Combined Diagnostic Efficacy of Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and Mean Platelet Volume (MPV) as Biomarkers of Systemic Inflammation in the Diagnosis of Colorectal Cancer

Abstract

Background Systemic inflammation in colorectal cancer (CRC) may be reflected by neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume (MPV). This study was designed to investigate the efficiency of preoperative NLR, PLR, and MVP as a tool for the assessment of tumor characteristics in newly diagnosed patients with CRC. Patients and Methods For 300 patients and 300 healthy volunteers, complete blood counts with automated differential counts were performed. The NLR was calculated by dividing the absolute neutrophil count by the absolute lymphocyte count; PLR was calculated by dividing the absolute platelet count by the absolute lymphocyte count. The diagnostic performance of NLR, PLR, and MVP was estimated by ROC curve. Results ROC curve analysis showed high diagnostic efficacy of NLR and PLR in CRC patients with cut-off values of 2.15 (AUC = 0.790, 95% CI 0.736-0.884, Se = 74.1%, and Sp = 73%) and 123 (AUC = 0.846, 95% CI 0.801-0.891, Se = 73.5%, and Sp = 80%) compared to healthy controls, respectively. The diagnostic efficacy of three combined markers was superior compared with individual markers (AUC = 0.904, 95% CI 0.812-0.989, Se = 96%, and Sp = 70%). Conclusion NRL, PLR, and MPV may be useful markers in diagnostic and early recognition of different stages of CRC; additionally combined all together have stronger diagnostic efficacy.

Nomogram for predicting overall survival in stage II‐III colorectal cancer

“…Furthermore, it was previously reported that patients with increased MPV had worse survival rates than those of patients with normal MPV levels . Additionally, one study found that the PDW levels of patients with CRC were higher than those in healthy participants but lower than those in adenomatous patients . That signified that PDW was an advantageous prognostic factor for the survival of patients with CRC.…”

“…Many scholars have reported that MPV levels might serve as potential biomarkers for the diagnosis and early recognition of different stages of CRC. 26,27 Furthermore, it was previously reported that patients with increased MPV had worse survival rates than those of patients with normal MPV levels. 28 Additionally, one study found that the PDW levels of patients with CRC were higher than those in healthy participants but lower than those in adenomatous patients.…”

“…Through the LASSO regression algorithm, which effectively processed the demographic and clinical feature selection as a statistical method for high‐dimensional data, we distinguished preoperative MPV, preoperative PDW, monocytes, and postoperative adjuvant chemotherapy as independent prognostic factors. Many scholars have reported that MPV levels might serve as potential biomarkers for the diagnosis and early recognition of different stages of CRC . Furthermore, it was previously reported that patients with increased MPV had worse survival rates than those of patients with normal MPV levels .…”

“…28 Additionally, one study found that the PDW levels of patients with CRC were higher than those in healthy participants but lower than those in adenomatous patients. 26 That signified that PDW was an advantageous prognostic factor for the survival of patients with CRC. Furthermore, research has suggested that colorectal infection could induce an inflammatory reaction and promote CRC development.…”

MicroRNA expression profile in the N2 phenotype neutrophils of colorectal cancer and screen of putative key mircRNAs

“…N1 TANs has antitumor effect, while N2 TANs can promote the occurrence, development and metastasis of tumors [7]. In addition, A number of studies revealed that the increase of neutrophil count in peripheral blood was related to poor clinical outcomes in CRC, but the mechanism of this process was unclear [8][9][10][11].…”