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Original Research ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Oncol. | doi: 10.3389/fonc.2019.00960

Higher levels of pre-operative peripheral lymphocyte count is a favorable prognostic factor for patients with stage I and II rectal cancer

Ying-ying Zhang1, Wan-Qing Li1, Zhen-Fa Li1, Xiao-Hua Guo1, Shen-Kang Zhou2, Aifen Lin1* and  Wei-Hua Yan1, 3*
  • 1School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, China
  • 2Department of Gastrointestinal Surgery, Zhejiang Taizhou Hospital, China
  • 3Taizhou Hospital, Wenzhou Medical University, China

The clinical significance of peripheral blood parameters have been considered to be potential prognostic indicators for malignancies. In this study, 224 colorectal cancer (CRC; ncolon=103; nrectal=121) patients underwent resection were enrolled, and the pre- and post-operative clinical laboratory data within 1 week before and after surgery were collected, and prognostic value of the counts of white blood cell (WBC), neutrophil, lymphocyte and platelet, and the neutrophil to lymphocyte ratio (NLR) and systemic immune-inflammation index (SII) were analyzed. Data revealed that pre-operative lymphocyte count (pre-LC) was much higher than that of post-LC (p<0.001), and only rectal cancer patients with pre-LChigh (>median:1.61×109/L) had a significantly better overall survival (OS) and 5-year survival rate (SR) than those with pre-LClow (OS: 62.3 months vs 49.5 months; SR: 74.0% vs 43.0%; p=0.006). Cox’s proportional hazard models revealed that pre-LChigh was an independent favorable prognostic factor for rectal cancer patients (hazard ratio=0.348; p=0.003). Moreover, when the disease stages were stratified, the pre-LChigh was significantly associated with better prognosis of rectal cancer patients with stage I+II (n=65; OS: 67.5 months vs 54.3 months; p=0.011). Taken together, our study revealed that pre-operative lymphocyte count is an independent prognostic factor for patients with stage I and II rectal cancer.

Keywords: colorectal cancer, Survival, prognosis, biomarker, blood lymphocyte count

Received: 09 May 2019; Accepted: 10 Sep 2019.

Copyright: © 2019 Zhang, Li, Li, Guo, Zhou, Lin and Yan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Dr. Aifen Lin, Wenzhou Medical University, School of Laboratory Medicine and Life Sciences, Wenzhou, 325035, Zhejiang Province, China, aifenlin@yahoo.com
Mx. Wei-Hua Yan, Wenzhou Medical University, School of Laboratory Medicine and Life Sciences, Wenzhou, 325035, Zhejiang Province, China, yanwhcom@yahoo.com