Prediction of Neoadjuvant Chemotherapy for Advanced Colon Cancer by NLR,NLR/PA,and Tumor Markers

ZHANG Lamei; ZHANG Yu; LIU Xiaomin; ZHU Jingjing

doi:10.3969/j.issn.2096-305X.2025.04.014

Abstract：Objective To explore the evaluation value of the neutrophil-to-lymphocyte ratio(NLR),the ratio of NLR to prealbumin(NLR/PA),and combined with tumor markers[carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125)]in the efficacy of neoadjuvant chemotherapy for patients with advanced colon cancer.Methods 82 patients with advanced colon cancer who received neoadjuvant chemotherapy at the First Affiliated Hospital of Henan University of Science and Technology from January 2021 to January 2023 were selected as the research subjects.After 3 cycles of chemotherapy,they were followed up for 1 month.According to the effect of neoadjuvant chemotherapy,they were divided into the effective group and the ineffective group.The differences in NLR,NLR/PA,CEA,and CA125 levels between the two groups of patients were compared,and the ROC curve was drawn to analyze the evaluation value of NLR,NLR/PA,CEA,and CA125 levels before neoadjuvant chemotherapy for the new adjuvant chemotherapy effect of patients with advanced colon cancer;the clinical data of the two groups of patients were collected and Logistic regression analysis was conducted to identify the factors influencing the new adjuvant chemotherapy effect.Results One month after the completion of neoadjuvant chemotherapy,among the 82 patients,14 achieved complete remission,31 had partial remission,27 remained stable,and 10 experienced progression.The chemotherapy effective rate was 53.66％(44/82).The levels of NLR,NLR/PA,CEA,and CA125 in the neoadjuvant chemotherapy effective group were all lower than those in the ineffective group(P＜0.05).NLR,NLR/PA,CEA,and CA125 were all factors influencing the neoadjuvant chemotherapy effect in patients with advanced colon cancer(P＜0.05).When the cutoff values of NLR,NLR/PA,CEA,and CA125 were set at 2.85,0.05,4.79 ng/mL,and 42.21 U/mL respectively,the areas under the curve(AUC)of these indicators for single diagnosis of the neoadjuvant chemotherapy effect in patients with advanced colon cancer were 0.747,0.754,0.862,and 0.879 respectively,and the AUC of the combined diagnosis was 0.997(P＜0.05).Conclusion An increase in NLR,NLR/PA,and tumor markers CEA and CA125 may lead to the ineffectiveness of neoadjuvant chemotherapy in patients with advanced colon cancer.The combination of these four indicators can be used as an auxiliary indicator for clinical assessment of the effectiveness of neoadjuvant chemotherapy in patients.