{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,14]],"date-time":"2026-11-14T00:17:16Z","timestamp":1794615436471,"version":"4.9.1"},"reference-count":23,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,8,31]],"date-time":"2025-08-31T00:00:00Z","timestamp":1756598400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Oradea"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Systemic inflammation plays a key role in cancer progression, and markers such as neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have gained attention as potential prognostic tools in colorectal cancer. However, their comparative utility in colon cancer remains unclear. Objective: This study was aimed to assess and compare the prognostic value of preoperative NLR and PLR in evaluating tumor aggressiveness in colon cancer patients undergoing elective surgery. Methods: We conducted a retrospective observational study on 64 patients with histologically confirmed colon cancer treated between 2019 and 2022. Only elective cases were included; rectal and emergency surgeries were excluded. Demographic, clinical, pathological, and laboratory data were collected. Tumor aggressiveness was assessed based on tumor size, histologic grade, lymphovascular and perineural invasion, and lymph node involvement. Statistical analysis included Pearson correlation, ANCOVA, logistic regression, and principal component analysis (PCA). Results: PLR showed a significant positive correlation with tumor size (r = 0.428, p &lt; 0.001) and tumor stage (r = 0.314, p = 0.012), whereas NLR did not. Logistic regression and PCA indicated that PLR better reflected tumor burden, while NLR was more associated with systemic inflammation. Neither marker significantly predicted postoperative complications or in-hospital mortality. Conclusions: PLR may serve as a useful, non-invasive biomarker for assessing tumor aggressiveness in colon cancer, supporting its integration into preoperative risk stratification. The results from this single-center, retrospective cohort showed moderate associations between PLR and tumor size and stage, whereas NLR did not. These findings are hypothesis-generating and insufficient for clinical implementation; prospective, adequately powered studies with survival endpoints are required.<\/jats:p>","DOI":"10.3390\/medicina61091580","type":"journal-article","created":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T08:28:15Z","timestamp":1756715295000},"page":"1580","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Comparative Prognostic Role of PLR and NLR in Colon Cancer: A Retrospective Analysis of Preoperative Inflammatory Markers"],"prefix":"10.3390","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7620-9845","authenticated-orcid":false,"given":"Roxana Loriana","family":"Negrut","sequence":"first","affiliation":[{"name":"Department of Surgical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3734-7991","authenticated-orcid":false,"given":"Adrian","family":"Cote","sequence":"additional","affiliation":[{"name":"Department of Surgical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-7055-4834","authenticated-orcid":false,"given":"Bogdan","family":"Feder","sequence":"additional","affiliation":[{"name":"Department of Surgical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8332-7708","authenticated-orcid":false,"given":"Florian Dorel","family":"Bodog","sequence":"additional","affiliation":[{"name":"Department of Surgical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian Marius","family":"Maghiar","sequence":"additional","affiliation":[{"name":"Department of Surgical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,31]]},"reference":[{"key":"ref_1","unstructured":"National Cancer Institute (2024, November 15). SEER Cancer Stat Facts: Colorectal Cancer. Surveillance, Epidemiology, and End Results Program, Available online: https:\/\/seer.cancer.gov\/statfacts\/html\/colorect.html."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2648","DOI":"10.1002\/ijc.27942","article-title":"Biomarkers of inflammation are associated with colorectal cancer risk in women but are not suitable as early detection markers","volume":"132","author":"Toriola","year":"2013","journal-title":"Int. J. Cancer"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Hernandez-Ainsa, M., Velamazan, R., Lanas, A., Carrera-Lasfuentes, P., and Piazuelo, E. (2022). Blood-Cell-Based Inflammatory Markers as a Useful Tool for Early Diagnosis in Colorectal Cancer. Front. Med., 9.","DOI":"10.3389\/fmed.2022.843074"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Turri, G., Caligola, S., Ugel, S., Conti, C., Zenuni, S., Barresi, V., Ruzzenente, A., Lippi, G., Scarpa, A., and Bronte, V. (2023). Pre-diagnostic prognostic value of leukocytes count and neutrophil-to-lymphocyte ratio in patients who develop colorectal cancer. Front. Oncol., 13.","DOI":"10.3389\/fonc.2023.1148197"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Song, Y., Yang, Y., Gao, P., Chen, X., Yu, D., Xu, Y., Zhao, J., and Wang, Z. (2017). The preoperative neutrophil to lymphocyte ratio is a superior indicator of prognosis compared with other inflammatory biomarkers in resectable colorectal cancer. BMC Cancer, 17.","DOI":"10.1186\/s12885-017-3752-0"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Xia, L.-J., Li, W., Zhai, J.-C., Yan, C.-W., Chen, J.