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ORIGINAL RESEARCH article

Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
Volume 15 - 2024 | doi: 10.3389/fimmu.2024.1415804
This article is part of the Research Topic Peripheral Blood-Based Biomarkers for Immune Monitoring of Cancer and Cancer Therapy View all 18 articles

Increased neutrophil counts are associated with poor overall survival in patients with colorectal cancer: A Five-Year Retrospective Analysis

Provisionally accepted
Libia A. Garcia Flores Libia A. Garcia Flores 1Teresa Dawid De Vera Teresa Dawid De Vera 1Jesus Pilo Jesus Pilo 1Alejandro Rego Alejandro Rego 1Gema Gomez-Casado Gema Gomez-Casado 1Isabel Arranz-Salas Isabel Arranz-Salas 1Isabel Hierro Isabel Hierro 1Julia Alcaide Julia Alcaide 1Esperanza Torres Esperanza Torres 1Almudena Ortega-Gómez Almudena Ortega-Gómez 1Hatim Boughanem Hatim Boughanem 2*MANUEL M. MACIAS-GONZALEZ MANUEL M. MACIAS-GONZALEZ 1
  • 1 Biomedical Research Institute of Malaga, University of Malaga, Málaga, Andalusia, Spain
  • 2 Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordova, Spain

The final, formatted version of the article will be published soon.

    Background. Colorectal cancer (CRC) continues to be a major health concern in today's world. Despite conflictive findings, evidence supports systemic inflammation's impact on CRC patients' survival rates. Therefore, this study aims to assess the prognostic role of the innate immune system in patients with CRC. Method. A total of 449 patients were included, with a 5-year follow-up period, and absolute neutrophil counts and their related ratios were measured. Results. The non-survival group had increased levels of white blood cells, neutrophils (both p<0.001), and monocytes (p=0.038), compared to the survival group, along with other neutrophil-related ratios. We observed increased mortality risk in patients in the highest tertile of white blood cells [HR=1.85 (1.09-3.13), p<0.05], neutrophils [HR=1.78 (95% CI: 1.07-2.96), p<0.05], and monocytes [HR=2.11 (95% CI:1.22-3.63)], compared to the lowest tertile, after adjusting for all clinicopathological variables. Random forest analysis identified neutrophils as the most crucial variable in predicting survival rates, having an AUC of 0.712, considering all clinicopathological variables. A positive relationship between neutrophil counts and metastasis was observed when neutrophil counts are considered continuous (β=0.92 (0.41), p<0.05) and tumor size (width) when neutrophils were considered as logistic variable (T1 vs T3) [OR=1.42, (95% CI: 1.05-1.98), p<0.05]. Conclusion. This study offers comprehensive insights into the immune factors that impact the prognosis of CRC, emphasizing the need for personalized prognostic tools.

    Keywords: colorectal cancer, Neutrophils, overall survival, prognosis, Inflammation

    Received: 11 Apr 2024; Accepted: 30 Aug 2024.

    Copyright: © 2024 Garcia Flores, Dawid De Vera, Pilo, Rego, Gomez-Casado, Arranz-Salas, Hierro, Alcaide, Torres, Ortega-Gómez, Boughanem and MACIAS-GONZALEZ. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Hatim Boughanem, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordova, 14004, Spain

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