Lab Med Online.  2020 Jan;10(1):75-83. 10.3343/lmo.2020.10.1.75.

Clinical Impact of Myeloid-Derived Suppressor Cells, Lymphocyte Subsets, and Neutrophil-to-Lymphocyte Ratio in Patients with Colorectal Cancer

  • 1Department of Laboratory Medicine, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Korea.
  • 2Department of Surgery, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Korea.
  • 3Department of Laboratory Medicine, GwangYang Sarang General Hospital, GwangYang, Korea.
  • 4Brain Korea 21 Plus Project, Chonnam National University Medical School, Gwangju, Korea.
  • 5College of Korean Medicine, Dongshin University, Naju, Korea.


Preoperative myeloid-derived suppressor cells (MDSCs), neutrophil-to-lymphocyte ratio (NLR), and lymphocyte subsets have been reported to be associated with the clinical outcomes in colorectal cancer (CRC). However, studies on the clinical impact of each parameter have produced controversial results. Moreover, there is a paucity of comprehensive studies regarding these parameters in Korean CRC patients.
Sixty-eight CRC patients who underwent surgical resection were recruited for this study. NLR was measured using an automated blood cell counter. Flow cytometric analysis was performed to determine lymphocyte subsets and identify MDSCs during the diagnostic stage. Clinical and laboratory data were analyzed according to each blood parameter.
The distribution of lymphocytes, MDSCs, and NLR were not associated with TNM stages. Large tumor sizes (P=0.042) and greater perineural invasion (P=0.031) were significantly associated with high CD19+ B-cell populations. Elevated granulocytic MDSCs (P=0.234), total MDSCs (P=0.234), and NLR (P=0.062) were associated with the poorly differentiated type of CRC, albeit without statistical significance. Additionally, patients in the high CD19+ B-cell group (P=0.012) revealed a moderately inferior relapse-free survival.
Our findings indicate that preoperative evaluation of CD19+ B-cell proportion is recommended to predict the clinical outcomes of patients with stage II-III CRC.


Myeloid-derived stem cell; Lymphocyte subset; Neutrophil-to-lymphocyte ratio; Colorectal cancer
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