-B., and Yang, H. (2020). Significance of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, lymphocyte-to-monocyte ratio and prognostic nutritional index for predicting clinical outcomes in T1\u20132 rectal cancer. BMC Cancer, 20.","DOI":"10.1186\/s12885-020-6698-6"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Mazaki, J., Katsumata, K., Kasahara, K., Tago, T., Wada, T., Kuwabara, H., Enomoto, M., Ishizaki, T., Nagakawa, Y., and Tsuchida, A. (2020). Neutrophil-to-lymphocyte ratio is a prognostic factor for colon cancer: A propensity score analysis. BMC Cancer, 20.","DOI":"10.1186\/s12885-020-07429-5"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1186\/s12957-023-03108-4","article-title":"Evaluation of multiple biological indicators for the combined diagnosis of metastases from colorectal cancer\u2014A retrospective study based on 1163 patients","volume":"21","author":"Chen","year":"2023","journal-title":"World J. Surg. Oncol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"69","DOI":"10.2147\/JIR.S391932","article-title":"Fashionable, but What is Their Real Clinical Usefulness? NLR, LMR, and PLR as a Promising Indicator in Colorectal Cancer Prognosis: A Systematic Review","volume":"16","author":"Misiewicz","year":"2023","journal-title":"J. Inflamm. Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1347","DOI":"10.1007\/s00384-012-1459-x","article-title":"Can neutrophil-to-lymphocyte ratio predict the survival of colorectal cancer patients who have received curative surgery electively?","volume":"27","author":"Chiang","year":"2012","journal-title":"Int. J. Color. Dis."},{"key":"ref_11","first-page":"e19025","article-title":"Predictive Ability of Neutrophil-Lymphocyte Ratio in Determining Tumor Staging in Colorectal Cancer","volume":"13","author":"Pereira","year":"2021","journal-title":"Cureus"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"260","DOI":"10.21614\/chirurgia.2023.v.118.i.3.p.260","article-title":"Systemic Neutrophil-to-Lymphocyte Ratio as a Prognostic Biomarker for Colon Cancer","volume":"118","author":"Iaciu","year":"2023","journal-title":"Chirurgia"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1186\/s12957-016-1044-9","article-title":"Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios predict chemotherapy outcomes and prognosis in patients with colorectal cancer and synchronous liver metastasis","volume":"14","author":"Wu","year":"2016","journal-title":"World J. Surg. Oncol."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Ma, L., Yang, F., Guo, W., Tang, S., and Ling, Y. (2024). Prognostic role of platelet-to-lymphocyte ratio in patients with rectal cancer undergoing resection: A systematic review and meta-analysis. Front. Oncol., 14.","DOI":"10.3389\/fonc.2024.1415443"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"3201","DOI":"10.1182\/blood.2019003977","article-title":"Aspirin and antiplatelet treatments in cancer","volume":"137","author":"Tao","year":"2021","journal-title":"Blood"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"6584","DOI":"10.18632\/oncotarget.3164","article-title":"P-selectin-mediated platelet adhesion promotes tumor growth","volume":"6","author":"Qi","year":"2015","journal-title":"Oncotarget"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Guo, G., Hu, X., Gao, T., Zhou, H., Li, B., Zhou, C., Yu, B., and Wang, G. (2023). Potential impact of platelet-to-lymphocyte ratio on prognosis in patients with colorectal cancer: A systematic review and meta-analysis. Front. Surg., 10.","DOI":"10.3389\/fsurg.2023.1139503"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1055\/s-0034-1370767","article-title":"Platelet-cancer interactions","volume":"40","author":"Goubran","year":"2014","journal-title":"Semin. Thromb. Hemost."},{"key":"ref_19","first-page":"61","article-title":"Can the Inflammatory Cell Ratio NLR and PLR be Used as a Reliable Marker in Colon Cancer? A Prospective Study","volume":"13","author":"Ramesh","year":"2023","journal-title":"Euroasian J. Hepatogastroenterol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e3837","DOI":"10.1097\/MD.0000000000003837","article-title":"Prognostic role of platelet-lymphocyte ratio in colorectal cancer: A systematic review and meta-analysis","volume":"95","author":"Tan","year":"2016","journal-title":"Medicine"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Lubi\u0144ski, J., Lener, M.R., Marciniak, W., Pietrzak, S., Derkacz, R., Cybulski, C., Gronwald, J., D\u0119bniak, T., Jakubowska, A., and Huzarski, T. (2023). Serum Essential Elements and Survival after Cancer Diagnosis. Nutrients, 15.","DOI":"10.3390\/nu15112611"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1186\/s12943-023-01732-y","article-title":"Cuproptosis: Mechanisms and links with cancers","volume":"22","author":"Xie","year":"2023","journal-title":"Mol. Cancer"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Menyhart, O., Fekete, J.T., and Gy\u0151rffy, B. (2024). Inflammation and Colorectal Cancer: A Meta-Analysis of the Prognostic Significance of the Systemic Immune-Inflammation Index (SII) and the Systemic Inflammation Response Index (SIRI). Int. J. Mol. Sci., 25.","DOI":"10.3390\/ijms25158441"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/9\/1580\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:36:46Z","timestamp":1760035006000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/9\/1580"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,31]]},"references-count":23,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,9]]}},"alternative-id":["medicina61091580"],"URL":"https:\/\/doi.org\/10.3390\/medicina61091580","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,31]]}}}