Document Type : Original Article

Authors

1 Department of Oncology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China

2 Department of Bio-Therapeutic, the First Medical Centre, Chinese People's Liberation Army General Hospital, Beijing, China

3 Department of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran

Abstract

This study was designed to investigate the value of red blood cell distribution width (RDW), prealbumin (PA), platelet to lymphocyte ratio (PLR), and carcinoembryonic antigen (CEA) in the diagnosis of colorectal cancer.  There was  500 colorectal cancer (CRC) patients, 250 polyps of colorectal patients, and 250 healthy volunteers performed to complete blood counts with automated differential counts. The differences in RDW, PA, PLR, and CEA among the three groups were statistically significant (P<0.05). RDW, PA, PLR, CEA, and RDW+PA+PLR+CEA all had a high accuracy rate for the diagnosis of colorectal cancer. RDW, PA, PLR, CEA, and RDW+PA+PLR+CEA were divided into high-expression groups and low-expression groups according to ROC cut-off values. Age was statistically different between the high and low groups in RDW, PA, and CEA. M staging was statistically different between high and low groups in CEA, and PLR. T staging was statistically different between high and low groups in PA, CEA, PLR, and RDW+PA+CEA+ PLR. N staging and blood vessel invasion were statistically different between the high and low groups in CEA. TNM staging was statistically different between high and low groups in PA, CEA, PLR, and RDW+PA+CEA+PLR. Perineural invasion was statistically different between the high and low groups in PA and CEA. The number of lymph node metastases was significantly and positively correlated with CEA. CEA and PLR were independent risk factors for the TNM staging. And they had good diagnostic efficacy for the TNM staging of colorectal cancer. 

Graphical Abstract

Combined Diagnostic Efficacy of Red Blood Cell Distribution Width (RDW), Prealbumin (PA), Platelet-to-Lymphocyte Ratio (PLR), and Carcinoembryonic Antigen (CEA) as Biomarkers in the Diagnosis of Colorectal Cancer

Keywords

Main Subjects

Selected author of this article by journal

Dr. Xiaolei Li
Hospital of Anhui Medical University
ORCID

Open Access

This article is licensed under a CC BY License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit: http://creativecommons.org/licenses/by/4.0/

 

Publisher’s Note

CMBR journal remains neutral with regard to jurisdictional claims in published maps and institutional afflictions.

 

Letters to Editor

Given that CMBR Journal's policy in accepting articles will be strict and will do its best to ensure that in addition to having the highest quality published articles, the published articles should have the least similarity (maximum 15%). Also, all the figures and tables in the article must be original and the copyright permission of images must be prepared by authors. However, some articles may have flaws and have passed the journal filter, which dear authors may find fault with. Therefore, the editor of the journal asks the authors, if they see an error in the published articles of the journal, to email the article information along with the documents to the journal office.

CMBR Journal welcomes letters to the editor ([email protected], [email protected]) for the post-publication discussions and corrections which allows debate post publication on its site, through the Letters to Editor. Critical letters can be sent to the journal editor as soon as the article is online. Following points are to be considering before sending the letters (comments) to the editor.

[1] Letters that include statements of statistics, facts, research, or theories should include appropriate references, although more than three are discouraged.

[2] Letters that are personal attacks on an author rather than thoughtful criticism of the author’s ideas will not be considered for publication.

[3] There is no limit to the number of words in a letter.

[4] Letter writers should include a statement at the beginning of the letter stating that it is being submitted either for publication or not.

[5] Anonymous letters will not be considered.

[6] Letter writers must include Name, Email Address, Affiliation, mobile phone number, and Comments.

[7] Letters will be answered as soon as possible.

