Yan Tang, Feihong Zhao, Baian Zong, Haogang Zhang

General Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, People’s Republic of China

Correspondence: Haogang Zhang, General Surgery,The Second Affiliated Hospital of Harbin Medical University, Harbin, People’s Republic of China, Email zhg-id@126.com

Background: Inflammation can influence how tumors develop and is linked to patient outcomes. We studied a new marker called the Modified Neutrophil Platelet Score (MNPs), which uses blood neutrophil and platelet counts. This research aimed to verify if MNPs and other clinical markers help doctors better predict disease severity after surgery for people with colorectal cancer.
Methods: We reviewed records from 503 patients with colorectal cancer. All patients had curative surgery at the Second Affiliated Hospital of Harbin Medical University (2016– 2018). We collected their blood test results one week before surgery, including neutrophil, platelet, lymphocyte, and monocyte counts, plus CEA and CA199 levels. Using Kaplan–Meier analysis, we examined how MNPs relates to patients’ overall survival (OS) and recurrence-free survival (RFS). We performed univariate and multivariate Cox regression analyses. To compare MNPs with other inflammation markers, we calculated time-dependent ROC curves, C-index, and Brier scores.
Results: Overall Survival (OS): Patients with lower MNPs (score 0) lived longer. Compared to score 0 patients, those with score 1 had shorter survival (HR = 3.180, 95% CI 2.028– 4.988, p < 0.001), and score 2 patients lived significantly shorter lives (HR = 7.430, 95% CI 4.672– 11.816, p < 0.001). Recurrence-Free Survival (RFS): Patients with lower MNPs (score 0) stayed cancer-free longer. Score 1 patients had higher recurrence risk than score 0 patients (HR = 3.790, 95% CI 2.065– 6.954, p < 0.001), while score 2 patients faced the highest recurrence risk (HR = 10.023, 95% CI 5.428– 18.510, p < 0.001). Multivariate analysis confirmed MNPs independently predicts OS and RFS outcomes. Time-dependent ROC curves, C-index, and Brier scores showed MNPs predicts patient outcomes more accurately than other inflammation markers.
Conclusion: MNPs can help doctors predict outcomes for people with colorectal cancer. Patients with lower MNPs tend to live longer and stay cancer-free longer after surgery.

Keywords: modified neutrophil platelet score, colorectal cancer, platelet-lymphocyte ratio, neutrophil-to-lymphocyte ratio, systemic inflammation response index, systemic immune-inflammation index, prognosis