Frontiers in Immunology (Mar 2023)

Association between C-reactive protein-albumin-lymphocyte (CALLY) index and overall survival in patients with colorectal cancer: From the investigation on nutrition status and clinical outcome of common cancers study

  • Ming Yang,
  • Ming Yang,
  • Ming Yang,
  • Ming Yang,
  • Shi-Qi Lin,
  • Shi-Qi Lin,
  • Shi-Qi Lin,
  • Shi-Qi Lin,
  • Shi-Qi Lin,
  • Xiao-Yue Liu,
  • Xiao-Yue Liu,
  • Xiao-Yue Liu,
  • Xiao-Yue Liu,
  • Meng Tang,
  • Meng Tang,
  • Meng Tang,
  • Meng Tang,
  • Chun-Lei Hu,
  • Chun-Lei Hu,
  • Chun-Lei Hu,
  • Chun-Lei Hu,
  • Zi-Wen Wang,
  • Zi-Wen Wang,
  • Zi-Wen Wang,
  • Zi-Wen Wang,
  • Qi Zhang,
  • Qi Zhang,
  • Qi Zhang,
  • Qi Zhang,
  • Xi Zhang,
  • Xi Zhang,
  • Xi Zhang,
  • Xi Zhang,
  • Meng-Meng Song,
  • Meng-Meng Song,
  • Meng-Meng Song,
  • Meng-Meng Song,
  • Guo-Tian Ruan,
  • Guo-Tian Ruan,
  • Guo-Tian Ruan,
  • Guo-Tian Ruan,
  • Xiao-Wei Zhang,
  • Xiao-Wei Zhang,
  • Xiao-Wei Zhang,
  • Xiao-Wei Zhang,
  • Tong Liu,
  • Tong Liu,
  • Tong Liu,
  • Tong Liu,
  • Hai-Lun Xie,
  • Hai-Lun Xie,
  • Hai-Lun Xie,
  • Hai-Lun Xie,
  • He-Yang Zhang,
  • He-Yang Zhang,
  • He-Yang Zhang,
  • He-Yang Zhang,
  • Chen-An Liu,
  • Chen-An Liu,
  • Chen-An Liu,
  • Chen-An Liu,
  • Kang-Ping Zhang,
  • Kang-Ping Zhang,
  • Kang-Ping Zhang,
  • Kang-Ping Zhang,
  • Qin-Qin Li,
  • Qin-Qin Li,
  • Qin-Qin Li,
  • Qin-Qin Li,
  • Xiang-Rui Li,
  • Xiang-Rui Li,
  • Xiang-Rui Li,
  • Xiang-Rui Li,
  • Yi-Zhong Ge,
  • Yi-Zhong Ge,
  • Yi-Zhong Ge,
  • Yi-Zhong Ge,
  • Yi-Zhong Ge,
  • Yu-Ying Liu,
  • Yu-Ying Liu,
  • Yu-Ying Liu,
  • Yu-Ying Liu,
  • Yue Chen,
  • Yue Chen,
  • Yue Chen,
  • Yue Chen,
  • Yue Chen,
  • Xin Zheng,
  • Xin Zheng,
  • Xin Zheng,
  • Xin Zheng,
  • Han-Ping Shi,
  • Han-Ping Shi,
  • Han-Ping Shi,
  • Han-Ping Shi

DOI
https://doi.org/10.3389/fimmu.2023.1131496
Journal volume & issue
Vol. 14

Abstract

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BackgroundColorectal cancer (CRC) is among the most common malignant cancers worldwide, and its development is influenced by inflammation, nutrition, and the immune status. Therefore, we combined C-reactive protein (CRP), albumin, and lymphocyte, which could reflect above status, to be the CRP-albumin-lymphocyte (CALLY) index, and evaluated its association with overall survival (OS) in patients with CRC.MethodsThe clinicopathological and laboratory characteristics of 1260 patients with CRC were collected from the Investigation on Nutrition Status and Clinical Outcome of Common Cancers (INSCOC) study. Cox regression analysis was performed to assess the association between the CALLY index and OS. A nomogram including sex, age, the CALLY index and TNM stage was constructed. The Concordance Index (C-index) was utilized to evaluate the prognostic value of the CALLY index and classical CRC prognostic factors, such as modified Glasgow prognostic score (mGPS), neutrocyte to lymphocyte ratio (NLR), systemic immune inflammation index (SII), and platelet to lymphocyte ratio (PLR), as well as to assess the prognostic value of the nomogram and TNM stage.ResultsMultivariate Cox regression analyses demonstrated that the CALLY index was independently associated with OS in patients with CRC [Hazard ratio (HR) = 0.91, 95% confidence interval (CI) = 0.87-0.95, P<0.001]. The CALLY index showed the highest prognostic value (C-index = 0.666, 95% CI = 0.638-0.694, P<0.001), followed by mGPS, NLR, SII, and PLR. The nomogram demonstrated higher prognostic value (C-index = 0.784, 95% CI = 0.762-0.807, P<0.001) than the TNM stage.ConclusionThe CALLY index was independently associated with OS in patients with CRC and showed higher prognostic value than classical CRC prognostic factors. The nomogram could provide more accurate prognostic prediction than TNM stage.

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