Diagnostic value of hematological parameters platelet to lymphocyte ratio and hemoglobin to platelet ratio in patients with colon cancer

Highlights

• Hematological indexes are associated with colon cancer and benign colon tumors.

• Hematological ratios relates to clinicopathological features in colon cancer.

• Combined use of PLR, HPR and CEA can improve the diagnostic efficacy of colon cancer.

Abstract

Objective

This study was designed to retrospectively analyze the value of the hematological parameter platelet to lymphocyte ratio (PLR) and hemoglobin to platelet ratio (HPR) in patients with colon cancer.

Methods

The hematological parameters and clinical data of 354 cases patients with colon cancer, 108 cases patients with benign colon tumors and 123 healthy controls were collected from our hospital electronic medical records.

Results

Compared with the colon benign tumor group and the healthy control group, the colon cancer group had an increased PLR value and a decreased HPR value. The correlation between the clinicopathological features and the laboratory parameters of colon cancer patients was analyzed, and the results showed that both PLR and HPR were associated with tumor invasion and tumor size. Compared with PLR (AUC = 0.725, 95%CI: 0.682–0.765), HPR (AUC = 0.752, 95%CI: 0.710–0.790) or carcinoembryonic antigen (CEA) (AUC = 0.710, 95%CI: 0.666–0.751) used alone, the combination with PLR and CEA (AUC = 0.790, 95%CI: 0.750–0.826) or with HPR and CEA (AUC = 0.814, 95%CI: 0.775–0.848) can improve specificity and produce greater AUC in differentiating colon cancer from benign colon cancer.

Conclusion

Combined application of PLR, HPR, and CEA may improve the diagnostic efficacy of distinguishing between colon cancer and benign colon tumors.

Introduction

Colon cancer is a common malignant tumor of the digestive tract occurring in the colon [1]. In the 2018 cancer statistics, 1,096,601 new cases of colon cancer were found, accounting for the fourth highest incidence of global cancers [2]. In 2015, the incidence and mortality of colon cancer ranked fifth among all cancers in China [3]. The early clinical symptoms of most colon cancer patients are not obvious, and some symptoms such as bloody stools, anemia, and weight loss do not occur until the middle and late stages [4]. Colonoscopy is a common examination for assistant diagnosis of colon cancer, but it has the characteristics of invasive, traumatic, and expensive [5]. Therefore, finding a high diagnostic efficacy index that distinguishes between colon cancer and benign colon tumors is clinically significant.

In recent years, many studies have shown that inflammation is an indispensable part of the occurrence and development of tumors [6], [7]. Platelet to lymphocyte ratio (PLR) has been shown to be associated with systemic inflammation and its clinical value in a variety of diseases has been reported [8], [9], [10]. Anemia is a common clinical manifestation of cancer patients, and reduced hemoglobin to platelet ratio (HPR) is associated with the poor prognosis of renal cell carcinoma [11]. Carcinoembryonic antigen (CEA) is a well-known tumor marker commonly used to assist in the diagnosis of colon cancer, but its sensitivity and specificity are poor [12].

Therefore, this study aimed to investigate the clinical value of PLR, HPR, and CEA alone or in combination in differentiating colon cancer from benign colon tumors.