Systemic neutrophil-to-lymphocyte ratio in colorectal cancer: the relationship to patient survival, tumour biology and local lymphocytic response to tumour

被引:106
作者
Pine, J. K. [1 ,2 ]
Morris, E. [3 ]
Hutchins, G. G. [2 ]
West, N. P. [2 ]
Jayne, D. G. [4 ]
Quirke, P. [2 ]
Prasad, K. R. [1 ]
机构
[1] St James Univ Hosp, Dept HPB Surg, Leeds LS9 7TF, W Yorkshire, England
[2] Univ Leeds, Leeds Inst Canc & Pathol, Dept Pathol & Tumour Biol, Leeds LS9 7TF, W Yorkshire, England
[3] St James Univ Hosp, Leeds Inst Canc & Pathol, Canc Epidemiol Grp, Leeds LS9 7TF, W Yorkshire, England
[4] St James Univ Hosp, Leeds Inst Biomed & Clin Sci, Dept Colorectal Surg, Leeds LS9 7TF, W Yorkshire, England
关键词
neutrophil-to-lymphocyte ratio; colorectal cancer; inflammation; immune response; C-REACTIVE PROTEIN; ELEVATED PREOPERATIVE NEUTROPHIL; MICROSATELLITE INSTABILITY; INFLAMMATORY RESPONSE; CURATIVE RESECTION; PREDICTS SURVIVAL; STAGE-II; NEUTROPHIL/LYMPHOCYTE RATIO; PROGNOSTIC INDICATOR; COLON-CANCER;
D O I
10.1038/bjc.2015.87
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: Colorectal cancer (CRC) is a major cause of mortality and morbidity. The impact of inflammatory biomarkers (C-reactive protein etc.) on CRC is increasingly studied including systemic neutrophil-to-lymphocyte ratio (NLR) as they seem to predict outcome. Methods: All patients who underwent curative resection for CRC from 2000 to 2004 at Leeds Teaching Hospitals NHS Trust had pre-operative NLR calculated. Demographic, histopathological and survival data were collected. Tissue microarrays were created and stained to determine the mismatch repair (MMR) protein status of each tumour. Local lymphocytic response to the tumour was assessed and graded. Results: About 358 patients were eligible. Of these 88 had an NLR >= 5, which predicted lower overall survival and greater disease recurrence. A high NLR is associated with higher pT-and pN-stage and a greater incidence of extramural venous invasion. MMR protein status was not associated with NLR. A pronounced lymphocytic reaction at the invasive margin (IM) indicated a better prognosis and was associated with a lower NLR. Conclusion: Neutrophil-to-lymphocyte ratio predicts disease-free and overall survival and is associated with a more aggressive tumour phenotype. The lymphocytic response to tumour at the IM is associated with NLR however dMMR is not. Neutrophil-tolymphocyte ratio is a cheap, easy-to-access test that predicts outcome in CRC.
引用
收藏
页码:204 / 211
页数:8
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