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. 2022 Jan-Dec:21:15330338211064077.
doi: 10.1177/15330338211064077.

Preoperative Neutrophil-BMI Ratio As a Promising New Marker for Predicting Tumor Outcomes in Colorectal Cancer

Weishun Xie  1   2   3 , Xiaoliang Huang  1   2 , Chunyin Wei  1   2 , Xianwei Mo  1   2 , Haiming Ru  1   2 , Lihua Zhang  1   2 , Lianying Ge  2   3 , Weizhong Tang  1   2 , Jungang Liu  1   2
Affiliations

Preoperative Neutrophil-BMI Ratio As a Promising New Marker for Predicting Tumor Outcomes in Colorectal Cancer

Weishun Xie et al. Technol Cancer Res Treat. 2022 Jan-Dec.

Abstract

Background: Inflammation and nutritional status are highly associated with colorectal cancer (CRC) prognosis. This study aimed to evaluate the prognostic value of the preoperative neutrophil-BMI ratio (NBR) in patients with CRC. Methods: A retrospective analysis was performed on 2471 patients with CRC who underwent surgical resection between 2004 and 2019. Patients were divided into two groups based on the cutoff value for NBR. Cox regression and Kaplan-Meier curves were used to evaluate overall survival (OS). Results: High NBR was associated with female sex, low BMI, colon, right-sided CRC, poor differentiation, T3 to 4 stage, M1 to 2 stage, high carcinoembryonic antigen (CEA) level, III-IV stage, microsatellite instability (MSI), and no adjuvant chemotherapy (all P < .05). The high NBR group had a shorter OS than the low NBR group. Female and right sided patients with CRC and with high NBR had a worse prognosis. Univariate Cox regression suggested that NBR was significantly associated with poor prognosis. Multivariate analysis confirmed that age (P = .019,HR:1.012), differentiation (P = .001,HR:1.306), TNM stage (P < .001,HR:2.432), CEA (P = .014,HR:1.001), and NBR (P < .001, HR: 3.309) were independent poor prognostic factors for OS. Subgroup univariate analysis indicated that female patients with high NBR had a worse prognosis. A nomogram composed of TNM stage, CEA, and NBR was developed, and internal validation was based on female patients with CRC. The nomogram provided good discrimination for both the training and validation sets, with area under the curve values of 0.79 and 0.769, respectively. Conclusions: High preoperative levels of NBR are indicators of poor prognosis in patients with CRC.

Keywords: colorectal cancer; neutrophil-BMI ratio; nomogram; prognostic indicator; survival.

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Conflict of interest statement

Declaration of Conflicting Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Box plots show the relationship between NBR and clinical features.
Figure 2.
Figure 2.
Kaplan–Meier curves of OS of patients classified by NBR. A: Kaplan–Meier curves of OS in all patients with CRC. B: Kaplan–Meier curves of OS in I–II stage patients with CRC. C: Kaplan–Meier curves of OS in III–IV stage patients with CRC. A value of NBR above 0.25 is equivalent to the high level group.
Figure 3.
Figure 3.
Impact of NBR combined with other clinical features on prognosis. A: Kaplan–Meier curves of OS in NBR combined with age. B: Kaplan–Meier curves of OS in NBR combined with gender. C: Kaplan–Meier curves of OS in NBR combined with location. D: Kaplan–Meier curves of OS in NBR combined with KRAS status. E: Kaplan–Meier curves of OS in NBR combined with microsatellite status. The value of NBR above 0.25 is equivalent to the high-level group.
Figure 4.
Figure 4.
Univariate and multivariate analysis of clinicopathological variables for OS in 2471 patients with CRC. A: Univariate analysis of clinicopathological variables. B: Multivariate analysis of clinicopathological variables.
Figure 5.
Figure 5.
Subgroup univariate analysis of NBR in patients with CRC.
See this image and copyright information in PMC

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