  1. Mármol I, Sánchez-de-Diego C, Pradilla Dieste A, Cerrada E, Rodriguez Yoldi MJ (2017) Colorectal carcinoma: a general overview and future perspectives in colorectal cancer. International journal of molecular sciences 18 (1): 197. doi:https://doi.org/10.3390/ijms18010197
  2. Biller LH, Schrag D (2021) Diagnosis and treatment of metastatic colorectal cancer: a review. Jama 325 (7): 669-685. doi:https://doi.org/10.1001/jama.2021.0106
  3. Kim SY, Kim H-S, Park HJ (2019) Adverse events related to colonoscopy: Global trends and future challenges. World journal of gastroenterology 25 (2): 190. doi:https://doi.org/10.3748%2Fwjg.v25.i2.190
  4. Jain S, Maque J, Galoosian A, Osuna-Garcia A, May FP (2022) Optimal strategies for colorectal cancer screening. Current treatment options in oncology 23 (4): 474-493. doi:https://doi.org/10.1007/s11864-022-00962-4
  5. Song L-L, Li Y-M (2016) Current noninvasive tests for colorectal cancer screening: An overview of colorectal cancer screening tests. World journal of gastrointestinal oncology 8 (11): 793. doi:https://doi.org/10.4251%2Fwjgo.v8.i11.793
  6. Young GP, Pedersen SK, Mansfield S, Murray DH, Baker RT, Rabbitt P, Byrne S, Bambacas L, Hollington P, Symonds EL (2016) A cross‐sectional study comparing a blood test for methylated BCAT 1 and IKZF 1 tumor‐derived DNA with CEA for detection of recurrent colorectal cancer. Cancer medicine 5 (10): 2763-2772. doi:https://doi.org/10.1002/cam4.868
  7. Singh N, Baby D, Rajguru JP, Patil PB, Thakkannavar SS, Pujari VB (2019) Inflammation and cancer. Annals of African medicine 18 (3): 121. doi:https://doi.org/10.4103%2Faam.aam_56_18
  8. Murata M (2018) Inflammation and cancer. Environmental health and preventive medicine 23 (1): 1-8. doi:https://doi.org/10.1186/s12199-018-0740-1
  9. Song Y, Huang Z, Kang Y, Lin Z, Lu P, Lin Q, Cai Z, Cao Y, Zhu X (2018) Clinical usefulness and prognostic value of red cell distribution width in colorectal cancer. BioMed Research International 2018): Article ID: 9858943. doi:https://doi.org/10.1155/2018/9858943
  10. Ghuman S, Van Hemelrijck M, Garmo H, Holmberg L, Malmström H, Lambe M, Hammar N, Walldius G, Jungner I, Wulaningsih W (2017) Serum inflammatory markers and colorectal cancer risk and survival. British journal of cancer 116 (10): 1358-1365. doi:https://doi.org/10.1038/bjc.2017.96
  11. Yang F, Wei L, Huo X, Ding Y, Zhou X, Liu D (2018) Effects of early postoperative enteral nutrition versus usual care on serum albumin, prealbumin, transferrin, time to first flatus and postoperative hospital stay for patients with colorectal cancer: a systematic review and meta-analysis. Contemporary nurse 54 (6): 561-577. doi:https://doi.org/10.1080/10376178.2018.1513809
  12. Stojkovic Lalosevic M, Pavlovic Markovic A, Stankovic S, Stojkovic M, Dimitrijevic I, Radoman Vujacic I, Lalic D, Milovanovic T, Dumic I, Krivokapic Z (2019) Combined diagnostic efficacy of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume (MPV) as biomarkers of systemic inflammation in the diagnosis of colorectal cancer. Disease markers 2019): Article ID: 6036979. doi:https://doi.org/10.1155/2019/6036979
  13. Khandia R, Munjal A (2020) Chapter Six - Interplay between inflammation and cancer. In: Donev R (ed) Advances in Protein Chemistry and Structural Biology, vol 119. Academic Press, pp 199-245. doi:https://doi.org/10.1016/bs.apcsb.2019.09.004
  14. Mantovani A, Allavena P, Sica A, Balkwill F (2008) Cancer-related inflammation. nature 454 (7203): 436-444. doi:https://doi.org/10.1038/nature07205
  15. Campos-da-Paz M, Dórea JG, Galdino AS, Lacava ZG, de Fatima Menezes Almeida Santos M (2018) Carcinoembryonic antigen (CEA) and hepatic metastasis in colorectal cancer: update on biomarker for clinical and biotechnological approaches. Recent patents on biotechnology 12 (4): 269-279. doi:https://doi.org/10.2174/1872208312666180731104244
  16. Hao C, Zhang G, Zhang L (2019) Chapter Eleven - Serum CEA levels in 49 different types of cancer and noncancer diseases. In: Zhang L (ed) Progress in Molecular Biology and Translational Science, vol 162. Academic Press, pp 213-227. doi:https://doi.org/10.1016/bs.pmbts.2018.12.011
  17. Li X, Guo D, Chu L, Huang Y, Zhang F, Li W, Chen J (2019) Potential diagnostic value of combining inflammatory cell ratios with carcinoembryonic antigen for colorectal cancer. Cancer Management and Research 11): 9631. doi:https://doi.org/10.2147%2FCMAR.S222756
  18. de Gonzalo-Calvo D, de Luxán-Delgado B, Rodríguez-González S, García-Macia M, Suárez FM, Solano JJ, Rodríguez-Colunga MJ, Coto-Montes A (2012) Interleukin 6, soluble tumor necrosis factor receptor I and red blood cell distribution width as biological markers of functional dependence in an elderly population: A translational approach. Cytokine 58 (2): 193-198. doi:https://doi.org/10.1016/j.cyto.2012.01.005
  19. Ephrem G (2013) Red blood cell distribution width should indeed be assessed with other inflammatory markers in daily clinical practice. Cardiology 124 (1): 61-61. doi:https://doi.org/10.1159/000345925
  20. Fujii T, Sutoh T, Morita H, Katoh T, Yajima R, Tsutsumi S, Asao T, Kuwano H (2012) Serum albumin is superior to prealbumin for predicting short-term recurrence in patients with operable colorectal cancer. Nutrition and cancer 64 (8): 1169-1173. doi:https://doi.org/10.1080/01635581.2012.718034
  21. Sun F, Tan YA, Gao QF, Li SQ, Zhang J, Chen QG, Jiang YH, Zhang L, Ying HQ, Wang XZ (2019) Circulating fibrinogen to pre‐albumin ratio is a promising biomarker for diagnosis of colorectal cancer. Journal of Clinical Laboratory Analysis 33 (1): e22635. doi:https://doi.org/10.1002/jcla.22635
  22. Kilincalp S, Çoban S, Akinci H, Hamamcı M, Karaahmet F, Coşkun Y, Üstün Y, Şimşek Z, Erarslan E, Yüksel İ (2015) Neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and mean platelet volume as potential biomarkers for early detection and monitoring of colorectal adenocarcinoma. European journal of cancer prevention 24 (4): 328-333. doi:https://doi.org/10.1097/CEJ.0000000000000092