Abstract 500P
Background
In recent years, many inflammatory markers have been found to guide the prognoses of patients undergoing radical colorectal cancer surgery. However, few studies have demonstrated the relationship between local lymphatic reaction and systemic inflammatory markers, MSI and KRAS mutations.
Methods
339 colorectal cancer (CRC) patients from Hubei Cancer Hospital were included in the end, and we collected the pre-operative laboratory results and immunohistochemical results within a week before surgery. Four local lymphatic reaction indicators, including Crohn's-like lymphoid reaction, peritumoral lymphocytic reaction, intratumoral periglandular reaction, and tumor-infiltrating lymphocytes (TIL) were observed by a pathologist. Chi-square test was used to analyze the relationship between the four indicators of local lymphatic response, systemic inflammatory indicators, KRAS mutation and MSI respectively. Kaplan-Meier survival analysis, univariate COX regression and multivariate COX regression were used to assess the prognoses of colorectal cancer patients.
Results
Compared with patients with high pre-operative NLR (neutrophils to lymphocytes ratio), LMR (lymphocytes to macrophages ratio) and LNR ( positive lymph node /total lymph node), patients with low NLR, LMR and LNR were more likely to have Crohn's-like lymphoid reaction in their pathological sections (P=0.008, P=0.001, P≤0.001); Median follow-up time of 339 patients was 41.8 (2.2-73.8) (months) in our study. Patients with TIL had diseases-free survival (69.3%) (P≤0.001) and overall survival (80.2%) (P≤0.001) were better than those without TIL (10.0%, 20%). With the decrease of the degree of peritumoral lymphocytic reaction, diseases-free survival (79.8% vs 59.5% vs 59.5%) (P≤0.001) and overall survival (88.0% vs 70.2% vs 75%) (P=0.002) reduced. TIL (HR: 0.118;95% CI, 0.052-0.267) and LNR (HR: 4.020;95% CI, 1.632-9.901) could independently predict outcomes in CRC. The area under the ROC curve of LNR was 0.714, better than Cea (0.633) and Ca199 (0.566).
Conclusions
TIL and LNR can predict outcomes in CRC. Among them, LNR has better guiding significance for outcomes in CRC.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Hubei Cancer Hospital.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.