Online ISSN 2313-1519
Print    ISSN 1812-2892
Abstract - The contribution of hematological parameters to prediction of the phase in stage 2 and stage 3 colon cancers
[PDF]           
Erkan Karacan, Eyüp Murat Yılmaz, Buse Yıldız, Ahmet Ender Demirkiran

 

ABSTRACT

Purpose: Colorectal cancers are a significant cause of cancer-related deaths around the world. In the preoperative staging of colon cancers, radiological images and various blood tests are used. However, it is both difficult and expensive to apply radiological examinations. In our study, we aimed at predicting the stage of colon cancers by preoperatively viewing the hematological parameters, which are simple, cheap and easy to apply. 

Material and methods: The patients, who had been operated due to colon cancer by a single surgeon in the General Surgery Clinic between January 2015 and January 2020, were divided into two groups as stage 2 and stage 3 according to the tumor-nodule-metastases classification. In these groups, preoperative mean platelet volume, carcinoembryonic antigen, platelet/lymphocyte count ratio and neutrophil/lymphocyte count ratios were checked and evaluated in terms of staging and significance according to postoperative pathology results. According to the tumor-nodule-metastases classification, Stage 1-4 patients, emergency cases, patients with an inflammatory disease and rectal cancer were excluded from the study.   

Results: In the study, 38 of 59 patients who had been operated between January 2015 and January 2020 were found to be at stage 2 (group 1), and 21 patients at stage 3 (group 2). While no significant difference was found between carcinoembryonic antigen and neutrophil/lymphocyte levels between group 1 and group 2, a proportional increase was observed between the increase in platelet/lymphocyte ratio and staging (p=0.041). Mean platelet volume was seen to be proportional to stage progression (p=0.03).  

Conclusion: We think that platelet/lymphocyte ratio and mean platelet volume levels can easily be applied as a cheap and simple test in the prediction of the preoperative stage in stage 2-3 colon cancers.

Key words: colon cancer, neutrophil lymphocyte ratio, platelet lymphocyte ratio, mean platelet volume

 

Corresponding Author: Erkan Karacan, Department of General Surgery, Aydın State Hospital, Aydin, Turkey. Tel.: +905075657221, E-mail: erkan8806@gmail.com

 

 

References

1. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin. 2011; 61:69-90. https://doi.org/10.3322/caac.20107

2. Swiderska M, Choromańska B, Dąbrowska E, Konarzewska- Duchnowska E, Choromańska K, Szczurko G, et al. The diagnostics of colorectal cancer. Contemp Oncol (Pozn). 2014; 18:1-6.
https://doi.org/10.5114/wo.2013.39995

3. Barone C; Astone A; Cassano A; et aI. Advanced colon cancer: Staging and prognosis by CEA Test. Oncology. 1990; 47:128-132. https://doi.org/10.1159/000226804

4. Ong SL, Garcea G, Thomasset SC, Mann CD, Neal CP, Abu Amara M, et al. Surrogate markers of resectability in patients undergoing exploration of potentially resectable pancreatic adenocarcinoma. J Gastrointest Surg. 2008; 12:1068-73. https://doi.org/10.1007/s11605-007-0422-6

5. Ong SL, Garcea G, Thomasset SC, Mann CD, Neal CP, Abu Amara M, et al. Surrogate markers of resectability in patients undergoing exploration of potentially resectable pancreatic adenocarcinoma. J Gastrointest Surg. 2008; 12:1068-73. https://doi.org/10.1007/s11605-007-0422-6

6. H.-C. Kwon, S. H. Kim, S. Y. Oh et al. Clinical significance of preoperative neutrophil-lymphocyte versus platelet-lymphocyte ratio in patients with operable colorectal cancer. Biomarkers. 2012; 17(3):216-222. https://doi.org/10.3109/1354750X.2012.656705

7. J.-F. Feng, Y. Huang, Q. Zhao, and Q.-X. Chen. Clinical significance of preoperative neutrophil lymphocyte ratio versus platelet lymphocyte ratio in patients with small cell carcinoma of the esophagus. Scientific World Journal. 2013; 2013(504365):7. https://doi.org/10.1155/2013/504365

8. R. D'Incà, R. Cardin, L. Benazzato, I. Angriman, D. Martines, and G. C. Sturniolo. Oxidative DNA damage in the mucosa of ulcerative colitis increases with disease duration and dysplasia. Inflammatory Bowel Diseases. 2004; 10 (1):23-27. https://doi.org/10.1097/00054725-200401000-00003

