Neutrophil-lymphocyte ratio predicts pathologic tumor response and survival after preoperative chemoradiation for rectal cancer

BMC Surgery

Young Wan Kim¹  Sei Hwan You²  Ik Yong Kim¹ 

[1] Department of Surgery, Yonsei University Wonju College of Medicine, 162 Ilsan-dong, Wonju-si, Gangwon-do (220-701), Korea;Department of Radiation Oncology, Yonsei University Wonju College of Medicine, 162 Ilsan-dong, Wonju-si, Gangwon-do (220-701), Korea

关键词: Rectal neoplasm;    Preoperative chemoradiation;    Neutrophil-lymphocyte ratio;   

Others  :  1091193
DOI  :  10.1186/1471-2482-14-94

 received in 2014-02-16, accepted in 2014-08-01,  发布年份 2014

【 摘 要 】

Background

Neutrophil-lymphocyte ratio (NLR) reflects the balance between pro- and anti-tumor immune activities. We evaluated whether NLR is associated with pathologic tumor response and prognosis in rectal cancer patients that underwent preoperative chemoradiaton therapy (CRT) with surgery.

Methods

One hundred two patients with rectal cancer that were treated by preoperative CRT followed by surgery were enrolled. A total of 50.4 GY of radiation and 5-FU-based chemotherapy were delivered. An NLR ≥ 3 was considered to be elevated. Pathologic tumor response based on ypTNM stage was categorized into two groups, good response (n = 35, pathologic complete response and ypTNM I) and poor response groups (n = 67, ypTNM II, III, and IV).

Results

Twenty-five patients (24.5%) had elevated NLR. Multivariate analysis showed that an elevated CEA level (p = 0.001), larger tumor (p = 0.03), and elevated NLR (p = 0.04) were significant predictors for a poor response. Poor pathological tumor response and elevated NLR were risk factors for cancer-specific and recurrence-free survivals.

Conclusion

An elevated NLR before CRT can be used as predictors for poor tumor response and unfavorable prognostic factors. Dominant pro-tumor activities of neutrophils or reduced anti-tumor immune response by lymphocytes, as determined by NLR, may have a impact on poor tumor response and unfavorable prognosis.

【 授权许可】

   
2014 Kim et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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