Predictive value of preoperative systemic immune-infammation index on tumor stage in patients with colorectal cancer

The aim of this study was to demonstrate the clinical significance of the preoperative neutrophil-to-lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) in association with tumor stage of colorectal cancer (CRC) patients. We undertook a retrospective review of 144 patients with colorectal cancer. Preoperative whole blood counts, serum levels of carcinoembryonic antigen (CEA), carbohydrate antigen (CA-199), and clinicopathologic data were collected. The correlations between laboratory parameters and the tumor, node, and metastasis (TNM) stages were analyzed. ROC analysis indicated that both NLR (0.79) and PLR (0.64) had the comparable predictive powers for the presence of CRC in the general patient group. Kruskal-Wallis analysis revealed that significant elevations of NLR (P=0.0018) was firstly detected in all stages and showed a stage-dependent increase following the development of T, M stage (all P<0.05), while PLR was only identified as an independent factor for the T stage development (P<0.05). Accordingly, NLR and PLR was also identified as an independent factor associated with tumor grade (all P<0.05) by the univariate and multivariate regression analysis model. Thus, our data indicated that both neutrophil-and platelet-mediated inflammatory reactions are predominantly involved in the different stages of CRC development. Determination of pretreatment levels of NLR and PLR might provide useful information for the early diagnosis or the therapeutic choices in CRC patients.