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BioMed Research International
Volume 2017 (2017), Article ID 3809464, 10 pages
https://doi.org/10.1155/2017/3809464
Research Article

Combined Detection of Preoperative Neutrophil-to-Lymphocyte Ratio and CEA as an Independent Prognostic Factor in Nonmetastatic Patients Undergoing Colorectal Cancer Resection Is Superior to NLR or CEA Alone

1Department of General Surgery, The Second Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou 310009, China
2Department of Laboratory Medicine, Changhai Hospital, 168 Changhai Road, Shanghai 200433, China
3Department of General Surgery, Changhai Hospital, 168 Changhai Road, Shanghai 200433, China
4Department of Medical Oncology, The Second Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou 310009, China

Correspondence should be addressed to Kefeng Ding; nc.ude.ujz@gnefekgnid

Received 9 December 2016; Accepted 12 February 2017; Published 8 June 2017

Academic Editor: Xin-yuan Guan

Copyright © 2017 Xiaoli Zhan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. To explore the role of combined detection of carcinoembryonic antigen (CEA) and neutrophil-to-lymphocyte ratio (NLR) in the prognostic assessment of colorectal cancer (CRC). Methods. We investigated preoperative NLR and CEA in 125 surgical CRC patients, determined the patients’ thresholds by receiver operating characteristic (ROC) curve analysis, and assessed their prognostic values by Kaplan–Meier curve and Cox regression models. In addition, we used nomograms of several risk factors to evaluate the risk in survival and predictive accuracy by using Harrell’s concordance index (-index). Results. Results of multivariate analysis showed high NLR, high CEA, and high COCN (combination of CEA and NLR) were significantly correlated with decreased disease-free survival (DFS) [HR: 2.229, 95% CI: 1.012–4.911, and ; HR: 3.652, 95% CI: 1.630–8.179, and ; HR: 3.139, 95% CI: 1.800–5.472, and ]. But high CEA and COCN remained significant only for decreased overall survival (OS) [HR: 3.713, 95% CI: 1.396–9.873, and ; HR: 3.106, 95% CI: 1.576–6.123, and ]. High NLR showed higher mortality rates with worse OS (), and nomograms containing NLR improved the predictive accuracy. Area under the curve of COCN was higher than that of CEA or NLR. Conclusion. COCN acts as a better independent prognostic biomarker of CRC than NLR or CEA alone.