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Submitted
January 6, 2018
Accepted
August 30, 2018
Published
August 30, 2018
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Abstract

Background: Colorectal cancer is one of cancer that has a high mortality rate. Cancer is associated with a systemic inflammatory response. Carcinoembryonic antigen (CEA) is a colorectal cancer prognostic marker, but this examination is quite expensive and not always ubiquitously available. Therefore, systemic inflammatory markers through routine blood examination are expected as a colorectal cancer marker.
Objective: The present study is to determine a correlation of neutrophil-lymphocyte ratio (NLR), the platelet-lymphocyte ratio (PLR), the lymphocyte-monocyte ratio (LMR) and CEA level in colorectal cancer patients.
Methods: This retrospective cross-sectional study was conducted in November 2016-January 2017 at Dr. Sardjito Hospital, Yogyakarta. As many as 209 patients who underwent surgery in January 2015-Decemberr 2016 with colorectal cancer histopathologic diagnosis were included. Demographic, clinical, histopathology and preoperative NLR, PLR, LMR and CEA level was obtained from medical records. Correlation of NLR, PLR, LMR and CEA level was analyzed with Somer’s test.
Result: As many as 51.2% of subjects were male. Most subjects (n 42.6%) were diagnosed at 45-60 years old. The most common location of the tumor is in rectum (65.1%). Histopathology examination showed well differentiation in 51.7% subjects. The Somer’s analysis showed there was correlation of NLR and CEA level (p=0.023, r=0.164), there was a correlation between PLR and CEA level (p=0.016, r=0.146). Higher NLR and PLR was proportional to higher CEA level. There was a correlation of LMR and CEA level (p=0.001, r=-0.188), lower LMR correlates to higher CEA level.
Conclusion: There is significant positive correlation of NLR and CEA level, PLR and CEA level, and negative correlation of LMR and CEA level in colorectal cancer patients.

Keywords

neutrophil-lymphocyte ratio platelet-lymphocyte ratio lymphocyte-monocyte ratio carcinoembrionic antigen colorectal cancer

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How to Cite
Candrawati, O., Utomo, B. E. B. H., & Sofii, lmam. (2018). Correlation of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, lymphocyte-to-monocyte ratio and carcinoembrionic antigen level in colorectal cancer. JKKI : Jurnal Kedokteran Dan Kesehatan Indonesia, 9(2), 82–88. https://doi.org/10.20885/JKKI.Vol9.Iss2.art4
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References

