Monocyte-to-lymphocyte ratio as a prognostic factor in peripheral whole blood samples of colorectal cancer patients

Table 1 Characteristics of the study group (n = 160)

Parameter		n	Percentage (%)
Age (yr)	< 60	40	25.0
	≥ 60	120	75.0
Sex	Female	64	40.0
	Male	96	60.0
Location	Right-side	20	12.5
	Transverse	14	8.75
	Left-side	15	9.375
	Sigmoid	29	18.125
	Rectum	82	51.25
Tumour growth	Expanding	133	83.125
	Infiltrate	27	16.875
Tumour size	< 2.5 cm	27	16.875
	2.5-5.0 cm	106	66.25
	5.0 cm	27	16.875
TNM stage	1	42	26.25
	2	31	19.375
	3	69	43.125
	4	18	11.25
Grade of malignancy	2	148	92.5
	3	12	7.5
pT stage	1-2	65	40.625
	3-4	95	59.375
Venous invasion	Absent	113	70.625
	Present	46	28.75
Lymphatic invasion	Absent	121	75.625
	Present	38	23.75
Lymph-node metastasis	Absent	81	50.625
	Present	79	49.375
Distant metastasis	Absent	143	89.375
	Present	17	10.625
Tumour deposits	Absent	133	83.125
	Present	27	16.875
CEA levels (ng/mL)	< 3.5	124	77.5
	> 3.5	36	22.5
CA19-9 levels (U/mL)	< 27	150	93.75
	> 27	10	6.25
Monocyte count	Low group	152	95.0
	High group	8	5.0
MLR	Low group	112	70.0
	High group	48	30.0
PLT-NLR status	Score 0	46	28.75
	Score 1	82	51.25
	Score 2	32	20.0
NLR-PLR status	Score 0	16	10.0
	Score 1	21	13.125
	Score 2	123	76.875

TNM stage: Tumour-Node-Metastasis; CEA: Carcinoembryonic antigen; CA19-9: Carbohydrate antigen 19-9; MLR: Monocyte-to-lymphocyte ratio; PLT-NLR status: Platelet and neutrophil-to-lymphocyte ratio; NLR-PLR status: Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio.

Table 2 Correlations between neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio status and platelet and neutrophil-to-lymphocyte ratio status in pre and postoperative whole blood samples and clinicopathological features of patients with colorectal cancer

Parameter		n	NLR-PLR status		PLT-NLR status
		160	Pre- P value	Post- P value	Pre- P value	Post- P value
Age (yr)	< 60	40	0.326	0.120	0.427	0.155
	> 60	120
Sex	Female	64	0.729	0.370	0.258	0.435
	Male	96
Location	Right-side	20	0.963	0.167	0.475	0.183
	Transverse	14
	Left-side	15
	Sigmoid	29
	Rectum	82
Tumour growth	Expanding	133	0.671	0.776	0.349	0.728
	Infiltrate	27
Tumour size	< 2.5 cm	27	0.359	0.401	0.015a	0.554
	2.5-5.0 cm	106
	> 5.0 cm	27
Histological type	Mucinous	30	0.226	0.002a	0.895	0.002a
	Adenocarcinoma	130
Percentage of mucinous component	10%-30%	15	0.730	0.009a	0.810	0.007a
	30%-50%	15
TNM stage	1	42	0.722	0.583	0.266	0.703
	2	31
	3	69
	4	18
Grade of malignancy	2	148	0.687	0.883	0.464	0.864
	3	12
pT stage	1	3	0.590	0.196	0.853	0.253
	2	62
	3	91
	4	4
Venous invasion	Absent	113	0.437	0.993	0.618	0.917
	Present	46
Lymphatic invasion	Absent	121	0.917	0.994	0.414	0.940
	Present	38
Perineural invasion	Absent	143	0.714	0.343	0.037a	0.368
	Present	17
Lymph node metastasis	Absent	81	0.292	0.913	0.070	0.995
	Present	79
Distant metastasis	Absent	143	0.152	0.354	0.157	0.378
	Present	17
Tumour deposits	Absent	133	0.910	0.320	0.670	0.293
	Present	27
Tumour budding	Absent	94	0.771	0.575	0.302	0.692
	Present	66
Necrosis	Absent	45	0.599	0.521	0.273	0.449
	Focal	61
	Moderate	36
	Extensive	18
Fibrosis	Absent	11	0.258	0.390	0.400	0.282
	Focal	72
	Moderate	43
	Extensive	34

^aP < 0.05. TNM stage: Tumour-Node-Metastasis; PLT-NLR status: Platelet and neutrophil-to-lymphocyte ratio; NLR-PLR status: Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio; Pre: Preoperative blood samples; Post: Postoperative blood samples.

