Diagnostic significance of systemic inflammatory biomarkers in colorectal cancer: Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and Mean Platelet Volume (MPV)
Vural Argın, Ahmet Orhan Sunar, Ömer Özduman, Mürşit Dinçer, Serkan Senger, Selçuk Gülmez, Orhan Uzun, Erdal Polat, Mustafa DumanDepartment of Gastrointestinal Surgery, University of Health Sciences, Kosuyolu Yuksek Ihtisas Research and Training Hospital, Istanbul, TürkiyeINTRODUCTION: Colorectal cancer (CRC) is the third most common cancer worldwide with early detection being crucial for improving survival rates. Systemic inflammatory biomarkers such as the neutrophil-to-lympho-cyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and mean platelet volume (MPV) have gained attention as potential diagnostic tools in CRC.
This study aimed to evaluate the diagnostic value of NLR, PLR, MPV, red blood cell distribution width (RDW), hemoglobin (HB), white blood cell (WBC), platelet (PLT) in CRC screening.
METHODS: A retrospective, single-center study was conducted on 1,090 patients who under-went colonoscopy between January 2020, and January 2024. Patients were categorized into malignant, premalignant, and control groups. Hematological parameters including NLR, PLR, MPV, RDW, hemoglobin (HB), white blood cell (WBC), platelet (PLT) counts were analyzed. ROC curve analysis was performed to determine diagnostic cut-off values sensitivity, and specificity.
RESULTS: NLR and PLR values were significantly higher in the malignant and premalignant groups compared to the control group (p<0.001). NLR demonstrated the highest diagnostic performance, with an AUC of 0.629, sensitivity of 50.56%, and specificity of 73.13%. PLR had lower diagnostic accuracy (AUC: 0.579, sensitivity: 40.42%, specificity: 37.04%). MPV was significantly elevated in the premalignant group but lacked strong diagnostic value due to its susceptibility to systemic diseases. RDW levels were significantly elevated in both the malignant and premalignant groups but were not sufficient as standalone diagnostic markers.
DISCUSSION AND CONCLUSION: NLR emerged as the most reliable biomarker for CRC screening, while PLR demonstrated weaker diagnostic accuracy. MPV showed limited value in CRC diagnosis, and RDW, despite its statistical significance, was influenced by other systemic factors, limiting its diagnostic utility.
Manuscript Language: English