Retrospective Cohort Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 7, 2024; 30(33): 3823-3836
Published online Sep 7, 2024. doi: 10.3748/wjg.v30.i33.3823
Pan-immune-inflammation value as a prognostic biomarker for colon cancer and its variation by primary tumor location
Qian-Yu Wang, Wen-Tao Zhong, Yi Xiao, Guo-Le Lin, Jun-Yang Lu, Lai Xu, Guan-Nan Zhang, Jun-Feng Du, Bin Wu
Qian-Yu Wang, Yi Xiao, Guo-Le Lin, Jun-Yang Lu, Lai Xu, Guan-Nan Zhang, Bin Wu, Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
Wen-Tao Zhong, Jun-Feng Du, Medical Department of General Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
Co-corresponding authors: Jun-Feng Du and Bin Wu.
Author contributions: Wang QY and Wu B conceived the concept; Wang QY and Zhong WT collected the cohort data; Du JF and Wu B contributed to the reagents/materials/analysis tools; Wang QY wrote the original draft; Xiao Y, Lin GL, Lu JY, Xu L, Zhang GN, Du JF, and Wu B reviewed and edited the manuscript. Du JF and Wu B contributed to the supervision of this manuscript and should be considered as co-corresponding authors. All authors contributed to the article and approved the submitted version.
Supported by National High Level Hospital Clinical Research Funding, No. 2022-PUMCH-B-003.
Institutional review board statement: The ethics committee of Peking Union Medical College Hospital (I-24PJ0585) approved this study.
Informed consent statement: Owing to the anonymity and retrospective nature of the data, the requirement for written informed consent was waived.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The datasets used and/or analyzed in the current study presented in the study are included in the article/supplementary information section. Further inquiries can be directed to the corresponding author (Bin Wu, E-mail: Wubin@pumch.cn) upon reasonable request.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bin Wu, MD, Chief Doctor, Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan Road, Wangfujing, Dongcheng District, Beijing 100730, China. wubin@pumch.cn
Received: July 10, 2024
Revised: August 2, 2024
Accepted: August 19, 2024
Published online: September 7, 2024
Processing time: 53 Days and 16.2 Hours
Abstract
BACKGROUND

A growing body of research indicates significant differences between left-sided colon cancers (LCC) and right-sided colon cancers (RCC). Pan-immune-inflammation value (PIV) is a systemic immune response marker that can predict the prognosis of patients with colon cancer. However, the specific distinction between PIV of LCC and RCC remains unclear.

AIM

To investigate the prognostic and clinical significance of PIV in LCC and RCC patients.

METHODS

This multicenter retrospective cohort study included 1510 patients with colon cancer, comprising 801 with LCC and 709 with RCC. We used generalized lifting regression analysis to evaluate the relative impact of PIV on disease-free survival (DFS) in these patients. Kaplan-Meier analysis, as well as univariate and multivariate analyses, were used to examine the risk factors for DFS. The correlation between PIV and the clinical characteristics was statistically analyzed in these patients.

RESULTS

A total of 1510 patients {872 female patients (58%); median age 63 years [interquartile ranges (IQR): 54-71]; patients with LCC 801 (53%); median follow-up 44.17 months (IQR 29.67-62.32)} were identified. PIV was significantly higher in patients with RCC [median (IQR): 214.34 (121.78-386.72) vs 175.87 (111.92-286.84), P < 0.001]. After propensity score matching, no difference in PIV was observed between patients with LCC and RCC [median (IQR): 182.42 (111.88-297.65) vs 189.45 (109.44-316.02); P = 0.987]. PIV thresholds for DFS were 227.84 in LCC and 145.99 in RCC. High PIV (> 227.84) was associated with worse DFS in LCC [PIV-high: Adjusted hazard ratio (aHR) = 2.39; 95% confidence interval: 1.70-3.38; P < 0.001] but not in RCC (PIV-high: aHR = 0.72; 95% confidence interval: 0.48-1.08; P = 0.114).

CONCLUSION

These findings suggest that PIV may predict recurrence in patients with LCC but not RCC, underscoring the importance of tumor location when using PIV as a colon cancer biomarker.

Keywords: Colon cancer; Left-sided colon cancer; Right-sided colon cancer; Pan-immune-inflammation value; Systemic inflammatory biomarkers; Prognosis

Core Tip: This study underscores the critical role of tumor location in shaping the prognostic significance of the pan-immune-inflammation value in colon cancer patients. The findings reveal that a high pan-immune-inflammation value is strongly correlated with poorer disease-free survival in patients with left-sided colon cancer, while no such association was observed in right-sided colon cancer. These results suggest that integrating tumor location into prognostic evaluations could improve the identification of high-risk patients and facilitate more precise, personalized treatment strategies in clinical practice.