Prognostic significance of the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in patients with stage III and IV colorectal cancer

Kim, Jae Hyun; Lee, Junyeop; Kim, Hae Koo; Lee, Jin Wook; Jung, Sung Gyu; Jung, Kyoungwon; Kim, Sung Eun; Moon, Won; Park, Moo In; Park, Seun Ja

doi:10.3748/wjg.v23.i3.505

Cited by 61 publications

(60 citation statements)

References 38 publications

(42 reference statements)

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“…Similar to elevated platelet count, high PLR has been found to be associated with worse survival in a variety of solid (hepatocellular, ovarian, cervix, colorectal, bile duct, breast, lung, renal cell, gastric, prostate, and oesophageal) tumours [30][31][32][33][34][35][36][37][38][39][40]. Moreover, several studies confirmed the relationship between elevated NLR and a worse prognosis in patients with malignant oesophageal [41], colorectal [42,43], pancreas [44,45], prostate [46,47], hepatic [48,49], bile duct [50], breast [51], gastric [52,53], cutaneous melanocytic [54], thyroid medullary [55], and lung [56] tumours.…”

Section: Discussionmentioning

confidence: 98%

Neutrophil-To-Lymphocyte and Platelet-To-Lymphocyte Ratios as Prognostic Markers of Survival in Patients with Head and Neck Tumours—Results of a Retrospective Multicentric Study

Szilasi

Jósa

Zrubka

et al. 2020

IJERPH

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Background: The neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) may be useful for drawing conclusions about the survival of head and neck squamous cell carcinoma (HNSCC) patients. Methods: Clinical data of 156 patients managed for HNSCC at two head and neck surgery centres were analyzed retrospectively. We studied the relationships between survival and PLR as well as NLR. Results: With regards to 5-year survival, the difference between the two groups with PLR values lower or higher than the threshold was statistically significant (p = 0.004), and we found the same for disease-free survival (p = 0.05), and tumour-specific mortality (p = 0.009). Concerning NLR, the difference in tumour-specific survival was statistically significant (p = 0.006). According to the multivariate analysis, NLR values higher than the threshold indicated an enhanced risk for overall as well as for tumour-specific mortality. Conclusion: In HNSCC patients, a high NLR may be considered as an independent risk factor for 5-year overall survival.Malignant tumours influence the number of platelets and alter their functioning. However, the mechanisms of the relationship between thrombocytosis and the tumour have not yet been fully elucidated and several hypotheses have been proposed [2].The facilitatory role of chronic inflammation in the development and progression of solid tumours have been described for malignancies of the lung, breast, and gastrointestinal tract, the prostate, and the ovaries [3-7], as well as for HNSCC [8,9].Neutrophils might, in fact, facilitate tumour growth and the formation of metastases-these cells can inhibit the activities of the lymphocytes and thereby attenuate the antitumour immune response [10]. Neutrophil cells can contribute to carcinogenesis and tumour progression in many ways [11]: (1) These cells can release genotoxic substances, which damage the DNA of epithelial cells [12]. (2) They can promote tumour growth by releasing soluble factors and proteases, such as prostaglandin E2 and neutrophil elastase [13,14]. (3) Neutrophils facilitate metastasis formation by enhancing the capabilities of the tumour cells for migration, invasive spread, and colony formation, as well as by breaking down the extracellular matrix [15]. (4) They contribute to the formation of new blood vessels by producing pro-angiogenic factors, such as matrix metalloproteinase-9, and vascular endothelial growth factor [16]. (5) Neutrophils exert immunosuppressive action by inhibiting effector T-cells along with the proliferation and the functioning of natural killer cells, as well the fact that they enhance tumour growth and metastasis formation through the modulation of macrophage activity [17].These observations suggest that neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) determined in the blood of patients with a malignancy might be related to tumour growth [18].Our study intended to ascertain whether pre-treatment NLR and PLR values determined in HNSCC patients are suitable predi...

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Section: Discussionmentioning

confidence: 98%

Neutrophil-To-Lymphocyte and Platelet-To-Lymphocyte Ratios as Prognostic Markers of Survival in Patients with Head and Neck Tumours—Results of a Retrospective Multicentric Study

Szilasi

Jósa

Zrubka

et al. 2020

IJERPH

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“…Inflammation and tumor growth are dependent factors, and increasing numbers of studies have elucidated the role of systemic inflammatory response mediators in various solid cancers [13,14]. Among them, GC is one of the popular foci of these investigations that evaluated cancerrelated inflammation and possible predictors in the preoperative period [6][7][8].…”

Section: Discussionmentioning

confidence: 99%

“…Various studies have recommended different cutoff points for the NLR (ranging between 3 and 5) and PLR (ranging between 0.66 and 0.44) [3,7,13]. In the literature, different calculations have been proposed for the PLR, and this study used a relatively less common method (as described in the study by Inaoka et al) [3].…”

