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

BMC Surgery

Research Article

Sei Hwan You¹  Ik Yong Kim²  Young Wan Kim² 

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

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

DOI  :  10.1186/1471-2482-14-94

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

来源: Springer

【 摘 要 】

BackgroundNeutrophil-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.MethodsOne 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).ResultsTwenty-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.ConclusionAn 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】

CC BY   
© Kim et al.; licensee BioMed Central Ltd. 2014