Diagnostic and Prognostic values of systemic inflammatory markers in colorectal cancer

Abstract

Abstract Purpose Systemic inflammation plays an important role in the tumorigenesis of colorectal cancer (CRC). This study aims to systematically and comprehensively analyze the levels of systemic inflammatory markers in CRC patients and their correlation with clinicopathological parameters, to evaluate the diagnostic and prognostic value of systemic inflammatory markers for CRC. Methods A total of 115 patients with CRC, 79 patients with adenomatous polyp and 215 healthy subjects were enrolled in this study. Peripheral blood routine test was measured by SYSMEX XN-9000 Automatic five classifications hematology System. Serum carcinoembryonic antigen (CEA) was measured by electrochemiluminescence by immunoassay on the Roche Cobas e701. Results The levels of systemic inflammatory biomarkers such as neutrophils, monocytes, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic inflammatory response index (SIRI), systemic immune-inflammation index (SII) and red blood cell distribution width (RDW) in CRC patients were significantly higher than those in adenomas and healthy controls. Lymphocyte-to-monocyte ratio (LMR) was found statistically significantly lower in CRC patients compared with adenoma and healthy controls. The clinicopathological features of CRC have certain correlation with systemic inflammatory markers. ROC curve analysis showed that LMR, SIRI and RDW had better diagnostic efficiency than other inflammatory markers, and they could effectively distinguish CRC from healthy individuals and adenomas. The combination of systemic inflammatory biomarkers and CEA can improve the diagnostic efficacy of CRC. Especially, the combined application of SIRI, RDW and CEA had the best predictive value with a sensitivity of 78.3% and a specificity of 94%. RDW and CEA served as an independent prognostic indicator in CRC patients. Conclusions These results suggested that systemic inflammatory markers of LMR, SIRI and RDW had good diagnostic value. The combination of SIRI, RDW and CEA were the optimal diagnostic biomarkers for CRC. RDW and CEA could be acted as an independent risk factor for CRC prognostic.