Predictive Potential Of Systemic Inflammatory Markers In Diagnosing Colorectal Cancer

Background: Screening early is a significant measure to reduce the incidence and mortality rates of colorectal cancer(CRC).In order to detect asymptomatic colorectal cancer,we set to investigate the diagnostic potential of routine laboratory indicators(hematopoietic inflammatory markers and serum tumor markers)in CRC patients and its association with pathological features along with construction of a nomogram for predicting CRC.Methods: The general pathological data and laboratory indicators for 370 CRC patients and 340 healthy individuals were collected.Indicators included neutrophil-to-lymphocyte ratio(NLR),lymphocyte-to-monocyte ratio(LMR),platelet-to-lymphocyte ratio(PLR),red blood cell distribution width(RDW),carcinoembryonic antigen(CEA),and carbohydrate antigen 19-9(CA19-9).The diagnostic efficacy was measured by the receiver operating characteristic and independent risk factors for CRC were assessed based on multivariate binary logistic regression.The predictive nomogram was established,of which the predictive accuracy and clinical practicability were evaluated by calibration curves and decision curve analysis.Results: The levels of NLR,PLR,RDW,CEA,and CA19-9 were higher,while LMR was lower in CRC than in the control group.NLR,LMR,and PLR high-low groups could be individually distinguished using several pathological features.Moreover,the combined use of all indicators was found to be diagnostically more effective as compared to use of individual markers.We observed that some of these indicators were independent risk factors for CRC.Finally,a nomogram integrating the laboratory indexes,age,and sex was established,which performed well predictive accuracy in the calibration curve(c-statistic:0.866).Decision curve analysis was demonstrated its clinical efficacy.Conclusions: Our analysis suggests that NLR and LMR could assist the staging of CRC,and the combination of six laboratory indexes can improve the diagnostic efficiency in CRC.Furthermore,our nomogram may serve as a non-invasive and simple procedure to diagnose CRC in patients deprived of better medical facilities.