ABSTRACT
Objective Toexploretheprognosticvalueofpreoperativeneutrophil-to-lymphocyteratioandderived neutrophil-to-lymphocyteratioincolorectalcancer(CRC)individuals.Methods Theclinicalpathologicaldataand preoperative blood routine test results were collected from medical records,and 5 year follow up was performed in a total of 555 surgically resected CRC cases.Receiver operative curve (ROC)was used to calculate NLR and d -NLR cut-off value,and Kaplan-Meier curve and multiple COX regression were selected to evaluate the influence of preoperative NLR and d -NLR on clinical outcome of CRC cases and prognostic predictive nomogram was established to evaluate the predictivevalueofNLRandd-NLR.Results Usingoverallsurvival(OS)asanendpoint,theoptimalcut-offvaluesof NLR and d-NLR were 3.21 (Sensitivity=0.752,specificity=0.753,AUC=0.762)and 2.12 (sensitivity=0.721, specificity=0.683,AUC=0.720),respectively.Preoperative NLR and d-NLR were significantly associated with free-recurrent survival (RFS)and OS(P<0.01).NLR and d-NLR were independent factors for prediction of RFS (HRNLR=2.53,HRd-NLR=1.60)and OS (HRNLR=2.75,HRd-NLR=2.11)in II-III stage preoperative CRC patients.The C-indexes of RFS and OS predictive nomograms including NLR and d-NLR were 0.851 and 0.836,and C-indexes without NLRandd-NLRwere0.801and0.793,respectively.Conclusion ThisresultsindicatedthatRFSandOSofthe patients with preoperative high NLR and d-NLR were significantly shorter than those with relative low NLR and d-NLR, and they were independent prognostic predictive factors for RFS and OS,and nomograms including NLR and d-NLR could significantly improve the prognostic predictive efficacy in postoperative CRC individuals.