Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Sep 29;24(5):416.
doi: 10.3892/ol.2022.13536. eCollection 2022 Nov.

Preoperative carcinoembryonic antigen to body mass index ratio contributes to prognosis prediction in colorectal cancer

Jia Xiang  1 , Mengyao Ding  2 , Jixing Lin  3 , Tianhui Xue  1 , Qianwen Ye  1 , Bing Yan  1
Affiliations

Preoperative carcinoembryonic antigen to body mass index ratio contributes to prognosis prediction in colorectal cancer

Jia Xiang et al. Oncol Lett. .

Abstract

Both carcinoembryonic antigen (CEA) level and body mass index (BMI) are traditional prognostic markers in colorectal cancer (CRC); however, to the best of our knowledge, the value of the CEA to BMI ratio (CBR) has never been addressed. In the present study, 191 patients with CRC treated using radical resection were retrospectively included, and the significance of the CBR in predicting disease-free survival (DFS) or overall survival (OS) rates was calculated. The prognostic efficacy of the CBR in predicting OS was compared with individual CEA and BMI values. The survival differences of the subgroups were calculated by Kaplan-Meier analysis, and corresponding risk factors were then estimated by a Cox proportional hazards model. As a result, 29.84% (57/191) of the patients were assigned to the high CBR group (cut-off, ≥0.28); the CBR had a sensitivity of 56.50 and 68.90%, and a specificity of 80.60 and 80.10% for DFS and OS, respectively. Patients with a high CBR more commonly underwent laparotomy and exhibited advanced T stages, the presence of tumor deposits and advanced Tumor-Node-Metastasis stages (stage II or III). The CBR was more efficient than the CEA or BMI alone in predicting OS. In addition, patients with a high CBR presented with a significantly worse outcome than patients with a low CBR. Finally, the CBR was an independent risk factor for both DFS and OS. In conclusion, the CBR was a more robust prognostic factor in CRC, and patients with a relatively high CBR exhibited poorer survival.

Keywords: body mass index; carcinoembryonic antigen; colorectal cancer; prognosis; ratio; survival.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1.
Figure 1.
A consort diagram of the study. TNM, Tumor-Node-Metastasis; CRC, colorectal cancer.
Figure 2.
Figure 2.
Receiver operating characteristic analysis of the CBR for (A) disease-free survival and (B) overall survival. AUC, area under the curve; CBR, carcinoembryonic antigen to body mass index ratio.
Figure 3.
Figure 3.
Correlation of CBR with other inflammatory prognostic indicators, including (A) NLR, (B) PLR, (C) LMR and (D) PNI. CBR, carcinoembryonic antigen to body mass index ratio; NLR, neutrophil to lymphocyte ratio; LMR, lymphocyte to monocyte ratio; PLR, platelet to lymphocyte ratio; PNI, prognostic nutritional index.
Figure 4.
Figure 4.
Differences between the high or low CBR subgroups for DFS in (A) all stages, (C) stage I and (E) stage II, and (G) stage III; and for OS in (B) all stages, (D) stage I and (F) stage II, and (H) stage III. The 3-year DFS and OS rates are indicated by the dotted lines in (A) and (B). CBR, carcinoembryonic antigen to body mass index ratio; DFS, disease-free survival; OS, overall survival.
Figure 5.
Figure 5.
Nomograms for predicting the 3-year (A) DFS and (B) OS rates, and the calibration curves of the nomograms for predicting the 3-year (C) DFS and (D) OS rates. CBR, carcinoembryonic antigen to body mass index ratio; PNI, prognostic nutritional index; DFS, disease-free survival; OS, overall survival.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71:209–249. doi: 10.3322/caac.21660. - DOI - PubMed
    1. Siegel RL, Miller KD, Sauer AG, Fedewa SA, Butterly LF, Anderson JC, Cercek A, Smith RA, Jemal A. Colorectal cancer statistics, 2020. CA Cancer J Clin. 2020;70:145–164. doi: 10.3322/caac.21601. - DOI - PubMed
    1. Song Y, Yang Y, Gao P, Chen X, Yu D, Xu Y, Zhao J, Wang Z. The preoperative neutrophil to lymphocyte ratio is a superior indicator of prognosis compared with other inflammatory biomarkers in resectable colorectal cancer. BMC Cancer. 2017;17:744. doi: 10.1186/s12885-017-3752-0. - DOI - PMC - PubMed
    1. Tan D, Fu Y, Tong W, Li F. Prognostic significance of lymphocyte to monocyte ratio in colorectal cancer: A meta-analysis. Int J Surg. 2018;55:128–138. doi: 10.1016/j.ijsu.2018.05.030. - DOI - PubMed
    1. Takada K, Kashiwagi S, Asano Y, Goto W, Ishihara S, Morisaki T, Shibutani M, Tanaka H, Hirakawa K, Ohira M. Clinical verification of body mass index and tumor immune response in patients with breast cancer receiving preoperative chemotherapy. BMC Cancer. 2021;21:1129. doi: 10.1186/s12885-021-08857-7. - DOI - PMC - PubMed