Clin Lab. 2021 Sep 1;67(9). doi: 10.7754/Clin.Lab.2021.201130.
Colorectal cancer (CRC) is the third most common cancer and it is a worldwide challenge. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) had been suggested as markers of CRC, but the role of monocyte-to-lymphocyte ratio (MLR) in CRC patients before surgery and chemotherapy is unclear. The study aimed to compare the diagnosis and prognosis value of MLR, NLR, and PLR in CRC.
A retrospective study was conducted on 783 patients with histologically confirmed colorectal cancer between 2015 and 2017 in Fujian Medical University Union Hospital. A total of 1,232 healthy age-matched participants were eligible for the study. Receiver-operating characteristic (ROC) analysis was performed to compare the area under the ROC curve (AUC) of MLR, NLR, PLR, carcinoembryonic antigen (CEA), and carbohydrate antigen 19-9 (CA19-9). Furthermore, chi-squared test was conducted to determine the prognostic values of MLR, NLR, and PLR.
The levels of MLR, NLR, and PLR in CRC patients were significantly higher than those in 1,232 healthy participants. The area under the ROC curves (AUCs) of MLR, CEA, PLR, NLR, and CA19-9 were 0.739, 0.726, 0.683, 0.610, and 0.603, respectively. Moreover, the combined marker of CEA + MLR with an AUC of 0.815 acted as a superior diagnostic marker compared to the other combined markers, including the combined marker of CEA + CA19-9. Furthermore, the level of MLR was associated with tumor size (p = 0.001), and a high level of NLR was significantly correlated with pT stage (p = 0.048) and tumor size (p = 0.004).
The present study shows for the first time that MLR rather than NLR and PLR is the better diagnostic marker for colorectal cancer, and NLR may be a better prognostic marker for CRC patients.
结直肠癌（CRC）是全球范围内的第三大常见癌症，也是一个全球性的挑战。中性粒细胞与淋巴细胞比值（NLR）和血小板与淋巴细胞比值（PLR）已被提出作为 CRC 的标志物，但在手术和化疗前 CRC 患者中单核细胞与淋巴细胞比值（MLR）的作用尚不清楚。本研究旨在比较 MLR、NLR 和 PLR 在 CRC 中的诊断和预后价值。
回顾性分析 2015 年至 2017 年期间在福建医科大学附属协和医院经组织学证实的 783 例结直肠癌患者的临床资料。共纳入 1232 名年龄匹配的健康参与者。采用受试者工作特征（ROC）曲线分析比较 MLR、NLR、PLR、癌胚抗原（CEA）和糖类抗原 19-9（CA19-9）的 ROC 曲线下面积（AUC）。进一步采用卡方检验确定 MLR、NLR 和 PLR 的预后价值。
CRC 患者的 MLR、NLR 和 PLR 水平明显高于 1232 名健康参与者。MLR、CEA、PLR、NLR 和 CA19-9 的 ROC 曲线下面积（AUCs）分别为 0.739、0.726、0.683、0.610 和 0.603。此外，CEA+MLR 的联合标志物 AUC 为 0.815，作为诊断标志物优于包括 CEA+CA19-9 在内的其他联合标志物。此外，MLR 水平与肿瘤大小相关（p=0.001），高 NLR 水平与 pT 分期（p=0.048）和肿瘤大小（p=0.004）显著相关。
本研究首次表明，MLR 而不是 NLR 和 PLR 是结直肠癌更好的诊断标志物，而 NLR 可能是 CRC 患者更好的预后标志物。
