Prognostic role and clinical significance of C-reactive protein-lymphocyte ratio in colorectal cancer

Figures & data

Table 1. The relationship between CLR and clinicopathological features of CRC patients

Characteristics	Case	CLR		*P
		Low(CLR≤5)	High(CLR>5)
Total	2471	1742	729
Gender (%)				0.001*
Male	971(39.3)	722(41.4)	249(34.2)
Female	1500(60.7)	1020(58.6)	480(65.8)
Age (year, mean (SD))	2471	57.26(12.74)	59.56(13.14)	<0.001*
BMI (kg/m^2,mean (SD))	2471	22.14(3.08)	21.81(3.24)	0.015*
Lymphocyte (1 × 10^9,mean (SD))	2471	1.87(0.63)	1.51(0.56)	<0.001*
Location (%)				<0.001*
Rectum	1221(49.4)	756(43.4)	465(63.8)
Colon	1250(50.6)	986(56.6)	264(36.2)
Left- and Right-Sided CRC (%)				<0.001*
Left	1888(76.4)	1417(81.3)	471(64.6)
Right	583(23.6)	325(18.7)	258(35.4)
Differentiation (%)				<0.001*
Well	222(8.9)	158(9.1)	64(8.8)
Moderately	1576(63.8)	1154(66.2)	422(57.9)
Poorly	673(27.2)	430(24.7)	243(33.3)
T stage (%)				<0.001*
Tis+T1-2	401(16.2)	326(18.7)	75(10.3)
T3-4	2070(83.8)	1416(81.3)	654(89.7)
N stage (%)				0.882
N0	1362(55.1)	958(55.0)	404(55.4)
N1-2	1109(44.9)	784(45.0)	325(44.6)
M stage (%)				<0.001*
M0	2095(84.8)	1516(87.0)	579(79.4)
M1-2	376(15.2)	226(13.0)	150(20.6)
TNM stage (%)				<0.001*
0	23(0.9)	17(1.0)	6(0.8)
I	287(11.6)	238(13.7)	49(6.7)
II	938(38.0)	637(36.6)	301(41.3)
III	847(34.3)	624(35.8)	223(30.6)
IV	376(15.2)	226(13.0)	150(20.6)
CEA (ng/ml,mean (SD))	2471	16.02(60.98)	35.65(117.33)	<0.001*
CLR (mean (SD))	2471	1.72(1.26)	25.62(39.62)	<0.001*
CRP (mean (SD))	2471	3.04(2.37)	33.68(38.14)	<0.001*
KRAS (%)				0.311
Wild	323(13.1)	220(12.6)	103(14.1)
Mutation	171(6.9)	124(7.1)	47(6.4)
NA	1977(80.0)	1398(80.3)	579(79.4)
Microsatellite status (%)				<0.001*
MSI	101(4.1)	54(3.1)	47(6.4)
MSS	1000(40.5)	741(42.5)	259(35.5)
NA	1370(55.4)	947(54.4)	423(58.0)

The chi-square test was used for categorical variables and the t-test was used for continuous variables.

*P value ≤ 0.05 was considered significant.

BMI: body mass index; CEA: carcinoembryonic antigen; CLR: C-reactive protein-lymphocyte ratio; CRP: C-reactive protein; KRAS: mutation in Kirsten rat sarcoma viral oncogene homolog; MSI: microsatellite instability; MSS: microsatellite stability.

Figure 1. Violin plots show the relationship between CLR and clinical features. The clinical features include age, gender, tumor location, left- and right-sided CRC, T stage, N stage, M stage, TNM stage, KRAS mutation, microsatellite, and differentiation. Except for N stage and KRAS mutation, other parameters are statistically significant

Figure 2. Kaplan–Meier curves of overall survival in patients stratified by CLR ratio. (a) Kaplan–Meier curves of overall survival in all CRC patients. The value of CLR above 5 means high level group and vice versa. (b) Kaplan–Meier curves of overall survival in stage I–II CRC patients. (c) Kaplan–Meier curves of overall survival in stage III–IV CRC patients

Figure 3. Impact of CLR combined with other clinical features on prognosis. Age subgroup: high CLR, age>60 group means poor prognosis. Gender subgroup: high CLR, female group means poor prognosis. Left-right subgroup: high CLR, right group means poor prognosis. KRAS subgroup: high CLR, mutation KRAS group means poor prognosis. MMR subgroup: high CLR, MSS group means poor prognosis

Figure 4. Univariate and multivariate analyses of the potential predictive factors for overall survival. (a) Univariate analysis of clinicopathological factors for overall survival. (b) Multivariate analysis of clinicopathological factors for overall survival

Figure 5. Subgroup analysis of CRC patients stratified by baseline features in the high CLR group. Univariate analysis of the CLR values of baseline features for overall survival in the high CLR group

Availability of data and material

All original data included in the manuscript are available upon reasonable request.