Factors influencing pathological complete response following neoadjuvant chemoimmunotherapy in locally advanced microsatellite stable colorectal cancer: a retrospective analysis

作者：Mingxiang Liu, Qi Zhou, Bin Lan, Jialiang Gan, Sen Zhang · 发表于：Frontiers in Medicine · 年份：2025 · DOI：10.3389/fmed.2025.1587684 · 被引用次数：3 · 研究领域：Genetic factors in colorectal cancer、Colorectal Cancer Surgical Treatments、Colorectal Cancer Treatments and Studies

Objective The purpose of this study is to identify and analyze the factors associated with achieving pathological complete response (pCR) in patients with locally advanced microsatellite stable (MSS) or proficient mismatch repair (pMMR) colorectal cancer who underwent neoadjuvant chemoimmunotherapy. Methods A retrospective cohort study was conducted on 116 such patients at the First Affiliated Hospital of Guangxi Medical University from January 2023 to July 2024. Univariate and multivariate analyses were used to find factors associated with pCR. Perform Cohen’s Kappa coefficient analysis to assess the agreement between clinical staging and pathological staging following neoadjuvant chemoimmunotherapy. Results Among 116 patients who received neoadjuvant chemoimmunotherapy followed by radical curative surgery, 32.8% (38/116) achieved a pCR. Univariate analysis showed that pCR was not associated with sex, tumor location, etc., ( P > 0.05 for all), but was significantly associated with age, body mass index (BMI), neutrophil–lymphocyte ratio (NLR), systemic inflammation index (SII), albumin–to–globulin ratio (AGR), post–treatment carcinoembryonic antigen (CEA) levels, and natural killer (NK) cell count ( P < 0.05). Multivariate analysis identified age (OR = 0.952, 95% CI: 0.911–0.995, P = 0.031) and sex (OR = 0.188, 95% CI: 0.057–0.625, P = 0.006) as independent predictors of pCR in locally advanced MSS or pMMR colorectal cancer. Kappa concordance tests indicated poo...