Value of brief hematological characteristics in differentiating carcinoembryonic-antigen-negative colorectal cancer from benign colorectal diseases.

Background: Colorectal cancer (CRC) remains one of the most common malignancies worldwide, with a significant subset of patients exhibiting absence of carcinoembryonic-antigen (CEA) expression. The lack of effective diagnostic method for CEA-negative CRC prevents its early treatment.

Aim: To identify potentially valuable biomarkers for identifying CEA-negative CRC, the hematological characteristics of patients with CEA-negative CRC was investigated.

Methods: In this retrospective analysis, 74 patients were included who had been pathologically confirmed to have CEA-negative CRC, along with 79 individuals diagnosed with benign colorectal conditions. The utility of various biomarkers was evaluated using analysis of the receiver operating characteristic (ROC) curve.

Results: Compared with patients with benign colorectal diseases, those with CEA-negative CRC had lower hemoglobin-to-red blood cell distribution width ratio (HRR) and lymphocyte-to-red blood cell distribution width ratio (LRR), and higher platelet-to-lymphocyte ratio (PLR) (P < 0.05). Correlation analysis showed that HRR was negatively correlated with T stage (r = -0.237), LRR was negatively correlated with T stage (r = -0.265) and distant metastasis (r = -0.321), and PLR was positively correlated with T stage (r = 0.251) (all P < 0.05). ROC analysis indicated that HRR outperformed LRR and PLR in identifying CEA-negative CRC. Combining HRR and PLR provided the highest area under the curve (area under the curve = 0.808; sensitivity = 82.43%; specificity = 68.35%) for distinguishing CEA-negative CRC from benign colorectal diseases.

Conclusion: HRR, LRR, and PLR alone or in combination could be used to distinguish CEA-negative CRC from benign colorectal diseases.