The predictive value of complete blood count and systemic immune-inflammatory index in the diagnosis of malignancy in patients undergoing colonoscopy

Colorectal cancer (CRC) is one of the most common cancers worldwide and the leading cause of cancer-related deaths. The aim of this study was to determine the predictive value of parameters obtained by complete blood count in the diagnosis of CRC. It was aimed to reduce morbidity and mortality related to the disease by referring patients to an advanced center in a short time for early diagnosis and treatment of CRC, and to contribute to the development of cost-effective screening methods. In our study, patients who underwent colonoscopy at Tokat Gaziosmanpaşa University Hospital between 01.10.2013 and 01.10.2023 and had a hemogram examination within 0-30 days before colonoscopy were evaluated. Demographic data, hemogram result, colonoscopy result and histopathologic data were recorded. Patients were grouped as normal, benign, premalignant and malignant according to the results of colonoscopy and hematologic parameters were compared between the groups. In the hospital records, 14,456 people who underwent colonoscopy between 01.10.2013-01.10.2023 were identified. A total of 282 patients who met the inclusion and exclusion criteria were included in the study. In the study group, 48.9% (n=138) were male and 51.1% (n=144) were female, 81.2% (n=229) were between 50-70 years of age and 18.8% (n=53) were over 70 years of age. NLO, TLO, MLO, SII, platelets, neutrophils, WBC and RDW were significantly higher and HGB was significantly lower in the malignant group compared to the whole population (p<0.05). There was found to be a weak level of significant, positive correlation among the parameters. Sensitivity and specificity were 60.4-39.3% for NLO, 58.5-41.5% for TLO, 60.4-39.7% for MLO and 62.3-37.6% for SII, calculated respectively. Our study showed that NLO-MLO-TLO-SII may be useful biomarkers in the diagnosis of malignancy. With the predictive help of hemogram parameters and SII, early detection of systemic inflammatory response in primary care and early referral of patients to advanced centers can be achieved. It may also contribute to the revision of colonoscopy waiting lists and prioritization of patients. Keywords; colorectal cancer, systemic immune inflammatory index, neutrophil/lymphocyte ratio, monocyte/lymphocyte ratio, thrombocyte/lymphocyte ratio