Serum albumin-carcinoembryonic antigen ratio as an effective clinical tool for predicting recurrence and overall survival in patients with rectal cancer
BackgroundThe albumin–carcinoembryonic antigen ratio (ACR), leveraging the strengths of albumin and CEA, has emerged as a promising serum prognostic marker. However, no studies to date have explored the association between ACR and the prognosis of patients with rectal cancer. This study aimed to det...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Nutrition |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnut.2024.1521691/full |
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| author | Hailun Xie Hailun Xie Lishuang Wei Shuangyi Tang Jialiang Gan Jialiang Gan |
| author_facet | Hailun Xie Hailun Xie Lishuang Wei Shuangyi Tang Jialiang Gan Jialiang Gan |
| author_sort | Hailun Xie |
| collection | DOAJ |
| description | BackgroundThe albumin–carcinoembryonic antigen ratio (ACR), leveraging the strengths of albumin and CEA, has emerged as a promising serum prognostic marker. However, no studies to date have explored the association between ACR and the prognosis of patients with rectal cancer. This study aimed to determine the value of albumin–carcinoembryonic antigen ratio (ACR) in predicting the progression-free survival (PFS) and overall survival (OS) of patients with rectal cancer.MethodsSurvival analysis was conducted using the Kaplan–Meier method, and hazard ratios (HR) were calculated using Cox regression analyses. Nomograms were created based on variables with p < 0.05 in the multivariate Cox regression analysis. The predictive ability of the model was evaluated using the C-index and calibration curve, and its prognostic predictive abilities were compared to those of traditional Tumor Node Metastasis (TNM) stage using discriminant indices.ResultsA total of 736 patients with rectal cancer were included in the study. ACR was significantly higher in patients with poor survival or cancer recurrence. A low ACR was associated with increased tumor invasiveness, longer hospital stays, and higher hospitalization costs. Patients with a high ACR had significantly better PFS (62.9% vs. 35.2%, p < 0.001) and OS (67.0% vs. 37.2%, p < 0.001) than those with a low ACR. ACR can serve as an effective auxiliary tool for pathological staging, especially in patients with stage III–IV disease. The relationship between ACR and mortality risk was L-shaped. ACR is an independent prognostic factor for PFS [HR = 0.581, 95% confidence interval (CI): 0.458–0.738, p < 0.001] and OS (HR = 0.560, 95% CI: 0.435–0.720, p < 0.001) in rectal cancer patients. ACR-based nomograms have good predictive accuracy and outperform traditional TNM stage in predicting prognosis.ConclusionAlbumin–carcinoembryonic antigen ratio is a simple and effective clinical tool for predicting the recurrence and survival of patients with rectal cancer and is a useful supplement to the TNM stage. |
| format | Article |
| id | doaj-art-c37f12e3d738478ea8165878a41d9363 |
| institution | Kabale University |
| issn | 2296-861X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Nutrition |
| spelling | doaj-art-c37f12e3d738478ea8165878a41d93632025-01-17T05:10:46ZengFrontiers Media S.A.Frontiers in Nutrition2296-861X2025-01-011110.3389/fnut.2024.15216911521691Serum albumin-carcinoembryonic antigen ratio as an effective clinical tool for predicting recurrence and overall survival in patients with rectal cancerHailun Xie0Hailun Xie1Lishuang Wei2Shuangyi Tang3Jialiang Gan4Jialiang Gan5Department of Gastrointestinal and Gland Surgery, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, ChinaGuangxi Key Laboratory of Enhanced Recovery After Surgery for Gastrointestinal Cancer, Nanning, Guangxi, ChinaDepartment of Geriatric Respiratory Disease Ward, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, ChinaDepartment of Pharmacy, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, ChinaGuangxi Key Laboratory of Enhanced Recovery After Surgery for Gastrointestinal Cancer, Nanning, Guangxi, ChinaDepartment of Colorectal and Anal Surgery, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, ChinaBackgroundThe albumin–carcinoembryonic antigen ratio (ACR), leveraging the strengths of albumin and CEA, has emerged as a promising serum prognostic marker. However, no studies to date have explored the association between ACR and the prognosis of patients with rectal cancer. This study aimed to determine the value of albumin–carcinoembryonic antigen ratio (ACR) in predicting the progression-free survival (PFS) and overall survival (OS) of patients with rectal cancer.MethodsSurvival analysis was conducted using the Kaplan–Meier method, and hazard ratios (HR) were calculated using Cox regression analyses. Nomograms were created based on variables with p < 0.05 in the multivariate Cox regression analysis. The predictive ability of the model was evaluated using the C-index and calibration curve, and its prognostic predictive abilities were compared to those of traditional Tumor Node Metastasis (TNM) stage using discriminant indices.ResultsA total of 736 patients with rectal cancer were included in the study. ACR was significantly higher in patients with poor survival or cancer recurrence. A low ACR was associated with increased tumor invasiveness, longer hospital stays, and higher hospitalization costs. Patients with a high ACR had significantly better PFS (62.9% vs. 35.2%, p < 0.001) and OS (67.0% vs. 37.2%, p < 0.001) than those with a low ACR. ACR can serve as an effective auxiliary tool for pathological staging, especially in patients with stage III–IV disease. The relationship between ACR and mortality risk was L-shaped. ACR is an independent prognostic factor for PFS [HR = 0.581, 95% confidence interval (CI): 0.458–0.738, p < 0.001] and OS (HR = 0.560, 95% CI: 0.435–0.720, p < 0.001) in rectal cancer patients. ACR-based nomograms have good predictive accuracy and outperform traditional TNM stage in predicting prognosis.ConclusionAlbumin–carcinoembryonic antigen ratio is a simple and effective clinical tool for predicting the recurrence and survival of patients with rectal cancer and is a useful supplement to the TNM stage.https://www.frontiersin.org/articles/10.3389/fnut.2024.1521691/fullalbumincarcinoembryonic antigennutritionrectal cancerrecurrenceoverall survival |
| spellingShingle | Hailun Xie Hailun Xie Lishuang Wei Shuangyi Tang Jialiang Gan Jialiang Gan Serum albumin-carcinoembryonic antigen ratio as an effective clinical tool for predicting recurrence and overall survival in patients with rectal cancer Frontiers in Nutrition albumin carcinoembryonic antigen nutrition rectal cancer recurrence overall survival |
| title | Serum albumin-carcinoembryonic antigen ratio as an effective clinical tool for predicting recurrence and overall survival in patients with rectal cancer |
| title_full | Serum albumin-carcinoembryonic antigen ratio as an effective clinical tool for predicting recurrence and overall survival in patients with rectal cancer |
| title_fullStr | Serum albumin-carcinoembryonic antigen ratio as an effective clinical tool for predicting recurrence and overall survival in patients with rectal cancer |
| title_full_unstemmed | Serum albumin-carcinoembryonic antigen ratio as an effective clinical tool for predicting recurrence and overall survival in patients with rectal cancer |
| title_short | Serum albumin-carcinoembryonic antigen ratio as an effective clinical tool for predicting recurrence and overall survival in patients with rectal cancer |
| title_sort | serum albumin carcinoembryonic antigen ratio as an effective clinical tool for predicting recurrence and overall survival in patients with rectal cancer |
| topic | albumin carcinoembryonic antigen nutrition rectal cancer recurrence overall survival |
| url | https://www.frontiersin.org/articles/10.3389/fnut.2024.1521691/full |
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