Pre- and postoperative neutrophil and lymphocyte count and neutrophil-to-lymphocyte ratio in patients with colorectal cancer

Abstract

Colorectal cancer (CRC) is one of the most common malignant cancers worldwide. Patients with CRC are diagnosed based on various predictors, including performance status, clinicopathological factors and TNM classification. The aim of the present study was to analyze the neutrophil and lymphocyte counts, as well as the neutrophil-to-lymphocyte ratio (NLR) in pre- and postoperative blood samples of patients with CRC in correlation with specific anatomical variables and disease- free survival (DFS). The variables pre- and postoperative neutrophil count (preNEU and postNEU, respectively), lymphocyte count and NLR were significantly higher in cancer patients than those noted in healthy subjects (all P<0.001). PreNEU count correlated with tumor size, necrosis and tumor budding (R=0.204, P=0.014; R=0.189, P=0.023; R=-0.174, P=0.036, respectively). Moreover, postNEU was associated only with the histological type (R=0.174; P=0.047). The PreLYMPH count was correlated with distant metastasis (R=-0.153, P=0.046). PreNLR and postNLR were associated with the expression of various histological markers of disease progression. Analysis of DFS indicated that the postNEU count in the low group exhibited a tendency to lower DFS duration, although the results were not significant (P=0.055). In conclusion, the present study indicated a significant correlation between the factors analyzed in blood samples of CRC patients and the disease progression markers.

Keywords: colorectal cancer; neutrophil count; neutrophil-to-lymphocyte ratio; prognosis.

Copyright © 2020, Spandidos Publications.

Figures

Figure 1

ROC curve of pre- and postoperative neutrophil count, lymphocyte count and NLR. Analysis of ROC curve according to investigated parameters in blood samples before and after surgery: (A and B) neutrophil count, (C and D) lymphocyte count and (E and F) NLR. NEU, neutrophil count; LYMPH, lymphocyte count; ROC, receiver operating characteristics; AUC, area under the ROC curve; NLR, neutrophil-to-lymphocyte ratio.

Figure 2

Disease-free survival curve according to Kaplan-Meier method. The association between neutrophil count, lymphocyte count and NLR in blood samples of patients with colorectal cancer before and after surgery and disease-free survival were examined by Kaplan-Meier survival analysis and log-rank test. The survival analysis revealed that only high vs. low neutrophil count before treatment exhibited a tendency to be associated with shorter disease-free survival (P=0.055). Analysis of survival time according to investigated parameters in blood samples before and after surgery: (A and B) neutrophil count, (C and D) lymphocyte count and (E and F) NLR. NLR, neutrophil-to-lymphocyte ratio.