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MINERVA CHIRURGICA

A Journal on Surgery


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Minerva Chirurgica 2018 Apr 12

DOI: 10.23736/S0026-4733.18.07430-8

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Neutrophil to lymphocyte ratio (NLR) predicts risk of nodal involvement in T1 colorectal cancer patients

Damiano CAPUTO 1 , Alessandro COPPOLA 2, Vincenzo LA VACCARA 1, Silvia ANGELETTI 3, Gianluca RIZZO 2, Massimo CICCOZZI 4, Claudio COCO 2, Roberto COPPOLA 1

1 Department of Surgery, University Campus Bio-Medico di Roma, Rome, Italy; 2 Department of Surgery, Università Cattolica del Sacro Cuore, Rome, Italy; 3 Unit of Clinical Laboratory Science, University Campus Bio-Medico di Roma, Rome, Italy; 4 Medical Statistic and Molecular Epidemiology Unit, University Campus Bio-Medico di Roma, Rome, Italy


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BACKGROUND: Risk of nodal involvement in T1 colorectal cancer is assessed by tumor histological features. In several tumours, the ratio between neutrophils and lymphocytes (NLR) or platelets and lymphocytes (PLR) have been applied to lymph-node metastases prediction. The aim of this study was to evaluate the role of NLR, derived NLR (dNLR) and PLR in predicting nodal involvement in T1 colorectal cancers.
METHODS: NLR, derived NLR (dNLR) and PLR in surgical resected T1 colorectal cancers were retrospectively calculated and analysed in nodal positive and negative cases.
RESULTS: Data regarding 102 patients were considered. Nodal involvement rate was 10.8%. NLR values were higher in node positive patients (p 0.04). A trend toward significance (p 0.05) was found for higher dNLR values and positive nodal status. For NLR, ROC curve analysis allowed to choose a predictive cut-off value of 3.7 (AUC of 0.69; 95% CI 0.48-0.89). Nodal positivity was reported in 71.5% of high NLR patients; only two N0 cases (28.5%) were registered in high NLR group (p < 0.001). The logistic regression analysis aimed to evidence the predictive role of high NLR in node positivity resulted in a significant OR of 37.1 (p< 0.0001; 95% CI 0.48-0.89). NLR allowed to distinguish N0 from N1 patients in 99.4% of cases.
CONCLUSIONS: NLR < 3.7 was associated with lower risk of lymph-node metastases in T1 colorectal cancer patients. NLR could be used with histopathological data to identify patients at lower risk of nodal metastases.


KEY WORDS: Derived neutrophil to lymphocyte ratio - Early colorectal cancer - Lymph-node metastasis - Neutrophil to lymphocyte ratio - T1 colorectal cancer

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Publication History

Article first published online: April 12, 2018
Manuscript accepted: April 6, 2018
Manuscript revised: February 27, 2018
Manuscript received: June 9, 2017

Cite this article as

Caputo D, Coppola A, La Vaccara V, Angeletti S, Rizzo G, Ciccozzi M, et al. Neutrophil to lymphocyte ratio (NLR) predicts risk of nodal involvement in T1 colorectal cancer patients. Minerva Chir 2018 Apr 12. DOI: 10.23736/S0026-4733.18.07430-8

Corresponding author e-mail

d.caputo@unicampus.it