Furukawa Shunsuke, Hiraki Masatsugu, Kimura Naoya, Kohya Naohiko, Sakai Masashi, Ikubo Akashi, Samejima Ryuichiro
Department of Surgery, Japanese Red Cross Society Karatsu Red Cross Hospital, Karatsu, Japan.
Cancer Diagn Progn. 2025 May 3;5(3):370-377. doi: 10.21873/cdp.10449. eCollection 2025 May-Jun.
BACKGROUND/AIM: The C-reactive protein (CRP)-albumin-lymphocyte (CALLY) index is an innovative immunonutritional biomarker calculated from CRP, serum albumin, and lymphocyte count levels. This study aimed to determine the significance of the preoperative CALLY index as a prognostic biomarker in patients with stage II-III colorectal cancer who underwent colorectal surgery.
This retrospective study included 223 patients who underwent colorectal surgery for stage II-III colorectal cancer. The CALLY index was calculated as follows: (albumin × lymphocyte)/(CRP × 104). The patients were divided into CALLY-high group (n=112) and CALLY-low group (n=111) according to the preoperative CALLY index. The associations between the preoperative CALLY index and recurrence-free survival (RFS) and overall survival (OS) were evaluated.
The cutoff value of the CALLY index was 3.41. The Kaplan-Meier survival curves for both RFS and OS in patients with stage II-III colorectal cancer demonstrated worse outcomes in the CALLY-low group than in the CALLY-high group (p=0.062 and p=0.008, respectively). A subgroup analysis of both stage II and stage III showed that patients in the CALLY-low group who did not receive postoperative adjuvant chemotherapy had the worst RFS and OS.
The preoperative CALLY index may serve as a prognostic biomarker in patients with colorectal cancer. Additionally, a low CALLY index may indicate a poorer prognosis, particularly in patients who did not receive postoperative adjuvant chemotherapy.
背景/目的：C反应蛋白（CRP）-白蛋白-淋巴细胞（CALLY）指数是一种根据CRP、血清白蛋白和淋巴细胞计数水平计算得出的创新性免疫营养生物标志物。本研究旨在确定术前CALLY指数作为接受结直肠手术的II-III期结直肠癌患者预后生物标志物的意义。
这项回顾性研究纳入了223例接受II-III期结直肠癌手术的患者。CALLY指数的计算方法如下：（白蛋白×淋巴细胞）/（CRP×104）。根据术前CALLY指数，将患者分为CALLY高分组（n=112）和CALLY低分组（n=111）。评估术前CALLY指数与无复发生存期（RFS）和总生存期（OS）之间的关联。
CALLY指数的截断值为3.41。II-III期结直肠癌患者的RFS和OS的Kaplan-Meier生存曲线显示，CALLY低分组的预后比CALLY高分组差（分别为p=0.062和p=0.008）。II期和III期的亚组分析均显示，未接受术后辅助化疗的CALLY低分组患者的RFS和OS最差。
术前CALLY指数可作为结直肠癌患者的预后生物标志物。此外，低CALLY指数可能预示预后较差，尤其是在未接受术后辅助化疗的患者中。
