ISSN 2149-2247 | E-ISSN 2149-2549
Original Investigation
Neutrophile-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio and Red Blood Cell Distribution Width as a New Biomarkers in Patients with Colorectal Cancer
1 Department of Gastroenterology, Cumhuriyet University Faculty of Medicine, Sivas, Turkey  
2 Department of Surgery, Cumhuriyet University Faculty of Medicine, Sivas, Turkey  
Erciyes Med J ; : -
DOI: 10.5152/etd.2017.0051
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Key Words: Biomarkers, colon cancer, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, red blood cell distribution width

Objective: The incidence of colorectal cancer in developed countries has been found to increase with age. Early diagnosis and screening decrease the rates of mortality in colorectal cancer. The objective of this study was to use the inflammatory markers neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and red blood cell distribution width (RDW) to determine as a new biomarkers that can be used for early diagnosis and screening in patients with colorectal cancer.


Materials and Methods: A total of 59 patients with colorectal cancer and 59 healthy participants, similar in terms of age and sex, were included in the study. The localization, tumor node metastasis (TNM) stage and preoperative hemoglobin levels, neutrophil, lymphocyte, platelet and RDW values were taken from medical records. By using the receiver-operating characteristic (ROC) curve, the optimal cut-off levels of biomarkers were determined.


Results: The NLR, PLR and RDW ratios were significantly higher in patients with colorectal cancer compared to healthy participants (p<0.001). According to ROC analysis, the cut-off value for NLR was 2.05 [area under the curve (AUC): 0.740, sensitivity: 78%, specificity: 66%]; the cut-off value for PLR was 130 [AUC: 0.702, sensitivity: 65%, specificity: 72%]; and the cut-off value for RDW was 14 [AUC: 0.774, sensitivity: 68%, specificity: 73%].


Conclusion: NLR, PLR and RDW were found to be significantly higher in patients with colorectal cancer than in healthy subjects. Therefore, it is recommended that these can be used as additional biomarkers for the early diagnosis and screening of colorectal cancer.

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