Department of Gastrointestinal Oncology, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Peking University Cancer Hospital Yunnan, Kunming, China.
Sci Rep. 2024 Sep 3;14(1):20489. doi: 10.1038/s41598-024-68150-y.
The aim of this study was to evaluate the prognostic value of peripheral blood inflammation indexes in patients with metastatic Colorectal Cancer (CRC) and to establish a predictive scoring system. A total of 324 CRC patients diagnosed through pathological examination from January 2017 to July 2022 at the Third Affiliated Hospital of Kunming Medical University were included. The prognosis of patients with metastatic CRC was examined, and the correlation between IL-10 expression in pathological tissues and IL-10 expression in serum was analyzed. The results showed that the prognosis of CRC was poorer when metastasis occurred (P < 0.001). Additionally, IL-10 was highly expressed in the metastatic CRC group (P = 0.018), and the expression of IL-10 in pathological tissues of patients with metastatic CRC was positively correlated with the expression of IL-10 in serum (P = 0.037). The neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-white blood cell ratio (LWR), aggregate index of systemic inflammation (AISI), monocyte-to-lymphocyte ratio (MLR), systemic inflammatory response index (SIRI), prognostic nutritional index (PNI), advanced lung cancer inflammation index (ALI), and interleukin-10 (IL-10) were calculated and determined by ROC curve. The critical values were 2.135, 3.735, 353.745, 0.265, 1.025, 52.975, 353.635, and 11.25, respectively. Inflammatory indexes with an AUC of more than 0.6 were selected, and each colorectal cancer patient with any of these risk factors was assigned a score of one. The 324 patients were then divided into two groups: 0-4 for the low-risk group and 4-8 for the high-risk group. The occurrence of distant metastases in the two groups was statistically analyzed. The results showed that the OS and PFS of the low-risk group were significantly superior to those of the high-risk group (P < 0.05). These findings indicate that NLR, LWR, AISI, MLR, SIRI, PNI, ALI, and IL-10 are risk factors for distant metastasis in CRC patients. Therefore, the prediction scores of these indexes can be used to effectively evaluate the prognosis of patients with metastatic CRC.
本研究旨在评估外周血炎症指标对转移性结直肠癌(CRC)患者的预后价值,并建立预测评分系统。共纳入 2017 年 1 月至 2022 年 7 月在昆明医科大学第三附属医院经病理检查诊断的 324 例 CRC 患者。检查转移性 CRC 患者的预后,并分析组织中 IL-10 表达与血清中 IL-10 表达的相关性。结果显示,发生转移时 CRC 的预后更差(P<0.001)。此外,转移性 CRC 组中 IL-10 高表达(P=0.018),转移性 CRC 患者组织中 IL-10 的表达与血清中 IL-10 的表达呈正相关(P=0.037)。计算并通过 ROC 曲线确定中性粒细胞与淋巴细胞比值(NLR)、淋巴细胞与白细胞比值(LWR)、全身炎症反应综合指数(AISI)、单核细胞与淋巴细胞比值(MLR)、全身炎症反应指数(SIRI)、营养预后指数(PNI)、晚期肺癌炎症指数(ALI)和白细胞介素-10(IL-10)。临界值分别为 2.135、3.735、353.745、0.265、1.025、52.975、353.635 和 11.25。选择 AUC 大于 0.6 的炎症指标,每位具有任何这些危险因素的结直肠癌患者均得 1 分。然后将 324 例患者分为两组:低危组 0-4 分,高危组 4-8 分。统计分析两组患者远处转移的发生情况。结果显示,低危组的 OS 和 PFS 明显优于高危组(P<0.05)。这些发现表明 NLR、LWR、AISI、MLR、SIRI、PNI、ALI 和 IL-10 是 CRC 患者远处转移的危险因素。因此,这些指标的预测评分可用于有效评估转移性 CRC 患者的预后。