Abstract
PurposeThe purpose of this study is to explore the prognostic value of associating pre-treatment neutrophil–lymphocyte ratio (NLR) with circulating tumor cells counts (CTCs) in patients with gastrointestinal cancer.Materials and MethodsWe collected the related data of 72 patients with gastric cancer (GC) and colorectal cancer (CRC) who received different therapies from August 2016 to October 2020, including age, gender, primary tumor location, TNM stage, tumor-differentiation, NLR, CTCs, disease-free survival (DFS) and overall survival (OS). We chose the optimal cut-off value of NLR >3.21 or NLR ≤3.21 and CTC >1 or CTC ≤1 by obtaining receiver operating characteristic (ROC) curve. The Kaplan–Meier survival analysis and Cox regression analysis were used to analyze DFS and OS. To clarify the role of the combination of NLR and CTCs counts in predicting the prognosis, we analyzed the DFS and OS when associated NLR and CTCs counts.ResultsA high NLR (>3.21) was associated with shorter DFS (P <0.0001) and OS (P <0.0001). Patients with high CTCs level (>1) had shorter DFS (P = 0.001) and OS (P = 0.0007) than patients with low CTCs level. Furthermore, patients who had both higher NLR and higher CTCs counts had obvious shorter DFS (P <0.0001) and OS (P <0.0001).ConclusionsPatients with higher NLR and more CTCs respectively tended to have poor prognosis with shorter DFS and OS, which might be regarded as predictors of gastrointestinal cancer. In particular, associating NLR and CTCs counts might be a reliable predictor in patients with gastrointestinal cancer.
Highlights
Gastrointestinal cancer is a kind of primary tumor located in the digestive tract, which mainly includes gastric cancer (GC) and colorectal cancer (CRC)
A sensible and easy indicator is urgently required to assist predicting prognosis of GC and CRC, which is significant for improving survival
The included criteria of the group of patients were as follows: 1) patients were aged from 18 to 85 years; 2) patients had the whole clinicopathological data and follow-up data; 3) the blood examination and Circulating tumor cells (CTCs) counts detection were carried out before the postoperative antitumor treatment, such as chemotherapy or other therapies; 4) patients were diagnosed definitely by histopathology; 5) patients who were excluded were those who had chronic infection or acute infection in the process of tumor treatment confirmed by microbiology; 6) patients who were excluded were those who were under the treatment with glucocorticoids in a week
Summary
Gastrointestinal cancer is a kind of primary tumor located in the digestive tract, which mainly includes gastric cancer (GC) and colorectal cancer (CRC). GC and CRC are the most common malignancies in the world. The 5-year survival rate was approximately 30% in GC patients with radical surgery [1] and about 68.9% in CRC postoperative patients [2]. The prognosis of GC and NLR and CTCs Predict Prognosis. CRC patients was significantly correlated with tumor location, TNM stage, and the tumor size [3]. The patients after surgery are mainly monitored by imaging examinations for recurrence or metastasis, but imaging is difficult to detect micro-metastatic lesions. A sensible and easy indicator is urgently required to assist predicting prognosis of GC and CRC, which is significant for improving survival
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