Acta clinica Croatica, Vol. 57. No. 4., 2018.
Original scientific paper
https://doi.org/10.20471/acc.2018.57.04.03
The Role of Complete Blood Count Parameters in Patients with Colorectal Cancer
Melih Solak Mekić
; Hospital for Tumors, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
Ivo Pedišić
; Hospital for Tumors, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
Hrvoje Šobat
; Hospital for Tumors, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
Vanja Vučićević Boras
; Department of Oral Medicine, School of Dental Medicine, Zagreb, Croatia; Zagreb University Hospital Centre, Zagreb, Croatia
Iva Kirac
; Hospital for Tumors, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
Ljilja Štefančić
; Hospital for Tumors, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
Mario Šekerija
; Croatian Institute of Public Health, Zagreb, Croatia
Borna Vrdoljak
; School of Medicine, University of Zagreb, Zagreb, Croatia
Danko Velimir Vrdoljak
; Hospital for Tumors, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
Abstract
Chronic inflammation has been linked with many cancers. It seems that easily available and usual blood inflammatory markers might serve as a prognostic factor for overall survival and disease-free survival in patients with various cancers. Preoperative neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), as well as hemoglobinemia, thrombocytosis, elevated C-reactive protein values, neutropenia and leukocytosis have been shown to affect overall survival and disease-free survival in patients with colorectal cancer (CRC), however, with controversial results. Complete blood count, NLR and PLR were determined in 71 patients with CRC (stages 3 and 4) after neoadjuvant chemo-radiotherapy and before surgery, treated at Hospital for Tumors in Zagreb. Statistical analysis included Mann-Whitney U test, Student’s t-test, univariate and multivariate analysis. The results of Mann-Whitney U test and Student’s t-test showed that neutrophil count (p=0.024), NLR (p=0.003) and PLR (p=0.007) correlated significantly with overall survival. However, there was no significant correlation of age, leukocyte, lymphocyte and platelet counts and hemoglobin values with overall survival of patients. Furthermore, the same tests showed that leukocyte (p=0.04), neutrophil (p=0.0014) and platelet (p=0.006) counts, NLR (p=0.0006) and PLR (p=0.0015), as well as hemoglobin values (p=0.028) correlated significantly with disease-free survival. The results of univariate analysis showed that unlike PLR, NLR correlated with overall survival and disease-free survival (p=0.0002), although the correlation of PLR and disease-free survival almost reached significance (p=0.059). Furthermore, the results of univariate analysis showed significant correlation of advanced pathological TNM stage with overall survival. There was no correlation of patient age and gender, tumor stage and neoadjuvant chemo-radiotherapy with overall survival and disease-free survival. The results of multivariate analysis showed that NLR (cut-off value 3.27) and advanced pathological TNM stage significantly correlated with disease-free survival but not with overall survival. It seems that NLR might be an accurate marker for overall survival and disease-free survival in CRC patients after neoadjuvant chemo-radiotherapy and before surgery.
Keywords
Inflammation; Blood cell count; Colorectal neoplasms; Disease-free survival; C-reactive protein
Hrčak ID:
217804
URI
Publication date:
1.12.2018.
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