Significance of preoperative blood tests in the prognosis of colorectal cancer: A prospective, multicenter study from Hungary. Issue 1 (23rd November 2021)

• Record Type: Journal Article
• Authors: Biró, Adrienn; Kolozsi, Péter; Nagy, Attila; Varga, Zsolt; Káposztás, Zsolt; Tóth, Dezső
• Is Part Of: Journal of clinical laboratory analysis. Volume 36:Issue 1(2022)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2021-11-23
• Subjects: biomarker -- colorectal cancer -- laboratory -- leukocyte -- neutrophil -- prognostic -- survival; Diagnosis, Laboratory -- Periodicals; Medical laboratory technology -- Periodicals; 616
• DOI: 10.1002/jcla.24128
• Languages: English
• ISSNs: 0887-8013

Abstract

Abstract: Background: The focus of this study was to analyze the prognostic value of different combinations of inflammatory and coagulation factors using preoperative blood and to appraise the clinical importance of these biomarkers in colorectal cancer patients. Methods: A prospective, multicenter study included patients undergoing radical colorectal surgery in three county hospitals. Inflammatory and coagulation markers were analyzed preoperatively. Results: Two hundred and one patients were included. We examined patients based on their tumor localization. Colon cancer group involved patients with the tumor localized in the colon ( n = 105, 52.24%) and rectal cancer group the patients with the tumor in the rectum ( n = 96, 47.76%). Examining coagulation factors, univariate Cox analysis of colon cancer patients showed that activated partial thromboplastin time ( p = 0.020) was significantly associated with overall survival, but we could not prove it in multivariate analysis. In colon cancer patients, neutrophil‐to‐lymphocyte ratio (NLR, p < 0.001) was positively correlated with tumor size and had significant association ( χ 2 = 5.48, p = 0.019, df = 1) with perineural invasion. Univariate and multivariate Cox analysis of colon cancer patients showed that NLR ( p = 0.011 and p = 0.048) was significantly associated with disease‐free survival (DFS). Conclusion: NLR was proved to be an independent prognostic factor for DFS in patients with non‐metastatic colon cancer. NLR might help to recognize the high‐risk patients between patients with the same tumor‐node‐metastasis stage and could help with the decision on adjuvant chemotherapy. Since the biomarkers in preoperative blood tests are habitually evaluated, NLR could be an inexpensive prognostic marker that can be easily assessed in clinical practice. Abstract : Neutrophil‐to‐lymphocyte ratio (NLR) was proved to be an independent prognostic factor for disease‐free survival in patients with non‐metastatic colon cancer in our Hungarian multicenter study. NLR might help to recognize the high‐risk patients between patients with the same tumor‐node‐metastasis stage and could help with the decision on adjuvant chemotherapy. The biomarkers in preoperative blood tests are habitually evaluated, and NLR could be an inexpensive prognostic marker that can be easily assessed in clinical practice.