Background. This study was to evaluate the prognostic value of the preoperative neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and carcinoembryonic antigen (CEA) in colorectal cancer (CRC) patients and to identify the potential and easily accessible prognostic biomarkers for CRC. Methods. We retrospectively reviewed altogether the records of 330 CRC patients according to inclusion criteria. The clinical characteristics include age at diagnosis, body mass index (BMI), preoperative CEA level, neutrophil , lymphocyte, and platelet count, tumor primary site and size, clinical pathological TNM stage, and survival status were recorded through the review of medical records. The overall survival (OS) was calculated using the Kaplan–Meier method. The Cox proportional hazards model was used for the univariate and multivariate analysis to evaluate the prognostic factors of CRC. Results. A total of 330 patients were finally included in the current study. The mean follow-up duration was 32.8 ± 19.1 months (range, 0.1–67.7). Compared with the median OS, preoperative high NLR, PLR, and CEA, and low BMI had lower median OS. The NLR and PLR value rise indicates lower median OS in stage I-II CRC; however, the NLR value and CEA level rise indicates lower median OS in stage III-IV CRC. Preoperative high NLR, PLR, and CEA level and low BMI have poorer OS by univariate analysis. By multivariate analysis, the age, sex, N, M stage, and BMI demonstrated independently influence the OS of CRC. NLR was an independent predictor of stage I-II CRC, and the CEA level was an independent predictor of stage III-IV CRC. Conclusions. Our results show that preoperative high NLR, PLR, CEA, and low BMI had poorer OS, NLR was an independent predictor of stage I-II CRC, and the CEA level was an independent predictor of stage III-IV CRC.

BackgroundThis study aims to analyze the correlation between ARHGAP4 in the expression and clinical characteristics of colorectal cancer (CRC), and the influence of ARHGAP4 expression on the prognosis of CRC, and to evaluate whether ARHGAP4 is a potential prognostic oncotarget for CRC.MethodsARHGAP4 was identified using the Gene Expression Omnibus database through weighted gene coexpression network analysis. Using the Gene Expression Profiling Interactive Analysis to perform and analyze the expression and prognosis of ARHGAP4 in CRC. The expression of AGRGAP4 and immune cells was analyzed by the Tumor IMmune Estimation Resource online database. Finally, immunohistochemistry was used to analyze the expression difference and prognosis of ARHGAP4 in CRC and adjacent normal tissues, as well as the relationship between AGRGAP4 expression and clinical features of CRC.ResultsWe identified ARHGAP4 that is related to the recurrence of CRC from GSE97781 data. ARHGAP4 has not been reported in CRC. The high expression of ARHGAP4 in select colon adenocarcinoma indicates a poor prognosis by database analysis. In our clinical data results, ARHGAP4 is highly expressed in CRC and lowly expressed in normal tissues adjacent to cancer. Compared with the low-expression group, the high-expression group has a significantly poorer prognosis. In colon cancer, the B-cell, macrophage, neutrophil, and dendritic-cell levels are downregulated after ARHGAP4 gene knockout; the levels of CD8+ and CD4+ T cells, neutrophils, and dendritic cells are upregulated after the amplification of the ARHGAP4 gene. In addition, ARHGAP4 expression is related to N,M staging and clinical staging.ConclusionARHGAP4 is highly expressed in CRC, and the high expression of ARHGAP4 has a poor prognosis. The expression of ARHGAP4 in CRC is related to the immune cells such as B cells, CD8+ and CD4+ T cells, macrophages, neutrophils, and dendritic cells. ARHGAP4 is correlated with N,M staging and clinical staging in CRC. ARHGAP4 may be a potential biomarker for the prognosis of CRC.

Background Colorectal cancer (CRC) is the third most prevalent type of cancer in the world. Its prognosis is closely related to the disease stage at the time of diagnosis. Early detection of symptomless CRC or precursor lesions through population screening could reduce CRC mortality. However, screening programs are only effective if enough people are willing to participate. The incidence of CRC has a significantly increasing trend in China. Objective Evaluation of the necessity of screening colonoscopy for community fecal occult blood-positive patients and exploration of the differences in the epidemiology of colorectal adenomas (CRA) and CRC of community screening patients and patients with different symptoms. Methods We selected the 40-79 years age group of healthy people in the community of the Fengxian District of Shanghai who had two consecutive fecal occult blood and screening colonoscopies completed in our hospital between June 1, 2014 and October 31, 2014 as the screening group. Patients in the same age group with different symptoms (such as abdominal pain, bloody stool, diarrhea, change in bowel habits, weight loss, anemia, etc.) who had completed colonoscopy in our hospital during the same period comprised up the control group. Differences in the detection rates of colorectal polyps and CRC in the two groups and differences in the detection rates of CRA and early CRC between the two groups were compared. Results There were 2251 patients in the colonoscopy screening group and 1836 patients in the control group. The colorectal polyps detection rates of the two groups were 19.46% (438/2251) and 21.95% (403/1836), respectively, and the difference was not statistically significant (p = 0.052). The CRC detection rates of the two groups were 0.8% (18/2251) and 2.02% (37/1836), respectively, the difference of which was statistically significant (p = 0.001). The detection rates of CRA were 17.73% (399/2251) and 19.88% (365/1836), respectively, which was not statistically significantly different (p = 0.083). Finally, the detection rates of early CRC were 0.36% (8/2251) and 0.44% (8/1836), respectively, which was not statistically significantly different in the two groups (p = 0.803). Conclusion The detection rates of CRA among community screening patients and patients with different symptoms were not different. However, the detection rate of CRC in community screening patients was lower than that of the patients with different symptoms. Therefore community colonoscopy screening of fecal occult blood-positive asymptomatic healthy people is necessary, as it can help with the early detection and treatment of CRA.