Clinical predictive value of methylated SEPT9 combined with NLR, PLR and LMR in colorectal cancer

Abstract

Abstract Purpose This study aimed to investigate clinical predictive values of methylated septin9 (mSEPT9) combined with neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and lymphocyte-to-monocyte ratio (LMR) in colorectal cancer (CRC).Methods 329 subjects composed of 114 CRC patients, 105 polyps patients and 104 healthy participants were prospectively recruited. Clinicopathologic features were collected and analyzed. Plasma samples were collected for mSEPT9, NLR, PLR and LMR test. The sensitivity, specificity and area under the curve (AUC) of each biomarker separately or in combination were estimated by the receiver operating characteristic (ROC) curve.Results The levels of NLR and PLR and the positive detection rate (PDR) of mSEPT9 in CRC patients were obviously higher than non-CRC subjects, while LMR was the opposite. The PDR of mSEPT9 in CRC patients was significantly correlated with age, tumor size, tumor stage and M stage. ROC curve analysis demonstrated moderate diagnostic values of mSEPT9, NLR, PLR and LMR in CRC patients with AUC of 0.78 (Se = 0.68, and Sp = 0.89), 0.78 (Se = 0.68, and Sp = 0.83), 0.80 (Se = 0.68, and Sp = 0.81), and 0.77 (Se = 0.72, and Sp = 0.73), respectively. Combination of these four biomarkers dramatically enhanced the diagnostic accuracy of CRC (AUC = 0.92, Se = 0.90, and Sp = 0.87), especially CRC patients with large tumors (AUC = 0.95) or distal metastasis (AUC = 0.95).Conclusion mSEPT9, NLR, PLR and LMR showed the potential to be reliable biomarkers for the diagnosis of CRC. Combination of all together further improved the diagnostic accuracy of CRC.