The tumor infiltration lymphocyte as local inflammation and neutrophil to lymphocyte ratio as systemic inflammation have been known as prognostic factors in colorectal cancer. But little is known about the correlation and impression of the local and systemic inflammation together on the prognosis of colorectal cancer. This study aimed to evaluate the effects of this combination on prognosis.
In a retrospective study, 206 patients from 2006-2015 with colorectal cancer after curative surgery have been investigated. the patients diagnosed with stage IV or simultaneously had secondary cancers were excluded. The pathological samples after surgery were studied for tumor infiltration lymphocytes (TIL) and other pathological features. Also neutrophil to lymphocyte ratio (NLR>2.38) was calculated from up to 3 days before surgery from peripheral blood. For analysis the combination of these markers, patients were divided to four groups for local inflammation or systemic inflammation predominantly (high TIL/High NLR, high TIL/Low NLR, Low TIL/High NLR and Low TIL/Low NLR) and then the overall survival (OS) and Disease free survival (DFS) for each group were calculated. Then compared with each other.
For these identified patients the number of death events was 73and 133 were alive the median OS was 68 months(Range1 to 122) months .There was significant relationship between local and systemic inflammation (TIL and NLR) (p-value=0.0003), so that, when the local inflammation was predominantly and the systemic inflammation was dramatically low simultaneously, (high TIL/Low NLR) was associated with the best outcomes and improved the overall survival (mean OS = 72.56 month and HR:0.45) also low TIL was significant associated with poor prognosis on OS and DFS (p-value
The analysis of combination of local and systemic inflammation may predict the prognosis of colorectal cancer in patients who underwent the curative surgery. So in future this unexpansive and available methods seem can be used for determining the prognosis for these patients and used as markers.
Clinical trial identification
Legal entity responsible for the study
Seyyed Mohammad Reza Mortazavizadeh
All authors have declared no conflicts of interest.