Colorectal cancer and markers of anemia

Schneider, Cornelia; Bodmer, Michael; Jick, Susan S.; Meier, Christoph

doi:10.1097/cej.0000000000000397

Cited by 20 publications

(14 citation statements)

References 30 publications

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“…Our group previously reported that MCV was a prognostic factor for RFS in patients who underwent R0 resection for stage I/II/III CRC, independent of the tumor stage [22]; a low MCV or microcytosis (MCV < 80 fL) was associated with favorable outcomes. Schneider C et al reported that Hb and MCV dropped shortly before the CRC diagnosis, and low MCV was weakly associated with survival of patients with CRC [23]. CRC is often accompanied by iron-deficiency anemia, which leads to decreased MCV.…”

Section: Discussionmentioning

confidence: 99%

Blood cell markers that can predict the long-term outcomes of patients with colorectal cancer

et al. 2019

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Objectives To identify blood cell markers that predict the long-term outcomes of patients with colorectal cancer. Methods Data from 892 stage II and III colorectal cancer patients who underwent R0 resection were included. We analyzed the correlations of the preoperative blood data, previously reported prognostic indices, and clinicopathologic factors with the long-term outcomes, such as relapse-free survival and overall survival, using univariate and multivariate analyses. Results Multivariate analysis showed that tumor location, stage, mean corpuscular volume, neutrophil-to-lymphocyte ratio, and lymphocyte-to- monocyte ratio were significantly correlated with relapse-free survival. A mean corpuscular volume ≥80.5 fL, neutrophil-to-lymphocyte ratio ≥5.5, and lymphocyte-to- monocyte ratio <3.4 had hazard ratios for disease relapse between 1.39 and 1.93. The cumulative scores of these three factors were aggregated into a laboratory prognostic score, with a maximum score at 6. The relapse-free survival and overall survival were well stratified by a laboratory prognostic score between 0–3 and 4–6, respectively, independent of the stage. Conclusion The mean corpuscular volume, neutrophil-to-lymphocyte ratio, and lymphocyte-to- monocyte ratio can serve as blood cell markers to predict the long-term outcomes of patients who underwent R0 resection for stage II/III colorectal cancer.

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Section: Discussionmentioning

confidence: 99%

Blood cell markers that can predict the long-term outcomes of patients with colorectal cancer

et al. 2019

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“…Even though possible positive correlations between levels of Ferritin and cancer-specific processes (including CRC) have been shown, iron deficiency anemia caused by chronic gastrointestinal bleeding might antagonize this effect. 41,42 The progression in colorectal neoplasia from HRA to CRC might cause increased gastrointestinal bleeding, which could explain why levels of Ferritin are decreased in individuals with CRC compared to individuals with HRA in the present study.…”

Section: Discussionmentioning

confidence: 73%

“… Complex interactions; levels in the circulation are positive correlated to cancer-specific processes which could be antagonized by iron-deficiency anemia caused by chronic gastrointestinal bleeding. [ 26 , 27 , 37 , 41 , 42 ] Galectin-3 Increased expression in tumor tissue of CRC and associated with advanced CRC. [ 43 ] hs-CRP Associated with CRC and carcinogenesis in general.…”

Section: Introductionmentioning

confidence: 99%

<p>Early Detection and Recurrence of Colorectal Adenomas by Combination of Eight Cancer-Associated Biomarkers in Plasma</p>

