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Impact of platelet to lymphocyte ratio and metabolic syndrome on the prognosis of colorectal cancer patients

Authors You J, Zhang H, Shen Y, Chen C, Liu W, Zheng M, Van Poucke S, Guo G, Huang Z

Received 18 January 2017

Accepted for publication 13 March 2017

Published 18 April 2017 Volume 2017:10 Pages 2199—2208

DOI https://doi.org/10.2147/OTT.S132621

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Akshita Wason

Peer reviewer comments 2

Editor who approved publication: Dr Ingrid Espinoza

Jie You,1,2,* Huxiang Zhang,3,* Yanyan Shen,2,* Chuanzhi Chen,2 Wenyue Liu,4 Minghua Zheng,5 Sven Van Poucke,6 Guilong Guo,2 Zonghai Huang1

1Department of General Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, 2Department of Oncological Surgery, 3Department of Pathology, 4Department of Endocrinology, 5Department of Hepatology, Liver Research Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China; 6Department of Anesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Ziekenhuis Oost-Limburg, Genk, Belgium

*These authors contributed equally to this work

Objective: The aim of this study was to evaluate the prognostic value of both platelet to lymphocyte ratio (PLR) and metabolic syndrome (MetS) in colorectal cancer (CRC) patients.
Patients and methods: We retrospectively enrolled 1,163 CRC patients. Preoperative values of PLR were stratified into three groups according to cut-off values of 120 and 220. The Kaplan–Meier analysis was used to calculate cumulative survival rate related to PLR and MetS. Cox proportional hazard regression models were used to analyze potential risk factors and the prognosis associated with PLR and MetS in CRC patients.
Results: PLR was significantly higher in the MetS(+) group as compared to MetS(–) group (P=0.039). An elevated PLR was significantly associated with mortality (P=0.014), but not the existence of MetS (P=0.235). In multivariate regression analysis, PLR was an independent risk factor for overall survival (OS) (P=0.046). For the subgroup with a PLR >220, MetS was an independent predictor for both OS and disease-free survival (P=0.039 and P=0.047, respectively) by multivariate analysis adjusting for confounding covariates. In addition, the presence of MetS was associated with a 2-fold increased risk of mortality and tumor recurrences (hazard ratio [HR] =2.0 and HR =1.9, P<0.05, respectively).
Conclusion: Preoperative PLR was associated with MetS in CRC patients. Testing for the combined presence of PLR and MetS could potentially improve the predictive accuracy of CRC prognosis.

Keywords: colorectal cancer, platelet to lymphocyte ratio, metabolic syndrome, prognosis

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