Department of Colorectal and Anal Surgery, The First Affiliated Hospital, Guangxi Medical University, 6 Shuangyong Road, Nanning, 530021, Guangxi, People's Republic of China.
Department of Pharmacy, The First Affiliated Hospital, Guangxi Medical University, 6 Shuangyong Road, Nanning, 530021, Guangxi, People's Republic of China.
Sci Rep. 2023 Oct 23;13(1):18080. doi: 10.1038/s41598-023-45550-0.
This study aimed to assess the relationship between the Cancer-Inflammation Prognostic Index (CIPI) and disease-free survival (DFS) and overall survival (OS) in patients with stage I-III colorectal cancer (CRC). The relationship between the CIPI and survival was evaluated using restricted cubic splines. Survival curves were established using the Kaplan-Meier method and the log-rank test. Cox proportional hazards models were used to explore independent prognostic factors for CRC. Meaningful variables from the multivariate analysis were used to construct prognostic nomograms. The relationship between the CIPI values on a continuous scale and the risk of DFS/OS mortality was an inverted L-shape. Patients with a high CIPI had significantly lower DFS (53.0% vs. 68.5%, p < 0.001) and OS (55.5% vs. 71.7%, p < 0.001) than those with a low CIPI. The CIPI can also serve as an effective auxiliary tool to further distinguish the prognosis of patients with CRC at the same pathological stage, especially for stages II and III. After multivariate adjustment, a high CIPI was found to be an independent risk factor for DFS (HR 1.443, 95% CI 1.203-1.730, p < 0.001) and OS (HR 1.442, 95% CI 1.189-1.749, p < 0.001) in CRC patients. These nomograms have the advantage of integrating individual profiles, tumour characteristics, and serum inflammatory markers, providing favourable discrimination and calibration values. Compared with traditional TNM staging, nomograms have a better predictive performance. The CIPI is an effective and easy-to-use clinical tool for predicting the recurrence and overall mortality of patients with stage I-III CRC.
本研究旨在评估癌症-炎症预后指数（CIPI）与Ⅰ-Ⅲ期结直肠癌（CRC）患者无病生存（DFS）和总生存（OS）之间的关系。使用限制性立方样条评估 CIPI 与生存之间的关系。使用 Kaplan-Meier 方法和对数秩检验建立生存曲线。使用 Cox 比例风险模型探讨 CRC 的独立预后因素。多变量分析中有意义的变量用于构建预后列线图。CIPI 值在连续尺度上与 DFS/OS 死亡率风险之间的关系呈倒 L 形。CIPI 较高的患者 DFS（53.0%比 68.5%，p<0.001）和 OS（55.5%比 71.7%，p<0.001）明显低于 CIPI 较低的患者。CIPI 还可以作为一种有效的辅助工具，进一步区分同一病理分期 CRC 患者的预后，尤其是对于Ⅱ期和Ⅲ期患者。多变量调整后，CIPI 较高是 CRC 患者 DFS（HR 1.443，95%CI 1.203-1.730，p<0.001）和 OS（HR 1.442，95%CI 1.189-1.749，p<0.001）的独立危险因素。这些列线图具有整合个体特征、肿瘤特征和血清炎症标志物的优势，提供了良好的区分度和校准值。与传统的 TNM 分期相比，列线图具有更好的预测性能。CIPI 是一种有效且易于使用的临床工具，可预测Ⅰ-Ⅲ期 CRC 患者的复发和总死亡率。
