Correlation Of Peripheral Blood Markers In Diagnosis And Staging Of Colorectal Cancer

Objective（s）:Colorectal cancer is one of the most common malignant tumor of digestive system,incidence of a disease is the third in the malignant tumor,mortality is ranked second.Nowadays,surgery,radiotherapy,chemotherapy and molecular targeted therapy and immunotherapy has become the main method of treatment of colorectal cancer,and greatly improves the survival.But the prognosis of patients with locally advanced colorectal cancer is still poor and the most of the early clinical symptoms of patients with colorectal cancer is not obvious,some symptoms such as blood,anemia,weight do not appear until finally.Early diagnosis may help to reduce mortality in patients with colorectal cancer,is and quality of improve patient’s prognoslife.This study through the retrospective analysis of patients with colorectal cancer and non-colorectal cancer patients with preoperative peripheral inflammation index and the levels of tumor markers,explore preoperative peripheral inflammation and tumor marker levels and the correlation of colorectal cancer diagnosis and staging.Methods:The clinical data of colorectal cancer patients and non-colorectal cancer patients admitted to The second affiliated hospital of kunming medical university from January 2016 to December 2022 were retrospectively collected.After screening according to the inclusion and exclusion criteria,a total of 95 patients were included in the colorectal cancer group and 222 patients were included in the non-colorectal cancer group.The general data,laboratory data and pathological data of the two groups were collected retrospectively.CRC patients were divided into groups according to their pathological data,and the differences of related indexes among groups were analyzed and compared.Univariate and multivariate logistic regression analysis was used to screen independent predictors of CRC and establish a model.Receiver operating characteristic curve（ROC）was used to test the predictive power of the model,and area under curve（AUC）was calculated.AUC between 0.50 and0.70 was considered to have low accuracy.The accuracy is moderate between0.71-0.90;while higher than 0.90 is considered high accuracy.A P value<0.05 was considered statistically significant.Results:A total of 95 patients with colorectal cancer were included in this study,60（63.15%）were male patients and 35（36.84%）were female patients;The mean age was（63.52±11.23）years,ranging from 31 to 86 years.Among them,40 cases were in the right colon,2 cases in the transverse colon,12 cases in the left colon,25 cases in the sigmoid colon and 16 cases in the rectum.7 cases were T₁,10 cases were T₂,73cases were T₃,5 cases were T₄;There were 55 cases in stage N₀,32 cases in stage N₁and 8 cases in stage N₂.83 cases were M₀,12 cases were M1;The clinical stages were stageⅠ13 cases,stageⅡ38 cases,stageⅢ31 cases,stageⅣ12 cases.There were222patients in non-tumor control group,including 182 male patients（81.9%）and 40 female patients（18.01%）.The mean age was（56.29±15.15）years,ranging from 27 to84 years.Age,neutrophil count,lymphocyte count,platelet count,albumin,cholesterol,CEA,CA199,NLR,PNLR,ALI levels in colorectal cancer group were higher than those in non-colorectal cancer group（P<0.05）,but CA125 had no significant difference（P>0.05）.Logistic analysis results showed that age,neutrophil,platelet,albumin and cholesterol were independent influencing factors of CRC.According to the results of Logistic regression analysis,the clinical predictive prob-ability model of CRC was obtained:P=1/[1+e（-5.314+0.029*age+0.350*neutrophil count+0.005*platelet count-0.196*albumin count-0.548*cholesterol count）].The predictive power of the predictive model was tested by ROC curve,AUC was 0.868（P<0.001）,the maximum Youden index was 0.602,and the corresponding sensitivity was:70.7%,specificity:89.5%.The levels of platelet,CEA,CA199 and CA125 in patients with CRC in different stages were significantly higher than those in patients with CRC in stages I to II（P<0.05）.Platelet and CA125 levels in patients with T3-T4 stage were significantly higher than those in patients with T1-T2 stage（P<0.05）.Platelet levels in patients with stage N1-2were significantly higher than those in patients with stage N0（P<0.05）.CEA,CA199and CA125 levels in patients with M1 stage were significantly higher than those in patients with M0 stage（P<0.05）Conclusion（s）:1.Platelets and colorectal cancer in different TNM staging,T stage,N stage,platelets with local tumor progression and lymph node metastasis occurs gradually increased.2.According to the results of Logistic regression analysis,age,neutrophil and platelet,albumin,cholesterol is an independent predictor of CRC,in turn,can get clinical prediction probability model:P=1/(1+e（5.314+0.029+0.350**age neutrophil number+0.005*platelet count-count-0.548*0.196*albumin cholesterol）],by using the prediction model of ROC curve test,the prediction efficiency,AUC is 0.868（P<0.001）,about a maximum index is 0.602,the corresponding sensitivity is:70.7%,specific degrees for:89.5%,showed that age,neutrophil and platelet,albumin,cholesterol,formed by the five indicators in the diagnosis of system can be used in the preliminary prediction of CRC,the CRC has certain predictive value.3.CEA,CA199 and CA125 is associated with colorectal cancer M stage,and increased with tumor distant metastasis occurs gradually,help clinical judgment distant metastasis of colorectal cancer.