Gao Shunhui, Xie Hailun, Wei Lishuang, Liu Mingxiang, Liang Yanren, Wang Qiwen, Tang Shuangyi, Gan Jialiang
Department of Gastrointestinal Surgery, The Second People's Hospital of Nanning, Nanning, China.
Guangxi Key Laboratory of Enhanced Recovery After Surgery for Gastrointestinal Cancer, The First Affiliated Hospital, Guangxi Medical University, Nanning, China.
Front Oncol. 2023 Jun 20;13:1155520. doi: 10.3389/fonc.2023.1155520. eCollection 2023.
This study aimed to explore the relationship between creatinine/cystatin C ratio and progression-free survival (PFS) and overall survival (OS) in colorectal cancer (CRC) patients undergoing surgical treatment.
A retrospective analysis was conducted on 975 CRC patients who underwent surgical resection from January 2012 to 2015. Restricted three-sample curve to display the non-linear relationship between PFS/OS and creatinine-cystatin C ratio. Cox regression model and Kaplan-Meier method were used to evaluate the effect of the creatinine-cystatin C ratio on the survival of CRC patients. Prognostic variables with p-value ≤0.05 in multivariate analysis were used to construct prognostic nomograms. The receiver operator characteristic curve was used to compare the efficacy of prognostic nomograms and the traditional pathological stage.
There was a negative linear relationship between creatinine/cystatin C ratio and adverse PFS in CRC patients. Patients with low creatinine/cystatin C ratio had significantly lower PFS/OS than those with high creatinine/cystatin C ratio (PFS, 50.8% vs. 63.9%, p = 0.002; OS, 52.5% vs. 68.9%, p < 0.001). Multivariate analysis showed that low creatinine/cystatin C ratio was an independent risk factor for PFS (HR=1.286, 95%CI = 1.007-1.642, p=0.044) and OS (HR=1.410, 95%CI=1.087-1.829, p=0.010) of CRC patients. The creatinine/cystatin C ratio-based prognostic nomograms have good predictive performance, with a concordance index above 0.7, which can predict the 1-5-year prognosis.
Creatinine/cystatin C ratio may be an effective prognostic marker for predicting PFS and OS in CRC patients, aid in pathological staging, and along with tumour markers help in-depth prognostic stratification in CRC patients.
本研究旨在探讨肌酐/胱抑素C比值与接受手术治疗的结直肠癌（CRC）患者无进展生存期（PFS）和总生存期（OS）之间的关系。
对2012年1月至2015年接受手术切除的975例CRC患者进行回顾性分析。采用受限三样本曲线来显示PFS/OS与肌酐-胱抑素C比值之间的非线性关系。使用Cox回归模型和Kaplan-Meier方法来评估肌酐-胱抑素C比值对CRC患者生存的影响。多因素分析中p值≤0.05的预后变量用于构建预后列线图。采用受试者工作特征曲线比较预后列线图与传统病理分期的效能。
CRC患者中肌酐/胱抑素C比值与不良PFS之间存在负线性关系。肌酐/胱抑素C比值低的患者的PFS/OS显著低于肌酐/胱抑素C比值高的患者（PFS，50.8%对63.9%，p = 0.002；OS，52.5%对68.9%，p < 0.001）。多因素分析显示，低肌酐/胱抑素C比值是CRC患者PFS（HR = 1.286，95%CI = 1.007 - 1.642，p = 0.044）和OS（HR = 1.410，95%CI = 1.087 - 1.829，p = 0.010）的独立危险因素。基于肌酐/胱抑素C比值的预后列线图具有良好的预测性能，一致性指数高于0.7，可预测1至5年的预后。
肌酐/胱抑素C比值可能是预测CRC患者PFS和OS的有效预后标志物，有助于病理分期，并与肿瘤标志物一起帮助对CRC患者进行深入的预后分层。
