Can the Inflammatory Cell Ratio NLR and PLR be Used as a Reliable Marker in Colon Cancer? A Prospective Study.

BACKGROUND: Simple approaches for detecting the tumor stage of colon cancer patients are required during the preoperative period. In recent years, the neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) have been employed as predictive parameters for systemic inflammatory response and long-term prognosis in a variety of malignancies. The purpose of this study was to determine whether the NLR and PLR correspond with tumor characteristics in colon cancer patients.

MATERIALS AND METHODS: About 90 patients with colon cancer who reported to our institute during the time interval July 2021 to December 2022 were included in the study. The NLR and PLR were calculated using data obtained from a complete blood count evaluation. The relationship between inflammatory cell ratio and tumor-specific characteristics were analyzed.

RESULTS: Neutrophil-lymphocyte ratio and PLR correlated with pTNM staging in 88 patients. Two patients exhibited diffuse peritoneal metastasis. A significant association was found between PLR and early (Tis + T1 + T2) and advanced (T3 + T4) groups. Although the difference was not statistically significant, patients with lymphovascular invasion (LVI) and perineural invasion (PNI) had greater mean NLR and PLR.

CONCLUSION: Platelet-lymphocyte ratio was found to be more accurate than NLR in predicting colon cancer tumor depth/invasion. A high PLR value aids in prognosticating advanced T-stage colon cancer patients and can be used as a valuable tool for preoperative counseling, but it must be validated with a survival analysis.

CLINICAL PRACTICE POINTS: The tumor microenvironment contains a variety of inflammatory cells that contribute to the growth and spread of the neoplasm. The NLR and PLR have been shown to be clinically and prognostically important in a variety of gastrointestinal cancers. The results of this study demonstrate that PLR was more accurate than NLR in predicting colon cancer tumor depth/invasion. Also, a high PLR value aids in prognosticating advanced T-stage colon cancer patients and may be used as a valuable tool for preoperative counseling.

HOW TO CITE THIS ARTICLE: Ramesh SK, Swain SK, Munikrishnan V, et al . Can the Inflammatory Cell Ratio NLR and PLR be Used as a Reliable Marker in Colon Cancer? A Prospective Study. Euroasian J Hepato-Gastroenterol 2023;13(2):61-65.