Original Contribution
Evaluation of Haematological Parameters and their Correlation with
Histological Grade and Stage of Colorectal Cancer
1. *Dr. Susmita Naha, Assistant Professor, Department of Pathology, Shaheed Sayed Nazrul Islam
Medical College, Kishoreganj. dr.susmitanaha@yahoo.com.
2. Prof. Dr. AFM Saleh, Professor and Head, Department of Pathology, President Abdul Hamid
Medical College, Kishoreganj.
3. Dr. Dulal Chandra Das, Assistant Professor, Department of Medicine, Shaheed Sayed Nazrul Islam
Medical College, Kishoreganj.
4. Dr. Halima Khatun Doly, Assistant Professor, Department of Pathology, Khwaja Yunus Ali Medical College,
Sirajganj.
*For correspondence
Abstract
Background: Colorectal cancer (CRC) is a common and lethal disease worldwide which is
increasingly being reported in the developing countries. Prognosis is largely dependent on its
histological grade and stage. TNM staging system has been regarded as standard but there are still
variations between patients who have the same stage. There is need for more efficient biomarkers
that are low-cost, highly efficient and sensitive in the preoperative period, beneficial in clinical
usage and with both prognostic and predictive value. The aim of this study was to evaluate
preoperative haematological parameters including haemoglobin level (Hb), total leukocyte count,
neutrophil to lymphocyte ratio (NLR), platelet count (PC) and their correlation with histological
grade and stage of colorectal cancer.
Methods: This cross-sectional study was carried out in the Pathology department of Mymensingh
Medical College, Mymensingh, during March 2018 to December 2019 and a total of 45 patients
were included. Preoperative blood samples were evaluated from patients diagnosed as colorectal
carcinoma by colonoscopy in Surgery department of MMCH who underwent colectomy and all the
resected specimens were sectioned, stained and studied. Tumors were graded as well, moderately
and poorly differentiated as per WHO criteria. Staging was done according to TNM classification
as per AJCC Cancer Staging Manual.
Results: Histologically most of the cancers are adenocarcinoma (93.3%). Hb level had a negative
significant correlation with grade and a negative non-significant correlation with stage.NLR had a
positive non-significant correlation with grade but a positive significant correlation with stage.
ROC curve analysis of NLR with area under curve (AUC) 0.694 and a cut off value 3.07
demonstrated 63.6% sensitivity and 78.3% specificity for prediction of regional lymph node
involvement (N stage). Platelet count showed a positive significant correlation with grade but a
positive non-significant correlation with stage.
Conclusion: So, some commonly done preoperative haematological parameters may play a role in
predicting grade and stage of CRC and may be used as adjunct to clinical, radiological and
pathological findings in disease evaluation.
[Shaheed Syed Nazrul Islam Med Col J 2023, Jul; 8 (2):88-97]
Keywords: Hemoglobin, platelet, white blood cell, NLR, colorectal cancer, tumor grade, tumor
stage.
Full Article