9. Roxburgh CS, McMillan DC. Role of systemic inflammatory response in predicting survival in patients with primary operable cancer. Future Oncol. 2010; 6:149-63. https://doi.org/10.2217/fon.09.136

10. O. Andronic, Alexandra Bolocan, Georgiana Radu, D.N. Păduraru, D. Ion, S.M. Hematologicial parameters and tumor size in rectal cancer. Journal of Surg Scienc. 2019; 6(2). https://doi.org/10.33695/jss.v6i2.269

11. Roxburgh CS, Salmond JM, Horgan PG, Oien KA, McMillan DC. Comparison of the prognostic value of inflammation-based pathologic and biochemical criteria in patients undergoing potentially curative resection for colorectal cancer. Ann Surg. 2009; 249:788-93. https://doi.org/10.1097/SLA.0b013e3181a3e738

12. G Absenger, J Szkandera, M Pichler, M Stotz, F Arminger, M Weissmueller et al. A derived neutrophil to lymphocyte ratio predicts clinical outcome in stage II and III colon cancer patients. Br J Cancer. 2013; 109(2):395-400. https://doi.org/10.1038/bjc.2013.346

13. Joanna Szkandera, Martin Pichler, Gudrun Absenger, Michael Stotz, Franziska Arminger, Melanie Weissmueller et al. The elevated preoperative platelet to lymphocyte ratio predicts decreased time to recurrence in colon cancer patients. The American Journal of Surgery. 2014; 208:210-214 https://doi.org/10.1016/j.amjsurg.2013.10.030

14. You J, Zhu GQ, Xie L, Liu WY, Shi L, Wang OC et al. Preoperative platelet to lymphocyte ratio is a valuable prognostic biomarker in patients with colorectal cancer. Oncotarget. 2016; 7(18): 25516-25527. https://doi.org/10.18632/oncotarget.8334

15. Zhou X, Du Y, Huang Z, Xu J, Qiu T, Wang J et al. Prognostic Value of PLR in Various Cancers: A Meta-Analysis. PloS one. 2014; 9(6). https://doi.org/10.1371/journal.pone.0101119

16. Jing Jia, Xiongwei Zheng, Ying Chen, Lin Wang, Lu Lin, Xingming Ye et al. Stage-dependent changes of preoperative neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in colorectal cancer. Tumor Biology. 2015; 36(12):9319-9325. https://doi.org/10.1007/s13277-015-3667-9

17. H. A. Goubran, J. Stakiw, M. Radosevic, and T. Burnouf. Platelets effects on tumor growth. Seminars in Oncology. 2014; 41(3):359-369. https://doi.org/10.1053/j.seminoncol.2014.04.006

18. Serta Kilincalp, Şahin Çoban, Hakan Akinci, Mevlüt Hamamcı, Fatih Karaahmet, Yusuf Coşkun et al. Neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and mean platelet volume as potential biomarkers for early detection and monitoring of colorectal adenocarcinoma. European Journal of Cancer Prevention. 2015; 24(4):328-333. https://doi.org/10.1097/CEJ.0000000000000092

19. Jia-Ying Li, Ying Li, Zheng Jiang, Rui-Tao Wang, Xi-Shan Wang. Elevated mean platelet volume is associated with presence of colon cancer. Asian Pac J Cancer Prev. 2014; 15(23):10501-10504.
https://doi.org/10.7314/APJCP.2014.15.23.10501

20. Xianjin Zhu, Yingping Cao, Pingxia Lu, Yanli Kang, Zhen Lin, Taisen Hao et al. Evaluation of platelet indices as diagnostic biomarkers for colorectal cancer. Scientific reports. 8(1):1-7. https://doi.org/10.1038/s41598-018-29293-x

21. Chen CC, Yang SH, Lin JK, Lin TC, Chen WS, Jiang JK et al. Is it reasonable to add preoperative serum level of CEA and CA19-9 to staging for colorectal cancer? Journal of surgical research. 2005; 124(2):169-174. https://doi.org/10.1016/j.jss.2004.08.013

22. Stojkovic Lalosevic M, Stankovic S, Stojkovic M, Markovic V, Dimitrijevic I, Lalosevic J et al. Can preoperative CEA and CA19-9 serum concentrations suggest metastatic disease in colorectal cancer patients? Hell J Nucl Med. 2017; 20(1):41-45.

23. Duffy, M. J. (2001). Carcinoembryonic antigen as a marker for colorectal cancer: is it clinically useful? Clinical chemistry. 47(4):624-630. https://doi.org/10.1093/clinchem/47.4.624

Volume 3, Number 57 (2020)