Diagnostic value of peripheral blood inflammatory indices for clinicopathological profile of colorectal cancer: a retrospective observational study.

Abstract

Background: Colorectal cancer (CRC) ranks as the third most prevalent cancer globally and the second leading cause of cancer-related mortality. This study investigates the diagnostic value of peripheral blood inflammatory indices, including the Cancer-Inflammation Prognostic Index (CIPI), Systemic Inflammation Response Index (SIRI), Hemoglobin-Albumin-Lymphocyte-Platelet (HALP) index, Neutrophil-to-Lymphocyte Ratio (NLR), and Platelet-to-Lymphocyte Ratio (PLR), in the early diagnosis of clinicopathological characteristics of CRC.

Method: This retrospective observational study involved 224 patients with CRC aged over 45, admitted to Rasoul-Akram Hospital from September 2019 to 2023, undergoing elective CRC surgery. Key demographic and clinicopathological data were collected alongside blood samples to derive inflammatory indices. Univariate and multivariate analyses were applied to determine metastasis and stage predictors. A receiver operating characteristic (ROC) analysis was performed to evaluate the SIRI diagnostic value in differentiating tumors with and without metastasis and the CIPI diagnostic value in differentiating tumors with high and low stage.

Results: The study identified a significant association between elevated SIRI levels and metastasis in univariate analysis (OR = 2.79, CI = 1.12-6.94). Multivariate analysis shows CIPI is associated with advanced tumor stages (OR = 1.97, CI = 1.14-3.38). According to the ROC curve, the optimal cut-off value of SIRI and CIPI was 1.376 (sensitivity 52.6%, specificity 60.8%, AUC = 61.5%) for diagnosing the metastasis and 7.114 (sensitivity 59.8%, specificity 57%, AUC = 57.9%) for diagnosing the tumor stage, respectively.

Discussion: The findings show that a higher SIRI value is associated with a higher chance of metastasis and a higher CIPI value is associated with a higher chance of advanced stages. Furthermore, the study advocates for the integration of these inflammatory indices into clinical practice to facilitate personalized treatment strategies and early diagnosis, enhancing the prognosis and survival in CRC.