Indonesian Journal of Global Health Research
Vol. 8 No. 3 (2026): Indonesian Journal of Global Health Research

Analysis of the Relationship Between Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and Red Blood Cell Distribution Width (RDW) With Colorectal Cancer Staging

Mei Vrayanti F.S (Universitas Sumatera Utara)
Jelita Siregar (Universitas Sumatera Utara)
Adi Muradi Muhar (Universitas Sumatera Utara)



Article Info

Publish Date
31 May 2026

Abstract

This study aimed to examine the relationship between the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and red blood cell distribution width (RDW) with colorectal cancer (CRC) staging. Colorectal cancer is one of the most prevalent malignancies worldwide and a leading cause of cancer-related mortality, particularly in Indonesia. Inflammation plays an important role in cancer progression, and systemic inflammatory markers such as NLR, PLR, and RDW are considered practical, accessible, and cost-effective indicators for assessing disease severity and prognosis. An observational analytic study with a cross-sectional design was conducted at H. Adam Malik General Hospital, Medan, from November 2024 to January 2025. A total of 56 newly diagnosed CRC patients who had not undergone surgery or chemotherapy were enrolled using consecutive sampling. Blood samples were analyzed using a Sysmex XN-1500 hematology analyzer. Statistical analyses included independent t tests, Mann–Whitney tests, Spearman correlation, and receiver operating characteristic (ROC) analysis. The results demonstrated a significant difference in PLR values between early- and advanced-stage CRC (p = 0.003), with a moderate positive correlation between PLR and cancer stage (r = 0.297, p = 0.026). RDW showed a weak but statistically significant correlation with CRC stage (r = 0.284, p = 0.034). In contrast, NLR did not show a statistically significant correlation with CRC staging (p = 0.109). These findings suggest that PLR and RDW are promising, simple, and inexpensive inflammatory biomarkers that may assist in the preoperative staging of colorectal cancer, whereas NLR alone may not be a reliable predictor of CRC stage.

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Journal Info

Abbrev

IJGHR

Publisher

Subject

Description

Indonesian Journal of Global Health Research is a open access, peer reviewed and refereed international journal. Indonesian Journal of Global Health Research aim to publish original research paper devoted to various area of all health sciences. Indonesian Journal of Global Health Research provides a ...