Systemic inflammation markers in blood samples of colorectal cancer patients

Introduction: Colorectal cancer (CRC) is one of the most common cancers in Poland. The aim of this study was to investigate the clinical significance of absolute monocyte count, neutrophil-to-monocyte ratio (NMR) and monocyte­to­lymphocyte ratio (MLR) in pre- and postoperative blood samples of patients with CRC. Materials and Methods: We retrospectively reviewed medical records of 160 patients diagnosed with CRC who underwent surgery. Blood samples were obtained within 3 days before and after the surgical treatment. Venous blood samples were also obtained from 42 healthy controls. Results: Pre- and postoperative NMR were significantly higher than healthy controls (p<0.0001; p<0.0001). Moreover, MLR in pre-and postoperative blood samples were higher than voluntaries (p<0.001; p<0.001). The area under the ROC curve for pre and postNMR showed that the parameter exhibits strong diagnostic power (1.000). Pre- and postMLR had moderate diagnostic power amount 0.751 and 0.746. There is also correlation between monocyte count in samples obtained before and after surgery and, lymph node metastasis and size of lymph node metastasis in both cases. PreNMR value was significantly associated with venous and lymphatic invasion and the presence of cancer deposits. PostNMR was found to correlate with presence of distant metastasis and cancer cell deposits (R=0.633, p<0.001; R=0.158, p=0.040). Moreover, preMLR value was correlated with only perineural invasion. Conclusions: Analyzed hematologic markers may be useful as simply obtained parameters, next to histopathological examination, that determine a systemic immune response