Preoperative platelet to lymphocyte ratio is a valuable prognostic biomarker in patients with colorectal cancer.

// Jie You 1, 2, * , Gui-Qi Zhu 3, 4, * , Linka Xie 5, * , Wen-Yue Liu 6 , Liang Shi 7 , Ou-Chen Wang 1 , Zong-Hai Huang 2 , Martin Braddock 8 , Gui-Long Guo 1 , Ming-Hua Zheng 3, 9 1 Department of Oncological Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China 2 Department of General Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China 3 Department of Infection and Liver Diseases, Liver Research Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China 4 School of The First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou 325000, China 5 Cancer Center of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China 6 Department of Endocrinology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China 7 Department of Laboratory Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China 8 Global Medicines Development, AstraZeneca R & D, Alderley Park, United Kingdom 9 Institute of Hepatology, Wenzhou Medical University, Wenzhou 325000, China * Co-first authors, the author contributed equally to this work Correspondence to: Ming-Hua Zheng, e-mail: zhengmh@wmu.edu.cn Gui-Long Guo, e-mail: wzguoguilong@163.com Keywords: colorectal cancer, platelet to lymphocyte ratio, overall survival, disease-free survival, prognostic biomarker Received: December 04, 2015      Accepted: March 07, 2016      Published: March 24, 2016 ABSTRACT Objectives: Recent studies suggest that an elevated preoperative platelet to lymphocyte ratio (PLR) may be considered a poor prognostic biomarker in patients with colorectal cancer (CRC). The aim of this study was to evaluate the prognostic impact of PLR in patients with CRC. Methods: We enrolled 1314 patients who underwent surgery for CRC between 2005 and 2011. Preoperative PLR level was stratified into quintiles for Kaplan-Meier analysis and multivariable Cox proportional hazard regression models. Results: Higher PLR quintiles were significantly associated with poorer overall survival ( P = 0.002). Multivariate analysis showed that PLR was an independent risk factor for overall survival (OS) ( P = 0.034). Patients in PLR quintile 5 had lower overall survival than in quintile 1 (hazard ratio (HR) = 1.701, 95% confidence interval (CI): 1.267–2.282, P 65 years) and body mass index (≤ 25) ( P < 0.05 for all measurements). The results remained unchanged when the PLR was analyzed as a dichotomous variable by applying different cut-off values of 150, 185, 220. Conclusions: Elevated preoperative PLR was independently associated with an increased risk of mortality in patients with CRC. The utility of PLR may help to improve prognostic predictors.