Colon adenocarcinomas: correlation of systemic neutrophil/lymphocyte ratios with clinicopathological parameters and prognosis

Beyond classical prognostic factors, the neutrophil-to-lymphocyte ratio (NLR) have emerged in recent years as prognostic indicators in colorectal carcinoma (CRC). Objective is to determine the relationship between preoperative NLR values and clinicopathologic parameters, survival, and mismatch repair (MMR) status. Over 532 patients diagnosed with colon adenocarcinoma between 2019 and 2023, none of whom had received neoadjuvant therapy. NLR values were calculated from preoperative complete blood counts, using ROC analysis, a population-specific optimal cut-off for NLR was determined and patients were classified into low and high NLR groups. High NLR was found to be significant associated with advanced T stage, lymph-node metastasis, distant metastasis, lymphovascular invasion and perineural invasion. No significant association was identified between NLR and age, sex, tumor location/size or histologic grade. Both overall and disease-free survival were significantly shorter in high-NLR group. Analyses also showed that proportion of patients with high NLR was higher in the mismatch-repair–proficient (pMMR) group than in the mismatch-repair-deficient (dMMR) group. The effect of NLR on survival was significant in tumors with pMMR. With its large sample size, this study is among the investigations in CRC that delineate the relationship of NLR with clinicopathologic parameters and survival. Considering NLR together with clinicopathological parameters and survival data can provide a more accurate and holistic approach for accurate diagnoses and such a multifaceted approach can also support patient treatment plan.