Table 3 Prognostic factors of 3-yr disease-free survival in patients with colorectal cancer

Variables	Univariate P value	Multivariate P value	HR (95%CI)
Age ( ≤ 60 vs ≥ 60 yr)	0.554	-	1.020 (0.953-1.093)
Sex (female vs male)	0.971	-	1.015 (0.426-2.421)
Tumour growth (expanding vs infiltrate)	0.902	-	0.925 (0.265-3.223)
Tumour size, < 2.5 cm vs 2.5-5 cm vs > 5 cm	0.313	-	1.472 (0.694-3.123)
TNM stage (I-IV)	0.328	-	1.011 (0.988-1.033)
Adenocarcinoma type (nonmuc vs partim mucin)	0.182	-	0.026 (0.000-5.528)
Grade of malignancy (2 vs 3)	0.196	-	0.288 (0.043-1.893)
Preoperative treatment (yes vs no)	0.097	-	2.153 (0.869-5.335)
pT stage (1-4)	0.234	-	1.723 (0.702-4.226)
Venous invasion (yes vs no)	0.379	-	0.358 (0.003-3.535)
Lymphatic invasion (yes vs no)	0.194	-	4.737 (0.451-49.770)
Perineural invasion (yes vs no)	0.100	-	0.134 (0.012-1.474)
Number of lymph nodes removed (< 5 vs 5-10 vs < 10)	0.023a	0.020a	0.415 (0.193-0.890)
Lymph node metastasis (yes vs no)	0.145	-	0.091 (0.003-2.286)
Type of lymph node metastasis (micro vs macro)	0.256	-	0.480 (0.135-1.703)
Number of metastatic lymph nodes (< 5 vs > 5)	0.060	-	1.768 (0.974-3.201)
Lymph node pouch invasion (yes vs no)	0.022a	0.385	14.191 (1.458-138.08)
Distant metastasis (yes vs no)	0.847	-	1.186 (0.209-6.729)
Distant metastasis size (< 10 mm vs > 10 mm)	0.333	-	0.829 (0.568-1.211)
Tumour deposits (yes vs no)	0.074	-	1.996 (0.933-4.270)
Inflammatory cell infiltration in the invasive front (present vs absent)	0.044a	0.015a	1.590 (1.011-2.525)
Monocyte-to-lymphocyte ratio (MLR) before surgery (low vs high)	0.015a	0.214	2.000 (0.814-5.063)
Monocyte-to-lymphocyte ratio (MLR) after surgery (low vs high)	0.265	-	1.000 (0.265-4.302)

^aP < 0.05. TNM stage: Tumour-Node-Metastasis; MLR: Monocyte-to-lymphocyte ratio.

Table 4 Prognostic factors of 5-yr disease-free survival in patients with colorectal cancer

Variables	Univariate P value	Multivariate P value	HR (95%CI)
Age, ≤ 60 vs ≥ 60 yr	0.207	-	0.665 (0.325-1.253)
Sex (female vs male)	0.466	-	0.982 (0.937-1.030)
Tumour growth (expanding vs infiltrate)	0.815	-	1.103 (0.484- 2.514)
Tumour size (< 2.5 cm vs 2.5-5 cm vs > 5 cm)	0.082	-	0.613 (0.354-1.064)
TNM stage (I-IV)	0.487	-	0.919 (0.726-1.164)
Adenocarcinoma type (nonmucin vs partim mucin)	0.701	-	1.326 (0.312-5.627)
Grade of malignancy (2 vs 3)	0.489	-	0.575 (0.119-2.762)
Preoperative treatment (yes vs no)		-
pT stage (1-4)	0.074	-	1.895 (0.937-3.832)
Venous invasion (yes vs no)	0.315	-	0.453 (0.096-2.121)
Lymphatic invasion (yes vs no)	0.633	-	1.486 (0.290-7.599)
Perineural invasion (yes vs no)	0.677	-	0.776 (0.236-2.552)
Number of lymph nodes removed (< 5 vs 5-10 vs < 10)	0.140	-	1.036 (0.988-1.087)
Lymph node metastasis (yes vs no)	0.050a	0.105	0.813 (0.653-1.013)
Type of lymph node metastasis (micro vs macro)	0.369	-	0.747 (0.369-1.411)
Number of metastatic lymph nodes (< 5 vs > 5)	0.806	-	1.188 (0.290-4.741)
Lymph node pouch invasion (yes vs no)	0.529	-	0.719 (0.257-2.006)
Distant metastasis (yes vs no)	0.933	-	0.954 (0.324-2.812)
Distant metastasis size (< 10 mm vs > 10 mm)	0.371	-	1.109 (0.883-1.394)
Tumour deposits (yes vs no)	0.536	-	1.242 (0.623-2.475)
Inflammatory cell infiltration in the invasive front (present vs absent)	0.991	-	0.997 (0.642-1.549)
Monocyte-to-lymphocyte ratio before surgery (low vs high)	0.996	-	1.001 (0.548-1.826)
Monocyte-to-lymphocyte ratio after surgery (low vs high)	0.005a	0.034a	2.903 (1.368-6.158)

^aP < 0.05. TNM stage: Tumour-Node-Metastasis; MLR: Monocyte-to-lymphocyte ratio.