Background Systemic inflammation in colorectal cancer (CRC) may be reflected by neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume (MPV). This study was designed to investigate the efficiency of preoperative NLR, PLR, and MVP as a tool for the assessment of tumor characteristics in newly diagnosed patients with CRC. Patients and Methods For 300 patients and 300 healthy volunteers, complete blood counts with automated differential counts were performed. The NLR was calculated by dividing the absolute neutrophil count by the absolute lymphocyte count; PLR was calculated by dividing the absolute platelet count by the absolute lymphocyte count. The diagnostic performance of NLR, PLR, and MVP was estimated by ROC curve. Results ROC curve analysis showed high diagnostic efficacy of NLR and PLR in CRC patients with cut-off values of 2.15 (AUC = 0.790, 95% CI 0.736-0.884, Se = 74.1%, and Sp = 73%) and 123 (AUC = 0.846, 95% CI 0.801-0.891, Se = 73.5%, and Sp = 80%) compared to healthy controls, respectively. The diagnostic efficacy of three combined markers was superior compared with individual markers (AUC = 0.904, 95% CI 0.812-0.989, Se = 96%, and Sp = 70%). Conclusion NRL, PLR, and MPV may be useful markers in diagnostic and early recognition of different stages of CRC; additionally combined all together have stronger diagnostic efficacy.

SummaryBackgroundThe purpose of the present study was to report and discuss the hematological and biochemical behavior of elite soccer players, in order to get more insight in the physiological characteristics of these sportsmen and to provide trainers and sports doctors with useful indicators.MethodsNineteen male soccer players volunteered to participate in this study. We followed the young elite soccer players during a competitive half season. Venous blood samples were collected between 9:00 and 10:00 a.m. after an overnight fast (10 h) at baseline, after 45 and 90 days and hematological and biochemical parameters were measured.ResultsHemoglobin and hematocrit levels were significantly reduced over the observational period (p<0.05), but erythrocyte count and iron levels remained unchanged. Bilirubin and ferritin levels significantly increased in response to regular soccer training (p<0.05). We observed a significant decrease in muscle enzyme plasma activity during the 90 days study period. ANOVA analysis revealed a significant increase in the leukocyte and neutrophil counts (p<0.05), in parallel with a significant decrease in the lymphocyte count (p<0.05) after the observational period of 90 days.ConclusionsElite soccer players are characterized by significant changes in biochemical and hematological parameters over the half season, which are linked to training workload, as well as adaptation induced by the soccer training. Although the values of the measured parameters fell within the reference range, regular monitoring of the biochemical and hematological parameters is fundamental for the identification of a healthy status and related optimal performances by sport doctors and trainers and selection of a correct workload by trainers.

Objective: Interleukin 6 (IL6) has the ability to influence each level of the hypothalamo-pituitaryadrenocortical (HPA) axis. The aim of the study was to test whether IL6 concentration correlates with the adrenal cortex response to ACTH in healthy humans. We postulated that higher basal IL6 concentration would be associated with the higher cortisol response to the stimulation. Design and methods: Basal IL6 concentration was measured and a low dose (1 mg) ACTH test was performed to assess cortisol response. Twenty-seven apparently healthy subjects (11 male, 16 female, mean age 31.1 years, age range 22-47 years) were included in the study. Results: Data are presented as meanGS.E.M. Basal IL6 level was 0.84G0.10 pg/ml. Basal cortisol was 351.9G18.3 nmol/l. Maximal cortisol during synacthen test was 653.0G20.6 nmol/l. Maximal cortisol increment was 301.1G20.0 nmol/l. IL6 concentration was not correlated with basal or maximal cortisol concentration, but correlated significantly with cortisol increment (rZ0.63, 95% confidence interval) 0.42-0.83). Conclusions: In our study, we found that higher basal IL6 concentration is associated with the higher cortisol response to ACTH stimulation. Based on previous research and our data, IL6, even in low concentrations and under physiologic conditions, modulates adrenal cortex responsivity to ACTH. Therefore, it seems that immune modulation of HPA axis is also present under physiologic and not only pathologic conditions. European Journal of Endocrinology 159 649-652

Objective: Metastases of the adrenal gland are a frequent ®nding in patients with malignant tumors like bronchogenic carcinoma or breast cancer. Only limited and con¯icting data on adrenocortical function in these patients are available. Design: Cross-sectional study. Methods: We investigated the impact of adrenal macrometastases on adrenocortical function in a series of 28 tumor patients using the ACTH 1±24 stimulation test and dexamethasone suppression test. Seven normal controls (Con), eleven patients without adrenal metastases (No Met), eight patients with unilateral (Uni Met) and nine patients with bilateral adrenal metastases (Bil Met) were investigated. Results: The prevalence of adrenal insuf®ciency was low in our study population, with only two of nine patients with bilateral metastases having subclinical adrenocortical insuf®ciency. In the remaining patients with uni-or bilateral metastases, baseline and stimulated cortisol concentrations were higher than in controls and cancer patients without metastases (baseline cortisol (in nmol/l): Con: 307633.2 vs Uni Met: 440 6 53.5, and Bil Met: 637.6 6 92.1, P 0.04 by ANOVA; cortisol 60 min after ACTH 1±24 : Con: 794.6 6 41.2 vs Uni Met: 990.8 6 92.9, and Bil Met: 1151.4 6 155.5, P 0.03 by ANOVA). Simultaneously, baseline and stimulated serum aldosterone concentrations were signi®-cantly blunted in the tumor groups. Conclusions: Adrenal insuf®ciency is infrequent and develops only in patients with bilateral metastases. However, the majority of patients have activation of the hypothalamic±pituitary±adrenal axis despite adrenal metastases with strongly elevated cortisol concentrations. European Journal of Endocrinology 143 91±97