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. 2021 Mar 3;11(1):5027.
doi: 10.1038/s41598-021-84475-4.

Combination of lymphocyte count and albumin concentration as a new prognostic biomarker for rectal cancer

Takehito Yamamoto  1 , Kenji Kawada  2 , Koya Hida  1 , Ryo Matsusue  3 , Yoshiro Itatani  1 , Rei Mizuno  1 , Takashi Yamaguchi  3 , Iwao Ikai  3 , Yoshiharu Sakai  1
Affiliations

Combination of lymphocyte count and albumin concentration as a new prognostic biomarker for rectal cancer

Takehito Yamamoto et al. Sci Rep. .

Abstract

Although numerous studies have highlighted the prognostic values of various inflammation-related markers, clinical significance remains to be elucidated. The prognostic values of inflammation-related biomarkers for rectal cancer were investigated in this study. A total of 448 patients with stage II/III rectal cancer undergoing curative resection were enrolled from the discovery cohort (n = 240) and validation cohort (n = 208). We comprehensively compared the prognostic values of 11 inflammation-related markers-derived from neutrophil, lymphocyte, platelet, monocyte, albumin, and C-reactive protein for overall survival (OS) and recurrence-free survival (RFS). Among 11 inflammation-related markers, only "lymphocyte × albumin (LA)" was significantly associated with both OS and RFS in the discovery cohort (P = 0.007 and 0.015, respectively). Multivariate analysis indicated that low LA was significantly associated with poor OS (hazard ratio [HR] 2.19, 95% confidence interval [CI] 1.09-4.58, P = 0.025), and poor RFS (HR 1.61, 95% CI 1.01-2.80, P = 0.048). Furthermore, using the discovery cohort, we confirmed that low LA was significantly associated with poor OS (HR 2.89, 95% CI 1.42-6.00, P = 0.002), and poor RFS (HR 1.79, 95% CI 1.04-2.95, P = 0.034). LA can be a novel prognostic biomarker for stage II/III rectal cancer.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
A schema of the 11 inflammation-related markers adopted in the present study. As systemic inflammatory factors, we chose 5 parameters (neutrophil, lymphocyte, platelet, monocyte, and albumin). The combination of each parameter (i.e., a total of 9 possible combinations) as well as two established inflammation-related scoring systems (i.e., GPS and SIS) were investigated.
Figure 2
Figure 2
Prognostic impact of LA on OS and RFS in the discovery cohort (a,b) and validation cohort (c,d). Cox’s proportional hazard regression model. (a,c) LA > 5950 or ≤ 5950 for OS, (b,d) LA > 5950 or ≤ 5950 for RFS.
Figure 3
Figure 3
Stratification of the prognostic impact of LA levels in the discovery cohort (a,b) and validation cohort (c,d). Comparison of prognostic impact on OS (a,c) and RFS (b,d) among three groups; higher LA group (LA > 7920), middle LA group (4515 < LA ≤ 7920), and lower LA group (LA ≤ 4515). The upper quartile and the lower quartile of LA were 7920 and 4515, respectively. * P < 0.05
See this image and copyright information in PMC

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