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Preoperative combination score of neutrophils, monocytes, and lymphocytes as a predictor for locally advanced rectal cancer

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Objective

The aim of this study was to investigate the prognostic value of baseline peripheral blood neutrophils, monocytes, and lymphocytes on locally advanced rectal cancer (LARC) patients.

Methods

Clinicopathologic data of 317 LARC patients during July 2010 and October 2016 were retrospectively gathered. X-tile software was used to acquire the optimal cutoff values of neutrophils, monocytes, and lymphocytes. Peripheral blood immune score (PBIS) system was proposed and built based on neutrophils, monocytes, and lymphocytes. The Cox model was used to analyze the associations between clinicopathological characteristics and potential outcomes. C-index was used to assess model performance. A nomogram was constructed to predict prognosis, and a calibration plot was used to verify the accuracy of the nomogram prediction model.

Results

Cutoff values of neutrophils, lymphocytes, and monocytes were 4.46 (× 109/L), 1.66 (× 109/L), and 0.39 (× 109/L), respectively. PBIS was related to sex (P < 0.001), tumor length (P = 0.003), and tumor thickness (P = 0.014). Multivariate Cox regression analysis revealed that PBIS (HR = 0.707, 95% CI: 0.549–0.912, P = 0.008) was an independent predictor of DFS. High PBIS (HR = 0.697, 95% CI: 0.492–0.988, P = 0.043) and high lymphocyte count (HR = 0.511, 95%CI: 0.273–0.958, P = 0.036) were favorable factors of OS. Both C-index (0.74, 95% CI: 0.549–0.912) and the calibration plot showed good prediction ability of the nomogram for DFS.

Conclusion

PBIS, composed of baseline peripheral blood neutrophils, monocytes, and lymphocytes, is an independent predictor of the prognosis of LARC. Combination of PBIS and ypTNM stage may be a promising marker to guide adjuvant therapy after the operation.

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Funding

Supported by The Joint Funds for the Innovation of Science and Technology, Fujian province (Grant number: 2019Y9065).

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Authors and Affiliations

  1. Department of Colorectal Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian, China

    Da-Zhang Wu, Jing-Ming Zhong, Ze-Song Liao, Sheng-Hui Huang, Yan-Wu Sun, Yu Lin, Dao-Xiong Ye, Chi Pan & Wei-Zhong Jiang

  2. Department of General Surgery, Quanzhou Hospital of Traditional Chinese Medicine, Quanzhou, Fujian, China

    Da-Zhang Wu

  3. Department of Radiation Oncology, Zhongshan Hospital, affiliated to Xiamen University, Xiamen, Fujian, China

    Wei-Ping Jiang

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  1. Da-Zhang Wu
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Correspondence to Chi Pan or Wei-Zhong Jiang.

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Da-Zhang Wu, Jing-Ming Zhong, and Wei-Ping Jiang are co-first authors.

Supplementary information

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384_2022_4143_MOESM1_ESM.tif

Supplementary file1 (TIF 5727 KB) Fig. S1 Correlation between neutrophil and tumor length (a), neutrophil and tumor thickness (b), monocyte and tumor length (c), monocyte and tumor thickness (d)

Supplementary file2 (DOC 90 KB)

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Wu, DZ., Zhong, JM., Jiang, WP. et al. Preoperative combination score of neutrophils, monocytes, and lymphocytes as a predictor for locally advanced rectal cancer. Int J Colorectal Dis 37, 1097–1106 (2022). https://doi.org/10.1007/s00384-022-04143-5

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  • DOI: https://doi.org/10.1007/s00384-022-04143-5

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