Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Mar 12;8(6):967-975.
doi: 10.7150/jca.18000. eCollection 2017.

The monocyte to red blood cell count ratio is a strong predictor of postoperative survival in colorectal cancer patients: The Fujian prospective investigation of cancer (FIESTA) study

Feng Peng  1 , Dan Hu  2 , Xiandong Lin  2 , Gang Chen  2 , Binying Liang  3 , Chao Li  2 , Yan Chen  4 , Zhaolei Cui  4 , Hejun Zhang  2 , Jixiu Lin  1 , Xiongwei Zheng  2 , Wenquan Niu  5
Affiliations

The monocyte to red blood cell count ratio is a strong predictor of postoperative survival in colorectal cancer patients: The Fujian prospective investigation of cancer (FIESTA) study

Feng Peng et al. J Cancer. .

Abstract

Background and Aims: We sought to evaluate the prognosis of preoperative blood routine parameters for the mortality of colorectal cancer patients after surgery by eliciting a subset of data from the ongoing Fujian prospective investigation of cancer (FIESTA) study. Methods: 1318 colorectal cancer patients with completed survival data were enrolled between 2000 and 2008. Effect-size estimates are expressed as hazard ratio (HR) and 95% confidence interval (CI). Results: The median follow-up time was 58.6 months. Elevated levels of neutrophil (adjusted HR, 95% CI, P: 1.22, 1.06-1.41, 0.006) and monocyte (1.32, 1.06-1.65, 0.013) were significantly associated with an increased risk of colorectal cancer mortality, whereas that of lymphocyte (0.60, 0.44-0.82, 0.001) and red blood cell count (0.20, 0.09-0.43, <0.001) were significantly associated with a reduced risk. Additionally, remarkable significance was reached for the neutrophil-to-lymphocyte ratio (1.12, 1.06-1.19, <0.001) and lymphocyte-to-monocyte ratio (0.60, 0.46-0.79, <0.001). Based on individual effect-estimates, a new derivate, monocyte to red blood cell count ratio namely MRR was created, and its association with colorectal cancer mortality was strikingly significant (1.48, 1.18-1.85, 0.001). Notably, elevated MRR was significantly associated with the mortality of early stage colorectal cancer, especially in patients with stage I-II (1.63, 1.04-2.56, 0.034), invasion depth T1-T2 (2.85, 1.45-5.61, 0.002), regional lymph node metastasis N0 (1.89, 1.29-2.77, 0.001) and tumor size ≤ 4.5 cm (1.84, 1.25-2.70, 0.002). Conclusions: We created a new derivate MRR, which was superior over classic blood routine derivates, and importantly the MRR exhibited a stronger ability in predicting poor prognosis of colorectal cancer, especially at the early stage.

Keywords: Blood routine parameter; Colorectal cancer; FIESTA study.; Prognosis; Survival.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interest exists.

Figures

Figure 1
Figure 1
Survival tree structure (A) and Kaplan-Meier curve (B) of blood routine parameters or derivates, demographic and clinical characteristics on the prognosis of colorectal cancer mortality. Abbreviations: NLR, Neutrophil-to-lymphocyte ratio; PLR, Platelet-to-lymphocyte ratio; LMR, lymphocyte-to-monocyte ratio; MRR, monocyte-to-red blood cell count ratio; LNM, lymph node metastasis; PLT, platelet count; RDW, red cell distribution width. The upper number in the box refers to the number of patients, and the lower number refers to the median survival time.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Chen W, Zheng R, Baade PD, Zhang S, Zeng H, Bray F. et al. Cancer statistics in China, 2015. CA Cancer J Clin. 2016;66:115–32. - PubMed
    1. O'Connell JB, Maggard MA, Ko CY. Colon cancer survival rates with the new American Joint Committee on Cancer sixth edition staging. J Natl Cancer Inst. 2004;96:1420–5. - PubMed
    1. Wang ZH, Fang JY. Colorectal Cancer in Inflammatory Bowel Disease: Epidemiology, Pathogenesis and Surveillance. Gastrointest Tumors. 2014;1:146–54. - PMC - PubMed
    1. Altobelli E, Angeletti PM, Latella G. Role of Urinary Biomarkers in the Diagnosis of Adenoma and Colorectal Cancer: A Systematic Review and Meta-Analysis. J Cancer. 2016;7:1984–2004. - PMC - PubMed
    1. Basnet S, Zhang ZY, Liao WQ, Li SH, Li PS, Ge HY. The Prognostic Value of Circulating Cell-Free DNA in Colorectal Cancer: A Meta-Analysis. J Cancer. 2016;7:1105–13. - PMC - PubMed

LinkOut - more resources