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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Gastrointestinal Cancers: Colorectal Cancer
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1394892
This article is part of the Research Topic Insulin Resistance Bridges Tumor and Inflammation View all articles

Prognostic importance of an indicator related to systemic inflammation and insulin resistance in patients with gastrointestinal cancer: A prospective study

Provisionally accepted
Guo-Tian Ruan Guo-Tian Ruan 1Jin-Yu Shi Jin-Yu Shi 1Hailun Xie Hailun Xie 1Heyang Zhang Heyang Zhang 1Hong Zhao Hong Zhao 1Xiaoyue Liu Xiaoyue Liu 1Yi-Zhong Ge Yi-Zhong Ge 1Xiaowei Zhang Xiaowei Zhang 1Ming Yang Ming Yang 1Julia Zhu Julia Zhu 1Han-Ping Shi Han-Ping Shi 1,2,3,4*
  • 1 Beijing Shijitan Hospital, Capital Medical University, Beijing, Beijing Municipality, China
  • 2 National Clinical Research Center for Geriatric Disorders, Xuanwu Hospital, Capital Medical University, Beijing, Beijing Municipality, China
  • 3 Key Laboratory of Cancer Food for Special Medical Purposes (FSMP) for State Market Regulation, Beijing, China
  • 4 Laboratory for Clinical Medicine, Capital Medical University, Beijing, China

The final, formatted version of the article will be published soon.

    Systemic inflammation (SI) and insulin resistance (IR) are correlated to the progression of gastrointestinal (GI) cancer. Therefore, this study aimed to analyze the potential clinical value of the C-reactive protein-triglyceride-glucose index (CTI) in relation to SI and IR in patients with GI cancer.This prospective cohort study included patients with GI cancer. Patient data were collected from Fujian Cancer Hospital as an external validation cohort. Prognostic AUC, time-dependent ROC curve, C-index, and calibration curve analyses were used to predict the efficacy and accuracy of CTI survival prediction. Multivariate survival analysis was performed to evaluate the potential prognostic value of the CTI. Multiple logistic regression was performed to evaluate the relationship between the CTI and 90-day and 180-day mortalities.We divided 1520 patients with GI cancer (mean age, 60.39±11.3 years; male sex, 67%) into a training cohort and internal validation cohort; the external validation cohort included 476 patients. Prognostic AUC, time-dependent ROC curve, C-index, and calibration curve analyses of all cohorts indicated that the CTI could reliably and accurately predict the short-and long-term survival outcomes of patients with GI cancer. Multivariate survival analysis showed that for each standard deviation increase in the CTI, the risk of death increased by 32%, 21%, and 40% in the training, internal validation, and external validation cohorts, respectively. A high CTI was correlated to worse survival in patients with GI cancer (training cohort, hazard ratio [HR]=1.67, 95% confidence interval[CI]=1.35-2.08; internal validation cohort, HR=1.51, 95% CI=1.07-2.14, and external validation cohort, HR=1.59, 95% CI=1.18-2.13). In different tumor subgroups, a high CTI predicted worse survival outcomes for upper GI cancer (HR=1.54, 95% CI=1.18-2.01) and lower GI cancer (HR=1.98, 95% CI=1.36-2.86). Multivariate logistic regression analysis showed that a high CTI was positively correlated with 90-day (odds ratio [OR]=3.25, 95% CI=1.75-6.23) and 180-day mortalities (OR=2.66, 95% CI=1.72-4.15).The CTI is related to SI and IR and can predict the short-and long-term prognosis of patients with GI cancer. Evaluation of the CTI could provide clinicians with an effective tool for predicting the prognosis of patients with GI cancer.

    Keywords: systemic inflammation, Insulin Resistance, cti, overall survival, gastrointestinal cancer

    Received: 10 Apr 2024; Accepted: 11 Nov 2024.

    Copyright: © 2024 Ruan, Shi, Xie, Zhang, Zhao, Liu, Ge, Zhang, Yang, Zhu and Shi. 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: Han-Ping Shi, Beijing Shijitan Hospital, Capital Medical University, Beijing, Beijing Municipality, China

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