Chen, Z. Y. et al. indicated NLR > 5 was associated with poor prognosis in metastatic colorectal cancer and high NLR was correlated with increased expression of inflammatory cytokines such as interleukin 6 (IL-6), IL-8, IL-2Ra, HGF, macrophage-colony stimulating factor (M-CSF), and vascular epidermal growth factor (VEGF)44. This evidence concerns the gene CSF1 and metastatic colorectal cancer.