The Relationship Between Peripheral Blood Neutrophils/lymphocytes And Clinicopathological Features And Prognosis Of Middle-aged And Elderly Patients With Colorectal Cancer

Objective To evaluate the relationship between preoperative neutrophil-lymphocyte ratio(NLR)and clinicopathological features and prognosis in patients(45>years old)with colorectal cancer(CRC).Methods A retrospective study was performed on 212 patients with CRC in the First Affiliated Hospital of Nanjing Medical University from January 2011 to June2013.All patients were divided into middle-aged group(46~65 years old,130 cases)and elderly group(>65 years old,82 cases).The optimal cut-off point of NLR was determined by ROC curve.Two groups were divided into two subgroups:high NLR group(>3.13)and low NLR group(≤3.13).We compared the clinicopathological features and analyzed prognosis between the subgroups.Result There was no significant difference in gender,tumor growth site,depth of invasion,tumor embolus,lymphatic metastasis,distant metastasis,TNM stage between low NLR groups and high NLR groups(P>0.05).However,in elderly group,diabetes was more likely fund in high NLR group(P=0.026).Among the 212patients,the overall 1-,2-,and 3-year survival rate was severally 96.22%,87.94%and 74.05%.In the low NLR group of middle-aged group,the 1-,2-,and 3-year survival rate was respectively 98.63%,92.55%and 85.37%,nevertheless those of the high NLR group was 95.04%,86.21%and 76.81%(χ~2=4.618,P=0.032).In elderly group,the 1-,2-,and 3-year survival rate was 97.50%,88.93%and 76.83%in the low NLR group respectively,but those of the high NLR group was 94.48%,85.94%and56.98%(χ~2=6.967,P=0.068).No significant difference was found in the survival rate between the low-NLR group of the middle-aged group and elderly group,and also between the high-NLR group of the two groups(χ~2=1.709,P=0.191;χ~2=3.343,P=0.068).In the univariate analysis,NLR and TNM stage in the middle-aged group was associated with prognosis(P<0.05).Distant metastasis,TNM staging,and NLR were associated with prognosis in the elderly group(P<0.05).212 patients were divided into low NLR group(131 cases)and high NLR group(81 cases).Cox model showed that TNM stage and NLR were both independent prognostic factors for patients above45yearsoldwith CRC(RR=1.301,95%CI:1.051~1.611,P=0.016;RR=1.640,95%CI:1.169~2.299,P=0.004).Conclusion Preoperative NLR>3.13 predicted poor prognosis in middle-aged and elderly patients with CRC.