The prognostic role of inflammation-based hematologic markers in stage I–III colorectal cancer: a retrospective analysis

作者：Kejin Li, Rong Zhang, Jiani Zhang, Ziyi Zhang, Kuan Wang, Yiyu Lu, Zeliang Zhao, Yi Chen, Shudong Ma · 发表于：BMC Cancer · 年份：2025 · DOI：10.1186/s12885-025-15165-x · 被引用次数：24 · 研究领域：Inflammatory Biomarkers in Disease Prognosis、Immune cells in cancer、Colorectal Cancer Surgical Treatments

BACKGROUND: Colorectal cancer (CRC) is a major global health burden with significant prognostic heterogeneity among patients with stage I-III disease. Conventional clinicopathological parameters insufficiently predict individual outcomes, highlighting the need for novel, cost-effective biomarkers. The neutrophil percentage to albumin ratio (NPAR), reflecting systemic inflammation and nutritional status, has emerged as a promising prognostic indicator, but its role in early-stage CRC remains unclear. METHODS: We conducted a retrospective multicenter study involving 691 patients with stage I-III CRC from two independent centers, divided into training (N = 484) and validation (N = 207) cohorts. Clinicopathological features and blood-based biomarkers, including albumin-to-globulin ratio (AGR) and NPAR, were evaluated. Independent prognostic factors were identified using least absolute shrinkage and selection operator (LASSO) and multivariate Cox regression analyses. A nomogram incorporating these factors was constructed to predict overall survival (OS). Model performance was assessed by concordance index (C-index), area under the receiver operating characteristic curve (AUC), calibration plots, and decision curve analysis (DCA). RESULTS: Nerve invasion, AGR, and NPAR were independently associated with OS (all p < 0.001). The nomogram demonstrated strong predictive accuracy with a C-index of 0.79 (95% CI, 0.73-0.84) in the training cohort. The AUCs for 1-, 3-, and 5-year OS were 0...