Study On The Clinical Value Of Neutrophil/Albumin Ratio Combined With Fibrinogen In Colorectal Cancer

Objective: To study the expression characteristics of peripheral blood Neutrophil-to-Albumin Ratio(NAR)and Fibrinogen(FIB)in colorectal cancer,colorectal polyps and healthy patients before operation,so as to explore the relationship between them and tumor pathological features and clinical stages,hoping to provide some new ideas for early screening,clinical diagnosis and analysis of colorectal cancer.Methods: A total of 245 patients with colorectal malignant tumor diagnosed by pathology in our hospital from 2017.01 to 2019.12 were selected as colorectal cancer group and hospitalized in our hospital in the same period.110 patients with colorectal polyps were set as polyps group and 91 healthy patients as experimental control group.The age,sex and other general conditions of the three groups of patients,the number of neutrophils and absolute value of albumin in peripheral venous blood routine before operation,fibrinogen(FIB)and carcinoembryonic antigen(CEA),and postoperative laboratory pathological results were compared and analyzed.Kruskal-Wallis rank sum test was used to compare whether there were differences in neutrophil count,fibrinogen,albumin absolute value and CEA expression level among the three groups of patients.At the same time,whether there were differences in blood NAR expression levels among patients with colorectal cancer in different TNM stages and pathological features were analyzed.The cutoff values of NAR and FIB for predicting colorectal cancer were measured according to the receiver working characteristic curve(ROC curve),and the performance of NAR and FIB in detecting colorectal cancer was analyzed.The best cut-off values of Δ NAR and Δ FIB were selected by ROC curve.The patients were divided into Δ NAR ≤ 0.084 group(n = 75),Δ NAR > 0.084 group(n = 170),Δ FIB > 3.435 group(n = 97)and Δ FIB > 3.435 group(n = 148).The differences of age,sex,depth of tumor invasion,tumor diameter,tumor pathological TNM stage,vascular invasion,lymphatic metastasis and distant metastasis between the two groups were analyzed by SPSS23.0 software.Results:(1)There was no significant difference in the expression of NAR and FIB among the three groups in terms of sex and age(P>0.05).There were significant differences in the expression of neutrophils,albumin and CEA among different groups(P<0.05).(2)The expression level of NAR and FIB in cancer group was higher than that in colorectal polyp group and healthy control group,and the difference was statistically significant(P<0.05).There was no significant difference in the expression of NAR and FIB between the polyp group and the control group(P>0.05).(3)NAR and NAR-FIB have good predictive value in colorectal cancer with different CRC stages,and provide some diagnostic value in helping to differentiate colorectal cancer.(4)There was significant difference in the expression of NAR in blood among different T1-T4 stages of colorectal cancer(P<0.05).There was no significant difference in blood NAR content among N0-N2 stages(P > 0.05).However,there was a significant difference in blood NAR between M1 stage and M0 stage of colorectal cancer,which was statistically significant(P<0.05).There was no significant difference in blood NAR content among colorectal cancer patients with different tumor growth location and tumor morphological characteristics(P>0.05).However,there were significant differences in blood NAR expression among patients with different tumor differentiation types(P<0.05).(5)Through the ROC curve,we measured NAR to predict the performance of colorectal cancer.The results showed that the cut-off value of NAR was 0.084,the sensitivity was 70.2%,the specificity was65.2%,and the area under the curve(AUC)= 0.735,95%,CI 0.676-0.794.The cut-off value of FIB for predicting colorectal cancer was 3.435,the sensitivity was60.4%,and the specificity was 84.8%.The sensitivity of neutrophil / albumin(NAR)combined with FIB,in predicting colorectal cancer in the population was74.7%,and the specificity was 75.3%.(6)There were significant differences in clinicopathological features such as tumor diameter,distant metastasis and clinical stage between high FIB group and low FIB group(P<0.05).There were no significant differences in sex and age,history of hypertension,depth of tumor invasion,vascular invasion and nerve invasion,distant metastasis and clinical stage between high NAR group and low NAR group(P>0.05).Conclusions:(1)The expression level of NAR in blood of patients with colorectal cancer was positively correlated with T stage and M stage,and negatively correlated with tumor differentiation type.(2)NAR and NAR-FIB have good predictive value in different CRC stages of colorectal cancer,and provide some diagnostic value in the differential diagnosis of colorectal cancer.(3)NAR combined with FIB can improve the sensitivity and specificity of colorectal cancer prediction in population.(4)The expression level of FIB in patients with colorectal cancer is closely related to the diameter of malignant tumor,distant metastasis and clinical stage,which provides a reference for the diagnosis and treatment of patients with colorectal cancer.