Diagnostic value of hematological parameters platelet to lymphocyte ratio and hemoglobin to platelet ratio in patients with colon cancer
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.
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Patients
This retrospective study included three groups: colon cancer group, benign colon tumor group and healthy control group. All clinical data were collected from the electronic medical records of the First Affiliated Hospital of Guangxi Medical University, China, from January 2012 to September 2019. The inclusion criteria for the colon cancer group were (i) patients treated with surgical resection and (ii) patients diagnosed with colon cancer by histopathology. Patients who met the following
Comparison of laboratory parameters among the different groups
The characteristics of the three groups included in the study are summarized in Table 1. For the colon cancer group, 203 males and 151 females were included, with an average age of 54.76 ± 12.45 years. For the colon benign tumor group, 73 males and 35 females were included, with an average age of 53.19 ± 13.11 years. For the healthy control group, 80 males and 43 females were included, with an average age of 53.41 ± 6.84 years. No statistical difference in age or gender was obeserved among the
Discussion
The early diagnosis of colon cancer is an important factor in improving the treatment rate and reducing the mortality of patients with colon cancer [13]. The genesis, development, invasion and metastasis of tumor cells are closely related to inflammatory response [14]. PLR, a classic indicator of inflammation, is associated with colon cancer [15]. Bailon-Cuadrado et al. [16] evaluated the prognosis of 201 patients with colon cancer treated with curative surgery, and found that the overall
Funding
This work is supported by National Natural Science Foundation of Guangxi (2018GXNSFAA28123) and Guangxi Natural Science Foundation Project (No. 2018GXNSFBA281160).
CRediT authorship contribution statement
Zuojian Hu: Validation, Writing - original draft, Writing - review & editing. Shaolin Tan: Methodology, Writing - review & editing. Siyuan Chen: Visualization. Shanzi Qin: Data curation, Huaping Chena, Formal analysis. Simeng Qin: Investigation, Resources. Zhili Huang: Software. Fengyuan Zhou: Software. Xue Qin: Conceptualization, Funding acquisition, Project administration, Supervision.
Declaration of Competing Interest
None.
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These authors contributed equally to this work and should be considered as co-first authors.