International Journal of Hematology and Oncology 2018, Vol 28, Num 1 Page(s): 220-228
The Use of Neutrophil/Lymphocyte Ratio (Nlr), Platelet/Lymphocyte Ratio (Plr), and Mean Platelet Volume (Mpv) As Inflammatory Biomarkers in the Prognosis of Patients with Early-Stage Colorectal Adenocarcinoma

A. Murat BUYRUK1, Seher Nazli KAZAZ2, Ilhan OZTOP2, Huseyin S. SEMIZ2, Utku OFLAZOGLU3, Isil SOMALI2

1Ege University Faculty of Medicine, Department of Gastroenterology, Izmir, TURKEY
2Dokuz Eylul University Faculty of Medicine, Department of Medical Oncology, Izmir, TURKEY
3Izmir Ataturk Training and Research Hospital, Department of Medical Oncology, Izmir, TURKEY

Keywords: Biomarker, Colorectal cancer, Inflammation, Prognosis
Colorectal cancer (CRC) represents the most prevalent cancer of the gastrointestinal system in adults. Despite long-term survival rates achieved by early resection and adjuvant therapies, relapse is a significant problem for those patients. The present study aims to investigate the possibility of using neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and mean platelet volume (MPV) as biomarkers for postoperative relapse in patients with CRC. We retrospectively analyzed 188 non-metastatic CRC patients followed up and treated at Dokuz Eylül University, Faculty of Medicine Hospital, Medical Oncology Clinic. We recorded demographic, laboratory and histopathological data from patient files and we calculated NLR, PLR and MPV, which were recorded as preoperative, postoperative and relapse values. This study classified patients into two groups: relapsed and relapse-free patients. Twenty-five patients (13.3%) developed a relapse during the follow-up period. The relapsed group had a higher NLR prior to tumor resection compared to the relapse-free patients, whereas PLR and MPV were not high. Despite the absence of any significant change in NLR or MPV after tumor resection, PLR displayed an upwards trend. At the time of relapse, CEA and MPV increased as PLR fell (compared to the postoperative period). The relapse-free group exhibited a significant decrease in CEA and MPV after tumor resection, and other parameters did not change. Comparing the results based on disease stages, stage III patients had significantly higher MPV levels than the stage II. NLR, MPV and PLR may help physicians identify prognosis after tumor resection in patients with CRC.