The Diagnostic Value And Risk Factors Of Preoperative NLR And PLR In Colorectal Cancer

Aim:To explore the diagnostic value and risk factors of neutrophil-lymphocyte ratio(NLR)and platelet-lymphocyte ratio(PLR)in peripheral blood before surgery in early colorectal cancer(ECC)and advanced colorectal cancer(ACRC),so as to find new indicators for colorectal cancer screening and discover the risk factors of colorectal cancer.It may provides new ideas for clinical diagnosis and analysis of colorectal cancer.Methods:Patients who underwent colorectal surgery in our hospital on January 1,2018 and October 1,2019 were selected for a retrospective study Among them,119 patients with advanced colorectal cancer confirmed by pathology after radical resection of colon cancer by gastric colorectal surgery in our hospital were taken as the advanced colorectal cancer group.51 patients with early colorectal cancer confirmed by pathology after ESD surgery in the endoscopic center of our hospital were included in the early colorectal cancer group.As the control group,45 patients who underwent intestinal polypectomy in the endoscopic center of our hospital were pathologically confirmed to be hyperplastic polyps,adenomatous polyps,dysplasia and other non-colorectal cancer.Basic information and clinical,endoscopic and pathological data of patients in each group were collected.Statistical methods were used to analyze and compare whether the differences of NLR and PLR between each group were statistically significant,and then the diagnostic value of the statistically significant indicators on the disease was evaluated.Finally,risk stratification of PLR was carried out according to the truncation value between each group to study its relationship with the risk of colorectal cancer.Results:1.PLR and NLR in peripheral blood of patients with advanced colorectal cancer were higher than those of the control group(P < 0.05).PLR in peripheral blood of patients in the advanced colorectal cancer group was higher than that in the early colorectal cancer group(P < 0.05),and there was no statistically significant difference in NLR between the two groups.There was no significant difference in PLR and NLR between the early colorectal cancer group and the control group.2.In the diagnostic value analysis of advanced colorectal cancer,the area under the PLR curve was 0.748(moderate diagnostic value),the sensitivity was 0.73,the specificity was 0.67,and the diagnostic cut-off value was 121.66(P < 0.001).The area under the NLR curve was 0.689(low diagnostic value),the sensitivity was 0.62,the specificity was 0.58,and the diagnostic cut-off value was 1.93(P=0.039).3.The diagnostic cutoff values of PLR between the advanced colorectal cancer group and the early colorectal cancer group and between the early colorectal cancer group and the control group were 124.54 and 107.89,respectively.According to these two cutoff values,PLR was divided into three groups: < 107.89 was low PLR group,107.89 ~ 124.54 was medium PLR group,and > 124.54 was high PLR group.The risk of colorectal cancer in the medium PLR group was 2.8 times higher than that in the low PLR group(OR=2.80,95%CI:1.06-7.38,P=0.037),and the risk of colorectal cancer in the high PLR group was 5.4 times higher than that in the low PLR group(OR=5.4,95%CI:2.51-11.65,P < 0.001).Conclusion:1.Both PLR and NLR have diagnostic value for advanced colorectal cancer,PLR has moderate diagnostic value,and its diagnostic efficacy is superior to NLR.2.The PLR and NLR in peripheral blood of patients in the advanced colorectal cancer group were higher than those in the control group,and there were no statistically significant differences in PLR and NLR between the early colorectal cancer group and the control group.Considering that,compared with the advanced colorectal cancer group,the inflammatory response in the early colorectal cancer stage was relatively weak,and the inflammatory response may mainly play a role in tumor progression.3.PLR in peripheral blood of patients in the advanced colorectal cancer group was higher than that in the early colorectal cancer group,and the cutoff value of PLR between the two groups was 124.54.It was considered that PLR > 124.54 May indicate a deeper tumor infiltration.4.PLR is a risk factor for colorectal cancer.With the increase of PLR,the risk of colorectal cancer increases,which will provide an important reference value for clinical screening of colorectal cancer.