Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Dec 27, 2024; 16(12): 3794-3805
Published online Dec 27, 2024. doi: 10.4240/wjgs.v16.i12.3794
Prognostic value of combined systemic inflammation response index and prognostic nutritional index in colorectal cancer patients
Ke-Jin Li, Zi-Yi Zhang, Subinur Sulayman, Yin Shu, Kuan Wang, Saibihutula Ababaike, Xiang-Yue Zeng, Ze-Liang Zhao
Ke-Jin Li, Zi-Yi Zhang, Subinur Sulayman, Yin Shu, Kuan Wang, Saibihutula Ababaike, Xiang-Yue Zeng, Ze-Liang Zhao, Department of Gastrointestinal Surgery, The Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi 830000, Xinjiang Uygur Autonomous Region, China
Author contributions: Li KJ wrote the original draft; Li KJ and Zhang ZY contributed to the data analysis; Zhao ZL led the quality assessments; Subinur S, Shu Y, Wang K, Saibihutula A, and Zeng XY collected the data; and all authors have agreed on the manuscript to be submitted.
Supported by the Natural Science Foundation of Xinjiang Uygur Autonomous Region, No. 2022D01C297.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of the Affiliated Cancer Hospital of Xinjiang Medical University (Approval No. K-2024056).
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: The authors declare no conflicts of interest for this article.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at zlzhao71@163.com. Participants gave informed consent for data sharing.
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: Ze-Liang Zhao, MD, PhD, Director, Doctor, Professor, Research Scientist, Department of Gastrointestinal Surgery, The Affiliated Cancer Hospital of Xinjiang Medical University, No. 789 Suzhou East Street, Xinshi District, Urumqi 830000, Xinjiang Uygur Autonomous Region, China. zlzhao71@163.com
Received: August 26, 2024
Revised: October 5, 2024
Accepted: October 22, 2024
Published online: December 27, 2024
Processing time: 92 Days and 16.6 Hours
Abstract
BACKGROUND

The prognosis of colorectal cancer (CRC) patients is notably influenced by both inflammation and nutritional status. The prognostic nutritional index (PNI) and systemic inflammatory response index (SIRI) have been reported in prognostic studies of various tumors. However, the efficacy of the combination of the two in predicting the prognosis of CRC patients has not been studied.

AIM

To evaluate the effectiveness of PNI and SIRI in predicting the prognosis of patients with CRC.

METHODS

We retrospectively gathered data from 470 CRC patients who underwent feasible radical surgery at Xinjiang Cancer Hospital. The optimal cut-off values for SIRI and PNI, along with their predictive power for survival, were determined through area under the receiver operating characteristic curve using time-dependent receiver operating characteristic analysis. The Kaplan-Meier method and log-rank test were applied to assess prognostic impact, and a multifactorial Cox proportional hazards model was employed for analysis. Additionally, a new model, PSIRI, was developed and assessed for its survival prediction capability.

RESULTS

The optimal cutoff values for PNI and SIRI were determined to be 47.80 and 1.38, respectively. Based on these values, patients were categorized into high PNI and low PNI groups, as well as high SIRI and low SIRI groups. Significant differences in age, T stage, neutrophil to lymphocyte ratio (NLR), monocyte to lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) subgroups were observed between the PNI groups in the baseline profile. In the SIRI group, notable differences were found in gender, T stage, nerve invasion, intravascular tumor emboli, NLR, MLR, and PLR subgroups. Both low PNI and high SIRI were identified as independent risk factors for poor prognosis in CRC patients. When combined into the PSIRI model, it was shown that patients with a PSIRI ≤ 1 had a higher risk of death compared to those with a PSIRI of 2.

CONCLUSION

We assessed the impact of PNI and SIRI on the prognostic survival of CRC patients and developed a new model, PSIRI. This model demonstrated superior predictive accuracy, with a concordance index of 0.767.

Keywords: Colorectal cancer; Prognostic nutritional index; Systemic inflammatory response index; Prognosis

Core Tip: In this study, we analyzed the impact of the systemic inflammation response index and prognostic nutritional index on colorectal cancer (CRC) patients. For the first time, we combined these two indices to create a new prognostic index and evaluated its effectiveness. Our results demonstrate that the new index offers superior prognostic accuracy. This new index serves as a more reliable predictor of survival in CRC patients, thereby enhancing prognosis and facilitating the development of more personalized and targeted treatment strategies.