PRETREATMENT PLATELET-TO-LYMPHOCYTE RATIO (PLR) AND PRETREATMENT NEUTROPHIL-TO-LYMPHOCYTE RATIO (NLR) AS A PROGNOSTIC FACTOR OF COLON CANCER AT H. ADAM MALIK MEDAN HOSPITAL IN 2011-2013

Danni Fauza; Adi Muradi Muhar; Edwin Saleh Siregar

Volume : VII, Issue : VIII, August - 2018

PRETREATMENT PLATELET-TO-LYMPHOCYTE RATIO (PLR) AND PRETREATMENT NEUTROPHIL-TO-LYMPHOCYTE RATIO (NLR) AS A PROGNOSTIC FACTOR OF COLON CANCER AT H. ADAM MALIK MEDAN HOSPITAL IN 2011-2013

Danni Fauza, Adi Muradi Muhar, Edwin Saleh Siregar

Abstract :

Introduction

Colorectal cancer is a malignancy of the colon and rectum epithelial cells and ranks third in malignancy. Colorectal cancer has a high mortality rate and can be prevented by knowing and avoiding risk factors. The Neutrophil–to–Lymphocyte Ratio (NLR) is associated with poor life expectancy in patients with colon cancer. Similarly, Platelet–to–Lymphocyte Ratio (PLR) is a method that can be used to predict the prognosis of patients with colon cancer. High pretreatment PLR can predict poor prognosis in patients suffering from tumors. The aim of this study was to determine pretreatment of Neutrophil–to–Lymphocyte Ratio (NLR) and Platelet–to–Lymphocyte Ratio (PLR) as a prognostic factor of colon cancer at H. Adam Malik Medan Hospital in 2011–2013.

Methods

This research is an analytical study with cross sectional design. During the period of 2011 to 2013, 33 colonic cancer patients who had been diagnosed histopathologically at Adam Malik Hospital Medan were included in this study. Patients who have metabolic, hematological and infection disorders and do not have a complete medical record were excluded from this study. In this study, survival analysis was analyzed by proportional cox testto assess the PLR and NLR as prognostic factors for colonic cancer patients.

Results

Of the 33 colon cancer patients, 23 (69.7%) of male were found, mean age 52.34 ± 11.15 years, with age group <60 years were 22 (66,7%) people. Ascending colon is the most common site of colon tumor, with the most histopathologic features in colon cancer patients is moderate differentiated as many as 16 (48.5%) patients. Based on the result of laboratory test, the average of platelet is 302,56 ± 139,12, mean of lymphocyte is 1,84 ± 0,49, mean of neutrophil is 3,8 ± 0,95, mean of NLR is 2,29 ± 1,2 with cut off point NLR is 2,2 and 19 (57,6%) patient at cut off point NLR <2,2, and mean of PLR is 185,19 ± 93,2 with cut off point PLR is 130 and 20 (60,6%) the patient was at PLR cutoff point> 130. Based on survival analysis with cox proportional regression model, there was a significant correlation between NLR value (pValue: 0.016; OR: 1.9; 95% CI: 46.5–54.0) and PLR (pValue: 0.001; OR: 1.9; 95% CI: 46.5–54.0) with 5 years of overall survival of colon cancer patients. Based on survival analysis with cox proportional regression model, there was a significant correlation between PLR value (pValue: 0.018; OR: 3.0; 95% CI: 35.1–47.2) with 5 years disease free survival of colon cancer patients. While at the value of NLR (pValue: 0.053; OR: 3.0; 95% CI: 35.1–47.2) no significant relationship was found.

Conclusion

Of the 33 study subjects who had colon cancer, the mean platelet count was 302.56 ± 139.12, lymphocyte mean was 1.84 ± 0.49, neutrophil mean was 3.8 ± 0.95, NLR mean was 2.29 ± 1.2 and PLR mean was 185.19 ± 93.2. Hypothesis test in this study using proportional cox test to assess the survival analysis showed a significant relationship between PLR values (pValue: 0.018; OR: 3.0; 95% CI: 35.1–47.2) with 5 years of disease free survival of colon cancer patients. While at the value of NLR (pValue: 0.053; OR: 3.0; 95% CI: 35.1–47.2) no significant relationship was found.