Zhang Ying-Ying, Li Wan-Qing, Li Zhen-Fa, Guo Xiao-Hua, Zhou Shen-Kang, Lin Aifen, Yan Wei-Hua
School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou, China.
Department of Gastrointestinal Surgery, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai, China.
Front Oncol. 2019 Sep 24;9:960. doi: 10.3389/fonc.2019.00960. eCollection 2019.
The clinical significance of peripheral blood parameters has been considered to be a potential prognostic indicator for malignancies. In this study, 224 colorectal cancer (CRC; n = 103; n = 121) patients who underwent resection were enrolled, and the pre- and post-operative clinical laboratory data within 1 week, before and after surgery, were collected. The prognostic value of the counts of white blood cell (WBC), neutrophil, lymphocyte and platelet, the neutrophil to lymphocyte ratio (NLR), and systemic immune-inflammation index (SII) were analyzed. Data revealed that pre-operative lymphocyte count (pre-LC) was much higher than that of post-LC ( < 0.001), and only rectal cancer patients with pre-LC (>median: 1.61 × 10/L) had a significantly better overall survival (OS) and 5-year survival rate (SR) than those with pre-LC (OS: 62.3 vs. 49.5 months; SR: 74.0 vs. 43.0%; = 0.006). Cox's proportional hazard models revealed that pre-LC was an independent, favorable prognostic factor for rectal cancer patients (hazard ratio = 0.348; = 0.003). Moreover, when the disease stages were stratified, the pre-LC was significantly associated with better prognosis of rectal cancer patients with stage I + II rectal cancer ( = 65; OS: 67.5 vs. 54.3 months; = 0.011). Taken together, our study revealed that pre-operative lymphocyte count is an independent prognostic factor for patients with stage I and II rectal cancer.
外周血参数的临床意义被认为是恶性肿瘤的一个潜在预后指标。在本研究中,纳入了224例接受切除术的结直肠癌(CRC;n = 103;n = 121)患者,并收集了手术前后1周内的临床实验室数据。分析了白细胞(WBC)、中性粒细胞、淋巴细胞和血小板计数、中性粒细胞与淋巴细胞比值(NLR)以及全身免疫炎症指数(SII)的预后价值。数据显示,术前淋巴细胞计数(pre-LC)远高于术后淋巴细胞计数(<0.001),只有术前淋巴细胞计数(>中位数:1.61×10⁹/L)的直肠癌患者的总生存期(OS)和5年生存率(SR)明显优于术前淋巴细胞计数较低的患者(OS:62.3个月对49.5个月;SR:74.0%对43.0%;P = 0.006)。Cox比例风险模型显示,术前淋巴细胞计数是直肠癌患者独立的有利预后因素(风险比 = 0.348;P = 0.003)。此外,当对疾病分期进行分层时,术前淋巴细胞计数与I + II期直肠癌患者的更好预后显著相关(n = 65;OS:67.5个月对54.3个月;P = 0.011)。综上所述,我们的研究表明术前淋巴细胞计数是I期和II期直肠癌患者的独立预后因素。