J Cancer 2018; 9(17):3093-3100. doi:10.7150/jca.26669

Research Paper

Systemic neutrophil lymphocyte ratio and mismatch repair status in colorectal cancer patients: correlation and prognostic value

Wen-Zhuo He1#, Wan-Ming Hu2,3,4#, Peng-Fei Kong1#, Lin Yang1, Yuan-Zhong Yang2, Qian-Kun Xie1, Chang Jiang1, Chen-Xi Yin1, Hui-Juan Qiu1, Bei Zhang1, Hui-Zhong Zhang2✉, Liang-Ping Xia1✉

1. VIP Region, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong 510060, P. R. China
2. Department of Pathology,SunYat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong 510060, P. R. China
3. Department of Pathology, School of Basic Medical Sciences, Southern Medical University, Guangzhou 510515, China
4. Department of Pathology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
#Wen-Zhuo He, Wan-Ming Hu and Peng-Fei Kong contributed equally to this paper.

This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY-NC) license (https://creativecommons.org/licenses/by-nc/4.0/). See http://ivyspring.com/terms for full terms and conditions.
Citation:
He WZ, Hu WM, Kong PF, Yang L, Yang YZ, Xie QK, Jiang C, Yin CX, Qiu HJ, Zhang B, Zhang HZ, Xia LP. Systemic neutrophil lymphocyte ratio and mismatch repair status in colorectal cancer patients: correlation and prognostic value. J Cancer 2018; 9(17):3093-3100. doi:10.7150/jca.26669. Available from http://www.jcancer.org/v09p3093.htm

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Abstract

Purpose: Mismatch repair-deficient (dMMR) colorectal cancer (CRC) is associated with increased local immune response as compared with mismatch repair-proficient (pMMR) CRC. We evaluated the relationship between MMR status and systemic inflammatory factors, including neutrophil lymphocyte ratio (NLR) and C-reactive protein (CRP). We also assessed the prognostic value of these parameters.

Methods and materials: We analysed the relationship between MMR status (obtained by histochemical analysis), neutrophil and lymphocyte counts, NLR, and CRP level. The impact of systemic inflammatory factors on survival was also evaluated in dMMR and pMMR CRC patients.

Results: A total of 1353 male and 892 female patients were eligible for analysis, of which, 253 patients (11.3%) were found to have dMMR status. Patients with dMMR status presented with increased neutrophil counts, and higher NLR and CRP levels in early stage CRC. In stage IV CRC patients, no correlation between MMR status and systemic inflammatory factors was found. Lymphocyte counts did not correlate with MMR status. High NLR was a prognostic factor for poor survival in pMMR CRC. However, NLR was not a prognostic factor in dMMR CRC.

Conclusions: Our results suggest that dMMR CRC correlates with higher neutrophil count, NLR and CRP levels only in non-metastatic patients, and NLR has prognostic value only in pMMR CRC.

Keywords: NLR, CEA, colorectal cancer, biomarker, prognosis