Role of neutrophil-to-lymphocyte, platelet-to-lymphocyte, and monocyte-to-lymphocyte ratios in rectal cancer prognosis.

Background: An efficient index holds the potential to predict rectal cancer prognosis.

Aim: To investigate the impact of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) on rectal cancer prognosis.

Methods: This retrospective study involved 180 patients with rectal cancer from the Changzhi People's Hospital of Shanxi Province. A 2-mL blood sample was collected at 24 h preoperatively and 72 h postoperatively to measure neutrophils, lymphocytes, platelets, and monocytes using an automatic blood analyzer. Preoperative and postoperative NLR, PLR, and MLR were compared. Patients were followed up for 12 months and categorized into good and poor prognosis groups. A receiver operating characteristic curve was constructed to analyze their predictive values.

Results: The NLR, PLR, and MLR values were significantly lower post-surgery (P < 0.05). A total of 152 and 28 patients were categorized in the good and poor prognosis groups, respectively. Patients with poor prognoses exhibited slightly higher postoperative NLR, PLR, and MLR values than those with good prognoses (P < 0.05). Receiver operating characteristic analysis showed that the area under the curve for NLR, PLR, and MLR was 0.828 with a sensitivity and specificity of 89.29% and 90.79%, respectively. These values were higher than individual NLR (area under the curve: 0.660, sensitivity: 67.86%, specificity: 54.61%), PLR (0.668, 75.00%, 55.30%), and MLR (0.635, 60.71%, 48.03%), all showing statistically significant differences (P < 0.05), effectively predicting patient outcomes.

Conclusion: The findings of this study indicated that NLR, PLR, and MLR values of patients with rectal cancer can be used to effectively predict the outcome of patients.