Diagnostic value of the lymphocyte-to-monocyte and albumin-to-globulin ratios in patients with colon cancer

Abstract

Background: Ample evidence has revealed that the lymphocyte-to-monocyte ratio (LMR) and albumin-to-globulin ratio (AGR) are cancer-related inflammatory markers. The present study aimed to assess whether LMR and AGR, alone or in combination with carcinoembryonic antigen (CEA), was a useful diagnostic marker for colon cancer.Methods: This retrospective study enrolled 251 patients with colon cancer, 171 patients with benign colon diseases, and 187 healthy control subjects from January 2012 to September 2019. Mann-Whitney U test or Chi-square test were used to analyze differences between groups in laboratory parameters and clinicopathological features. The diagnostic value of LMR and AGR combined or not with CEA in colon cancer patients was determined via a receiver operating characteristic (ROC) curve.Results: The levels of LMR and AGR were decreased in the colon cancer group compared with the healthy control and benign colon disease groups. The LMR and AGR were correlated with lymph node metastasis, tumor size, and clinical stage. Moreover, AGR was associated with distant metastasis. Both the LMR (r = −0.137, p = 0.030) and AGR (r = −0.178, p = 0.005) were negatively correlated with the concentration of CEA. LMR or AGR combined with CEA could enhance sensitivity (75.30% for LMR + CEA, 58.57% for AGR + CEA) and generate larger area under curve (AUC; 0.75 for LMR + CEA, 0.74 for AGR + CEA) compared with the LMR (p < 0.001), AGR (p < 0.001), or CEA (p < 0.001) alone.Conclusion: The combination of LMR or AGR with CEA may enhance the sensitivity and diagnostic efficacy of detecting colon cancer from benign colon diseases.