Correlation of neutrophil-lymphocyte ratio and serum cholinesterase in colorectal cancer patients: a cross-sectional study

Abstract

BACKGROUND: Colorectal cancer (CRC) is the third most common cancer and the fourth leading cause of death in the world. Inflammatory markers such as neutrophil-lymphocyte ratio (NLR) increase with cancer stage. Serum cholinesterase (ChE) examination, which measures nutritional status, can provide information on patient prognosis. The aim of this study was to determine the relationship between NLR value and serum ChE level in CRC patients.METHODS: A cross-sectional study was conducted on 56 CRC patients at Wahidin Sudirohusodo Hospital, March-May 2024. Samples were grouped based on metastases. NLR was calculated from the ratio of neutrophils to lymphocytes. Serum ChE levels were measured by ELISA. Data were analysed using Kolmogorov-Smirnov Test, independent t-test, and Spearman and Pearson’s correlation tests.RESULTS: This study found that most CRC patients were ≥50 years old (75%), with 66.1% having metastasis. The mean NLR value was 3.10±1.79, and the mean serum ChE level was 40.50±29.19 ng/mL. NLR was higher in patients with metastasis, while ChE levels were lower than those without metastasis, with significant differences (P<0.05). There was a significant correlation between NLR and ChE. In the metastasis group, there was a very strong correlation (r=-0.828), while in the group without metastasis, there was no correlation (r=-0.075).CONCLUSIONS: NLR increased and ChE decreased in patients with CRC. There was a correlation between the two in patients with metastasis, but no correlation in patients without metastasis.

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