Impact of neutrophils lymphocytes ratio on the prognosis of patients
with treated metastatic colorectal cancer undergoing immunotherapy
Abstract
Objective: The aim of this study was to investigate the effect
of factors such as neutrophils lymphocytes ratio(NLR) on the prognosis
of patients with treated metastatic colorectal cancer who undergo
immunotherapy, and the associated factors that influence the efficacy of
immunotherapy. Methods: Colorectal cancer patients who attended
the Department of Oncology of the Second Affiliated Hospital of Air
Force Medical University from October 2019 to February 2023 were
initially enrolled in this study, and 127 patients were finally included
after the inclusion and exclusion criteria. Statistical methods were
used to analyze the effects of whether or not to receive immune
checkpoint inhibitors, the type of immune checkpoint inhibitors, and NLR
on the evaluation of the efficacy of tumor treatment for patients with
treated metastatic colorectal cancer. The effects of different factors
such as gender, tumor site, KRAS status, mismatch repair protein(MMR),
and NLR on the prognosis of treated metastatic colorectal cancer.
Results: Of the 127 patients, 65 received immunotherapy and 62
did not. There was no statistically significant difference between the
therapeutic efficacy of domestic and imported immune checkpoint
inhibitors for metastatic colorectal cancer patients who had previously
received more than one first-line treatment . Kaplan-Meier survival
curves plotted by SPSS found that there was a statistical difference
between NLR ( P=0.007) and MMR (P=0.029) for progression free
survival(PFS) in patients with treated metastatic colorectal cancer.Cox
univariate survival analysis found that NLR (P=0.012) and MMR (P=0.046)
were two factors affecting PFS in colorectal cancer patients. Cox
multivariate analysis concluded that NLR<3 (P=0.024) was an
independent risk factor affecting survival time of patients with treated
metastatic colorectal cancer who received immune checkpoint inhibitors,
with a statistically significant difference. Conclusion: For
patients with treated metastatic colorectal cancer, NLR and MMR are
important indicators of PFS, and NLR<3 is an independent risk
factor for survival time of patients with treated metastatic colorectal
cancer who receive immune checkpoint inhibitors, which has an important
predictive value of prognosis.