Section: Discussionmentioning

confidence: 99%

Does the preoperative platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio predict morbidity after gastrectomy for gastric cancer?

et al. 2020

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Background: Gastric cancer is the 2nd most common cause of cancer-related deaths, and the morbidity rate after surgery is reported to be as high as 46%. The estimation of possible complications, morbidity, and mortality and the ability to specify patients at high risk have become substantial for an intimate follow-up and for proper management in the intensive care unit. This study aimed to determine the prognostic value of the preoperative platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) and their relations with clinical outcomes and complications after gastrectomy for gastric cancer. Methods: This single-center, retrospective cohort study evaluated the data of 292 patients who underwent gastrectomy with curative intent between January 2015 and June 2018 in a tertiary state hospital in Ankara, Turkey. A receiver operating characteristic curve was generated to evaluate the ability of laboratory values to predict clinically relevant postoperative complications. The area under the curve was computed to compare the predictive power of the NLR and PLR. Then, the cutoff points were selected as the stratifying values for the PLR and NLR. Results: The area under the curve values of the PLR (0.60, 95% CI 0.542-0.657) and NLR (0.556, 95% CI 0.497-0.614) were larger than those of the other preoperative laboratory values. For the PLR, the diagnostic sensitivity and specificity were 50.00 and 72.22%, respectively, whereas for the NLR, the diagnostic sensitivity and specificity were 37.50 and 80.16%, respectively. The PLR was related to morbidity, whereas the relation of the NLR with mortality was more prominent. This study demonstrated that the PLR and NLR may predict mortality and morbidity via the Clavien-Dindo classification in gastric cancer patients. The variable was grade ≥ 3 in the Clavien-Dindo classification, including complications requiring surgical or endoscopic interventions, life-threatening complications, and death. Both the PLR and NLR differed significantly according to Clavien-Dindo grade ≥ 3. In this analysis, the PLR was related to morbidity, while the NLR relation with mortality was more intense. Conclusion: Based on the results of the study, the PLR and NLR could be used as independent predictive factors for mortality and morbidity in patients with gastric cancer.

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“…Systemic inflammation has been proved to play an important part in the tumorigenesis and tumor progression because of inflammatory mediators having the ability of accelerating vascular permeability, facilitating tumor cell infiltration via blood and lymphatic vessels [4][5][6]. Some biomarkers of peripheral blood examination, such as platelet to lymphocyte ratio (PLR) [7,8], neutrophil to lymphocyte ratio (NLR) [9][10][11][12], the Glasgow prognostic score (GPS) [13], prognostic nutritional index (PNI) [14], have been shown to reflect the degree of systemic inflammation. This theory has led to widely investigate peripheral blood examination in the hope of developing reliable, reproducible and low-cost prognostic factor.…”

Section: Introductionmentioning

confidence: 99%

Preoperative lymphocyte to monocyte ratio and prognostic nutritional index were correlated with clinical outcomes in patients with operable colon cancer

Zhou

et al. 2019

Preprint

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KEYWORDScolon cancer, lymphocyte to monocyte ratio, prognostic nutritional index, prognosis, systemic inflammation 2 Abstract Background: Systemic inflammation plays an important part in tumorigenesis and progression. The predictive values of the preoperative lymphocyte to monocyte ratio (LMR) and prognostic nutritional index (PNI) in colon cancer remained unclear.Methods: A total of 308 patients with colon cancer undergoing radical resection were enrolled and analyzed. The receiver operating curves were applied to identify the thresholds for these biomarkers.Kaplan-Meier method and multivariate analysis were used to identify independent prognostic factors.Results: The univariate analysis showed that elevated LMR and PNI were significantly correlated with better overall survival and progression-free survival. The multivariate analysis showed that LMR and PNI were the independent prognostic factors for overall survival.Conclusions: Preoperative LMR and PNI could serve as useful prognostic factor in patients with colon cancer undergoing radical resection.

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Prognostic significance of the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in patients with stage III and IV colorectal cancer

Cited by 61 publications

References 38 publications

Neutrophil-To-Lymphocyte and Platelet-To-Lymphocyte Ratios as Prognostic Markers of Survival in Patients with Head and Neck Tumours—Results of a Retrospective Multicentric Study

Neutrophil-To-Lymphocyte and Platelet-To-Lymphocyte Ratios as Prognostic Markers of Survival in Patients with Head and Neck Tumours—Results of a Retrospective Multicentric Study

Does the preoperative platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio predict morbidity after gastrectomy for gastric cancer?

Preoperative lymphocyte to monocyte ratio and prognostic nutritional index were correlated with clinical outcomes in patients with operable colon cancer

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