Combination of Geriatric Nutritional Risk Index and Carcinoembryonic Antigen to Predict the Survival of Patients With Colorectal Cancer

Hailun Xie; Lishuang Wei; Guanghui Yuan; Mingxiang Liu; Yanren Liang; Shunhui Gao; Qiwen Wang; Xin Lin; Shuangyi Tang; Jialiang Gan

doi:10.3389/fnut.2022.902080

Combination of Geriatric Nutritional Risk Index and Carcinoembryonic Antigen to Predict the Survival of Patients With Colorectal Cancer

Front Nutr. 2022 Jun 30:9:902080. doi: 10.3389/fnut.2022.902080. eCollection 2022.

Authors

Hailun Xie^{1

2}, Lishuang Wei³, Guanghui Yuan^{1

2}, Mingxiang Liu^{1

2}, Yanren Liang^{1

2}, Shunhui Gao^{1

2}, Qiwen Wang^{1

2}, Xin Lin^{2

4}, Shuangyi Tang⁵, Jialiang Gan^{1

2}

Affiliations

¹ Department of Colorectal and Anal Surgery, The First Affiliated Hospital, Guangxi Medical University, Nanning, China.
² Guangxi Key Laboratory of Enhanced Recovery After Surgery for Gastrointestinal Cancer, Nanning, China.
³ Department of Geriatric Respiratory Disease Ward, The First Affiliated Hospital, Guangxi Medical University, Nanning, China.
⁴ Grade 2018, Department of Clinical Medicine, Guangxi Medical University, Nanning, China.
⁵ Department of Pharmacy, The First Affiliated Hospital, Guangxi Medical University, Nanning, China.

Abstract

Background: This study explored the value of the combination of Geriatric Nutritional Risk Index (GNRI) and carcinoembryonic antigen (CEA) for the prognosis assessment of CRC patients.

Methods: This study retrospectively enrolled 1,014 CRC patients who underwent surgery between 2012 and 2014. Kaplan-Meier and log-rank tests were used to compare survival differences. Cox proportional hazards regression analysis was used to assess risk factors associated with progression-free survival (PFS) and overall survival (OS). Nomograms were constructed to predict the prognosis of CRC patients. Randomized internal validation was used to confirm the predictive accuracy of the prognostic nomograms.

Results: The GNRI-CEA score was established by combining GNRI and CEA. Compared with patients with normal GNRI-CEA scores, patients with mild/moderate/severe GNRI-CEA scores had significantly lower survival (PFS, 68.99% vs. 57.75% vs. 41.34% vs. 31.36%, p < 0.001; OS, 68.99% vs. 57.75% vs. 41.34% vs. 31.36%, p < 0.001). The GNRI-CEA score is an independent factor predicting the prognosis of CRC patients. The risk of death was twofold higher in patients with low GNRI and high CEA than in those with both normal GNRI and CEA [PFS, hazard ratio (HR), 2.339; 95% confidence interval (CI), 1.656-3.303; p < 0.001; OS, HR, 2.340; 95% CI, 1.645-3.329; p < 0.001]. Prognostic nomograms had good resolution and accuracy in predicting 1-5 year PFS and OS. Randomized internal validation showed that the nomograms were reliable.

Conclusion: The combination of GNRI and CEA can effectively stratify the prognosis of CRC patients. The nomogram established based on the two indices can provide a personalized reference for prognostic assessment and clinical decision-making for CRC patients.

Keywords: CEA; GNRI; colorectal cancer; prognosis; surgery.