Objective This study aimed to investigate the efficacy of inflammatory markers (NLR, PLR) combined with tumor markers (CA50, CA199, CEA) in the diagnosis of colorectal cancer metastasis by a single-center retrospective study. Methods A total of 1163 CRC patients who received treatments in our hospital from January 2017 to December 2021 were enrolled retrospectively. Patients were grouped according to the absence of metastasis. The separate efficacy of tumor markers, NLR and PLR, was evaluated in the diagnosis of metastasis of colorectal cancer using ROC curve analysis, and their optimal cut-off values for distant metastases from colorectal cancer were determined. The area under the ROC curve (AUC) of the tumor markers combined with NLR and PLR was calculated by binary logistic regression analysis to evaluate the diagnostic efficacy of metastasis of colorectal cancer. In addition, patients were divided into two groups of high and low levels according to the optimal cut-off values, and the effects of NLR, PLR, and tumor markers on distant metastasis of colorectal cancer were evaluated using multiple logistic regression analysis. Result The abnormal rate of CA50, CA199, CEA, NLR, and PLR in two subgroupsIt was statistically significant (P < 0.05). After AUC testifying, the diagnostic efficacy of NLR and PLR was equivalent to that of tumor marker (P > 0.05). In assessment of liver metastasis, peritoneal metastasis, and multiple metastasis, AUC of NLR and PLR with CRC-specific tumor markers showed higher predictive efficacy than AUC without combined NLR nor PLR. The CA50, CA199, CEA, PLR, and NLR were proved independently associated with metastasis using multiple logistic regression analysis (P < 0.05). Conclusion NLR and PLR are noted tumor markers of colorectal cancer, which are characterized by noninvasive, high diagnostic efficacy, easy availability, and low cost. They can be combined with traditional tumor markers to evaluate and diagnose colorectal cancer metastasis by clinicians.

Background The incidence rate of sarcopenia is high and it will lead to many adverse consequences. It is necessary to explore the influencing factors of sarcopenia and find out its inflammatory indicators. Objectives We aimed to explore the association between hemoglobin-to-red blood cell distribution width ratio (HRR) and the risk of sarcopenia from the large and diverse National Health and Nutrition Examination Survey (NHANES) 1999–2006, 2011–2018 population sample. Methods The general characteristics, disease related characteristics, diet and exercise characteristics, blood indicators, appendicular lean mass index, the peak isokinetic strength of the knee extensors, gait speed, combined grip strength and appendicular lean mass index extracted from the adult(18-79y) from the NHANES database. t test, two sample Kolmogorove-Smirnov test, Chi-square test, multiple linear regression analyses, binary logistic regression was used to assess the association between HRR and sarcopenia. The cut-off value invented by Budczies et al was used to found the cut-off value for the HRR to sarcopenia. Results A total sample of 28,531 participants were included in the study (50.85% males and 49.15% females). The prevance of sarcopenia is 23.87% (43.52% males and 56.48% females) and severe-sarcopenia is 18.13% (53.03% males and 46.97% females). HRR levels were significantly lower in sarcopenic people than non-sarcopenic people, and lower in severe-sarcopenia people than light-sarcopenia people(P < 0.05). HRR was significantly positive associated with appendicular lean mass index (ALMI), gait speed, peak isokinetic, and combined grip strength (P < 0.05). Regression analysis shows that HRR was independently associated with sarcopenia (P < 0.05). Conclusions This study first reveal that HRR is an independent risk factor for sarcopenia and the mechanism of HRR to sarcopenia is not clear. It is necessary to further explore the mechanism of HRR to sarcopenia in the future research.

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