Elevated Neutrophil-to-Lymphocyte Ratio in Perioperative Periods is Suggestive of Poor Prognosis in Patients with Colorectal Cancer

Jung Hyun Kim,1 Jae-Hoon Lee,2 Hye Sun Lee,3 Su-Jin Shin,4 Eun Jung Park,1 Eun-Suk Cho,5 Seung Hyuk Baik,1 Kang Young Lee,6 Jeonghyun Kang1 1Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; 2Department of Nuclear Medicine, Gangnam Se...

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Autores principales:	Kim JH, Lee JH, Lee HS, Shin SJ, Park EJ, Cho ES, Baik SH, Lee KY, Kang J
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	nlr colorectal cancer survival iauc Pathology RB1-214 Therapeutics. Pharmacology RM1-950
Acceso en línea:	https://doaj.org/article/9ba9d1387167496183b2ebebe0e12c02
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spelling	oai:doaj.org-article:9ba9d1387167496183b2ebebe0e12c022021-12-02T14:56:12ZElevated Neutrophil-to-Lymphocyte Ratio in Perioperative Periods is Suggestive of Poor Prognosis in Patients with Colorectal Cancer1178-7031https://doaj.org/article/9ba9d1387167496183b2ebebe0e12c022021-09-01T00:00:00Zhttps://www.dovepress.com/elevated-neutrophil-to-lymphocyte-ratio-in-perioperative-periods-is-su-peer-reviewed-fulltext-article-JIRhttps://doaj.org/toc/1178-7031Jung Hyun Kim,1 Jae-Hoon Lee,2 Hye Sun Lee,3 Su-Jin Shin,4 Eun Jung Park,1 Eun-Suk Cho,5 Seung Hyuk Baik,1 Kang Young Lee,6 Jeonghyun Kang1 1Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; 2Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; 3Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Republic of Korea; 4Department of Pathology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; 5Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; 6Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of KoreaCorrespondence: Jeonghyun KangDepartment of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, Republic of KoreaTel +82-2-2019-3372Fax +82-2-3462-5994Email ravic@naver.comBackground: Recent data suggest that alterations in the neutrophil-to-lymphocyte ratio (NLR) in the perioperative periods can serve as prognostic factors. However, research on the clinical impact has been limited and even discordant in patients with colorectal cancer (CRC).Patients and Methods: The optimal cut-off value of preoperative NLR (NLR-pre), postoperative NLR (NLR-post), and its change (NLR-delta) were determined to maximize differences in overall survival (OS) between groups. Patients were categorized into four groups (NLR-trend) as follows: G1, low NLR-pre and NLR-post; G2, low NLR-pre and high NLR-post; G3, high NLR-pre and low NLR-post; and G4, high NLR-pre and NLR-post. Discriminatory performance was compared using integrated AUC (iAUC) between all indicators.Results: A total of 576 patients diagnosed with stage I–IV CRC were included. The cut-off points were determined as 2.33 for NLR-pre, 2.06 for NLR-post, and − 1.08 for NLR-delta. Subgroup dichotomization using NLR-pre, NLR-post, NLR-delta and NLR-trend were all identified as significant prognostic factors by univariate analysis. However, NLR-trend was only remained as an independent prognostic factor in the multivariate analysis. The iAUC of the NLR-trend was superior to that of NLR-pre (bootstrap iAUC mean difference=0.036; 95% CI 0.013– 0.073), NLR-post (bootstrap iAUC mean difference=0.045; 95% CI 0.019– 0.081) and NLR-delta (bootstrap iAUC mean difference=0.061; 95% CI 0.025– 0.104).Conclusion: Risk stratification and combining of preoperative and postoperative NLR (NLR-trend) can improve prognostic discrimination compared with single measurements or simple changes in NLR in patients with CRC.Keywords: NLR, colorectal cancer, survival, iAUCKim JHLee JHLee HSShin SJPark EJCho ESBaik SHLee KYKang JDove Medical Pressarticlenlrcolorectal cancersurvivaliaucPathologyRB1-214Therapeutics. PharmacologyRM1-950ENJournal of Inflammation Research, Vol Volume 14, Pp 4457-4466 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	nlr colorectal cancer survival iauc Pathology RB1-214 Therapeutics. Pharmacology RM1-950
