Prognostic evaluation of platelet to lymphocyte ratio in patients with colorectal cancer
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Chong Lu1,*, Peng Gao1,*, Yuchong Yang1, Xiaowan Chen1, Longyi Wang1, Dehao Yu1, Yongxi Song1, Qingzhou Xu1 and Zhenning Wang1
1Department of Surgical Oncology and General Surgery, The First Hospital of China Medical University, Shenyang 110001, PR China
*These authors have contributed equally to this work
Zhenning Wang, email: [email protected]
Keywords: colorectal cancer, meta-analysis, platelet to lymphocyte ratio, prognosis, TNM staging
Received: March 08, 2017 Accepted: August 23, 2017 Published: September 21, 2017
Growing evidence indicates that inflammation plays an important role in cancer progression and prognosis; however, the prognostic role of platelet to lymphocyte ratio (PLR) in colorectal cancer (CRC) is unknown. A cohort of 1845 CRC patients from the Department of Surgical Oncology at The First Hospital of China Medical University (CMU-SO) was retrospectively analyzed. Harrell’s concordance index (c-index) was used to determine the optimal cut-off value of PLR and evaluate its predictive ability. Our results from CMU-SO indicated that the overall survival (OS) rate was significantly lower in the high-PLR group compared with the low-PLR group (P = 0.001). A similar result was observed for the cancer-specific survival (CSS) rate between these two groups (P = 0.001). The multivariate analysis indicated that high PLR was an independent prognostic indicator of poor OS (hazard ratio [HR] = 1.356, 95% confidence interval [CI] = 1.117–1.647, P = 0.002) and CSS (HR = 1.364, 95% CI = 1.111–1.675, P = 0.003). In addition, the c-indexes of TNM staging combined with PLR were greater than those of TNM staging alone (OS: 0.768 vs. 0.732; CSS: 0.785 vs. 0.746). In conclusion, elevated PLR is a negative prognostic indicator of CRC and may serve as an additional index of the current TNM staging system for predicting CRC.
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