The Indicate Value Of Neutrophil/Lymphocyte Ratio In The Progress Of Colorectal Cancer

Background and objective:"Polyps-adenomas-carcinomas" has been considered as the classic evolution approach to colorectal cancer, inflammation play an important role in this procedure,and been called as" the seventh characteristics" of tumor,who participate in the development of tumor invasion and metastasis. Neutrophil/lymphocyte ratio (NLR) is a biomarker of system inflammation,increased NLR reflect the body’s inflammatory response activation and suppressed antitumor immunity.NLR level raised in varieties of malignant tumor patients and abnormally elevated NLR has been proved to be an independent risk factors of poor prognosis.Meanwhile,research about the screening value of NLR was just started in the last few years. Thus,we conduct this study to investigate the indicate value of NLR in the progress of colorectal cancer,and the relationship with clinicopathologic feature,then compared with biomarker CEA and CA199 to find a reliable combined detection program.Method:There was 45 patients with colorectal cancer,67 cases with adenomatous polyps(tubular adenoma,villous adenoma and tubulovillous adenoma) and 96 cases with hyperplastic polyps were enrolled in this study in our hospital between January 2013 to March 2015.We also selected 30 peopel as normal control group who completed colonoscopy examination but didn’t find any obvious lesions.Collect all patients clinical data, including gender,age,blood routine,tumor markers,pathology and imaging data,then perform statistical analysis.NLR was obtained from peripheral blood neutrophil count divide by lymphocyte count. All the data was processed by SPSS15.0 statistical software, P<0.05 was considered as statistical difference.Result:The NLR in colorectal cancer patients group is 3.13±1.59, which is significantly higher than that of adenomatous polyp, hyperplastic polyp and normal control groups (P<0.05);ROC curve analysis showed that the area under curve (AUC) of NLR is 0.727,95% CI (0.646-0.809), higher than that of CA199 (AUC 0.612, 95% CI (0.518～0.706))(P<0.05),but there is no statistical difference of AUC between NLR and CEA (P>0.05).The threshold of NLR is 2.73, and the best sensitivity and specificity of NLR in colorectal cancer screening is 58.7% and 76.0%,respectively.The sensitivity and specificity can reach as high as 81.62% and 95.08% when combine detection of NLR,CEA and CA199, higher than NLR combined CA199,NLR combine CEA and CEA combined CA199 detecting programs.The raised NLR is correlated with clinical stages,lymph node metastasis and distant metastasis of colorectal cancer patients,while have no relationship with gender,age,location of tumor,pathological type and degree of differentiation.Conclusion:1.As an indicator of inflammation, the level of peripheral blood NLR increased significantly in patients with colorectal cancer, NLR can be treated as a potential tumor markers for colorectal cancer screening.2.The sensitivity and specificity of NLR is not high enough in colorectal cancer screening, while combine detection with NLR,CEA and CA199 can improve the diagnosis accuracy.3.The increased NLR is associated with tumor stage, lymph node metastasis and distant metastasis in colorectal cancer patients, detect the NLR level is helpful to identify the clinical stage and progress of colorectal cancer.