1Department of General Surgery the First Affiliated Hospital of Hebei North University Zhangjiakou 075000 Hebei China
2Department
of General Surgery the Fourth Hospital of Hebei Medical University Shijiazhuang 050000 Hebei China
Abstract Objective To investigate the prognostic value of preoperative neutrophil - to - lymphocyte ratio NLR and
carcinoembryonic antigen CEA in patients with concurrent colorectal cancer liver metastases. Method The clinicopathological data of
patients with concurrent colorectal cancer liver metastases who underwent liver resection in our hospital from August 2012 to December
2017 were retrospectively analyzed and X-TILE software was used to calculate the best cut-off value of NLR. Kaplan-Meier method
and Log-rank test were used to draw and compare different survival curves and COX proportional hazards regression model was used to
analyze independent prognostic factors. The time dependent area under ROC curve t - AUC is used to draw and compare the
prognostic value of different indicators also in combination. Result A total of 122 patients with concurrent liver metastases from
colorectal cancer were included in this study. After calculation the best cut-off value for NLR for prognostic stratification is 2. 1. The
preoperative higher NLR was correlated with higher pathological T staging P= 0. 037 but compared with the low NLR group there
was no significant difference in other indicators all P > 0. 05 . Univariate survival analysis showed that preoperative NLR level
maximum liver metastasis diameter colorectal cancer pT stage lymph node metastasis and preoperative CEA level were correlated with
the prognosis of patients with concurrent colorectal cancer liver metastasis all P<0. 05 multivariate Survival analysis the number of
liver metastases HR= 1. 644 95%CI = 1. 063-2. 542 P= 0. 025 lymph node metastases HR= 1. 76 95%CI = 1. 045-2. 965 P =
0. 034 CEA≥3. 4 μg / L HR= 1. 611 95%CI = 1. 054-2. 460 P= 0. 028 and NLR≥2. 1 HR= 1. 625 95%CI = 1. 044-2. 539
P= 0. 033 are the prognosis of patients with liver metastases from concurrent colorectal cancer Independent risk factors. When NLR
·80· 肿瘤代谢与营养电子杂志 2023 年 2 月 9 日第 10 卷第 1 期 Electron J Metab Nutr Cancer, Feb. 9, 2023, Vol. 10, No. 1
predicts patient prognosis t-AUC is 60. 89% ~ 66. 41% CEA is 58. 15%-66. 41% and t-AUC is 64. 53%-68. 36% when the two
indicates are combined. In addition the C-index of CEA in predicting the prognosis of patients was 0. 648 95%CI = 0. 543-0. 752
and the NLR was 0. 688 95%CI = 0. 583-0. 795 . There was no significant difference between the two indicates P = 0. 29 . When
combination CEA and NLR to predict the prognosis the C-index could be increased to 0. 69 95%CI = 0. 586-0. 795 . However
there was no statistical difference when compared with CEA P = 0. 12 or NLR P = 0. 52 alone respectively. Conclusion The
elevate of preoperative NLR or CEA is closely related to the poor prognosis of patients with concurrent colorectal cancer liver
metastases. The combined use of preoperative NLR and CEA can improve the accuracy of predicting the prognosis of patients.
1Yang Cheng,1Nie Shuangfa,1 Wu Liang, et al. The prognostic value of preoperative neutrophil - lymphocyte ratio in patients with concurrent colorectal cancer and liver metastasis[J]. Electron J Metab Nutr Cancer, 2023, 10(1): 80-86.
