Neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and red blood cell distribution width as new biomarkers in patients with colorectal cancer

Abstract

Objective: The incidence of colorectal cancer in developed countries has been found to increase with age. Early diagnosis and screening decrease the mortality rates in colorectal cancer. This study aimed to use inflammatory markers neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and red blood cell distribution width (RDW) as new biomarkers for early diagnosis and screening in patients with colorectal cancer. Materials and Methods: A total of 59 patients with colorectal cancer and 59 age- and sex-matched healthy participants were included in the study. Localization, tumor node metastasis (TNM) stage, and preoperative hemoglobin levels, neutrophil counts, lymphocyte counts, platelet counts, and RDW values were obtained from medical records. Using the receiver operating characteristic (ROC) curve, the optimal cutoff levels of the biomarkers were determined. Results: NLR, PLR, and RDW were significantly higher in patients with colorectal cancer than in healthy participants (p<0.001). According to ROC analysis, the cutoff value for NLR was 2.05 [area under the curve (AUC): 0.740, sensitivity: 78%, specificity: 66%]; the cutoff value for PLR was 130 (AUC: 0.702, sensitivity: 65%, specificity: 72%); and the cutoff value for RDW was 14 (AUC: 0.774, sensitivity: 68%, specificity: 73%). Conclusions: NLR, PLR, and RDW were found to be significantly higher in patients with colorectal cancer than in healthy participants. Therefore, it is recommended that these additional biomarkers can be used for early diagnosis and screening of colorectal cancer.