Predictive Value Of The Tumor-Infiltrating Neutrophil-To-Lymphocyte Ratio In Patients With Colorectal Cancer

Tumor-infiltrating T lymphocytes have been reported to be involved in clinical outcome in colorectal cancer. However, whether tumor-infiltrating neutrophil-to-lymphocyte ratio (NLR) could potentially serve as a prognostic marker in colorectal cancer (CRC) is unclear. In present study, tumor-infiltrating CD66b and CD3 in paired intratumoral and peritumoral tissues were evaluated by immunohistochemistry (IHC) among a cohort of 210 CRC patients. The density of intratumoral CD66b(+) neutrophils and CD3(+) lymphocytes were significantly lower than those of peritumoral areas. Univariate analyses indicated that tumor-infiltrating CD66b(+) neutrophils, CD3(+) lymphocytes and NLR ratio in both intratumoral and peritumoral were significantly associated with decreased disease-free survival (DFS) and overall survival (OS), as well as other clinical parameters such as differentiation status, depth of invasion, lymphatic metastasis and TNM stage. Moreover, differentiation status, TNM stage and peritumoral NLR were significant correlated with DFS and OS according to multivariate analysis High NLR in both intratumoral and peritumoral were significantly correlated with lymphatic metastasis and TNM stage. Sub-group analysis of the pTNM stage II patients, higher tumor-infiltrating NLR was associated with shorter survival time. Peritumoral NLR was an independent prognostic factor with a higher hazard ratio. These results defined tumor-infiltrating neutrophil-tolymphocyte ratio as a novel prognostic marker for CRC.