What can preoperative blood tests tell us about colorectal cancer?

ABSTRACT

PURPOSE: To study the diagnostic and/or prognostic role of preoperative blood tests in colorectal cancer. METHODS: Preoperative complete blood count tests and lactate dehydrogenase (LDH) serum levels of 167 patients with colorectal adenocarcinoma were examined for associations with clinicopathological parameters, disease-specific survival (DSS) and relapse-free survival (RFS). RESULTS: The following parameters showed high sensitivity (≥85%) in detecting these features platelet to lymphocyte ratio (PLR) for T4 tumors, white blood cell count (WBC) and neutrophil count (NC) for distant metastases and lymphocyte count (LC) for high-grade tumors. The following parameters showed high specificity (≥85%) in excluding these features lymphocyte percentage (LP) for tumors larger than 5 cm, LP, neutrophil to lymphocyte ratio (NLR), neutrophil to monocyte ratio (NMR), lymphocyte to monocyte ratio (LMR) and LDH for T4 tumors, platelet to monocyte ratio (PMR) for T2-T4 tumors, LDH for more than three infiltrated regional lymph nodes and distant metastases, LMR for high-grade tumors and neutrophil percentage (NP) for lymphovascular invasion. WBC and NLR were independent prognostic factors for DSS, whereas WBC, NP, LP and NLR were independent prognostic factors for RFS. CONCLUSIONS: Preoperative complete blood count and LDH serum levels can provide valuable information about diagnosis and prognosis in colorectal cancer.