  1. World Health Organization. Estimated cancer incidence, mortality and prevalence worldwide in 2012. GLOBOCAN 2012 (IARC). http://globocan.iarc.fr/Pages/fact_sheets_cancer.aspx?cancer=colorectal. Published 2012. Accessed June 20, 2017.
  2. World Health Organization. Cancer Country Profiles 2014. 2014. http://www.who.int/cancer/country-profiles/idn_en.pdf. Accessed June 20, 2017.
  3. Macrae FA, Bendell J. Clinical presentation, diagnosis, and staging of colorectal cancer. UpToDate. https://www.uptodate.com/contents/clinical-presentation-diagnosis-and-staging-of-colorectal-cancer. Published April 2017. Accessed May 22, 2017.
  4. Li MX, Liu XM, Zhang XF, Zhang JF, Wang WL, Zhu Y, et al. Prognostic role of neutrophil-to-lymphocyte ratio in colorectal cancer: A systematic review and meta-analysis. International Journal of Cancer. 2014;134(10):2403-13.
  5. Tsai PL, Su WJ, Leung WH, Lai CT, Liu CK. Neutrophil–lymphocyte ratio and CEA level as prognostic and predictive factors in colorectal cancer: A systematic review and meta-analysis. Journal of Cancer Research and Therapeutics. 2016;12(2):582-9.
  6. Templeton AJ, Ace O, McNamara MG, Al-Mubarak M, Vera-Badillo FE, Hermanns T, et al. Prognostic role of platelet to lymphocyte ratio in solid tumors: A systematic review and meta-analysis. Cancer Epidemiology, Biomarkers & Prevention. 2014;23(7):1204-12.
  7. Tan D, Fu Y, Su Q, Wang H. Prognostic role of platelet–lymphocyte ratio in colorectal cancer. Medicine (Baltimore). 2016;95:e3837.
  8. Wu Q, Hu T, Zheng E, Deng X, Wang Z. Prognostic role of the lymphocyte-to-monocyte ratio in colorectal cancer. Medicine (Baltimore). 2017;96:e7051.
  9. Guo YH, Sun HF, Zhang YB, Liao ZJ, Zhao L, Cui J, et al. The clinical use of the platelet/lymphocyte ratio and lymphocyte/monocyte ratio as prognostic predictors in colorectal cancer: A meta-analysis. Oncotarget. 2017;8(12):. 20011-24
  10. Roche Diagnostic Lab. Carcinoembryonic antigen (CEA). 2015. www.roche.com. Accessed May 22, 2017.
  11. Locker GY, Hamilton S, Harris J, Jessup JM, Kemeny N, Macdonald JS, et al. ASCO 2006 Update of Recommendations for the Use of Tumor Markers in Gastrointestinal Cancer. Journal of Clinical Oncology. 2006;24(33):5313-27.
  12. Shibutani M, Maeda K, Nagahara H, Noda E, Ohtani H, Nishiguchi Y, et al. A high preoperative neutrophil-to-lymphocyte ratio is associated with poor survival in patients with colorectal cancer. Anticancer Research. 2013;33(8):3291-4.
  13. Chan JCY, Chan DL, Diakos CI, Engel A, Pavlakis N, Gill A, et al. The Lymphocyte-to-monocyte ratio is a superior predictor of overall survival in comparison to established biomarkers of resectable colorectal cancer. Annals of Surgery. 2017;265(3):539-46.
  14. Monteleone G, Pallone F, Stolfi C. The dual role of inflammation in colon carcinogenesis. International Journal of Molecular Sciences. 2012;13(12):11071-84.
  15. Mariani F. Inflammatory pathways in the early steps of colorectal cancer development. World Journal of Gastroenterology. 2014;20(29):9716-31.
  16. Terzic J, Grivennikov S, Karin E, Karin M. Inflammation and colon cancer. Gastroenterology. 2010;138(6):2101-14.e5.
  17. Kubo H, Murayama Y, Arita T, Kuriu Y, Nakanishi M, Otsuji E. The prognostic value of preoperative neutrophil-to-lymphocyte ratio in colorectal cancer. World Journal of Surgery. 2016;40(11):2796-802.
  18. Celik S, Yilmaz ME. Analysis of the relationship between the levels of carcinoembryonic antigen and lactate dehydrogenase, and the neutrophil/lymphocyte ratio in colorectal cancer. Immunochemistry and Immunopathology. 2016;2(1):1-4.
  19. Li H, Song J, Cao M, Wang G, Li L, Zhang B, et al. Preoperative neutrophil-to-lymphocyte ratio is a more valuable prognostic factor than platelet-to-lymphocyte ratio for nonmetastatic rectal cancer. International Immunopharmacology. 2016;40:327-31.
  20. Hung HY, Chen JS, Yeh CY, Changchien CR, Tang R, Hsieh PS, et al. Effect of preoperative neutrophil–lymphocyte ratio on the surgical outcomes of stage II colon cancer patients who do not receive adjuvant chemotherapy. International Journal of Colorectal Disease. 2011;26(8):1059-65.
  21. Ying HQ, Deng QW, He BS, Pan YQ, Wang F, Sun HL, et al. The prognostic value of preoperative NLR, d-NLR, PLR and LMR for predicting clinical outcome in surgical colorectal cancer patients. Medical Oncology. 2014;31(12).