Abstract
BackgroundInflammation-related parameters have been revealed to have prognostic value in multiple caners. However, the significance of some inflammation-related parameters, including the peripheral blood neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR) and prognostic nutritional index (PNI), remains controversial in T1–2 rectal cancer (RC).MethodsClinical data of 154 T1–2 RC patients were retrospectively reviewed. The cut-off values for NLR, PLR, LMR, and PNI were determined by receiver operating characteristic curves. The relationships of these parameters with postoperative morbidities and prognosis were statistically analysed.ResultsThe optimal cut-off values for preoperative NLR, PLR, LMR and PNI were 2.8, 140.0, 3.9, and 47.1, respectively. Significant but heterogeneous associations were found between NLR, PLR, LMR and PNI and clinicopathological factors. In addition, high NLR, high PLR, and low PNI were correlated with an increased postoperative morbidity rate. Patients with high NLR/PLR or low LMR/PNI had lower OS and DFS rates. On multivariate analysis, only high NLR was identified as an independent risk factor for poor DFS.ConclusionsNLR, PLR, and PNI are valuable factors for predicting postoperative complications in T1–2 RC patients. A preoperative NLR of more than 2.8 is an independent prognostic factor for poor DFS in T1–2 RC patients.
Highlights
Inflammation-related parameters have been revealed to have prognostic value in multiple caners
Baseline patient characteristics and inflammatory-related parameters A total of 154 T1–2 rectal cancer (RC) patients were enrolled in this study, and lymph node metastasis was present in 22 patients
The optimal cut-off values for preoperative neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR) and prognostic nutritional index (PNI) that best predicted Overall survival (OS) were calculated to be 2.8 (area under the curve (AUC): 0.71; sensitivity: 53.0%; specificity: 84.0%), 140.0 (AUC: 0.64; sensitivity: 80.0%; specificity: 58.0%), 3.9 (AUC: 0.68; sensitivity: 73.0%; specificity: 65.0%), and 47.1
Summary
Inflammation-related parameters have been revealed to have prognostic value in multiple caners. The significance of some inflammation-related parameters, including the peripheral blood neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR) and prognostic nutritional index (PNI), remains controversial in T1–2 rectal cancer (RC). The cut-off values for NLR, PLR, LMR, and PNI were determined by receiver operating characteristic curves. The relationships of these parameters with postoperative morbidities and prognosis were statistically analysed. With the prevalence of health screening, more patients are diagnosed at a relatively early stage with less invasion depth. Few reports have concentrated on investigating the predictive factors associated with prognosis for early T stage (T1–2) cancers [2]. To develop more individualized treatment strategies for T1–2 RC patients, novel prognostic biomarkers that can be conveniently obtained preoperatively are needed [3, 4]
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