Are Inflammatory Markers Useful in Determining The Anatomic Localisation of Colorectal Cancer? Immature Granulocytes and Red Cell Distributon Width.
Abstract
Background: There are embryological, clinicopathlogical, and prognostic differences between right and left colon tumours. The aim of this study was to investigate the diagnostic benefit of inflammatory markers in the differentiation of right and left colon cancers.
Methods: Two groups of patients were formed as 71 (33.8%) with right colon cancer (RCC) and 139 (66.2%) with left colorectal cancer (LCRC). The groups were compared in respect of clinical characteristics, hemoglobin, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), systemic immune inflammation index (SII), immature granulocyte count (IGC), immature granulocyte percentage (IG%), and red blood cell distribution width percentage (RDW%).
Results: The TNM grade, and NLR, PLR, SII, IGC, and IG% values were similar in both groups. In the RCC group, hemoglobin was determined to be lower than in the LCRC group (11.35 [6.40-16.40] vs. 13.00 [6.00-17.00] mg/dl), and RDW was higher (14.80% [11.90-27.90] vs. 13.70% [11.00-37.10]) (p=0.001, p=0.005, respectively). In ROC analysis, hemoglobin (AUC:0.640, p<0.001) and RDW% (AUC:0.621, p=0.004) were determined to be significant.
Conclusion: Inflammatory markers such as NLR and PLR, which have been previously investigated, and SII and IGC, promising and examined for the first time, are insufficient to show the anatomic localization of CRC. However, differences were observed in RDW and hemoglobin and these may be associated with subclinical bleeding, which is frequently seen in RCC.
Keywords
Colorectal Cancer, Colorectal Cancer Localisation, Inflammatory markers, Immature Granulocytes, Red Cell Distribution Width
Ethical Statement
No funds, grants, or other support was received.
All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.
All authors declare that the study was conducted in accordance with the Declaration of Helsinki and followed the ethical standards of Türkiye. Approval was granted by the Ethics Committee of Ankara Etlik City Hospital (Date: 20.03.2024, No: AEŞH-BADEK-2024-238).
References
- Siegel RL, Miller KD, Wagle NS, Jemal A. Cancer statistics, 2023. CA Cancer J Clin. 2023;73(1):17-48.
- Cronin KA, Scott S, Firth AU, Sung H, Henley SJ, Sherman RL, et al. Annual report to the nation on the status of cancer, part 1: National cancer statistics. Cancer. 2022;128(24):4251-84.
- Benedix F, Schmidt U, Mroczkowski P, Gastinger I, Lippert H, Kube R. Colon carcinoma—classification into right and left sided cancer or according to colonic subsite? Analysis of 29,568 patients. Eur J Surg Oncol. 2011;37(2):134-9.
- Siegel RL, Wagle NS, Cercek A, Smith RA, Jemal A. Colorectal cancer statistics, 2023. CA Cancer J Clin. 2023;73(3):233-54.
- Petrelli F, Tomasello G, Borgonovo K, Ghidini M, Turati L, Dallera P, et al. Prognostic survival associated with left-sided vs right-sided colon cancer: a systematic review and meta-analysis. JAMA Oncol. 2017;3(2):211-9.
- Yahagi M, Okabayashi K, Hasegawa H, Tsuruta M, Kitagawa Y. The worse prognosis of right-sided compared with left-sided colon cancers: a systematic review and meta-analysis. J Gastrointest Surg. 2016;20(3):648-55.
- Shen H, Yang J, Huang Q, Jiang MJ, Tan YN, Fu JF, et al. Different treatment strategies and molecular features between right-sided and left-sided colon cancers. World J Gastroenterol. 2015;21(21):6470-7.
- Brulé S, Jonker D, Karapetis C, O’Callaghan CJ, Moore M, Wong R, et al. Location of colon cancer (right-sided versus left-sided) as a prognostic factor and a predictor of benefit from cetuximab in NCIC CO.17. Eur J Cancer. 2015;51(11):1405-14.
- Saidi H, Karuri D, Nyaim E. Correlation of clinical data, anatomical site and disease stage in colorectal cancer. East Afr Med J. 2008;85(6):259-62.
- Borsig L, Wolf MJ, Roblek M, Lorentzen A, Heikenwalder M. Inflammatory chemokines and metastasis—tracing the accessory. Oncogene. 2014;33(25):3217-24.