A Novel Inflammation-Related Prognostic Biomarker for Predicting The Disease-free Survival of Patients With Colorectal Cancer

Abstract

Background: To develop and evaluate the prognostic value of a comprehensive inflammatory biomarker for postoperative colorectal cancer (CRC) patients.Methods: A total of 646 CRC patients were recruited between August 2017 and December 2019 from Fujian Medical University Union Hospital, with follow-up data up to 2021. The least absolute shrinkage and selection operator method (LASSO) was used to select inflammation indicators in order to construct a comprehensive biomarker (named NSAP). The Cox regression model was utilized to analyze the association between the NSAP and the disease-free survival (DFS) of CRC. Predictive performance and clinical utility of prognostic models were evaluated by area under the curve (AUC) and decision curve analyses (DCAs).Results: During a median follow-up of 23 months, 95 clinical outcomes were observed, with a one-year survival rate is 89.47%. A comprehensive inflammatory biomarker (NSAP) was established based on four blood indicators (including Neutrophil-to-Lymphocyte Ratio (NLR), Neutrophil×Monocyte-to-Lymphocyte Ratio (SIRI), Albumin-to-Globulin Ratio (AGR) and Platelet-to-Lymphocytes Ratio (PLR)). Patients with a lower NSAP had significantly associated with better DFS of CRC (HR=0.53, 95%CI: 0.32-0.89). Moreover, compared to a previously established model, the traditional TNM staging system or/and tumor markers, the nomogram based on NSAP displayed more excellent predictive ability (0.752 vs 0.597, 0.711 and 0.735, P < 0.05). DCAs also demonstrated that the established nomogram had better utility for decision making.Conclusions: Our study suggests that NSAP may be a useful comprehensive prognostic biomarker for predicting the DFS of CRC patients. The nomogram based on NSAP can be considered a valuable tool to estimate the prognosis of patients with CRC.

The efficient circulating immunoscore predicts prognosis of patients with advanced gastrointestinal cancer

“…Immunoscore constructed by researchers, which considered the infiltration level of T cell subtype, B cell subtype or macrophage in tumor microenvironment (TME) of primary lesions or metastases, is widely applied to predict the prognosis in patients with gastrointestinal tumors [21][22][23][24][25]. In addition, more and more peripheralrelated indicators are used to predict the prognosis of solid tumor patients [26][27][28]. The simplicity, reproducibility and accuracy of these scoring systems make them the most popular prediction models in clinical practice.…”