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ORIGINAL RESEARCH article
Front. Nutr.
Sec. Clinical Nutrition
Volume 11 - 2024 |
doi: 10.3389/fnut.2024.1442094
This article is part of the Research Topic Nutrition and Metabolism in Cancer: Role in Prevention and Prognosis View all 22 articles
Investigating the Clinical Predictive Utility of Inflammatory Markers and Nomogram Development in Colorectal Cancer Patients with Malnutrition
Provisionally accepted- 1 First People’s Hospital of Anning City (Jinfang Branch), Anning, China
- 2 Yunnan Cancer Hospital, Kunming, Yunnan Province, China
- 3 Ziyang People's Hospital, Ziyang, China
Objective The aim of this study is to investigate the relationship and prognostic significance of serum neutrophil-lymphocyte ratio (NLR), systemic immune-inflammatory index (SII), platelet-lymphocyte ratio (PLR), and prognostic nutritional index (PNI) in colorectal cancer (CRC) patients with malnutrition, as well as to construct a nomogram for predicting the onset of malnutrition.The clinical data of 391 inpatients who were hospitalised from December 1,2021 to January 31, 2023 the diagnosis of CRC were selected and divided into a malnutrition group (121 cases) and a well-nourished group (270 cases) according to whether they were malnourished or not. Focusing on comparing the differences in serum NLR, PLR, SII index, PNI index and general information between the two groups, the Binary logistics regression analysis was used to analyse the factors affecting malnutrition, and receiver operating characteristic (ROC) curves were established to assess the predictive value of serum NLR, PLR, SII index, and PNI index individually and jointly for malnutrition, and to calculate the optimal predictive thresholds.Finally a highly accurate clinical predictive nomogram was constructed. Results Compared with the well-nourished group, the malnourished group had higher serum NLR, SII index, PLR and lower PNI index levels, with statistically significant differences( P<0.001). The area under the curve of NLR, SII index,PLR, and PNI index alone and in combination predicted a poor prognosis of 0.705, 0.665, 0.636,0.773, and 0.784, respectively.After conducting Logistic regression analysis, the nomogram, which included BMI, NRS2002, long-term bed rest, and PNI, demonstrated strong predictive capabilities.Decision curves highlighted the clinical utility of the predictive nomograms. The receiver operating characteristic curve revealed strong discrimination (area under the curve [AUC] = 0.958, 95% CI: 0.937-0.979).Additionally, the ROC analysis indicated a sensitivity of 0.843 and specificity of 0.937. Calibration curves exhibited excellent concordance between nomogram predictions and observed outcomes.Decision curves highlighted the clinical utility of the predictive nomograms. Conclusion Serum NLR,SII index , PLR, and PNI are significant predictive factors for the development of malnutrition in patients with CRC. These indices, whether considered individually or collectively, possess clinical relevance in forecasting malnutrition. Furthermore, the creation of an innovative nomogram prediction model offers considerable clinical utility.
Keywords: systemic immune-inflammatory, Malnutrition, Colorectal Neoplasms, Nutrition Assessment, Nomograms
Received: 01 Jun 2024; Accepted: 05 Nov 2024.
Copyright: © 2024 Wang, Xu, Zhang, Chu, Chen and Wei. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Jinsong Xu, First People’s Hospital of Anning City (Jinfang Branch), Anning, China
Rong Zhang, Yunnan Cancer Hospital, Kunming, Yunnan Province, China
Jie Chu, Ziyang People's Hospital, Ziyang, China
Chunmei Chen, First People’s Hospital of Anning City (Jinfang Branch), Anning, China
Chunmei Wei, First People’s Hospital of Anning City (Jinfang Branch), Anning, China
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