Abstract:

Objective To investigate the correlations between albumin globulin ratio （AGR）, platelet lymphocyte ratio （PLR）, neutrophil lymphocyte ratio （NLR） and efficacy of chemotherapy for patients with metastatic colorectal cancer （mCRC）. Methods The clinical data of 107 mCRC patients who were treated at the First Hospital of Shanxi Medical University for chemotherapy from January 2016 to September 2020 were selected, and the values of AGR, NLR and PLR before chemotherapy and after 3 cycles of chemotherapy were collected for retrospective analysis. After 3 cycles, patients were divided into three groups according to efficacy evaluation： partial response （PR） group, stable disease （SD） group and progressive disease （PD） group. The changes of AGR, PLR and NLR values before and after chemotherapy, and the relationships between the degrees of changes and the therapeutic effects were analyzed. Results There were 18 cases in the PR group, 53 cases in the SD group and 36 cases in the PD group. There were no significant differences in age, sex, distant metastasis site, cancer site, T stage and N stage among the three groups （F=0.33, P=0.721; χ²=2.94, P=0.230; χ²=2.34, P=0.674; χ²=0.80, P=0.669; χ²=5.68, P=0.224; χ²=2.06, P=0.375）. The AGR, PLR and NLR values before chemotherapy in the PR group were 1.57±0.19, 180.05±102.77 and 5.19 （4.50, 5.83）, and they were 1.45±0.23, 115.81±55.79 and 1.83 （1.06, 2.84） after chemotherapy, with statistically significant differences （t=2.32, P=0.033; t=2.84, P=0.011; Z=-2.94, P=0.003）. In the SD group, AGR, PLR and NLR values before chemotherapy were 1.66 （1.40, 1.77）, 158.18 （103.81, 236.26）, 2.41 （1.75, 4.07）, and they were 1.35 （1.15,1.60）, 123.85 （94.86, 176.44）, 1.49 （1.27, 2.33） after chemotherapy, with statistically significant differences （Z=-4.51, P<0.001; Z=-3.31, P=0.001; Z=-3.90, P<0.001）. The AGR, PLR and NLR values in the PD group before chemotherapy were 1.60 （1.48, 1.87）, 122.07 （77.14, 175.72）, 2.37 （1.28, 4.20）, and they were 1.26 （1.08,1.40）, 176.39 （139.89, 280.64） and 4.71 （3.71, 6.96） after chemotherapy, with statistically significant differences （Z=-4.49, P<0.001; Z=-3.42, P=0.001; Z=-4.18, P<0.001）. The differences in AGR （OR=3.66, 95%CI： 1.29-10.39, P=0.015）, PLR （OR=0.99, 95%CI： 0.99-1.00, P<0.001） and NLR （OR=0.59, 95%CI： 0.49-0.70, P<0.001） before and after chemotherapy were related to clinical efficacy. The greater the difference of AGR, the worse the short-term efficacy. The greater the difference of PLR and NLR, the better the short-term efficacy. The correlation between the changes in AGR, PLR and NLR before and after treatment and the clinical efficacy was sorted in descending order Δ_NLR>Δ_PLR>Δ_AGR （r=-0.68, P<0.001; r=-0.51, P<0.001; r=0.25, P=0.009）. Conclusion The changes in the levels of AGR, NLR and PLR before and after chemotherapy are correlated with the short-term efficacy of mCRC, and it has certain significance for monitoring the curative effects of patients and further optimizing the treatment plan.

Key words: Colorectal neoplasms, Albumin globulin ratio, Platelet lymphocyte ratio, Neutrophil lymphocyte ratio