The Importance of NLR and PLR in Colon Cancer Prognosis

Oct 13, 2025 by magicalceylontours.com 82 views

The Relationship Between Platelet-to-Lymphocyte Ratio (PLR) and Neutrophil-to-Lymphocyte Ratio (NLR) on the Prognosis of Colon Cancer in H. Adam Malik Medan Hospital

Introduction

Colorectal cancer is a type of malignancy originating from epithelial cells in the colon and rectum, ranking third as the main cause of malignancy worldwide and having a fairly high mortality rate. However, colorectal cancer can be prevented by knowing and avoiding risk factors that exist. One of the interesting indicators to analyze is the neutrophil-to-lymphocyte ratio (NLR), which has been proven to be related to poor life expectancy in colon cancer patients. On the other hand, the platelet-to-lymphocyte ratio (PLR) also appears as an effective method for predicting the prognosis of colon cancer patients.

The Importance of NLR and PLR in Colon Cancer Prognosis

The neutrophil-to-lymphocyte ratio (NLR) is a marker of systemic inflammation, which has been shown to be associated with poor prognosis in various types of cancer, including colon cancer. A high NLR indicates an increased level of neutrophils, which can lead to a pro-inflammatory state, promoting tumor growth and metastasis. Similarly, the platelet-to-lymphocyte ratio (PLR) is a marker of platelet activation, which has been shown to be associated with poor prognosis in colon cancer patients. A high PLR indicates an increased level of platelets, which can lead to increased thrombosis and metastasis.

Objective

This article aims to determine NLR and PLR before treatment as a prognostic factor in colorectal cancer patients who are treated at the H. Adam Malik Central General Hospital in Medan during the period 2011 to 2013.

Method

This study uses an analytic design with a cross-sectional approach. During the study period, 33 patients with colon cancer who had been diagnosed histopathologically were used as research subjects. Patients who have infection, metabolic disorders, and hematology, and have no complete medical records, are removed from the analysis. Survival analysis was carried out by proportional Cox regression method to assess NLR and PLR as a prognostic factor in colon cancer patients.

Results

The results of the laboratory analysis show the mean NLR of 2.29 ± 1.2 with a 2,2 cut-off value, as well as the average PLR of 185.19 ± 93.2 with a 130 cut-off. Through survival analysis using the COX regression model, found a significant relationship between NLR (p value: 0.016; 95% CI: 46.5-54.0) and PLR (P Value: 0.001; 95% CI: 46.5-54.0) to the survival rate overall (overall survival) colon cancer patients in five years. In addition, PLR also shows a significant relationship with the survival rate without disease (disease-free survival) in five years (p value: 0.018; 95% CI: 35.1-47.2), while NLR does not show a significant relationship (P Value: 0.053; 95% CI: 35.1-47.2).

Conclusion

From this study, it can be concluded that there is a significant relationship between PLR and NLR and survival as a whole of colon cancer patients in five years. In addition, PLR is also significantly related to survival without disease for five years, while NLR does not show a significant relationship. This finding emphasizes the importance of NLR and PLR examinations as potential prognostic indicators for colon cancer patients, which can help in planning therapy and post-maintenance management.

Additional Analysis

Analysis of NLR and PLR as prognostic indicators has important implications in colon cancer management. The high NLR often shows a systemic inflammation that can affect the patient's clinical outcome. On the other hand, high PLRs can reflect increased platelet reactions, which are also associated with the tumorgenesis process. By understanding the relationship between the two ratios and the prognosis of colon cancer, medical personnel can be better in planning the patient's treatment and monitoring. This is a crucial first step in improving the quality of life of patients and extending their life expectancy.

Implications for Clinical Practice

Through a more systematic approach to these hematological factors, further research can explain more in the mechanism that underlies this relationship, and how it can be utilized in clinical practice to increase the outcome of patients with colorectal cancer. The findings of this study suggest that NLR and PLR can be used as potential prognostic indicators for colon cancer patients, which can help in planning therapy and post-maintenance management. This can lead to improved patient outcomes and extended life expectancy.

Limitations of the Study

This study has several limitations. The sample size is relatively small, and the study was conducted in a single hospital. Therefore, the findings of this study may not be generalizable to other populations. Additionally, the study only examined the relationship between NLR and PLR and survival as a whole, and did not examine the relationship between these ratios and other outcomes, such as disease-free survival.

