Clinical Value Of Neutrophil Lymphocyte Ratio And Platelet Lymphocyte Ratio Combined With Tumor Markers In Patients With Colorectal Cancer

Objective:The purpose of this study was to investigate the correlation between neutrophil lymphocyte ratio and platelet lymphocyte ratio and clinicopathological characteristics in patients with colorectal cancer.And the predictive value of inflammatory markers combined with tumor markers for colorectal cancer tumor invasion depth,lymph node metastasis,and distant metastasis,so as to improve the accuracy of prognosis of colorectal cancer by TNM staging,and provide guidance and ideas for clinical diagnosis and treatment of colorectal cancer.Methods:Collected from 2013 to 2019 in the first affiliated hospital of shanxi medical university digestive internal medicine and general surgery with complete data of300 patients with colorectal cancer and healthy physical examination,100 cases of colorectal cancer in patients with colorectal cancer 52 cases,115 cases of left co lon cancer,115 cases of right half colon cancer,postoperative pathological hint of37 cases infiltrating depth of T1,T2,T3,T4 of 185 cases with simultaneous liv er metastasis 55 cases,with the lungsThe average age of 19 patients with ovarian and other organ metastases was 57.5 years(30-85 years).Relevant clinical data o f patients and normal physical examiners were collected,and The measurement da ta that did not conform to the normal distribution were represented by the median(lower quartile,upper quartile),and the comparison between the two groups was conducted using the mann-whitney U test;ROC curves of NLR and PLR were p lotted,and the optimal critical values were found and grouped.The correlation bet ween NLR,PLR and clinicopathological features was analyzed by chi-square test.And USES the binary classification Logistic regression analysis of colorectal cance r infiltration depth,lymph node metastasis and distant metastasis of independent ri sk factors.Using ROC curve said inflammatory markers and tumor markers detect ion TNM staging of colorectal cancer prediction efficiency and calculate the area under the curve(AUC),evaluate the real clinical value of the individual and joint index.AUC > 0.5 and the closer to 1,shows that prediction performance better,P < 0.05 for the difference was statistically significant,inspection level bilateral alpha = 0.05Results:1.NLR and PLR in 300 patients with colorectal cancer were significantly higher than those in 100 healthy patients,and the differences were statistically significant(all P<0.001)?2.ROC curve was used to determine whether the NLR and PLR were the optimal critical values for the detection of colorectal cancer at the initial diagnosis stage(stage III-IV).The area under the curve was 0.636 and 0.584,respectively.When reaching the maximum jorden index respectively(0.25 and 0.156);The results of ROC analysis suggested that the sensitivity specificity and accuracy of NLR in judging advanced colorectal cancer were 57.3%,67.7% and 63.6%,respectively,when the NLR took 2.92 as the critical value and PLR 164.53 as the critical value.60.8%,54.8%,58.4%.3.The results of univariate analysis suggested that NLR was correlated with T NM staging of tumor differentiation and distant metastasis and CEA CA19-9.PLR was associated with TNM staging of tumor differentiation and CEA CA19-9 in tu mor infiltrating depth of lymph node metastasis,the difference was statistically significant(all P<0.05).However,there was no significant difference between the age and sex of the patients and the tumor type(all P>0.05).4.Logistic regression analysis suggested that the depth of tumor invasion in c olorectal cancer patients was closely related to the degree of tumor differentiation,lymph node metastasis and high NLR.Lymph node metastasis was closely related to the depth of tumor site invasion CEA,CA19-9.Distant metastasis was closely r elated to CEA of tumor lymph node metastasis,The difference was statistically sig nificant(all P<0.05).5.The ROC curve results of detecting TNM stage of colorectal cancer with inflammatory markers and tumor markers suggested that NLR combined with CEA was the better indicator to detect the depth of invasion of colorectal cancer,with an AUC value of 0.703,a sensitivity of 74.6% and a specificity of 65.1%.CEA combined with ca19-9 was the better index for the detection of lymph node metastasis in colorectal cancer,with an AUC value of 0.742,a sensitivity of 63.7%,and a specificity of79.5%.CEA combined with CA19-9 was also the better index for the detection of distant metastasis of colorectal cancer,with an AUC value of 0.826,a sensitivity of 61.9%,and an specificity of 83.3%Conclusion:Preoperative NLR,PLR,CEA,and CA19-9 were associated with the depth o f invasion,lymph node metastasis,and distant metastasis of colorectal cancer.In a ddition,the combination of systemic inflammatory markers and tumor markers has certain value in predicting TNM staging,which provides a reference for accurate clinical staging and effective prognosis assessment,and provides a theoretical bas is for clinical diagnosis and treatment of colorectal cancer.