Research Papers:
Preoperative platelet to lymphocyte ratio is a valuable prognostic biomarker in patients with colorectal cancer
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Abstract
Jie You1,2,*, Gui-Qi Zhu3,4,*, Linka Xie5,*, Wen-Yue Liu6, Liang Shi7, Ou-Chen Wang1, Zong-Hai Huang2, Martin Braddock8, Gui-Long Guo1, Ming-Hua Zheng3,9
1Department of Oncological Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
2Department of General Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
3Department of Infection and Liver Diseases, Liver Research Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
4School of The First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou 325000, China
5Cancer Center of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
6Department of Endocrinology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
7Department of Laboratory Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
8Global Medicines Development, AstraZeneca R & D, Alderley Park, United Kingdom
9Institute of Hepatology, Wenzhou Medical University, Wenzhou 325000, China
*Co-first authors, the author contributed equally to this work
Correspondence to:
Ming-Hua Zheng, e-mail: [email protected]
Gui-Long Guo, e-mail: [email protected]
Keywords: colorectal cancer, platelet to lymphocyte ratio, overall survival, disease-free survival, prognostic biomarker
Received: December 04, 2015 Accepted: March 07, 2016 Published: March 24, 2016
ABSTRACT
Objectives: Recent studies suggest that an elevated preoperative platelet to lymphocyte ratio (PLR) may be considered a poor prognostic biomarker in patients with colorectal cancer (CRC). The aim of this study was to evaluate the prognostic impact of PLR in patients with CRC.
Methods: We enrolled 1314 patients who underwent surgery for CRC between 2005 and 2011. Preoperative PLR level was stratified into quintiles for Kaplan-Meier analysis and multivariable Cox proportional hazard regression models.
Results: Higher PLR quintiles were significantly associated with poorer overall survival (P = 0.002). Multivariate analysis showed that PLR was an independent risk factor for overall survival (OS) (P = 0.034). Patients in PLR quintile 5 had lower overall survival than in quintile 1 (hazard ratio (HR) = 1.701, 95% confidence interval (CI): 1.267–2.282, P < 0.001). Although patients in PLR quintile 5 had significantly lower disease-free survival (DFS) than in quintile 1 (HR = 1.522, 95% CI: 1.114–2.080, P = 0.008), this association was not significant after multivariable adjustment (P = 0.075). In the subgroup analysis, PLR remained an independent factor in terms of advanced tumor stage (III, IV), male sex, carcinoembryonic antigen (≤ 5 ng/ml), age (> 65 years) and body mass index (≤ 25) (P < 0.05 for all measurements). The results remained unchanged when the PLR was analyzed as a dichotomous variable by applying different cut-off values of 150, 185, 220.
Conclusions: Elevated preoperative PLR was independently associated with an increased risk of mortality in patients with CRC. The utility of PLR may help to improve prognostic predictors.
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