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. 2025 Aug 27:18:11783-11799.
doi: 10.2147/JIR.S537431. eCollection 2025.

Modified Neutrophil Platelet Scores (MNPs): A Novel Prognostic Marker in Colorectal Cancer

Yan Tang  1 , Feihong Zhao  1 , Baian Zong  1 , Haogang Zhang  1
Affiliations

Modified Neutrophil Platelet Scores (MNPs): A Novel Prognostic Marker in Colorectal Cancer

Yan Tang et al. J Inflamm Res. .

Abstract

Background: Inflammation can influence how tumors develop and is linked to patient outcomes. We studied a new marker called the Modified Neutrophil Platelet Score (MNPs), which uses blood neutrophil and platelet counts. This research aimed to verify if MNPs and other clinical markers help doctors better predict disease severity after surgery for people with colorectal cancer.

Methods: We reviewed records from 503 patients with colorectal cancer. All patients had curative surgery at the Second Affiliated Hospital of Harbin Medical University (2016-2018). We collected their blood test results one week before surgery, including neutrophil, platelet, lymphocyte, and monocyte counts, plus CEA and CA199 levels. Using Kaplan-Meier analysis, we examined how MNPs relates to patients' overall survival (OS) and recurrence-free survival (RFS). We performed univariate and multivariate Cox regression analyses. To compare MNPs with other inflammation markers, we calculated time-dependent ROC curves, C-index, and Brier scores.

Results: Overall Survival (OS): Patients with lower MNPs (score 0) lived longer. Compared to score 0 patients, those with score 1 had shorter survival (HR = 3.180, 95% CI 2.028-4.988, p < 0.001), and score 2 patients lived significantly shorter lives (HR = 7.430, 95% CI 4.672-11.816, p < 0.001). Recurrence-Free Survival (RFS): Patients with lower MNPs (score 0) stayed cancer-free longer. Score 1 patients had higher recurrence risk than score 0 patients (HR = 3.790, 95% CI 2.065-6.954, p < 0.001), while score 2 patients faced the highest recurrence risk (HR = 10.023, 95% CI 5.428-18.510, p < 0.001). Multivariate analysis confirmed MNPs independently predicts OS and RFS outcomes. Time-dependent ROC curves, C-index, and Brier scores showed MNPs predicts patient outcomes more accurately than other inflammation markers.

Conclusion: MNPs can help doctors predict outcomes for people with colorectal cancer. Patients with lower MNPs tend to live longer and stay cancer-free longer after surgery.

Keywords: colorectal cancer; modified neutrophil platelet score; neutrophil-to-lymphocyte ratio; platelet-lymphocyte ratio; prognosis; systemic immune-inflammation index; systemic inflammation response index.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Relationship between preoperative modified neutrophil platelet score and OS in patients with colorectal cancer.
Figure 2
Figure 2
Relationship between preoperative modified neutrophil platelet score and RFS in patients with colorectal cancer.
Figure 3
Figure 3
OS and RFS with distinct risk classifications for rectal and colon cancer.
Figure 4
Figure 4
Comparison of c-index of OS predicted by MNPs and other indicators.
Figure 5
Figure 5
Comparison of c-index of RFS predicted by MNPs and other indicators.
Figure 6
Figure 6
ROC curve of MNPs predicting 3-year OS.
Figure 7
Figure 7
ROC curve of MNPs predicting 5-year OS.
Figure 8
Figure 8
Time dependent C-index of OS predicted by different indicators at each time point.
Figure 9
Figure 9
ROC curve of MNPs predicting 3-year RFS.
Figure 10
Figure 10
ROC curve of MNPs predicting 5-year RFS.
Figure 11
Figure 11
Time dependent C-index of RFS predicted by different indicators at each time point.
Figure 12
Figure 12
Brier score of OS predicted by MNPs and other indicators.
Figure 13
Figure 13
Brier score of RFs predicted by MNPs and other indicators.
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