Effect Of Preoperative SII Combined With CEA On The Prognosis Of Colorectal Cancer

Objective Inflammatory response plays an integral role in the development of colorectal cancer,and the aim of this study was to combine the systemic immune-inflammation index（SII）and carcinoembryonic antigen（CEA）to investigate the correlation between the two and the total survival（OS）of colorectal cancer patients and the impact of their combined index in the prognosis of colorectal cancer.To investigate the correlation between SII and CEA and their combined impact on the prognosis of colorectal cancer patients.Methods The clinicopathological data of patients who underwent radical colorectal cancer surgery at Minda Hospital,Hubei Minzu University from January 2013 to December 2016 were retrospectively analyzed,and systemic inflammatory response-related indexes（including systemic immune inflammatory index,neutrophil/lymphocyte ratio,and platelet/lymphocyte ratio）were calculated based on patients’ preoperative routine blood results,and the cases were followed up regularly.Subject operating characteristic curve（ROC curve）was established to obtain the optimal cutoff value of SII.The correlation between the clinicopathological factors of colorectal cancer patients in different subgroups of SII and CEA was analyzed by chi-square test,and the factors affecting the overall survival of patients after surgery were investigated by univariate and multifactorial COX regression analysis,as well as the Kaplan-Meier method was applied for survival analysis,and the Log-rank test was applied for survival comparison between groups to establish the composite score of preoperative SII combined with CEA.Results（1）About 48（64.9%）and 25（33.8%）patients had positive preoperative SII and elevated CEA respectively among 74 colorectal cancer patients.The chi-square test showed the significant differences in tumor infiltration depth,TNM stage,and neuropil infiltration in the SII subgroup,moreover,the chi-square test also showed the significant differences in histological staging and neuropil infiltration in the CEA subgroup.（2）Univariate and multifactor COX regression analysis showed that age,SII,TNM stage and histological differentiation were independent influences on overall survival time of patients.（3）The survival curve was poltted by Kaplan-Meier method,and the 3-year OS of patients with elevated preoperative SII was significantly lower than that of normal SII patients（40.2% vs 75.1%,P<0.05）.（4）The combined SII-CEA test was significantly associated with overall survival in colorectal cancer patients when both were positive.Conclusion In the combined SII-CEA test,the overall survival of colorectal patients was significantly affected when both SII and CEA were elevated,which could provide some basis for prognostic judgment.