Rasmussen¹,

Nielsen²,

Christensen³

2020

CEG

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Introduction: Plasma levels of eight combined proteins have shown value as biomarkers for detection of colorectal cancer (CRC). However, their value in identifying colorectal adenoma needs further evaluation. The aim was to evaluate the eight proteins (AFP, CA19-9, CEA, CyFra21-1, Ferritin, Galectin-3, hs-CRP and TIMP-1) in detection of highrisk adenoma (HRA) and in prediction of recurrence of adenoma. Furthermore, the discrimination between HRA and low-risk adenoma (LRA) or CRC lesions was evaluated. Methods: The study included 4698 individuals undergoing diagnostic colonoscopy. Automated ELISA platforms were used in the determination of protein levels in samples collected just before colonoscopy. Results: Univariably, five proteins (AFP, CEA, CyFra21-1, hs-CRP and TIMP-1), respectively, significantly discriminated individuals with HRA from individuals with non-malignant findings. Multivariably, the combination of CEA and hs-CRP improved performance; AUC= 0.63 (sensitivity=0.19 at specificity=0.90). CyFra21-1, Ferritin and TIMP-1 demonstrated significant discrimination between individuals with HRA and LRA in univariable analyses, respectively. Performance was improved in multivariable analysis; AUC=0.61 (sensitiv-ity=0.13 at specificity=0.90). Discrimination between individuals with colorectal adenomas and healthy individuals was significant for CA19-9, CEA, hs-CRP and TIMP-1, respectively, in univariable analyses. Multivariable analysis improved performance; AUC=0.63 (sensitiv-ity=0.17 at specificity=0.90). All proteins except AFP demonstrated significant discrimination between individuals with HRA and CRC. Combination of CEA, CyFra21-1, Ferritin, hs-CRP and TIMP-1 in multivariable analysis improved discrimination; AUC=0.78 (sensitivity=0.34 at specificity=0.90). Association between plasma levels of any of the eight proteins and recurrence of colorectal adenomas after endoscopic removal could not be demonstrated. Discussion: The protein panel shows a promising potential in detection of colorectal adenomas in general, but specifically of HRA. However, improvements are needed for the panel to be valuable as a screening test. Finally, plasma levels of the eight proteins were not predictive of recurrence of colorectal adenomas.

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“…In other words, preoperative CRP/MCV could predict aggressive tumor biology (39), which is conducive to risk stratification and guiding clinical work. Indeed, estimation of changes in CRP reflects the presence and intensity of an inflammatory process and differentiates inflammatory from non-inflammatory conditions, which are useful in managing the patient's disease and predicting the prognostic value in certain diseases (40). It has been reported that anemia in CRC frequently shows a microcytic phenotype (39,41), especially in high-grade T stage, proximal colon tumor location, lymph node metastasis, and elevated serum CRP with or without hypoalbuminemia (14,27).…”

Section: Discussionmentioning

confidence: 99%

“…Second, several diseases, such as iron deficiency anemia, alpha or beta-thalassemia minor, and liver disease, which can affect the value of MCV, were not screened; this may have led to a selection bias. Third, the use of a single parameter to assess nutritional status has been questioned since many other nutritional factors affect outcomes (40). Lastly, this study was conducted over a long period between 2004 and 2019, which can be associated with historical biases in treatment strategy and perioperative management.…”

Section: Discussionmentioning

confidence: 99%

An Applicable Inflammation-Joined and Nutrition-Related Prognostic Indicator in Patients With Colorectal Cancer

Guo

Liu

et al. 2021

Front. Oncol.

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PurposeThis study aimed to elucidate the prognostic significance of a novel inflammation-joined and nutrition-related clinicopathological marker for colorectal cancer (CRC).MethodsVarious factors from preoperative fasting blood samples from 2471 patients with CRC were retrospectively analyzed. Factors related to prognosis were evaluated using univariate and multivariate analyses. The Kaplan–Meier method was used to generate survival curves, while the log-rank test was used to measure survival differences between groups.ResultsUnivariate analysis revealed that C-reactive protein (CRP)/mean corpuscular volume (MCV) ratio, TNM stage, differentiation, right-sided tumor, age, carcinoembryonic antigen (CEA) level, and CRP level were significantly associated with poor prognosis in CRC. In contrast, adjuvant chemotherapy is regarded as a protective factor. Elevation of CRP/MCV ratio (odds ratio [OR]: 1.535, 95% confidence interval [CI]: 1.121–2.104, P = 0.008), TNM stage (OR: 2.747, 95% CI: 2.175–3.469, P < 0.001), and differentiation (OR, 1.384; 95% CI, 1.150–1.666; P = 0.001) were prognostic risk factors in the multivariate analyses. Subgroup analysis showed that CRP/MCV, TNM staging system, and differentiation also independently affected survival in patients with lymph node-positive CRC. The nomogram based on these three indicators showed that CRP/MCV had a greater prognostic value and clinical significance for lymph node-positive patients with poorly differentiated tumors at the late stage.ConclusionA novel nomogram using the clinicopathologic index of inflammation and nutrition was constructed to predict the prognosis of CRC. Early interventions should be emphasized for advanced-stage patients with severe inflammation and poor nutritional status.

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Colorectal cancer and markers of anemia

Cited by 20 publications

References 30 publications

Blood cell markers that can predict the long-term outcomes of patients with colorectal cancer

Blood cell markers that can predict the long-term outcomes of patients with colorectal cancer

<p>Early Detection and Recurrence of Colorectal Adenomas by Combination of Eight Cancer-Associated Biomarkers in Plasma</p>

An Applicable Inflammation-Joined and Nutrition-Related Prognostic Indicator in Patients With Colorectal Cancer

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