Development and Validation of a Nomogram Based on Inflammatory indicators and Tumor Markers for Prognosis Prediction of Colorectal Cancer

Abstract Background : Reliable evaluation methods play an important role in improving the prognosis of colorectal cancer patients, guiding the development of treatment plans, and prolonging patient survival. Several preoperative inflammatory indicators and tumor markers were evaluated in this study for predicting colorectal cancer (CRC) prognosis. Methods : A total of 224 eligible patients with CRC were enrolled in the present study. Patients were divided into a training group (n=150) and a validation group (n=74). The training cohort underwent both the least absolute shrinkage and selection operator (LASSO) regression and Cox regression analyses to discern pivotal prognostic factors, aiming to formulate a nomogram for the prediction of overall survival (OS). Results : LASSO regression, univariate and multivariate Cox regression analysis revealed that Neutrophil-lymphocyte ratio (NLR), carbohydrate antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA) were effective risk factors. The concordance index (C-index) of the nomogram in the training and validation groups were 0.716 and 0.7 respectively. The areas under curve (AUC) of the nomogram for 3-years were 0.748 and 0.776, for 5-years were 0.749 and 0.773 respectively. Conclusion : NLR, CA199 and CEA were effective supplements to traditional clinical assessment methods. The nomogram incorporating the three preoperative indicators can be effectively and efficiently used to predict the prognosis of CRC patients.