Hua-Jun Lu,1 Guo-Chao Ren,1 Yan Wang,2 Chao-Qun Wang,3 Da-Hai Zhang1 

1Department of Oncological Radiotherapy, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang, People’s Republic of China; 2Department of Medical Oncology, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang, People’s Republic of China; 3Department of Pathology, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang, People’s Republic of China

Correspondence: Da-Hai Zhang; Chao-Qun Wang, Email dyzdh@126.com; chaoqunw869@163.com

Background: The neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) have been confirmed to be related to the clinicopathological features and prognosis of colorectal cancer (CRC) patients. However, the results have been inconsistent, and few studies have focused on a specific point in time during surgery and dynamic changes prior to and after surgery.
Methods: We conducted a retrospective analysis of 349 CRC patients and explored the value of NLR, PLR and their dynamic changes in predicting clinicopathological variables and prognosis in CRC.
Results: Preoperative NLR (Pre-NLR) was correlated with CEA, CA199 levels, tumor and tumor stage (P=0.041, P=0.002, P=0.001 and P=0.012, respectively), whereas postoperative NLR (post-NLR) was relevant to age, sex, CA125 levels and T stage significantly (P=0.032, P=0.002, P=0.026, P=0.019, respectively). When comparing post- and pre-NLR values, there was a positive connection between increases in NLR and BMI, tumor , T stage, and tumor stage (P=0.034, P=0.005, P=0.023, P=0.023, respectively). In addition, Preoperative PLR (pre-PLR) was correlated with sex, smoke and drink history, CEA and CA199 levels, tumor , T stage and tumor stage (P=0.006, P=0.037, P=0.040, P=0.006, P=0.005, P< 0.001, P=0.007, P=0.003 respectively), while postoperativePLR (post-PLR) was only associated with tumor (P=0.010). Increases in PLR were significantly related to sex, smoking history, tumor and differentiation (P=0.001, P=0.002, P< 0.001, P=0.034, respectively). Patients with CRC who had a high post-PLR experienced significantly shorter relapse-free survival (RFS) compared to other patients (HR 0.607 (0.381– 0.968), P=0.036). Furthermore, this high post-PLR has tendency association with shorter overall survival (OS) (HR 0.596 (0.338– 1.050), P=0.076).
Conclusion: These findings suggest that levels and changes in NLR/PLR are associated with several unfavorable clinicopathological features in CRC patients. Furthermore, patients with high levels of post-PLR exhibit a worse prognosis.

Keywords: colorectal cancer, neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, prognosis, peripheral blood