Correlation between Lymphocyte-to-Monocyte Ratio (LMR), Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR) and Extramural Vascular Invasion (EMVI) in Locally Advanced Rectal Cancer

• Published in: Current oncology (Toronto) 2022-12, Vol.30 (1), p.545-558
• Main Authors: Gawiński, Cieszymierz, Hołdakowska, Anna, Wyrwicz, Lucjan
• Format: Article
• Language: English
• Subjects: extramural vascular invasion (EMVI); Humans; lymphocyte-to-monocyte ratio (LMR); Lymphocytes - pathology; Monocytes - pathology; neutrophil-to-lymphocyte ratio (NLR); Neutrophils - pathology; platelet-to-lymphocyte ratio (PLR); rectal cancer; Rectal Neoplasms - pathology; Retrospective Studies
• ISSN: 1718-7729; 1198-0052; 1718-7729
• DOI: 10.3390/curroncol30010043

Rectal cancer constitutes around one-third of all colorectal cancers. New markers are required to optimize the treatment. Extramural vascular invasion (EMVI) is a magnetic resonance imaging (MRI)-based negative prognostic marker. Lymphocyte-to-monocyte ratio (LMR), neutrophil-to-lymphocyte ratio (NLR) or platelet-to-lymphocyte ratio (PLR) are blood-based systemic inflammatory response markers with proven prognostic value in many cancers, including CRC. We hypothesized whether there is a relationship between LMR, NLR, PLR and the presence of EMVI on pre-treatment MRI in patients with locally advanced rectal cancer (LARC). We conducted a retrospective analysis of 371 patients with LARC treated in the Maria Skłodowska-Curie National Research Institute of Oncology, Warsaw, Poland between August 2016 and December 2021. One hundred eighty-four patients were found eligible for the study. A correlation between the extension of the tumour, nodal status, clinical stage of the disease and the presence of EMVI was found (p < 0.001). The pre-treatment level of neutrophils, platelets and carcinoembryonic antigen (CEA) was significantly higher in the EMVI-positive population (p = 0.041, p = 0.01, p = 0.027, respectively). There were no significant differences regarding the level of LMR, NLR and PLR between the EMVI-positive and EMVI-negative population. LMR, NLR and PLR do not differentiate patients in terms of EMVI; neither of these parameters is a good predictor of the status of EMVI in LARC.