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      Platelet-to-lymphocyte ratio and C-reactive protein as markers for colorectal polyp histological type

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          Abstract

          Background

          The platelet-to-lymphocyte ratio (PLR) and C-reactive protein (CRP) level are markers that have been reported to predict the histological type of various tumors, and here, we evaluated their utility in predicting colorectal polyp histological types.

          Methods

          We retrospectively reviewed 172 patients with colorectal polyps who underwent endoscopic polypectomy. The associations between histological type and clinicopathologic parameters were assessed by multivariate analysis.

          Results

          The optimal PLR and CRP cut-off values were 113.32 and 0.39, respectively. The PLR ( P = 0.002) and CRP ( P = 0.009) values were associated with the histological type according to the univariate analysis, whereas low PLR ( P ≤ 0.001) and CRP ( P = 0.017) values were independent risk factors in the multivariate analysis together with maximum tumor diameter ( P ≤ 0.001) and tumor number ( P = 0.0014).

          Conclusions

          Preoperative PLR and CRP are correlated with the colorectal polyp histological type.

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          Most cited references29

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          Cancer statistics, 2020

          Each year, the American Cancer Society estimates the numbers of new cancer cases and deaths that will occur in the United States and compiles the most recent data on population-based cancer occurrence. Incidence data (through 2016) were collected by the Surveillance, Epidemiology, and End Results Program; the National Program of Cancer Registries; and the North American Association of Central Cancer Registries. Mortality data (through 2017) were collected by the National Center for Health Statistics. In 2020, 1,806,590 new cancer cases and 606,520 cancer deaths are projected to occur in the United States. The cancer death rate rose until 1991, then fell continuously through 2017, resulting in an overall decline of 29% that translates into an estimated 2.9 million fewer cancer deaths than would have occurred if peak rates had persisted. This progress is driven by long-term declines in death rates for the 4 leading cancers (lung, colorectal, breast, prostate); however, over the past decade (2008-2017), reductions slowed for female breast and colorectal cancers, and halted for prostate cancer. In contrast, declines accelerated for lung cancer, from 3% annually during 2008 through 2013 to 5% during 2013 through 2017 in men and from 2% to almost 4% in women, spurring the largest ever single-year drop in overall cancer mortality of 2.2% from 2016 to 2017. Yet lung cancer still caused more deaths in 2017 than breast, prostate, colorectal, and brain cancers combined. Recent mortality declines were also dramatic for melanoma of the skin in the wake of US Food and Drug Administration approval of new therapies for metastatic disease, escalating to 7% annually during 2013 through 2017 from 1% during 2006 through 2010 in men and women aged 50 to 64 years and from 2% to 3% in those aged 20 to 49 years; annual declines of 5% to 6% in individuals aged 65 years and older are particularly striking because rates in this age group were increasing prior to 2013. It is also notable that long-term rapid increases in liver cancer mortality have attenuated in women and stabilized in men. In summary, slowing momentum for some cancers amenable to early detection is juxtaposed with notable gains for other common cancers.
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            Cancer-related inflammation.

            The mediators and cellular effectors of inflammation are important constituents of the local environment of tumours. In some types of cancer, inflammatory conditions are present before a malignant change occurs. Conversely, in other types of cancer, an oncogenic change induces an inflammatory microenvironment that promotes the development of tumours. Regardless of its origin, 'smouldering' inflammation in the tumour microenvironment has many tumour-promoting effects. It aids in the proliferation and survival of malignant cells, promotes angiogenesis and metastasis, subverts adaptive immune responses, and alters responses to hormones and chemotherapeutic agents. The molecular pathways of this cancer-related inflammation are now being unravelled, resulting in the identification of new target molecules that could lead to improved diagnosis and treatment.
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              Colorectal cancer screening and surveillance: clinical guidelines and rationale-Update based on new evidence.

              S Winawer (2003)
              We have updated guidelines for screening for colorectal cancer. The original guidelines were prepared by a panel convened by the U.S. Agency for Health Care Policy and Research and published in 1997 under the sponsorship of a consortium of gastroenterology societies. Since then, much has changed, both in the research rature and in the clinical context. The present report summarizes new developments in this field and suggests how they should change practice. As with the previous version, these guidelines offer screening options and encourage the physician and patient to decide together which is the best approach for them. The guidelines also take into account not only the effectiveness of screening but also the risks, inconvenience, and cost of the various approaches. These guidelines differ from those published in 1997 in several ways: we recommend against rehydrating fecal occult blood tests; the screening interval for double contrast barium enema has been shortened to 5 years; colonoscopy is the preferred test for the diagnostic investigation of patients with findings on screening and for screening patients with a family history of hereditary nonpolyposis colorectal cancer; recommendations for people with a family history of colorectal cancer make greater use of risk stratification; and guidelines for genetic testing are included. Guidelines for surveillance are also included. Follow-up of postpolypectomy patients relies now on colonoscopy, and the first follow-up examination has been lengthened from 3 to 5 years for low-risk patients. If this were adopted nationally, surveillance resources could be shifted to screening and diagnosis. Promising new screening tests (virtual colonoscopy and tests for altered DNA in stool) are in development but are not yet ready for use outside of research studies. Despite a consensus among expert groups on the effectiveness of screening for colorectal cancer, screening rates remain low. Improvement depends on changes in patients' attitudes, physicians' behaviors, insurance coverage, and the surveillance and reminder systems necessary to support screening programs.
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                Author and article information

                Contributors
                13583173280@163.com
                Journal
                BMC Cancer
                BMC Cancer
                BMC Cancer
                BioMed Central (London )
                1471-2407
                17 May 2021
                17 May 2021
                2021
                : 21
                : 556
                Affiliations
                [1 ]GRID grid.410587.f, Department of Gastroenterology, , Shandong Provincial Hospital Affiliated to Shandong First Medical University & Shandong Academy of Medical Sciences, ; 324 Jingwu Road, Jinan, 250021 Shandong People’s Republic of China
                [2 ]GRID grid.410587.f, Department of Oncology, , Shandong Provincial Hospital Affiliated to Shandong First Medical University & Shandong Academy of Medical Sciences, ; Jinan, Shandong China
                [3 ]GRID grid.410587.f, Department of Critical Care Medicine, , Shandong Provincial Hospital Affiliated to Shandong First Medical University & Shandong Academy of Medical Sciences, ; Jinan, Shandong China
                [4 ]GRID grid.410587.f, Department of Gastrointestinal Surgery, , Shandong Provincial Hospital Affiliated to Shandong First Medical University & Shandong Academy of Medical Sciences, ; Jinan, Shandong China
                Author information
                http://orcid.org/0000-0002-0222-8362
                Article
                8221
                10.1186/s12885-021-08221-9
                8127289
                816d0fbf-1665-485e-b3bf-ce425d667bbf
                © The Author(s) 2021

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 17 September 2020
                : 20 April 2021
                Funding
                Funded by: Natural Science Foundation of Shandong Province
                Award ID: ZR2017MH035
                Award ID: ZR2019QH014
                Award Recipient :
                Funded by: National Natural Science Foundation of China
                Award ID: 81902349
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2021

                Oncology & Radiotherapy
                platelet-to-lymphocyte ratio (plr),c-reactive protein (crp),colorectal polyps,histological type

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