The Research Of The PLR And NLR In The Prediction Of The Overall Survival Of The Patients Following The Curative Resection Of Stage Ⅱ Or Ⅲ Colorectal Cancer

Obiective:To evaluate the effect of the adjuvant chemotherapy of the patientsfollowing the curative resection of stage Ⅱor Ⅲcolorectal cancer on PLR and NLR.Methods: The pathological and clinical data of89patients with stage Ⅱor Ⅲcolorectal cancer，received curative resection of stage2or3colorectal cancer and theadjuvant chemotherapy from January2005to January2010， were analyzedretrospectively.With57men (64％)and32women(36％),a mean age of58years(30years-83yeas). Right hemicolon in24cases,left hemicolon in27cases,transverse colon in27cases, ascenging colon in11cases.All patients finish the standardadjuvant chemotherapy of FOLFOX4or XELOX.FOLFOX4: L-OHP85mg∕㎡，ivgtt2h，d1；CF200mg∕㎡，ivgtt2h,d1,d2；5-FU400mg∕㎡ivgtt22h，d1，d2;2weeks repeating theprocess,28d a cycle; XELOX: L-OHP130mg∕㎡，ivgtt2h，d1;XEloda2000mg∕㎡,po2∕d,d1-14;21d a cycle.N/L ratio was calculated from lymphocyte and neutrophil counts onroutine blood test before and after the adjuvant chemotherapy,with an NLR of3.0ormore were classified as high NLR individuals.P/L ratio was calculated from lymphocyteand platelet counts on routine blood test before and after the adjuvantchemotherapy,with an PLR of300or more were classfied as high PLR individuals andan PLR of150or less were classified as low PLR individuals.Collecting relativeparameters such as CEA、platelet counts、hemoglobin counts、lymphocyte counts、neutrophil counts、tumor staging、the numbers of lymphatic metastasis，age and genderbefore and after the adjuvant chemotherapy.Survival rate brtween groups using Logrank test, groups constitute a survival analysis using Kaplan-Meier method, log-ranktest, Cox proportional hazards model to analyze the prognostic factors than All results,P <0.05was considered statistically significant. Results:1.All patients were followed up until December2012, the median follow-up timeof OS is37months(17months-88months),and the median follow-up time of DFS is32months(6months-76months).2.The5-year survival and3-year disease free survival of patients with a high PLR(PLR≥300)was significantly worse than that with a low PLR(150＜PLR＜300)(91.2%vs100%,69.4%vs.99.1%).3.The5-year survival and3-year disease free survival of patients with a high NLR(NLR＞5)was worse than that with a low NLR(NLR≤5)(76.1%vs98.3%,31.2%vs.91.8%).4.Following the6cycles of the adjuvant chemotherapy with the patients who witha high PLR(PLR＞150) before the chemotherapy,the5-year survival and3-year diseasefree survival of patients with a high PLR(PLR＞150) after the adjuvant chemotherapywas worse than that with a low PLR(PLR≤150)(84.2%vs84.6%,48.9%vs.58.6%).5.Following the6cycles of the adjuvant chemotherapy with the patients who witha high NLR(NLR＞5) before the chemotherapy,the5-year survival and3-year diseasefree survival of patients with a high NLR(NLR＞5) after the adjuvant chemotherapywas worse than that with a low NLR(NLR≤5)(73.5%vs100%,59.8%vs.88.2%).6.There are51patients with a high PLR(PLR＞150) before the adjuvantchemotherapy. Following the6cycles of the adjuvant chemotherapy,people withFOLFOX4with a low PLR(PLR≤150) in21cases,accounting for67.7%,while XELOXin10cases.But there is no statistical significance between the chemotherapy regimens.7.There are30patients with a high NLR(NLR＞5) before the adjuvantchemotherapy. Following the6cycles of the adjuvant chemotherapy,people withFOLFOX4with a low NLR(NLR≤5) in8cases,accounting for44.1%,while XELOX in1cases.But there is no statistical significance between the chemotherapy regimens.8.There are38patients with a high PLR(PLR≤150) before the adjuvantchemotherapy. Following the6cycles of the adjuvant chemotherapy,people withFOLFOX4with a low PLR(PLR≤150) in34cases,accounting for91%,while150≤PLR<300in4cases,.accounting for9%. accounting for91%. There is no statisticalsignificance between the5-year survival and3-year disease free survival of patientswith a low PLR(PLR<150150) after the adjuvant chemotherapy and those with a highPLR(150≤PLR<300)(100%vs100%,94.8%vs.90.2%).9.There are59patients with a low NLR(NLR≤5) before the adjuvant chemotherapy. Following the6cycles of the adjuvant chemotherapy,people with alow NLR(PLR≤5) in11cases,accounting for18.2%,while NLR＞5in48cases. Thereis no statistical significance between the5-year survival and3-year disease free survivalof patients with a low NLR(NLR≤5) after the adjuvant chemotherapy and those with ahigh NLR＞5(94.2%vs93%,84%vs.63%).10.Cox proportional hazards model to analyze the prognostic factors such as T4、N2、a high PLR(PLR＞150) or a high NLR (NLR＞5) predicting poor prognosis ofpatients receiving the curative resection of stage2or3colorectal cancer.Conclusion:1.T4、N2、a high PLR(PLR＞150) or a high NLR (NLR＞5) predicting poorprognosis of patients receiving the curative resection of stage Ⅱor Ⅲ colorectalcancer.2.Those with a high PLR(PLR＞150) or a high NLR (NLR＞5) before and afterthe adjuvant chemotherapy may be more easily suffer the recurrence and metastasis ofthe tumor.3.FOLFOX4may have an advantage over lowering the risks of the recurrence andmetastasis of the patients receiving the curative resection of stage Ⅱor Ⅲ colorectalcancer than XELOX.