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Abstract

BACKGROUND: Colorectal cancer is a major cause of mortality and morbidity. The interplay between systemic inflammation and the local immune response was recognized as the seventh hallmark of cancer, and it has been demonstrated to be involved in the initiation, development, and progression of several types of malignancies. systemic immune-inflammation index, was reported as prognostic factors in some malignant tumors, including Colorectal cancer. AIM OF STUDY: To investigate the relationship between systemic immune-inflammation index and clinicopathological characteristics (sex, age, site of tumor, T stage, N stage, M stage, Clinical (TNM) stage, Duke stage, Grade, Lympho-Vascular Invasion and Carcino-Embryonic Antigen level) of colorectal cancer. METHOD: cross-sectional study was conducted, involving seventy patients with Colorectal cancer who were diagnosed by histopathological proof, to evaluate the relationship by dividing the patients into two groups depending on cut-off values: (1) those with high marker level, (2) those with low marker level. RESULTS: The study involved 70 patients who are 38 males and 32 females. Their mean age was 53 years. Tumor site was in 40% of them in the left colon. The majority (67.1%) of patients have no metastasis and moderately differentiated tumors, 22 of 38 patients (58%) have positive lymphovascular invasion. Only 53 patients (75%) have a recorded pretreatment Carcino-Embryonic Antigen level and the mean was 13.07 ng/ml. There was a statistically significant association between systemic immune inflammation index and T stage and presence of metastasis, thereby clinical and Duke stages, as the value of systemic immune inflammation index is higher in advanced stages. Higher values of systemic immune inflammation index were associated with higher grade and with positive lymphovascular invasion also. CONCLUSION: Elevated systemic immune-inflammation index is associated with higher stages and with lympho-vascular invasion of colorectal cancer. It is furtherly associated with higher grade of disease. Systemic immune inflammation index is easily accessible, and its association with poor prognostic indicators (like stage or presence of metastasis) warrant further investigation.

DOI

10.52573/ipmj.2020.169736

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