The clinical value of peripheral blood related indicators in the differential diagnosis of colon cancer and colon adenoma

Zhao Shiyu; Ju Ying; Gao Binbin; Tian Wenjun; Lu Bingru; Ding Shan; Liu Yiqing

doi:10.3760/j.issn.1673-4777.2024.04.018

Abstract：Objective To investigate the clinical value of peripheral blood neutrophil to white blood cell ratio(NWR),lymphocyte to white blood cell ratio(LWR),carcinoembryonic antigen(CEA),and carbohydrate antigen 125(CA125)in the differential diagnosis of colon cancer and colon adenoma.Methods A total of 129 colon cancer patients who were diagnosed with colon cancer and underwent radical colon cancer surgery at Shandong Provincial Hospital Affiliated to Shandong First Medical University from April 2015 to August 2022 were collected as the colon cancer group.During the same period,129 colon adenoma patients were randomly collected as the colon adenoma group for retrospective analysis.The clinical data and peripheral blood NWR,LWR,CEA and CA125 levels were compared between the two groups.The relationship between four peripheral blood indicators and the pathological characteristics of colon cancer was analyzed.The receiver operating characteristic(ROC)curve was drawn to analyze the clinical value of NWR,LWR,CEA,CA125 alone and combined detection in the differential diagnosis of colon cancer and colon adenoma.Results The levels of NWR,CEA and CA125 in colon cancer group were higher than those in colon adenoma group,and LWR was lower than that in colon adenoma group(all P＜0.05).The CEA of colon cancer patients with invasion depth beyond the muscular layer was higher than that of patients without invasion depth beyond the muscular layer,the LMR of peripheral blood of patients with tumor diameter ≥7 cm was lower than that of patients with tumor diameter＜7 cm,while NWR and CA125 levels were higher than those of patients with tumor diameter＜7 cm(all P＜0.05).The results of ROC curve analysis showed that the combined detection of NWR,LWR,CEA and CA125[area under the curve(AUC)=0.799,95％confidence interval:0.745-0.846]could improve the efficacy of differential diagnosis of colon cancer and colon adenoma patients compared with single detection(NWR AUC=0.746,95％ confidence interval:0.707-0.814;LWR AUC=0.739,95％confidence interval:0.681-0.792;CEA AUC=0.572,95％confidence interval:0.509-0.633;CA125 AUC=0.635,95％confidence interval:0.573-0.694).Conclusions The combined detection of NWR,LWR,CEA and CA1 25 has a certain predictive value for the differential diagnosis of colon cancer and colon adenoma,and can assist in the diagnosis of colon cancer.