Evaluation of Red Cell Distribution Width to Lymphocyte Ratio as Potential Biomarker for Detection of Colorectal Cancer

Jiahao Huang, Yang Zhao, Lin Liao, Shun Liu, Shaolong Lu, Changtao Wu, Chuanyi Wei, Shaoqiang Xu, Huage Zhong, Junjie Liu, Yun Guo, Sen Zhang, Feng Gao, Weizhong Tang, Jiahao Huang, Yang Zhao, Lin Liao, Shun Liu, Shaolong Lu, Changtao Wu, Chuanyi Wei, Shaoqiang Xu, Huage Zhong, Junjie Liu, Yun Guo, Sen Zhang, Feng Gao, Weizhong Tang

Abstract

Background and aim: Colorectal cancer (CRC) is the third most lethal cancer globally. This study sought to determine the feasibility of using red cell distribution width-to-lymphocyte ratio (RLR) as a tool to facilitate CRC detection.

Methods: Seventy-eight healthy controls, 162 patients diagnosed with CRC, and 94 patients with colorectal polyps (CP) from June 2017 to October 2018 were retrospectively reviewed. Clinical data were obtained to analyze preoperative RLR level, and receiver operating characteristic (ROC) curve analysis was performed to estimate the potential role of RLR as a CRC biomarker.

Results: RLR was higher in patients with CRC than in healthy participants (P < 0.05). ROC analysis indicated that combined detection of RLR and CEA appears to be a more effective marker to distinguish among controls, CP, and CRC patients, yielding 56% sensitivity and 90% specificity. RLR levels were significantly greater in those who had more advanced TNM stages (P < 0.05) and patients with distant metastasis stages (P < 0.05).

Conclusions: RLR might serve as a potential biomarker for CRC diagnosis.

Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
The levels of RDW (a), L (b), and RLR (c) were determined by hematology analyzer in CRC patients (N = 162), CP patients (N = 92), and healthy controls (N = 78). Data are presented as means ± SEM. ∗∗P < 0.05.
Figure 2
Figure 2
Receiver operating characteristics (ROC) curve analysis of the diagnostic performance of RLR in comparison to CEA and CA19-9. (a) ROC curves of RLR, CEA, and CA19-9 alone for discriminating CRC patients. (b) ROC curves of CEA + RLR, CA19-9 + RLR, and CEA + CA19-9 for discriminating CRC patients.

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