spellingShingle	nlr colorectal cancer survival iauc Pathology RB1-214 Therapeutics. Pharmacology RM1-950 Kim JH Lee JH Lee HS Shin SJ Park EJ Cho ES Baik SH Lee KY Kang J Elevated Neutrophil-to-Lymphocyte Ratio in Perioperative Periods is Suggestive of Poor Prognosis in Patients with Colorectal Cancer
description	Jung Hyun Kim,1 Jae-Hoon Lee,2 Hye Sun Lee,3 Su-Jin Shin,4 Eun Jung Park,1 Eun-Suk Cho,5 Seung Hyuk Baik,1 Kang Young Lee,6 Jeonghyun Kang1 1Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; 2Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; 3Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Republic of Korea; 4Department of Pathology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; 5Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; 6Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of KoreaCorrespondence: Jeonghyun KangDepartment of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, Republic of KoreaTel +82-2-2019-3372Fax +82-2-3462-5994Email ravic@naver.comBackground: Recent data suggest that alterations in the neutrophil-to-lymphocyte ratio (NLR) in the perioperative periods can serve as prognostic factors. However, research on the clinical impact has been limited and even discordant in patients with colorectal cancer (CRC).Patients and Methods: The optimal cut-off value of preoperative NLR (NLR-pre), postoperative NLR (NLR-post), and its change (NLR-delta) were determined to maximize differences in overall survival (OS) between groups. Patients were categorized into four groups (NLR-trend) as follows: G1, low NLR-pre and NLR-post; G2, low NLR-pre and high NLR-post; G3, high NLR-pre and low NLR-post; and G4, high NLR-pre and NLR-post. Discriminatory performance was compared using integrated AUC (iAUC) between all indicators.Results: A total of 576 patients diagnosed with stage I–IV CRC were included. The cut-off points were determined as 2.33 for NLR-pre, 2.06 for NLR-post, and − 1.08 for NLR-delta. Subgroup dichotomization using NLR-pre, NLR-post, NLR-delta and NLR-trend were all identified as significant prognostic factors by univariate analysis. However, NLR-trend was only remained as an independent prognostic factor in the multivariate analysis. The iAUC of the NLR-trend was superior to that of NLR-pre (bootstrap iAUC mean difference=0.036; 95% CI 0.013– 0.073), NLR-post (bootstrap iAUC mean difference=0.045; 95% CI 0.019– 0.081) and NLR-delta (bootstrap iAUC mean difference=0.061; 95% CI 0.025– 0.104).Conclusion: Risk stratification and combining of preoperative and postoperative NLR (NLR-trend) can improve prognostic discrimination compared with single measurements or simple changes in NLR in patients with CRC.Keywords: NLR, colorectal cancer, survival, iAUC
format	article
author	Kim JH Lee JH Lee HS Shin SJ Park EJ Cho ES Baik SH Lee KY Kang J
author_facet	Kim JH Lee JH Lee HS Shin SJ Park EJ Cho ES Baik SH Lee KY Kang J
author_sort	Kim JH
title	Elevated Neutrophil-to-Lymphocyte Ratio in Perioperative Periods is Suggestive of Poor Prognosis in Patients with Colorectal Cancer
title_short	Elevated Neutrophil-to-Lymphocyte Ratio in Perioperative Periods is Suggestive of Poor Prognosis in Patients with Colorectal Cancer
title_full	Elevated Neutrophil-to-Lymphocyte Ratio in Perioperative Periods is Suggestive of Poor Prognosis in Patients with Colorectal Cancer
title_fullStr	Elevated Neutrophil-to-Lymphocyte Ratio in Perioperative Periods is Suggestive of Poor Prognosis in Patients with Colorectal Cancer
title_full_unstemmed	Elevated Neutrophil-to-Lymphocyte Ratio in Perioperative Periods is Suggestive of Poor Prognosis in Patients with Colorectal Cancer
title_sort	elevated neutrophil-to-lymphocyte ratio in perioperative periods is suggestive of poor prognosis in patients with colorectal cancer
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/9ba9d1387167496183b2ebebe0e12c02
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Elevated Neutrophil-to-Lymphocyte Ratio in Perioperative Periods is Suggestive of Poor Prognosis in Patients with Colorectal Cancer

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