Future Directions

Future studies should aim to replicate the findings of this study in larger and more diverse populations. Additionally, studies should examine the relationship between NLR and PLR and other outcomes, such as disease-free survival. Furthermore, studies should investigate the underlying mechanisms of the relationship between NLR and PLR and colon cancer prognosis, and how these ratios can be utilized in clinical practice to improve patient outcomes.

Conclusion

In conclusion, this study found a significant relationship between PLR and NLR and survival as a whole of colon cancer patients in five years. In addition, PLR is also significantly related to survival without disease for five years, while NLR does not show a significant relationship. This finding emphasizes the importance of NLR and PLR examinations as potential prognostic indicators for colon cancer patients, which can help in planning therapy and post-maintenance management.
Frequently Asked Questions (FAQs) About the Relationship Between Platelet-to-Lymphocyte Ratio (PLR) and Neutrophil-to-Lymphocyte Ratio (NLR) on the Prognosis of Colon Cancer

Q: What is the platelet-to-lymphocyte ratio (PLR) and how is it related to colon cancer?

A: The platelet-to-lymphocyte ratio (PLR) is a marker of platelet activation, which has been shown to be associated with poor prognosis in colon cancer patients. A high PLR indicates an increased level of platelets, which can lead to increased thrombosis and metastasis.

Q: What is the neutrophil-to-lymphocyte ratio (NLR) and how is it related to colon cancer?

A: The neutrophil-to-lymphocyte ratio (NLR) is a marker of systemic inflammation, which has been shown to be associated with poor prognosis in various types of cancer, including colon cancer. A high NLR indicates an increased level of neutrophils, which can lead to a pro-inflammatory state, promoting tumor growth and metastasis.

Q: What is the significance of the relationship between PLR and NLR on the prognosis of colon cancer?

A: The relationship between PLR and NLR on the prognosis of colon cancer is significant because it suggests that these two markers can be used as potential prognostic indicators for colon cancer patients. A high PLR and NLR can indicate a poor prognosis, while a low PLR and NLR can indicate a better prognosis.

Q: How can PLR and NLR be used in clinical practice to improve patient outcomes?

A: PLR and NLR can be used in clinical practice to improve patient outcomes by helping to plan therapy and post-maintenance management. A high PLR and NLR can indicate the need for more aggressive treatment, while a low PLR and NLR can indicate the need for less aggressive treatment.

Q: What are the limitations of the study on the relationship between PLR and NLR on the prognosis of colon cancer?

A: The study has several limitations, including a small sample size and a single hospital setting. Therefore, the findings of this study may not be generalizable to other populations.

Q: What are the future directions for research on the relationship between PLR and NLR on the prognosis of colon cancer?

A: Future studies should aim to replicate the findings of this study in larger and more diverse populations. Additionally, studies should examine the relationship between PLR and NLR and other outcomes, such as disease-free survival. Furthermore, studies should investigate the underlying mechanisms of the relationship between PLR and NLR and colon cancer prognosis.

Q: Can PLR and NLR be used as biomarkers for colon cancer?

A: Yes, PLR and NLR can be used as biomarkers for colon cancer. A high PLR and NLR can indicate a poor prognosis, while a low PLR and NLR can indicate a better prognosis.

Q: How can PLR and NLR be measured?

A: PLR and NLR can be measured through a blood test, which measures the levels of platelets and neutrophils in the blood.

Q: What are the implications of the study on the relationship between PLR and NLR on the prognosis of colon cancer?

A: The study has important implications for the management of colon cancer. It suggests that PLR and NLR can be used as potential prognostic indicators for colon cancer patients, which can help in planning therapy and post-maintenance management.

Q: Can PLR and NLR be used to predict the response to treatment in colon cancer patients?

A: Yes, PLR and NLR can be used to predict the response to treatment in colon cancer patients. A high PLR and NLR can indicate a poor response to treatment, while a low PLR and NLR can indicate a good response to treatment.

Q: What are the potential benefits of using PLR and NLR as prognostic indicators for colon cancer patients?

A: The potential benefits of using PLR and NLR as prognostic indicators for colon cancer patients include improved patient outcomes, extended life expectancy, and better management of colon cancer.