title: [Predicting value of dynamic alteration of blood neutrophil/lymphocyte ratio on recurrence-free  survival in patients with advanced colon cancer after operation and chemotherapy].
abstract: OBJECTIVE
  To evaluate whether neutrophil-lymphocyte ratio(NLR) predicts risk of recurrence in patients with advanced colon cancer undergoing curative resection followed by adjuvant chemotherapy.
  
  
  METHODS
  A total of 149 patients with advanced colon cancer undergoing curative resection followed by adjuvant chemotherapy(FOLFOX6 protocol) were included. NLR was calculated preoperatively and before chemotherapy. The changes in NLR and the predictive value of NLR for prognosis were analyzed.
  
  
  RESULTS
  The NLR of 149 patients was 2.8±1.5. NLR of 3.5 was identified according to the ROC curve. NLR<3.5 and NLR≥3.5 were classified as low and high NLR group, respectively. The 5-year recurrence-free survival(RFS) of patients with high preoperative NLR(n=22) was significantly worse than that of those with low preoperative NLR(n=127)(50.9% vs. 76.4%, P=0.025). The difference of 5-year RFS between high pre-chemotherapy NLR group(n=34) and low pre-chemotherapy NLR group(n=115) was statistically significant(50.1% vs. 71.4%, P=0.032). The 5-year RFS was 79.5% in patients with low preoperative NLR converting to high pre-chemotherapy NLR(n=16), similar to the group with high pre-chemotherapy group(P=0.077). The 5-year RFS was 17.7% in patients with high preoperative NLR reverting to low pre-chemotherapy NLR(n=12), similar to the group with low pre-chemotherapy group(P=0.978). There was significant difference in 5-year RFS between the postoperatively elevated group and postoperatively decreased group(P=0.036).
  
  
  CONCLUSIONS
  An elevated blood NLR may be a biomarker of poor RFS in patients with advanced colon cancer after curative resection and chemotherapy.
authors.affiliation: The Third Department of General Surgery, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Li
authors.forename: Ying-bin
authors.initials: YB
authors.lastname: Jia
authors.forename: Chao-nong
authors.initials: CN
authors.lastname: Cai
authors.forename: Xiao-dong
authors.initials: XD
authors.lastname: Guan
authors.forename: Pei-ping
authors.initials: PP
authors.lastname: Li
authors.forename: Yu-yan
authors.initials: YY
authors.lastname: Xie
authors.forename: Bai-meng
authors.initials: BM
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D003110:Colonic Neoplasms / Q000097:blood / Q000628:therapy*; D018572:Disease-Free Survival; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D002955:Leucovorin / Q000627:therapeutic use; D008214:Lymphocytes / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000276:immunology*; D009944:Organoplatinum Compounds / Q000627:therapeutic use; D011379:Prognosis
chemical_list: D009944:Organoplatinum Compounds; D002955:Leucovorin; D005472:Fluorouracil