Hematological Parameters in Liver Metastasis: A Comprehensive Clinical Evaluation for Early Detection in Iraqi Patients
- Authors
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Zahraa A.G. AL Ghuraibawi
Iraqi National Cancer Research Center, University of Baghdad, Baghdad, Iraq -
Mohammed Mahmood Kamil
Al-Esraa University, College of Pharmacy, Baghdad, Iraq -
Khaleel Ibraheem Mohson
Iraqi National Cancer Research Center, University of Baghdad, Baghdad, Iraq -
Zainab Ghazi Sadeq
Iraq Natural History Research Center and Museum, University of Baghdad, Baghdad, Iraq -
Mareym M. Alkhaiat
Iraq Natural History Research Center and Museum, University of Baghdad, Baghdad, Iraq
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- Keywords:
- Liver metastasis, Hematological parameters, Neutrophil-to-Lymphocyte Ratio (NLR), Immune response, Systemic inflammation, Cancer
- Abstract
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Background: Liver metastasis significantly complicates cancer prognosis, yet easily accessible markers for its early detection and monitoring remain crucial. This study aimed to comprehensively evaluate key hematological parameters as potential indicators for liver metastasis in Iraqi patients.
Methods: We conducted a cross-sectional study comparing hematological profiles between 90 patients (presumably with liver metastasis) and 30 healthy controls. White Blood Cell (WBC) count, Lymphocyte percentage, Neutrophil percentage, and Neutrophil-to-Lymphocyte Ratio (NLR) were analyzed. Given non-normal data distributions (confirmed by the Shapiro-Wilk test), group comparisons were performed using the non-parametric Mann-Whitney U test.
Results: Statistically significant differences were observed across all investigated hematological parameters between the patient and control groups. Patients exhibited elevated WBC counts (p<0.0001) and neutrophil percentages (p=0.0310), indicative of systemic inflammation. Conversely, a highly reduction in lymphocyte percentage (p<0.0001) was noted in the patient group, suggesting relative lymphopenia and a potential shift towards innate over adaptive immune responses. Most notably, the Neutrophil-to-Lymphocyte Ratio (NLR) was significantly higher in patients (p<0.0001), reflecting a pronounced systemic inflammatory state and immune imbalance associated with advanced disease.
Conclusion: This study demonstrates a robust association between altered hematological profiles and disease status in patients, consistent with the immune dysregulation characteristic of liver metastasis. These parameters may serve as valuable indicators for early diagnosis and risk stratification in patients with liver metastasis. Their clinical utility could enhance treatment decision-making and patient monitoring in routine practice, and cost-effective and non-invasive markers for early detection, risk stratification, and therapeutic monitoring in Iraqi patients with liver metastasis. Further research is warranted to validate their role in specific clinical algorithms.
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- References
-
[1] Kostyleva NM, Yusupov TA. The use of ablation technologies for the treatment of hepatic metastases of colorectal cancer. Ukr J Clin Surg 2023; 90(5): 54-62.
[2] Horn SR, Stoltzfus KC, Lehrer EJ, Dawson LA, Tchelebi L, Gusani NJ, et al. Epidemiology of liver metastases. Cancer Epidemiol 2020; 67: 101760.
[3] Petrowsky H, Fritsch R, Guckenberger M, de Oliveira ML, Dutkowski P, Clavien PA. Modern therapeutic approaches for the treatment of malignant liver tumours. Nat Rev Gastroenterol Hepatol 2020; 17(12): 755-72.
[4] Tsilimigras DI, Brodt P, Clavien PA, Muschel RJ, D’Angelica MI, et al. Liver metastases. Nat Rev Dis Primers 2021; 7(1): 27.
[5] Rigamonti A, Feuerhake F, Donadon M, Locati M, Marchesi F. Histopathological and immune prognostic factors in colo-rectal liver metastases. Cancers (Basel) 2021; 13(5): 1075.
[6] LiY, Xu T, Wang X, Jia X, Ren M, Wang X. The prognostic utility of preoperative neutrophil-to-lymphocyte ratio (NLR) in patients with colorectal liver metastasis: a systematic review and meta-analysis. Cancer Cell Int 2023; 23(1): 39.
[7] Mantovani S, Mondelli MU. Cytokine-mediated immune dysregulation in hepatic metastasis. Liver Int 2025; 45(1): 99-110.
[8] Imtiaz F, Shafique K, Mirza SS, Ayoob Z, Vart P, Rao S. Neutrophil lymphocyte ratio as a measure of systemic inflammation in prevalent chronic diseases in Asian population. Int Arch Med 2012; 5(1): 1-6.
[9] Sionov RV. Leveling up the controversial role of neutrophils in cancer: when the complexity becomes entangled. Cells 2021; 10(9): 2486.
[10] Linde IL, Prestwood TR, Qiu J, Pilarowski G, Linde MH, Zhang X, et al. Neutrophil-activating therapy for the treatment of cancer. Cancer Cell 2023; 41(2): 356-72.
[11] Coffelt SB, Wellenstein MD, de Visser KE. Neutrophils in cancer: neutral no more. Nat Rev Cancer 2016; 16(7): 431-46.
[12] Bhola RK, Fudaly C, Rastogi S. A comparative evaluation of performance of Sysmex XN 3000 and Horiba Yumizen H2500 automated complete blood count analysers. Indian J Hematol Blood Transfus 2024; 40(2): 303-14.
[13] Lagunas-Rangel FA. Neutrophil-to-lymphocyte ratio and lymphocyte-to-C-reactive protein ratio in patients with severe coronavirus disease 2019 (COVID-19): a meta-analysis. J Med Virol 2020; 92(10): 1733.
[14] Zahorec R. Ratio of neutrophil to lymphocyte counts—rapid and simple parameter of systemic inflammation and stress in critically ill. Bratisl Lek Listy 2001; 102(1): 5-14.
[15] Rahlfs V, Zimmermann H. Effect size measures and their benchmark values for quantifying benefit or risk of medicinal products. Biom J 2019; 61(4): 973-982.
[16] Chow YH, Zhu XD, Liu L, Schwartz BR, Huang XZ, Harlan JM, et al. Role of Cdk4 in lymphocyte function and allergen response. Cell Cycle 2010; 9(24): 4922-30.
[17] Templeton AJ, McNamara MG, Šeruga B, Vera-Badillo FE, Aneja P, Ocaña A, et al. Prognostic role of neutrophil-to-lymphocyte ratio in solid tumors: a systematic review and meta-analysis. J Natl Cancer Inst 2014; 106(6): dju124.
[18] Zahorec R. Neutrophil-to-lymphocyte ratio, past, present and future perspectives. Bratisl Lek Listy.
[19] Kenig J. Hepatocellular cancer and colorectal liver metastasis treatment in the older population. Biuletyn Polskiego Towarzystwa Onkologicznego Nowotwory 2022; 7(1): 52-7.
[20] Martins EC, Silveira LDF, Viegas K, Beck AD, Fioravantti G, Cremonese RV, et al. Neutrophil-lymphocyte ratio in the early diagnosis of sepsis in an intensive care unit: a case-control study. Rev Bras Ter Intensiva 2019; 31: 64-70.
[21] Li Y, Wang J, Zhang X, Huang Y. Systemic inflammation and hematological changes in metastatic cancers: Diagnostic and prognostic value. Front Oncol 2023; 13: 1023450.
[22] LaRosa DF, Orange JS. Lymphocytes. J Allergy Clin Immunol 2008; 121(2 Suppl): S364-9.
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- 01-09-2025
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