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Prognostic Value of the Combination of Preoperative Hemoglobin, Lymphocyte, Albumin, and Neutrophil in Patients with Locally Advanced Colorectal Cancer

Hui-hong Jiang, A-jian Li, Er-jiang Tang, Xu Dan, Ying Chen, Yong Zhang, Min Tang, Yi-hua Xiao, Xia-xing Deng, Hua-guang Li, Mou-bin Lin

Department of General Surgery, Ruijin Hospital affiliated with Shanghai Jiaotong University School of Medicine, Shanghai, China (mainland)

Med Sci Monit 2016; 22:4986-4991

DOI: 10.12659/MSM.901934

Available online:

Published: 2016-12-19


BACKGROUND: Systemic inflammatory response and nutritional status are important to the prognosis of patients with colorectal cancer (CRC). This study aimed to investigate the prognostic value of the combination of preoperative hemoglobin, lymphocyte, albumin, and neutrophil (HLAN) in patients with locally advanced CRC (LACRC).
MATERIAL AND METHODS: We performed a retrospective analysis in 536 LACRC patients undergoing radical surgery. The value of HLAN was defined as follow: HLAN=Hemoglobin (g/L)×Lymphocyte (/L)×Albumin (g/L)/Neutrophil (/L)/100. The X-tile program was used to determine the optimal cut-point of HLAN, and the prognostic value of HLAN for overall survival (OS) was evaluated with the Cox proportional hazard model.
RESULTS: The cut-point of HLAN was set at 19.5. Compared with the high-HLAN group, the low-HLAN group had a 1.50-fold (95% confidence interval 1.09–2.05) increased risk of death and a significantly lower OS rate (P<0.001). Furthermore, the risk stratification model based on HLAN (AUC=0.72) displayed better accuracy in OS prediction than the TNM system (AUC=0.61).
CONCLUSIONS: HLAN is a valuable prognostic marker for patients with LACRC.

Keywords: Albumins, Colorectal Neoplasms, Hemoglobins, Lymphocytes, Neutrophils, Prognosis



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