The effect of pan immune inflammation value on survival in patients with metastatic colorectal cancer

Colorectal cancer is the third most common type of cancer in men and the second most common type of cancer in women, according to WHO data. The majority of sporadic cancers occur in people over the age of 50. Familial factors, smoking and alcohol use, consumption of red and processed meat, history of inflammatory bowel disease, history of diabetes and obesity, abdominal radiation, and some bacterial and viral agents are risk factors. Chemotherapy initiated in patients diagnosed with metastatic colorectal cancer depends on the patient's performance, history of comorbidities, presence of RAS and BRAF mutations, presence of microsatellite instability and tumor location. Some blood-based biomarkers in patients with colorectal cancer; Neutrophil/lymphocyte, platelet/lymphocyte, lymphocyte/monocyte ratio can be used as a prognosis indicator. The new biomarker pan immune inflammation value [(neutrophil x platelet x monocyte)/lymphocyte] has prognostic importance in patients with metastatic colorectal cancer. Based on this information, we aimed to investigate the effect of pan immune inflammation value (PIV) on survival in patients with metastatic colorectal cancer. Patients with metastatic colorectal cancer aged 18 years and over were included in our study. Individuals with acute infection, a history of other hematological or oncological malignancies, or autoimmune diseases were not included in our study. Patients' age, gender, medical history, family history, date of diagnosis, date of death, location of the tumor, pathology data, RAS mutation, metastatic lymph node, imaging (PET-CT, CT), operation history, treatments received and biochemical laboratory data (leukocyte, neutrophil, platelet, monocyte, lymphocyte, hemoglobin, crp, albumin, CEA, CA 19.9) were recorded. 128 patients, 44 women and 84 men, were included in our study. The average age of the patients is 63.7±11.3 years. Left-sided colon involvement (rectum, rectosigmoid, sigmoid, descending colon) constitutes 68.8% of the patients. 46.1% of the patients are in the T3 stage and 34.4% are in the N1 stage. The most common presenting complaint at the time of initial diagnosis is rectal bleeding with 25.8%. The pathology result of 88.3% of the patients was adenocarcinoma. Positive correlation between leukocyte and neutrophil, platelet, monocyte, lymphocyte, crp, CA 19.9 and PIV; A negative correlation was also detected with albumin value (p<0.05). If the PIV value of the patients is increased, a statistically significant increase in CRP and CEA values and a decrease in hemoglobin and albumin values are expected (p<0.05). While the average albumin value of surviving patients was 4.12±0.4, the average albumin value of exitus patients was 3.99±2.4. It was determined that the albumin value of patients with exitus was statistically lower(p:0.001). While the average PIV value of surviving patients was 959.5±889.3, the PIV value of exitus patients was 878.2±904.2. PIV value was not found to be statistically significant in patients who exited and were alive (p>0.05). It was determined that the median CEA and CA 19.9 values of patients with recurrent metastasis after a complete response due to colon cancer were statistically significantly lower than the metastatic patients who did not have a complete response (p < 0.05), and no statistical difference was found in terms of PIV (p > 0). .05). The estimated life expectancy of the patients included in the study was 2.9±0.2 years and the 1-year survey was 79.7%. No statistically significant relationship was detected between the variables and the survey (p>0.05). Since our study was single- center and the number of surviving metastatic patients was insufficient, different results may have been obtained from other similar studies. More research and studies are needed to determine whether PIV, which is not yet a standard biomarker, can be used as a prognostic biomarker in colorectal cancer and other cancers.