Abstract
Background
Colorectal cancer ranks as the third most diagnosed and second most lethal cancer globally. The challenge of early detection, essential for better outcomes, lies in the often non-specific or absent early symptoms, resulting in low diagnosis rates, particularly in resource-limited settings. For the first time, This study pioneers the evaluation of the diagnostic utility of hematological parameters, specifically the lymphocyte-monocyte ratio (LMR) and the hemoglobin-platelet ratio (HPR), in pre-operative CRC patients in Ghana.
Method
This unmatched case control study recruited 50 CRC patients pathologically diagnosed colorectal cancer and 50 healthy controls. Venous blood samples were collected for laboratory analyses using Beckmann780. All statistical analyses were performed using R Statistical Software (v4.3.2; R Core Team The receiver operating characteristic (ROC) curve and logistics regression model were used to assess the individual and combined diagnostic value of haematological parameters in detecting CRC at significance levels of p-value of < 0.05 and .95% confidence interval.
Results
The mean age of cases (55.92 years) was significantly higher than controls (37.92 years) (p < 0.0001). The clinical presentation of CRC patients wa mainlychanges in bowl (48.0%) and bleeding per rectum (42.0%). Colon cancer represented 58% of cases while rectal cancer represented 42%. Adenocarcinoma was the most common histologic type(100%). CRC patients had significantly lower levels of lymphocyte-monocyte ratio (p < 0.0001), haemoglobin-platelet ratio (p < 0.0001) and platelet-lymphocyte ratio (p < 0.05) compared to controls. At a cut-off of ≤ 0.068, HPR was the diagnostic marker for detecting CRC with high sensitivity of 81.6%, specificity of 98.0%, a positive predictive value of 97.6%, and a negative predictive value of 84.5% as well as area under the curve and accuracy of 91.6% and 89.9% respectively. HPR in combination with LMR (cOR: 3106682390.00, 95% CI: (0.00-inf); p = 0.9988) showed a significant increased chances of detecting CRC among study subjects.
Conclusion
The study identifies HPR as a potent standalone diagnostic marker for CRC and underscores its improved diagnostic efficacy when combined with LMR. This combination offers a cost-effective and accurate diagnostic tool for CRC, especially valuable in settings with limited resources.