Yi LL, Lao XJ, Lu LY, Zhu CL, Zhou DY, Li ST, Fan ML, Peng QL. Value of brief hematological characteristics in differentiating carcinoembryonic-antigen-negative colorectal cancer from benign colorectal diseases. World J Gastrointest Surg 2025; 17(2): 101403 [DOI: 10.4240/wjgs.v17.i2.101403]
Corresponding Author of This Article
Qi-Liu Peng, PhD, Professor, Department of Clinical Laboratory, Guangxi International Zhuang Medicine Hospital Affiliated to Guangxi University of Chinese Medicine, No. 8 Qiuyue Road, Liangqing District, Nanning 530201, Guangxi Zhuang Autonomous Region, China. pengql45@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Li-Ling Yi, Liu-Yi Lu, Chun-Ling Zhu, Dong-Yi Zhou, Si-Ting Li, Meng-Li Fan, Qi-Liu Peng, Department of Clinical Laboratory, Guangxi International Zhuang Medicine Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning 530201, Guangxi Zhuang Autonomous Region, China
Xian-Jun Lao, Department of Clinical Laboratory, The First Affiliated Hospital of Guangxi Medical University, Key Laboratory of Clinical Laboratory Medicine of Guangxi Department of Education, Nanning 530021, Guangxi Zhuang Autonomous Region, China
Co-first authors: Li-Ling Yi and Xian-Jun Lao.
Author contributions: Yi LL and Lao XJ designed, wrote and reviewed the manuscript; Lu LY and Zhu CL analyzed the data; Zhou DY, Li ST and Fan ML collected the data; Peng QL guided the study; All authors reviewed, edited, and approved the final manuscript and revised it critically for important intellectual content, gave final approval of the version to be published, and agreed to be accountable for all aspects of the work.
Supported by Youth Project of Guangxi International Zhuang Medicine Hospital, No. [2022]203; Discipline Project of Guangxi International Zhuang Medicine Hospital, No. [2021]33; and Research Fund of Guangxi International Zhuang Medicine Hospital, No. RCYJ202201.
Institutional review board statement: The study was reviewed and approved by the Guangxi International Zhuang Medicine Hospital Institutional Review Board (Approval No. 2022-047-01).
Informed consent statement: The Institutional Review Board waived the requirement for informed consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The data used in this study were shared without the consent of the participants, but the data provided have been anonymized and can be requested from the corresponding author (pengql45@163.com) if there is a valid reason for needing them.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qi-Liu Peng, PhD, Professor, Department of Clinical Laboratory, Guangxi International Zhuang Medicine Hospital Affiliated to Guangxi University of Chinese Medicine, No. 8 Qiuyue Road, Liangqing District, Nanning 530201, Guangxi Zhuang Autonomous Region, China. pengql45@163.com
Received: September 13, 2024 Revised: November 7, 2024 Accepted: December 3, 2024 Published online: February 27, 2025 Processing time: 131 Days and 5.5 Hours
Abstract
BACKGROUND
Colorectal cancer (CRC) remains one of the most common malignancies worldwide, with a significant subset of patients exhibiting absence of carcinoembryonic-antigen (CEA) expression. The lack of effective diagnostic method for CEA-negative CRC prevents its early treatment.
AIM
To identify potentially valuable biomarkers for identifying CEA-negative CRC, the hematological characteristics of patients with CEA-negative CRC was investigated.
METHODS
In this retrospective analysis, 74 patients were included who had been pathologically confirmed to have CEA-negative CRC, along with 79 individuals diagnosed with benign colorectal conditions. The utility of various biomarkers was evaluated using analysis of the receiver operating characteristic (ROC) curve.
RESULTS
Compared with patients with benign colorectal diseases, those with CEA-negative CRC had lower hemoglobin-to-red blood cell distribution width ratio (HRR) and lymphocyte-to-red blood cell distribution width ratio (LRR), and higher platelet-to-lymphocyte ratio (PLR) (P < 0.05). Correlation analysis showed that HRR was negatively correlated with T stage (r = -0.237), LRR was negatively correlated with T stage (r = -0.265) and distant metastasis (r = -0.321), and PLR was positively correlated with T stage (r = 0.251) (all P < 0.05). ROC analysis indicated that HRR outperformed LRR and PLR in identifying CEA-negative CRC. Combining HRR and PLR provided the highest area under the curve (area under the curve = 0.808; sensitivity = 82.43%; specificity = 68.35%) for distinguishing CEA-negative CRC from benign colorectal diseases.
CONCLUSION
HRR, LRR, and PLR alone or in combination could be used to distinguish CEA-negative CRC from benign colorectal diseases.
Core Tip: A retrospective analysis was used to investigate the hematological characteristics of carcinoembryonic-antigen (CEA)-negative colorectal cancer (CRC) with the aim of identifying potentially valuable biomarkers for distinguishing between CEA-negative CRC and benign colorectal diseases. We found that hematological parameters were associated with CEA-negative CRC and benign colorectal diseases. Moreover, hematological ratios were related to clinicopathological features of CEA-negative CRC. The results suggest that hemoglobin-to-red blood cell distribution width ratio, lymphocyte-to-red blood cell distribution width ratio, and platelet-to-lymphocyte ratio either individually or in combination could effectively differentiate CEA-negative CRC from benign colorectal diseases.
