The Value Of Preoperative Blood Inflammatory Markers In The Diagnosis And Prognosis Of Colorectal Cancer

Objective:To investigate the tumor diagnostic performance of Neutrophil-to-Lymphocyte ratio(NLR),Lymphocyte-to-Monocyte ratio(LMR),Platelet-to-Lymphocyte ratio(PLR),Red cell distribution width-to-Lymphocyte ratio(RLR),Systemic Immune-Inflammation Index(SII)and Advanced Lung cancer Inflammation index(ALI)in peripheral blood of patients with colorectal cancer before operation,and their relationship with clinicopathological data and their influence on prognosis.Methods:The clinical data of 184 CRC patients were analyzed retrospectively,including age,gender,body mass index(BMI),tumor location,tumor size,TNM stage,tumor differentiation,tumor invasion depth,lymph node metastasis,nerve invasion,vascular invasion,etc.Retrospective analysis of 124 healthy people as age matched control group.To collect hematological indexes of healthy people and CRC patients within one week before operation,and calculated NLR(absolute neutrophil count/absolute lymphocyte count),PLR(absolute platelet count/absolute lymphocyte count),LMR(absolute lymphocyte count/absolute monocyte value),RLR(Red cell distribution width/absolute lymphocyte count),SII(absolute platelet count*absolute neutrophil count/absolute lymphocyte count),ALI(BMI*albumin count/NLR).The diagnostic performance of NLR,PLR,LMR,RLR,S? and ALI was estimated by ROC curve.According to the ROC curve,the optimal critical value was obtained,and patients were divided into high and low groups.The 5-year survival of each group was analyzed by Kaplan-Meier survival curve.Results:ROC curve analysis showed high diagnostic efficacy of NLR,PLR,LMR,RLR,S? and ALI in CRC patients with cut-off values of 2.09(AUC=0.764,95%CI 0.712-0.817,Se=57.9%,Sp=88%),143.88(AUC=0.732,95%CI 0.676-0.789,Se=60.7%,Sp=82%),4.65(AUC=0.780,95%CI 0.728-0.832,Se=82%,Sp=62.5%),7.58(AUC=0.774,95%CI 0.719-0.830,Se=61.9%,Sp=83.8%),440.87(AUC=0.747,95%CI 0.692-0.802,Se=66.5%,Sp=74.4%),540.88(AUC=0.821,95%CI 0.761-0.881,Se=89.7%,Sp=68.6%).The combination of ALI and RLR had higher diagnostic performance(AUC=0.861,95%CI 0.804-0.917,Se=79.4%,Sp=84.6%).Kaplan-Meier survival curve showed that the five-year mean survival time of high NLR group(46.94±1.57 months)was significantly lower than that of low NLR group(51.78±1.71 months)(P=0.036),and that of high LMR group(53.45±1.60 months)was significantly higher than that of low LMR group(46.59±1.53 months)(P=0.011).Conclusions:NLR,PLR,RLR,LMR,S? and ALI may be used as markers for early diagnosis of CRC,and detection of RLR and ALI at the same time has better diagnostic performance.Higher PLR may be the risk factor of CRC,and higher Ali may be the protective factor of CRC.NLR and LMR may be used to predict the prognosis of CRC patients.