Preoperative inflammation and nutrition-based comprehensive biomarker for predicting prognosis in resectable colorectal cancer

Abstract

BackgroundColorectal cancer (CRC) remains a major global health concern, with significant morbidity and mortality rates. In this study, we aimed to develop a comprehensive blood indicator based on systemic inflammation and nutritional condition to predict the prognosis of resectable CRC patients.MethodsA retrospective cohort of 210 CRC patients who underwent radical resection at the First Affiliated Hospital of Chongqing Medical University, China, between January 2015 and December 2017, was included in the analysis. Baseline characteristics, preoperative blood markers, including neutrophil count, monocyte count, lymphocyte count, platelets, albumin, and CEA were retrospectively reviewed. Various blood indicators, such as NLR, PLR, MLR, SIRI and OPNI were calculated. The least absolute shrinkage and selection operator (LASSO) method was employed to select indicators to establish a novel comprehensive biomarker (named PSI). Kaplan-Meier survival curves and log-rank tests were used to evaluate the prognostic impact of preoperative OPNI, SIRI, and PSI. Univariate and multivariate Cox regression model were conducted to identify independent prognostic factors for CRC. The receiver operating characteristic (ROC) method assessed the predictive ability of PSI, stage, OPNI, and SIRI.ResultsPatients with higher preoperative OPNI and lower SIRI values had significantly better overall survival (OS). PSI was identified as an independent prognostic factor for OS in both univariate and multivariate analysis. Patients with medium (28.3-43.4) and high (>43.4) PSI scores exhibited superior OS compared to those with low (≤ 28.3) PSI scores. PSI showed higher predictive ability (AUC: 0.734) than individual indicators alone (OPNI: 0.721, SIRI: 0.645, stage: 0.635).ConclusionThe novel indicator, PSI, based on preoperative SIRI and OPNI, demonstrated significant prognostic value for resectable CRC patients. PSI outperformed individual indicators and could serve as a reliable tool for prognostic evaluation in CRC patients.

Development and validation of a prognostic immunoinflammatory index for patients with gastric cancer

“…Zhang et al [ 38 ] and He et al [ 39 ] proposed SII as a good biomarker for diagnosing gastric cancer compared with NLR and PLR, highlighting its significant correlation with OS in this setting. It has been shown that SIRI predicts patient prognosis in a variety of cancer types[ 40 , 41 ]. In our hospital, the study of lymphocyte subpopulations further affirmed their role as predictive biomarkers for gastric cancer, surpassing the predictive capability of inflammatory biomarkers[ 42 ].…”

Achieving Health Equity: Advancing Colorectal Surgery among Racial and Ethnic Minorities in America

“…Preoperative malnutrition in patients with CRC is associated with many postoperative complications and overall poor prognosis. 57 Because NHB patients are more likely to reside in food-desert neighborhoods, 40 it might be advantageous to administer nutritional screenings and provide patient-education related to presurgical nutrition.…”

Red Cell Distribution Width as a Predictor of Survival in Patients with Hepatocellular Carcinoma

“…Complete blood count-based biomarkers have been shown to correlate well with clinical outcomes in numerous chronic [ 5 , 6 , 7 , 8 , 9 , 10 ], infectious [ 11 , 12 , 13 , 14 , 15 ], and surgical conditions [ 16 , 17 , 18 , 19 , 20 ], as well as in cancer [ 21 , 22 , 23 , 24 , 25 , 26 ]. In particular, the potential role of the red cell distribution width (RDW), a biomarker of the heterogeneity of red blood cells’ size, in predicting adverse events and survival currently represents a topic of intense research in numerous clinical conditions [ 27 , 28 ], including malignancies such as colorectal cancer [ 29 , 30 , 31 ], esophageal cancer [ 32 , 33 ], lung cancer [ 34 , 35 ], breast cancer [ 36 , 37 ], and other malignancies [ 38 , 39 , 40 , 41 , 42 ].…”