The Role of Circulating CD16+CD56+ Natural Killer Cells in the Screening, Diagnosis, and Staging of Colorectal Cancer before Initial Treatment.

Background and Objective. A reliable noninvasive prediction tool for the screening, diagnosis, and/or staging of colorectal cancer (CRC) before surgery is critical for the choice of treatment and prognosis. Methods. Patients admitted for initial treatment of CRC between January 1, 2015, and December 31, 2018, were retrieved and reviewed. Records of CD16+CD56+ natural killer (NK) cells were analyzed according to the stages of CRC. Results. The number of qualified participants in the healthy, stage I, stage II, stage III, and stage IV CRC patients were 60, 66, 60, 70, and 68, respectively. There was a significant difference in circulating CD16+CD56+ NK cells between the healthy group and the CRC group (p < 0.01), as well as between the healthy group and stage III or IV CRC group (p < 0.01 and 0.001, respectively). The percentage of circulating CD16+CD56+ NK cells in lymphocytes was negatively correlated with the occurrence of CRC. When comparing the pool of stage I and II CRC cases with the pool of stage III and IV CRC cases using circulating CD16+CD56+ NK cells, the area under the Receiver Operating Characteristic curve was 0.878. Using an optimal cutoff value of 15.6%, the OR was 0.06 (0.03, 0.11), p < 0.001, sensitivity was 86.5%, specificity was 72.5%, positive predictive value was 74.2%, and negative predictive value was 85.5%. Conclusions. Circulating CD16+CD56+ NK cells can be used as a screening and diagnostic/staging tool for CRC.