Colorectal Cancer-One Disease, Two Fires: Distinct Inflammatory Landscapes in Colon and Rectal Cancer.

IF 3.3 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

Diagnostics Pub Date : 2025-09-19 DOI:10.3390/diagnostics15182387

Catalin Vladut Ionut Feier, Florin Grama, Georgiana Viorica Moise, Razvan Constantin Vonica, Vasile Gaborean, Alaviana Monique Faur, Vladut Iosif Rus, Calin Muntean

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引用次数: 0

Abstract

Background: Systemic inflammatory indices are increasingly used to predict prognosis in colorectal cancer (CRC), yet direct comparisons between colon cancer (CC) and rectal cancer (RC) remain limited. Methods: We conducted a retrospective matched-cohort study including 296 patients (148 with CC and 148 with RC) surgically treated between January 2018 and December 2024. Patients were matched by tumor stage, sex, and age (±3 years). Preoperative blood samples were used to calculate several inflammatory markers, including Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), Monocyte-to-Lymphocyte Ratio (MLR), Systemic Inflammation Response Index (SIRI), Systemic Immune-Inflammation Index (SII), and Aggregate Index of Systemic Inflammation (AISI). Subgroup analyses were performed based on the Charlson Comorbidity Index (>3 vs. ≤3), surgical context (elective vs. emergency), and tumor stage (T1-T2 vs. T3-T4). Results: Colon cancer patients exhibited significantly higher levels of systemic inflammation compared to those with rectal cancer, with notable differences in NLR (3.99 vs. 2.84, p < 0.001), PLR (219.8 vs. 163.3, p < 0.001), SIRI (3.7 vs. 1.91, p = 0.004), SII (1533.8 vs. 847.8, p < 0.001), and AISI (1714.7 vs. 593.6, p = 0.009). These differences remained statistically significant in key subgroups. In elective surgeries, CC patients had elevated PLR (p < 0.001), SIRI (p = 0.003), SII (p < 0.001), and AISI (p = 0.013). Among patients with advanced tumors (T3-T4), CC was associated with higher SII (p < 0.001), AISI (p = 0.008), PLR (p < 0.001), and SIRI (p = 0.004). For those with a Charlson index > 3, CC patients showed significantly higher PLR (p < 0.001), NLR (p < 0.001) and SIRI (p = 0.001). Conclusions: colon cancer presents with a markedly stronger systemic inflammatory response than rectal cancer, particularly in patients with advanced disease, elective surgical treatment, and higher comorbidity burden. These findings suggest that indices such as SIRI, SII, and PLR may serve as valuable stratification tools beyond tumor location in CRC.

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结直肠癌——一种疾病，两种火焰：结直肠癌中不同的炎症景观。

背景：系统性炎症指标越来越多地用于预测结直肠癌（CRC）的预后，但结肠癌（CC）和直肠癌（RC）之间的直接比较仍然有限。方法：我们进行了一项回顾性匹配队列研究，包括296例2018年1月至2024年12月接受手术治疗的患者（148例CC和148例RC）。患者按肿瘤分期、性别、年龄（±3岁）进行配对。术前取血计算几种炎症指标，包括中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、单核细胞与淋巴细胞比值（MLR）、全身炎症反应指数（SIRI）、全身免疫-炎症指数（SII）和全身炎症综合指数（AISI）。根据Charlson合并症指数（bbbb3 vs≤3）、手术背景（择期vs急诊）和肿瘤分期（T1-T2 vs T3-T4）进行亚组分析。结果：结肠癌患者全身性炎症水平明显高于直肠癌患者，NLR （3.99 vs. 2.84, p < 0.001）、PLR （219.8 vs. 163.3, p < 0.001）、SIRI （3.7 vs. 1.91, p = 0.004）、SII （1533.8 vs. 847.8, p < 0.001）和AISI （1714.7 vs. 593.6, p = 0.009）差异显著。这些差异在关键亚组中仍然具有统计学意义。在择期手术中，CC患者PLR （p < 0.001）、SIRI （p = 0.003）、SII （p < 0.001）和AISI （p = 0.013）升高。在晚期肿瘤（T3-T4）患者中，CC与较高的SII （p < 0.001）、AISI （p = 0.008）、PLR （p < 0.001）和SIRI （p = 0.004）相关。对于Charlson指数bbb3的患者，CC患者的PLR （p < 0.001）、NLR （p < 0.001）和SIRI （p = 0.001）均显著升高。结论：结肠癌呈现出明显强于直肠癌的全身炎症反应，特别是在疾病晚期、选择性手术治疗和更高合并症负担的患者中。这些发现表明，SIRI、SII和PLR等指标可以作为CRC肿瘤定位以外的有价值的分层工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diagnostics Biochemistry, Genetics and Molecular Biology-Clinical Biochemistry

CiteScore

4.70

自引率

8.30%

发文量

2699

审稿时长

19.64 days

期刊介绍： Diagnostics (ISSN 2075-4418) is an international scholarly open access journal on medical diagnostics. It publishes original research articles, reviews, communications and short notes on the research and development of medical diagnostics. There is no restriction on the length of the papers. Our aim is to encourage scientists to publish their experimental and theoretical research in as much detail as possible. Full experimental and/or methodological details must be provided for research articles.