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已发表论文
联合泛免疫炎症值与预后营养指数作为结直肠癌肠切除术患者预后生物标志物
Authors Chen Z, Liang L , Pan C, Ju H, Li J, Yang M, Yang J, Zhao T
Received 9 October 2025
Accepted for publication 10 December 2025
Published 24 December 2025 Volume 2025:18 Pages 18039—18052
DOI https://doi.org/10.2147/JIR.S570477
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Junhao Wang
Zihao Chen,1,* Lei Liang,1,* Chenglong Pan,2,* Hongping Ju,3 Jiangyu Li,3 Man Yang,3 Jun Yang,1 Ting Zhao4
1Department of Surgical Oncology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650032, People’s Republic of China; 2Department of Pathology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650032, People’s Republic of China; 3School of Medicine, Kunming University, Kunming, Yunnan, 650032, People’s Republic of China; 4Department of Clinical Pharmacy, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650032, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Ting Zhao, Department of Clinical Pharmacy, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650032, People’s Republic of China, Email zhaoting@kmmu.edu.cn Jun Yang, Department of Surgical Oncology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650032, People’s Republic of China, Email yangjun6@kmmu.edu.cn
Background: Robust biomarkers are needed to address the prognostic heterogeneity in colorectal cancer (CRC). The pan-immune-inflammation value (PIV) and prognostic nutritional index (PNI) are biomarkers of systemic inflammation and immunonutritional status, respectively. This study aimed to develop and validate a novel combined PIV-PNI score to predict survival in CRC patients undergoing curative resection.
Methods: This study included a total of 2116 CRC patients who underwent surgical treatment. The PIV and PNI were evaluated and cut-off values were determined. The PIV-PNI value range was 0 to 2, where 2 represented high PIV (≥ 208.9) and low PNI (≤ 49.05), with high PIV or low PNI indicated by 1 and neither is represented by a 0, respectively. The Cox regression model was used to determine the independent risk factors affecting the prognosis of the patients. A nomogram based on PIV-PNI was constructed, and its performance was evaluated using the C-index, calibration curve, ROC curve, and DCA curve. Finally, the nomogram model was compared with the existing staging models.
Results: Patients with higher PIV-PNI scores had a poorer prognosis. In the multivariate analysis, it was found that the PIV-PNI score was an independent predictor for the overall survival rate and disease-free survival rate of CRC patients. The nomogram based on PIV-PNI demonstrated excellent discrimination, calibration, and clinical net benefit. The proposed nomogram performed better than other existing staging systems, as evidenced by its higher AUC value.
Conclusion: The PIV-PNI score is a potent, non-invasive prognostic biomarker. The developed nomogram facilitates accurate risk stratification, potentially guiding personalized postoperative surveillance and adjuvant therapy decisions for CRC patients.
Keywords: colorectal cancer, pan-immune inflammatory value, nutritional status indicators, intestinal resection, prognosis
1Department of Surgical Oncology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650032, People’s Republic of China; 2Department of Pathology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650032, People’s Republic of China; 3School of Medicine, Kunming University, Kunming, Yunnan, 650032, People’s Republic of China; 4Department of Clinical Pharmacy, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650032, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Ting Zhao, Department of Clinical Pharmacy, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650032, People’s Republic of China, Email zhaoting@kmmu.edu.cn Jun Yang, Department of Surgical Oncology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650032, People’s Republic of China, Email yangjun6@kmmu.edu.cn
Background: Robust biomarkers are needed to address the prognostic heterogeneity in colorectal cancer (CRC). The pan-immune-inflammation value (PIV) and prognostic nutritional index (PNI) are biomarkers of systemic inflammation and immunonutritional status, respectively. This study aimed to develop and validate a novel combined PIV-PNI score to predict survival in CRC patients undergoing curative resection.
Methods: This study included a total of 2116 CRC patients who underwent surgical treatment. The PIV and PNI were evaluated and cut-off values were determined. The PIV-PNI value range was 0 to 2, where 2 represented high PIV (≥ 208.9) and low PNI (≤ 49.05), with high PIV or low PNI indicated by 1 and neither is represented by a 0, respectively. The Cox regression model was used to determine the independent risk factors affecting the prognosis of the patients. A nomogram based on PIV-PNI was constructed, and its performance was evaluated using the C-index, calibration curve, ROC curve, and DCA curve. Finally, the nomogram model was compared with the existing staging models.
Results: Patients with higher PIV-PNI scores had a poorer prognosis. In the multivariate analysis, it was found that the PIV-PNI score was an independent predictor for the overall survival rate and disease-free survival rate of CRC patients. The nomogram based on PIV-PNI demonstrated excellent discrimination, calibration, and clinical net benefit. The proposed nomogram performed better than other existing staging systems, as evidenced by its higher AUC value.
Conclusion: The PIV-PNI score is a potent, non-invasive prognostic biomarker. The developed nomogram facilitates accurate risk stratification, potentially guiding personalized postoperative surveillance and adjuvant therapy decisions for CRC patients.
Keywords: colorectal cancer, pan-immune inflammatory value, nutritional status indicators, intestinal resection, prognosis