High preoperative CEA and systemic inflammation response index (C-SIRI) predict unfavorable survival of resectable colorectal cancer

Q: What was the purpose of evaluating preoperative C-SIRI and CEA in resectable colorectal cancer?

To investigate whether preoperative CEA and the systemic inflammation response index (C-SIRI) have prognostic significance for patients with resectable colorectal cancer.

Q: How were C-SIRI and CEA groups defined in the study?

Optimal cutoffs were set for SIRI (1.1) and CEA (4.1 ng/L and 13.0 ng/L). Patients were assigned values based on whether CEA and SIRI were below or above these thresholds.

Q: What did the study find about survival prediction?

High preoperative C-SIRI was significantly associated with poorer overall survival in univariate analysis and remained an independent predictor in multivariate Cox regression analysis.

Sep 24, 2026

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Background: Carcinoembryonic antigen (CEA) and systemic inflammation have been linked to colorectal cancer growth, invasion, and metastasis. This study evaluates whether the preoperative systemic inflammation response index (C-SIRI) and CEA meaningfully predict prognosis in patients with resectable colorectal cancer. Methods: Two hundred seventeen CRC patients (2015–2017) had preoperative CEA and blood-cell counts retrospectively reviewed; optimal cutoffs defined C-SIRI and CEA group scores. Survival was tested with uni- and multivariate analyses, and results were interpreted using hazard ratios and confidence intervals.

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Cai etal. World Journal of Surgical Oncology (2023) 21:178 [https://doi.org/10.1186/s12957-023-03056-z](https://doi.org/10.1186/s12957-023-03056-z) World Journal of Surgical Oncology RESEARCH Open Access High preoperative CEA and systemic inflammation response index (C-SIRI) predict unfavorable survival of resectable colorectal cancer Hao Cai1, Yu Chen1, Qiao Zhang1, Yang Liu 1 and HouJun Jia1* Abstract Background CEA and systemic inflammation were reported to correlate with proliferation, invasion, and metastasis of colorectal cancer. This study investigated the prognostic significance of the preoperative CEA and systemic inflammation response index (C-SIRI) in patients with resectable colorectal cancer. Methods Two hundred seventeen CRC patients were recruited from Chongqing Medical University, the first affiliated hospital, between January 2015 and December 2017. Baseline characteristics, preoperative CEA level, and peripheral monocyte, neutrophil, and lymphocyte counts were retrospectively reviewed. The optimal cutoff value for SIRI was defined as 1. 1, and for CEA, the best cutoff values were 4.1 ng/l and 13.0 ng/l. Patients with low levels of CEA (< 4.1 ng/l) and SIRI (< 1 . 1) were assigned a value of 0, those with high levels of CEA (≥ 13.0 ng/l) and SIRI (≥1 . 1) were assigned a value of 3, and those with CEA (4 .1–13.0 ng/l) and SIRI (≥1 . 1), CEA (≥ 13.0 ng/l), and SIRI (< 1 . 1) were assigned a value of 2. Those with CEA (< 4.1 ng/l) and SIRI (≥1 . 1) and CEA (4 .1–13.0 ng/l) and SIRI (< 1 . 1) were assigned a value of 1. The prognostic value was assessed based on univariate and multivariate survival analysis. Results Preoperative C-SIRI was statistically correlated with gender, site, stage, CEA, OPNI, NLR, PLR, and MLR. However, no difference was observed between C-SIRI and age, BMI, family history of cancer, adjuvant therapy, and AGR groups. Among these indicators, the correlation between PLR and NLR is the strongest. In addition, high preoperative C-SIRI was significantly correlated with poorer overall survival (OS) (HR: 2 . 782, 95% CI: 1.630–4. 746, P < 0. 001) based on univariate survival analysis. Moreover, it remained an independent predictor for OS (HR: 2 . 563, 95% CI: 1.419–4. 628, p = 0. 002) in multivariate Cox regression analysis. Conclusion Our study showed that preoperative C-SIRI could serve as a significant prognostic biomarker in patients with resectable colorectal cancer. Keywords Systemic inflammation response index, Colorectal cancer, Carcinoembryonic antigen, Prognosis *Correspondence: HouJun Jia [13908329596@163.com](13908329596@163.com) 1 Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, No. 1, Medical College Road, Yuzhong District, Chongqing 400016, China Introduction Globally, colorectal cancer (CRC) has become the third most common cancer and the second leading cause of tumor-related death. CRC accounts for approximately 10% of all new cancer diagnoses and cancer-related deaths each year [1, 2]. Although recent advancesin pathophysiological research have provided more © The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creativecomm

FAQs

What was the purpose of evaluating preoperative C-SIRI and CEA in resectable colorectal cancer?

To investigate whether preoperative CEA and the systemic inflammation response index (C-SIRI) have prognostic significance for patients with resectable colorectal cancer.

How were C-SIRI and CEA groups defined in the study?

Optimal cutoffs were set for SIRI (1.1) and CEA (4.1 ng/L and 13.0 ng/L). Patients were assigned values based on whether CEA and SIRI were below or above these thresholds.

What did the study find about survival prediction?

High preoperative C-SIRI was significantly associated with poorer overall survival in univariate analysis and remained an independent predictor in multivariate Cox regression analysis.

Sep 24, 2026

Uploaded by Genevieve