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- Title
The Neutrophil-to-Lymphocyte Ratio as a Marker of Lymph Node Status in Patients with Rectal Cancer.
- Authors
Khan, aftab a.; akritidis, Georgios; Pring, Toby; alagarathnam, Swethan; Roberts, Geoffrey; Raymond, Regina; Varcada, Massimo; Novell, Richard
- Abstract
Aim: The aim of the study was to investigate the role of the neutrophil-to-lymphocyte ratio (NLR) as a prognostic marker of rectal cancers. Methods: We undertook a retrospective review of patients with rectal cancer. Pre-treatment NLR was assessed for association and predictive values against clinicopathological staging and post-treatment outcomes. Results: A total of 140/180 cases were included in the final analysis [male:female 2: 1; mean age 68 years (interquartile range 58-75)]. The pre-operative mean NLR was 5.4 ± 6.8. There was a strong positive correlation between NLR and C-reactive protein (Spearman's rho 64.3%, p < 0.001). A high NLR was associated with a positive nodal status on MRI (5.2 vs. 3.8, p = 0.03) and histopathological (4.8 vs. 3.8, p = 0.02) assessment. The NLR showed an average value for predicting MRI and pathological nodal status on receiver operating characteristic analysis [area under the curve = 0.72 (95% CI = 0.54-0.91), p = 0.031 and area under the curve = 0.64 (95% CI = 0.52-0.077), p = 0.021, respectively]. On multivariate analysis, the total lymph node retrieved at operation was the best predictor of pathological nodal involvement; NLR did not show any predictive value. Patients with an NLR >4 showed reduced recurrence-free (60 vs. 86 months, p = 0.52) and overall survival (57 vs. 84 months, p = 0.40) without statistical significance. Conclusion: Raised pretreatment NLR may indicate nodal involvement in patients with rectal cancer.
- Subjects
BIOMARKERS; C-reactive protein; CONFIDENCE intervals; LYMPH nodes; LYMPHOCYTES; NEUTROPHILS; PROBABILITY theory; RECTUM tumors; STATISTICS; DATA analysis; RECEIVER operating characteristic curves
- Publication
Oncology, 2016, Vol 91, Issue 2, p69
- ISSN
0030-2414
- Publication type
Article
- DOI
10.1159/000443504