgne

Lefèbvre³

et al. 2021

JPM

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“…Okugawa ( 20 ) et al. showed that two peripheral blood parameters, lymphocyte count and C-reactive protein level, had the highest correlation with recurrence compared to other parameters, and low preoperative LCR was significantly associated with undifferentiated histology, advanced T-stage, lymph node metastasis, distant metastasis, and advanced grade; reduced preoperative LCR was an independent prognostic factor for disease-free and overall survival, and was an independent risk factor for postoperative complications and surgical site infections in colorectal cancer patients; Wenting Ou ( 25 ) et al. showed that LCR had the highest prognostic predictive value of all inflammatory scores and that low LCR was significantly associated with multiple clinicopathological features of tumor infiltration and progression.…”

Section: Discussionmentioning

confidence: 98%

“…Since tumor patients have both inflammatory infections and immune disorders after surgery, and CRP and lymphocyte levels precisely also reflect well the inflammatory infections and immune status of patients after surgery, a series of studies on colorectal cancer patients in recent years have defined the ratio of lymphocytes to CRP as a new index and reported the correlation between LCR and prognosis of colorectal cancer (20)(21)(22)(23)(24)(25)(26)(27)(28)(29). However, the findings of the studies are not uniform and the cut-off values for this index are not consistent; therefore, this study used Meta-analysis to objectively and systematically investigate the prognostic significance of treatment LCR levels in colorectal cancer patients and the relationship between LCR and the clinicopathological characteristics of colorectal cancer patients.…”

Section: Introductionmentioning

confidence: 99%

Prognostic Role of Lymphocyte-C-Reactive Protein Ratio in Colorectal Cancer: A Systematic Review and Meta Analysis

et al. 2022

Front. Oncol.

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IntroductionThe lymphocyte-C-reactive protein ratio (LCR) is a new immunoinflammatory score and prognostic marker, but the relationship between this index and the prognosis of colorectal cancer patients remains controversial.Therefore, aim of the study was to assess the relationship between LCR and prognosis for colorectal cancer patients through a systematic evaluation and meta-analysis.MethodsWe systematically searched PubMed, EMBASE, Web of Science, and Cochrane Library databases for randomized controlled studies and observational studies on the relationship between LCR and prognosis of colorectal cancer patients, all searched from the date of database creation to January 6, 2022.Our primary endpoints observed were overall survival (OS) and disease-free survival (DFS) of colorectal cancer patients, and secondary observables were basic characteristics of included studies, such as country, study duration, sample size, LCR threshold, and pathological characteristics of patients in each study, such as degree of differentiation, gender, tumor location, T stage, and lymphatic metastasis.ResultsA total of 10 case-control studies including 7068 patients were included. Meta-analysis results showed that overall survival (OS) and disease-free survival (DFS) were worse in colorectal cancer patients with lower levels of LCR (HR=0.44, 95% CI=0.38-0.52, P<0.001; HR=0.56, 95% CI=0.41-0.76, P< 0.001).Subgroup analysis based on country, study length, sample size, and LCR threshold showed that lower levels of LCR were all associated with poorer OS (P < 0.05). Regarding pathological characteristics, patients in the low LCR group were generally poorly differentiated (OR=1.79, 95% CI=1.55-2.07, P<0.001), while there was no significant relationship with gender, tumor location, T stage, and lymphatic metastasis (P>0.05).Discussion/ConclusionLCR can be used as a prognostic marker for colorectal cancer patients, and patients with lower levels of LCR may have a poor prognosis. Due to the limitation of the number and quality of the included studies, the above findings need to be validated by more high-quality studies.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42022296563.

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“…Recent studies have focused on establishing the prognostic value of the preoperative LCR in patients with CRC 34 . Suzuki et al .…”

Section: Discussionmentioning

confidence: 99%

Prognostic significance of the preoperative lymphocyte to C‐reactive protein ratio in patients with stage III colorectal cancer

Eren

2022

ANZ Journal of Surgery

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Background: Stage III colorectal cancer (CRC), which accounts for approximately one third of all CRC cases, is associated with worsened prognosis. The aim of this study was to compare the preoperatively measured systemic inflammatory markers and to define the most significant marker in terms of its prognostic value in stage III CRC. Methods: Surgically treated stage III CRC patients were included. Demographics, preoperatively measured Glasgow prognostic score (GPS), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), lymphocyte/C-reactive protein ratio (LCR) and C-reactive protein/albumin ratio (CAR) values, clinicopathological features, surgical, oncological and survival outcomes were recorded and statistically analysed. Results: The study group of 102 patients consisted of 65 (63.7%) men and 37 (36.3%) women with a median age of 64 (range: 26-89). The mean follow-up period was 42.8 AE 30.5 (range: 6-107) months. Overall survival (OS) and disease-free survival (DFS) rates were 71.6%, and 67.7%, respectively. Elevated CRP, GPS 2, LCR ≤ 0.530, CAR ≥ 0.080, higher numbers of metastatic lymph nodes and N2b nodal status were detected to impair DFS (P = 0.001, P = 0.015, P = 0.001, P = 0.001, P = 0.001 and P = 0.043, respectively). Variables including GPS 2, PLR≥190.83, CAR≥0.045, LCR≤0.684, surgical site infection and longer hospital stay decreased OS (P = 0.004, P = 0.002, P = 0.005, P = 0.001, P = 0.001 and P = 0.001, respectively). According to multivariate analysis; PLR ≥ 190.83 was associated with three times [HR: 2.892 (95% CI: 1.100-7.602), P = 0.031], and LCR ≤ 0.684 was associated with four times [HR: 3.919 (95% CI: 1.130-13.592), P = 0.031] greater risk of cancer-related mortality. Conclusion: As an independent prognostic factor, LCR had the highest impact on predicting survival after curative resection for stage III CRC.

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Prognostic Significance of Preoperative Lymphocyte-to-C-Reactive Protein Ratio in Patients with Non-Metastatic Colorectal Cancer

Cited by 13 publications

References 28 publications

Prognostic Value of C-Reactive Protein to Lymphocyte Ratio (CLR) in Emergency Department Patients with SARS-CoV-2 Infection

Prognostic Value of C-Reactive Protein to Lymphocyte Ratio (CLR) in Emergency Department Patients with SARS-CoV-2 Infection

Prognostic Role of Lymphocyte-C-Reactive Protein Ratio in Colorectal Cancer: A Systematic Review and Meta Analysis

Prognostic significance of the preoperative lymphocyte to C‐reactive protein ratio in patients with stage III colorectal cancer

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