Department of Surgery, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-0003, Japan.
Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Sci Rep. 2024 Jun 23;14(1):14428. doi: 10.1038/s41598-024-65457-8.
Colorectal cancer (CRC) poses a significant global health challenge, demanding reliable prognostic tools to guide treatment decisions. This study introduces a novel prognostic scoring system, the albumin-total lymphocyte count-RAS index (ALRI), integrating serum albumin, lymphocyte count, and RAS gene mutations. A cohort of 445 stage I-III CRC patients undergoing curative resection was analyzed, revealing ALRI's association with clinicopathological factors, including age, tumor location, and invasion depth. The ALRI demonstrated superior prognostic value, with a cutoff value of 2 distinguishing high and low-risk groups. The high-ALRI group exhibited elevated rates of recurrence. Univariate and multivariate analyses identified ALRI as an independent predictor for both 5 year recurrence-free survival (RFS) and overall survival (OS). Kaplan-Meier curves illustrated significant differences in RFS and OS between high and low-ALRI groups, emphasizing ALRI's potential as a prognostic marker. Importantly, ALRI outperformed existing nutritional indices, such as controlling nutritional status and neutrophil-to-lymphocyte ratio, in predicting overall survival. The study underscores the comprehensive insight provided by ALRI, combining inflammatory, nutritional, and genetic information for robust prognostication in CRC patients. This user-friendly tool demonstrates promise for preoperative prognosis and personalized treatment strategies, emphasizing the crucial role of inflammation and nutrition in CRC outcomes.
结直肠癌（CRC）是一个全球性的健康挑战，需要可靠的预后工具来指导治疗决策。本研究引入了一种新的预后评分系统，即白蛋白-总淋巴细胞计数-RAS 指数（ALRI），该系统综合了血清白蛋白、淋巴细胞计数和 RAS 基因突变。分析了 445 例接受根治性切除术的 I-III 期 CRC 患者，结果表明 ALRI 与临床病理因素（包括年龄、肿瘤位置和浸润深度）相关。ALRI 具有优越的预后价值，截断值为 2 可区分高风险和低风险组。高 ALRI 组的复发率较高。单因素和多因素分析均表明 ALRI 是 5 年无复发生存率（RFS）和总生存率（OS）的独立预测因素。Kaplan-Meier 曲线表明，高 ALRI 组和低 ALRI 组之间的 RFS 和 OS 存在显著差异，强调了 ALRI 作为预后标志物的潜力。重要的是，ALRI 在预测总生存率方面优于现有的营养指数，如控制营养状况和中性粒细胞与淋巴细胞比值。该研究强调了 ALRI 提供的综合见解，它结合了炎症、营养和遗传信息，为 CRC 患者提供了强大的预后预测。这种易于使用的工具有望用于术前预后和个性化治疗策略，强调炎症和营养在 CRC 结局中的关键作用。
