Analysis of pre-diagnostic values of leukocytes count and neutrophil-to-lymphocyte ratio in patients who develop colorectal cancer

Author:

Turri Giulia1,Caligola Simone2,Ugel Stefano2,Conti Cristian1,Zenuni Silvia1,Barresi Valeria3,Ruzzenente Andrea1,Lippi Giuseppe4,Scarpa Aldo3,Guglielmi Alfredo1,Pedrazzani Corrado1

Affiliation:

1. Division of General and Hepatobiliary Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona

2. Immunology Section, University Hospital and Department of Medicine, University of Verona

3. Department of Diagnostics and Public Health, Section of Pathology, University of Verona

4. Department of Neurological, Biomedical and Movement Sciences, Section of Clinical Biochemistry, University of Verona

Abstract

Abstract Background: Emerging evidence is pointing towards a relevant role of immunity in cancer development. Alterations in leukocytes count and neutrophil-to-lymphocyte ratio (NLR) at diagnosis of colorectal cancer (CRC) seems to predict poor prognosis, but no data is available for the pre-diagnostic values. Methods: Retrospective analysis of patients who underwent surgery for CRC at our center (2005 – 2020). 334 patients with a complete blood count dating at least 24 months prior to diagnosis were included. Changes in pre-diagnosis values of leukocytes (Pre-Leu), lymphocytes (Pre-Lymph), neutrophils (Pre-Neut), and NLR (Pre-NLR) and their correlation with overall- (OS) and cancer-related survival (CRS) were analyzed. Results: Pre-Leu, Pre-Neut and Pre-NLR showed an increasing trend approaching the date of diagnosis, while Pre-Lymph tended to decrease. The parameters were tested for associations with survival after surgery through multivariable analysis. After adjusting for potential confounding factors, Pre-Leu, Pre-Neut, Pre-Lymph and Pre-NLR resulted independent prognostic factors for OS and CRS. On sub-group analysis considering the interval between blood sampling and surgery, higher Pre-Leu, Pre-Neut, and Pre-NLR and lower Pre-Lymph were associated with worse CRS, and the effect was more evident when blood samples were closer to surgery. Conclusion: To our knowledge, this is the first study showing a significant correlation between pre-diagnosis immune profile and prognosis in CRC.

Publisher

Research Square Platform LLC

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