Clinical Value Of Preoperative PNI /NLR And Pathological Features Of Colorectal Cancer And Prediction Of Lymph Node Metastasis

Objective:Inflammatory cell related parameters have been used to predict the prognosis of many types of cancer,including colorectal cancer.This study investigated the relationship between preoperative neutrophil/lymphocyte ratio(NLR)and prognostic nutritional index(PNI)and clinicopathological features and prediction of lymphatic metastasis in patients with CRC.Methods:This study collected data on patients with colon cancer resection admitted to the Yinjishan Hospital of Wannan Medical College from June 2017 to June 2018.According to the inclusion criteria,146 patients were selected as the study subjects,including 76 male patients.(52%),70(48%)female patients.83 patients(56.8%)were older than 60 years old,63(43.2%)were younger than or equal to 60 years old,and the average age was 61.26 years old.Per patient peripheral blood serum neutrophil count,absolute lymphocyte count,and albumin concentration(g/L)were collected from each patient to calculate the PNI and NLR values of each patient.NLR and PNI were analyzed in patients with colorectal cancer.The distribution in the middle,and the ROC curve is drawn to determine the threshold of NLR and PNI,and the patients are divided into high-level group and low-level group according to the threshold.Patient pathology data were collected and staged according to the seventh edition of the TNM staging issued by UICC/AJCC.The clinical pathological characteristics of the two groups of patients with high and low levels of NLR and PNI were compared.The related factors of lymph node metastasis were analyzed.Results:1.Preoperative NLR was associated with TNM stage(P=0.002),lymph node metastasis(P=0.003),and tumor invasion depth(P=0.016).NLR was not associated with gender,age,tumor location,tumor diameter,pathological type,and degree of differentiation(P>0.05).2.Preoperative PNI and age(P=0.034),tumor location(P=0.007),tumor diameter(P=0.002),degree of differentiation(P=0.003),TNM stage(P=0.005),lymph node metastasis rate(P =0.034),tumor invasion depth(P=032),PNI was not related to gender and pathological type(P>0.05).3.Univariate analysis found that lymph node metastasis was associated with tumor diameter(P=0.005),degree of differentiation(P<0.001),depth of tumor invasion(P<0.001),and NLR(P=0.003)PNI(P=0.034).Multivariate analysis found that NLR,tumor diameter,degree of differentiation,and depth of tumor invasion were independent risk factors for lymph node metastasis.NLR and PNI have a certain predictive effect on the evaluation of preoperative colorectal cancer lymphatic metastasis.Conclusion:1.In colorectal cancer,NLR=2.31 and PNI=44.25 are the cut-off values.Preoperative high-level NLR or low-level PNI may indicate that the higher the TNM stage,the higher the lymph node metastasis rate and the deeper the tumor infiltration depth.2.NLR and PNI have some reference value for evaluating preoperative lymph node metastasis and guiding intraoperative lymph node dissection.3.NLR,tumor diameter,degree of differentiation,and depth of tumor invasion are independent risk factors for lymph node metastasis.