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

OBJECTIVE:To investigate the preoperative systemic inflammation response index(SIRI),systemic immune-inflammation index(SII),platelet-lymphocyte ratio(PLR),lymphocyte-monocyte ratio(LMR),platelet-lymphocyte ratio(PLR)and platelet-monocyte ratio(LMR)in colorectal cancer patients undergoing radical surgery.Platelet-lymphocyte ratio(PLR),lymphocyte-monocyte ratio(LMR),hemoglobin-platelet ratio(HPR),neutrophil-lymphocyte ratio(LMR),and neutrophil-lymphocyte ratio(LMR).The diagnostic efficacy of the inflammatory factors of Neutrophil-lymphocyte ratio(NLR)and Advanced lung cancer inflammation index(ALI)in the diagnosis of colorectal tumours was analysed in relation to gender,tumour location,tumour diameter,depth of infiltration,local lymph node metastasis,distant metastasis and TNM stage.The results of the study showed that there was a correlation between the inflammation factor and gender,tumour location,tumour diameter,depth of infiltration,local lymph node metastasis,distant metastasis,TNM stage and independent risk factors for the depth of infiltration of colorectal cancer.METHODSThe clinical data of 189 patients aged 65 years or older who had undergone radical colorectal cancer surgery,including age,gender,body mass index BMI,past history,tumor location,maximum tumor diameter,infiltration depth T,regional lymph nodes N,distant metastasis M,and TNM stage,were retrospectively analyzed,while193 patients aged 65 years or older with colorectal polyps or adenomas who were seen in our hospital during the same period were selected as control group.Peripheral blood test indexes were collected from colorectal patients and benign tumor patients one week before surgery,and SIRI(Systemic inflammation response index),SII(Systemic immune-inflammation index),PLR(Platelet-lymphocyte ratio),LMR(Lymphocyte-monocyte ratio),HPR(hemoglobin to platelet ratio)were calculated.count/platelet count),NLR(Neutrophil-lymphocyte ratio),and ALI(BMI*albumin/NLR).The diagnostic performance was calculated from the receiver operating characteristic curve(ROC)and compared with the carcinoembryonic antigen to find a more accurate marker or a combination of diagnostic markers to improve the diagnostic efficacy,which was derived from the ROC curve Logostic regression was used to analyze the predictive role of inflammatory factors on the depth of tumor infiltration.Results1.The optimal cut-off values for SIRI,SII,PLR,LMR,HPR,ALI,and NLR were determined according to the ROC curve,and the area under the ROC curve was compared with the diagnostic calibration of 1.20 for SIRI(AUC=0.633,95% CI:0.578-0.689).the optimal cut-off value for SII was 626.72(The best critical value for PLR was 193.74(AUC=0.689,95% CI: 0.636-0.743).the best critical value for LMR was 3.90(AUC=0.631,95% CI: 0.576-0.687).the best critical value for HPR was0.51(AUC=0.710,95% CI: 0.659-0.762).the best critical value for ALI was 286.33(AUC=0.688,95% CI: 0.635-0.742).the best critical value for NLR was 2.82(AUC=0.639,95% CI: 0.583-0.694).The diagnostic efficacy of the ROC curve was highest when CEA+HPR+AIL was combined(AUC=0.829,95% CI: 0.787-0.868),and the sensitivity and specificity of the combined assay were higher than those of CEA alone.When analyzed after grouping according to the best cut-off value,there was a correlation between inflammatory factor indexes and tumor size,depth of infiltration,local lymph node condition,distant metastasis,and TNM stage in each group.And CEA(OR=1.116,95%: 1.013-1.230)and HPR(OR=0.039,95%:0.003-0.545)were independent risk factors for the depth of infiltration of colorectal cancer.Conclusions1.Relative to controls,blood inflammatory parameters(SIRI,SII,PLR,LMR,HPR,ALI,NLR)were significantly altered in colorectal cancer patients,and the ROC curve had the highest diagnostic efficacy when the combination of CEA+HPR+AIL was measured.2.SIRI,SII,PLR,LMR,HPR,ALI,NLR were correlated for gender,tumor location,tumor diameter,depth of tumor infiltration,local lymph nodes,distant metastasis,and TNM in CRC patients.3.HPR had correlation with tumor infiltration depth of colorectal cancer.