Diagnosis Of Colorectal Cancer By Neutrophil-lymphocyte Ratio Combined With Carcinoembryonic Antigen

Objective:Colorectal cancer?CRC?is the third most common cancer worldwide and the second leading cause of cancer-related death^[1].The reason for its high mortality rate is that a simple and cost-effective CRC screening method has not been found so far.In recent years,studies at home and abroad have shown that inflammation plays a key role in the occurrence,development and metastasis of tumors,and the neutrophil-lymphocyte ratio?NLR?in peripheral blood as a substitute for inflammatory response has also been reported in many literatures,pointing out that NLR is closely related to the diagnosis,staging and prognosis of colorectal cancer.Carcinoembryonic antigen?CEA?,as a tumor marker,has long been clinically applied for colorectal cancer diagnosis,prognosis prediction,auxiliary staging and follow-up.The purpose of this study was to explore the significance of NLR alone and CEA in the early diagnosis of colorectal cancer.Methods:By retrospective analysis,103 cases of colorectal cancer patients newly treated in our hospital from January 2016 to January 2018 were selected as the research group,and 147 cases of colorectal adenomatous polyps patients and 150 cases of healthy patients in the physical examination center of our hospital during the same period were selected as the polyp group and healthy control group.Basic data including gender,age,neutrophil count and lymphocyte count in preoperative peripheral blood routine,CEA and postoperative pathological diagnosis were collected.The Logistic regression analysis and receiver operating characteristic curve?ROC curve?were used to determine the critical value of NLR in the diagnosis of colorectal cancer,and the independent and combined indicators of NLR and CEA for the detection of colorectal cancer were analyzed.Results:?1?There was no statistical difference in gender and age between the NLR and CEA of the three groups?P>0.05?.There was a statistically significant difference in neutrophils among the three groups?F=17.915,P<0.001?,in which the neutrophils expression in the cancer group was higher than that in the polyp group and the control group,and the difference was statistically significant?P<0.001 in both groups?.There was no difference between the polyp group and the control group,which was not statistically significant.The lymphocyte expression in the control group was higher than that in the cancer group and the polyp group,and the lymphocyte expression in the polyp group was higher than that in the cancer group,and the difference was statistically significant?all P<0.001?.The difference between NLR and CEA was statistically significant??²=77.034,P<0.001;?²=68.713,P<0.001?.The expression levels of NLR and CEA in the cancer group were higher than those in the polyp group and the control group,and the expression levels of NLR and CEA in the polyp group were higher than those in the control group,with statistically significant differences?all P<0.001?.?2?the optimal cut-off point value,sensitivity 83.13%,specificity 62.00%,area under the curve?AUC?0.80 and 95%confidence interval?CI?0.75-0.86 for the diagnosis of colorectal cancer were determined by ROC curve.According to the current studies on CEA,5ng/ml was used as the diagnostic threshold,that is,serum CEA greater than or equal to 5ng/ml was diagnosed as positive,while serum CEA less than 5ng/ml was negative.The sensitivity and specificity of CEA in diagnosis of colorectal cancer were53.01%,95.33%,0.79 AUC and 0.72-0.85 CI.The sensitivity and specificity of NLR combined with CEA in the diagnosis of colorectal cancer were 75.90%,93.35%,0.89AUC and 0.84-0.94 CI.Conclusion:?1?Neutrophils,lymphocytes and NLR showed no difference in age or sex.?2?ROC curve showed that the optimal critical value of NLR in the diagnosis of colorectal cancer was 1.76,and the sensitivity and specificity were 83.13%and 62.00%,respectively.Therefore,NLR has a high sensitivity and specificity in the diagnosis of colorectal cancer.?3?The sensitivity and specificity of NLR combined with CEA in the diagnosis of colorectal cancer are 75.90%and 93.33%,so the combined application of NLR and CEA can improve the sensitivity and specificity of early colorectal cancer.