The prognostic value of the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in colorectal cancer and colorectal anastomotic leakage patients: a retrospective study
Abstract Objective The purpose of this study was to investigate the influence and predictive value of preoperative peripheral blood neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) index on the prognosis of colorectal anastomotic leakage (CAL) patients. Methods This study...
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BMC
2025-02-01
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| Series: | BMC Surgery |
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| Online Access: | https://doi.org/10.1186/s12893-024-02708-5 |
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| author | Nuo Xu Jian-Xin Zhang Jia-Jie Zhang Zhuo Huang Lian-Chun Mao Zhi-Yong Zhang Wei-Dong Jin |
| author_facet | Nuo Xu Jian-Xin Zhang Jia-Jie Zhang Zhuo Huang Lian-Chun Mao Zhi-Yong Zhang Wei-Dong Jin |
| author_sort | Nuo Xu |
| collection | DOAJ |
| description | Abstract Objective The purpose of this study was to investigate the influence and predictive value of preoperative peripheral blood neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) index on the prognosis of colorectal anastomotic leakage (CAL) patients. Methods This study retrospectively analyzed the clinical data of 1016 patients who underwent radical resection for colorectal cancer at a single center between January 1, 2007 and December 31, 2023. In this study, NLR and PLR were analyzed before surgery. Kaplan–Meier survival analysis was performed according to the postoperative survival status of the patients. Nomogram and calibration curve were established by proportional hazards model (COX) to verify its predictive value. Results A total of 890 patients with colorectal cancer, 102 patients with CAL, and 788 patients with non- anastomotic leakage (AL) colorectal cancer were enrolled for a median follow-up of 96 months (quartile range 33–133). In this study, COX regression analysis showed that preoperative NLR and PLR could predict the prognosis of CAL patients, and the optimal cut-off points of NLR and PLR were 2.89 and 157.62, respectively. Kaplan–Meier survival curve results showed that 5-year overall survival (OS) and disease-free survival (DFS) in the low NLR and PLR group were significantly higher than those in the high NLR and PLR group. OS and DFS were divided into high, low NLR and PLR groups. Finally, based on COX model, a nomogram analysis was conducted to analyze the risk factors affecting OS and DFS, and the accuracy and practicality of the model were verified by calibration curve and decision curve. Conclusion Preoperative NLR and PLR can predict the long-term prognosis of colorectal cancer (CRC) and CAL patients, and patients with NLR ≥ 2.89 and PLR ≥ 157.62 have poor survival prognosis. Nomogram and calibration curve analysis will further improve the accuracy of OS and DFS prediction. |
| format | Article |
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| institution | Kabale University |
| issn | 1471-2482 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
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| series | BMC Surgery |
| spelling | doaj-art-fa2e32c8cdd5439ea5eb50d38bbe46fe2025-02-09T12:09:05ZengBMCBMC Surgery1471-24822025-02-0125112510.1186/s12893-024-02708-5The prognostic value of the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in colorectal cancer and colorectal anastomotic leakage patients: a retrospective studyNuo Xu0Jian-Xin Zhang1Jia-Jie Zhang2Zhuo Huang3Lian-Chun Mao4Zhi-Yong Zhang5Wei-Dong Jin6Wuhan University of Science and Technology, School of MedicineChinese People’s Liberation Army Central Theater General Hospital General Surgery DepartmentDepartment of Statistics and Applied Probability, University of CaliforniaChinese People’s Liberation Army Central Theater General Hospital General Surgery DepartmentChinese People’s Liberation Army Central Theater General Hospital General Surgery DepartmentChinese People’s Liberation Army Central Theater General Hospital General Surgery DepartmentChinese People’s Liberation Army Central Theater General Hospital General Surgery DepartmentAbstract Objective The purpose of this study was to investigate the influence and predictive value of preoperative peripheral blood neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) index on the prognosis of colorectal anastomotic leakage (CAL) patients. Methods This study retrospectively analyzed the clinical data of 1016 patients who underwent radical resection for colorectal cancer at a single center between January 1, 2007 and December 31, 2023. In this study, NLR and PLR were analyzed before surgery. Kaplan–Meier survival analysis was performed according to the postoperative survival status of the patients. Nomogram and calibration curve were established by proportional hazards model (COX) to verify its predictive value. Results A total of 890 patients with colorectal cancer, 102 patients with CAL, and 788 patients with non- anastomotic leakage (AL) colorectal cancer were enrolled for a median follow-up of 96 months (quartile range 33–133). In this study, COX regression analysis showed that preoperative NLR and PLR could predict the prognosis of CAL patients, and the optimal cut-off points of NLR and PLR were 2.89 and 157.62, respectively. Kaplan–Meier survival curve results showed that 5-year overall survival (OS) and disease-free survival (DFS) in the low NLR and PLR group were significantly higher than those in the high NLR and PLR group. OS and DFS were divided into high, low NLR and PLR groups. Finally, based on COX model, a nomogram analysis was conducted to analyze the risk factors affecting OS and DFS, and the accuracy and practicality of the model were verified by calibration curve and decision curve. Conclusion Preoperative NLR and PLR can predict the long-term prognosis of colorectal cancer (CRC) and CAL patients, and patients with NLR ≥ 2.89 and PLR ≥ 157.62 have poor survival prognosis. Nomogram and calibration curve analysis will further improve the accuracy of OS and DFS prediction.https://doi.org/10.1186/s12893-024-02708-5Colorectal cancerAnastomotic leakageNeutrophil-to-lymphocyte ratioPlatelet-to-lymphocyte ratioPrognostic value |
| spellingShingle | Nuo Xu Jian-Xin Zhang Jia-Jie Zhang Zhuo Huang Lian-Chun Mao Zhi-Yong Zhang Wei-Dong Jin The prognostic value of the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in colorectal cancer and colorectal anastomotic leakage patients: a retrospective study BMC Surgery Colorectal cancer Anastomotic leakage Neutrophil-to-lymphocyte ratio Platelet-to-lymphocyte ratio Prognostic value |
| title | The prognostic value of the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in colorectal cancer and colorectal anastomotic leakage patients: a retrospective study |
| title_full | The prognostic value of the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in colorectal cancer and colorectal anastomotic leakage patients: a retrospective study |
| title_fullStr | The prognostic value of the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in colorectal cancer and colorectal anastomotic leakage patients: a retrospective study |
| title_full_unstemmed | The prognostic value of the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in colorectal cancer and colorectal anastomotic leakage patients: a retrospective study |
| title_short | The prognostic value of the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in colorectal cancer and colorectal anastomotic leakage patients: a retrospective study |
| title_sort | prognostic value of the neutrophil to lymphocyte ratio nlr and platelet to lymphocyte ratio plr in colorectal cancer and colorectal anastomotic leakage patients a retrospective study |
| topic | Colorectal cancer Anastomotic leakage Neutrophil-to-lymphocyte ratio Platelet-to-lymphocyte ratio Prognostic value |
| url | https://doi.org/10.1186/s12893-024-02708-5 |
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