Survey of Neutrophil to Lymphocyte Ratio as Prognostic Factor in Colorectal Cancer

Neutrophil-lymphocyte ratio (NLR) is derived from the neutrophil and lymphocyte count obtained from routine complete blood count with the differential test (CBC/diff). The aim of the present study is to determine the relationship between NLR with prognostic factors in colorectal cancer.

A total of 70 patients with colorectal cancer were studied according to the research objectives. Independent T-test and Mann-Whitney U Mann- Whitney test were used to compare the NLR with qualitative variables such as pathology type. Pearson or Spearman correlation coefficient was used for correlating the quantitative variables. The significance level was considered as P<0.05.

Most of the enrolled patients were in the age group of 60-69 years (31.5%). The mean and standard deviation of NLR was 2.1 ± 0.1. Only 4.3% of the subjects had NLR greater than 5. The association between NLR with N-stage (P=0.005) and inflammatory factor (CRP) was statistically significant (P = 0.016). The correlation between NLR and these variables showed that Grade (P=0.091), PNI (P=0.093), LDH (P=0.20), diabetes (P=0.264), M-stage (P=0.282), ESR (P=0.386), LVSI (P=0.473), T-stage (P=0.527), CEA (P=0.582), and BMI (P=0.681) with NLR was not meaningful.

NLR can be associated with prognosis and risk of disease progression, especially in lymph nodes. Since NLR does not require additional testing and request and is quite easy and cost-effective, it is recommended considering this ratio during the initial assessment and the classification of the risk and stage of the disease.