Predictive value of combined detection of peripheral blood related indicators on 3-year survival of patients with colorectal cancer after radical resection

Ren Shipu; Li Yunxia; Zhu Zengqiang; Li Wen; Wang Yubin

doi:10.3760/j.issn.1673-4777.2025.02.013

Abstract：Objective To investigate the predictive value of preoperative circulating tumor DNA(ctDNA),red blood cell volume distribution width to platelet ratio(RPR)and neutrophil to lymphocyte ratio(NLR)in 3-year survival of patients with colorectal cancer after radical resection.Methods A total of 114 patients who underwent radical resection of colorectal cancer in Lanzhou Petrochemical General Hospital from March 2020 to March 2021 were selected as the colorectal cancer group.A total of 114 healthy volunteers were selected as the control group.The levels of ctDNA,RPR and NLR in peripheral blood were detected and calculated.All patients with colorectal cancer were followed up for 3 years after radical resection,and were divided into death group and survival group according to survival situation.The Kaplan-Meier method was used to analyze the relationship between the levels of ctDNA,RPR and NLR in peripheral blood and the 3-year survival of patients with colorectal cancer after radical resection.The receiver operating characteristic curve was used to analyze the predictive value of the combined detection of ctDNA,RPR and NLR in peripheral blood for the 3-year survival of patients with colorectal cancer after radical resection.Results The levels of ctDNA,RPR,and NLR in peripheral blood of patients with colorectal cancer were significantly higher than those in the control group(all P＜0.001).The levels of ctDNA,RPR and NLR in peripheral blood are related to TNM stage,differentiation degree,lymph node metastasis and carcinoembryonic antigen level(all P＜0.05).In this study,40 patients died(death group)and 74 patients survived(survival group).The levels of ctDNA,RPR and NLR in peripheral blood of patients in the death group were significantly higher than those in the survival group[(98±12)μg/L vs(79±12)μg/L,(0.19±0.05)vs(0.14±0.04),(2.8±0.4)vs(2.1±0.5)](t=8.221,5.825,7.384,all P＜0.001).The 3-year survival rates of patients in the high level group of ctDNA,RPR and NLR were lower than those in the low level group(all P＜0.05).The area under the receiver operating characteristic curve of the combined detection of ctDNA,RPR and NLR in predicting the 3-year survival of patients with colorectal cancer after radical resection was significantly larger than that of ctDNA,RPR and NLR alone(all P＜0.05).Conclusion The combination of ctDNA,RPR and NLR can be used as a predictor of survival in patients with colorectal cancer after radical resection.