Retrospective Cohort Study
Copyright ©The Author(s) 2025.
World J Gastrointest Oncol. Jul 15, 2025; 17(7): 107399
Published online Jul 15, 2025. doi: 10.4251/wjgo.v17.i7.107399
Table 1 Baseline data table for research variables grouped by chemotherapy, n (%)
Variables
Total (n = 1512)
No chemotherapy (n = 841)
Chemotherapy (n = 671)
P value
Gender0.279
    Female282 (18.7)165 (19.6)117 (17.4)
    Male1230 (81.3)676 (80.4)554 (82.6)
Old, mean ± SD59.8 ± 9.961.6 ± 9.857.5 ± 9.4< 0.001
Smoke0.459
    No smoking816 (54.0)461 (54.8)355 (52.9)
    Long term smoking696 (46.0)380 (45.2)316 (47.1)
Drink0.421
    No drinking1268 (83.9)711 (84.5)557 (83)
    Long term drinking244 (16.1)130 (15.5)114 (17)
Glycuresis0.349
    No glycuresis1407 (93.1)778 (92.5)629 (93.7)
    Glycuresis105 (6.9)63 (7.5)42 (6.3)
Hypertension0.206
    No hypertension1199 (79.3)657 (78.1)542 (80.8)
    Hypertension313 (20.7)184 (21.9)129 (19.2)
Diseases0.828
    No diseases1397 (92.8)774 (92.7)623 (93)
    Cardiovascular and cerebrovascular diseases108 (7.2)61 (7.3)47 (7)
Location0.263
    Proximal 826 (55.5)444 (53.8)382 (57.7)
    Middle282 (19.0)159 (19.2)123 (18.6)
    Distal380 (25.5)223 (27)157 (23.7)
Lauren0.148
    Intestinal252 (32.1)139 (34.9)113 (29.2)
    Diffuse258 (32.9)120 (30.2)138 (35.7)
    Mixed275 (35.0)139 (34.9)136 (35.1)
Histological grade0.005
    Moderately384 (28.6)232 (32.2)152 (24.4)
    Moderately to highly385 (28.6)200 (27.8)185 (29.6)
    Highly574 (42.7)287 (39.9)287 (46)
AJCC stage< 0.001
    I259 (18.4)230 (30.4)29 (4.4)
    II325 (23.0)161 (21.3)164 (25)
    III778 (55.1)347 (45.9)431 (65.8)
    IV48 (3.4)17 (2.2)31 (4.7)
    Invasion depth T< 0.001
    I212 (15.0)188 (24.7)24 (3.7)
    II120 (8.5)82 (10.8)38 (5.8)
    III424 (30.0)200 (26.3)224 (34.3)
    IV658 (46.5)290 (38.2)368 (56.3)
    Vascular invasion< 0.001
    No invasion772 (54.2)488 (63.2)284 (43.5)
    Invasion653 (45.8)284 (36.8)369 (56.5)
Perineural invasion< 0.001
    No invasion827 (58.0)502 (65)325 (49.7)
    Invasion599 (42.0)270 (35)329 (50.3)
Surgical type< 0.001
    Laparoscope surgery532 (35.2)343 (40.8)189 (28.2)
    Traditional surgery937 (62.1)464 (55.2)473 (70.6)
    Non radical surgery41 (2.7)33 (3.9)8 (1.2)
Neutrophils, mean ± SD3.9 ± 1.73.9 ± 1.74.0 ± 1.70.207
    NLR2.3 ± 1.62.3 ± 1.62.3 ± 1.50.651
    PLR153.2 ± 73.8148.7 ± 71.8158.8 ± 75.80.008
    CEA6.7 ± 17.95.7 ± 16.08.0 ± 19.90.017
    CA19941.3 ± 88.238.2 ± 88.145.0 ± 88.10.154
    CA5024.9 ± 109.228.3 ± 129.021.1 ± 82.10.284
    CA72413.9 ± 36.713.7 ± 37.114.1 ± 36.20.808
    CA24224.3 ± 63.020.7 ± 57.728.4 ± 68.50.025
    TPS126.3 ± 153.7127.7 ± 145.9124.8 ± 162.20.762
    AFP90.5 ± 1774.914.8 ± 163.4178.4 ± 2602.00.09
State0.011
    Survival770 (50.9)453 (53.9)317 (47.2)
    Death742 (49.1)388 (46.1)354 (52.8)
NLR: Neutrophil-to-lymphocyte ratio; PLR: Platelet-to-lymphocyte ratio; CEA: Carcinoembryonic antigen; CA: Carbohydrate antigen; TPS: Tissue polypeptide specific antigen; AFP: Alpha-fetoprotein.
Table 2 Cox single factor regression analysis
Variables
HR (95%CI)
P value
Gender: Male vs female1.05 (0.84, 1.31)0.668
Old1.02 (1.01, 1.03)< 0.001
Smoke: No smoking vs long term smoking1.0006 (0.8662, 1.1559) 0.994
Drink: No drinking vs long term drinking0.92 (0.76, 1.13)0.438
Glycuresis: Glycuresis vs No Glycuresis0.95 (0.72, 1.27) 0.736
Hypertension: Hypertension vs No Hypertension0.96 (0.8, 1.15) 0.65
Diseases: Cardiovascular and cerebrovascular diseases vs no diseases0.95 (0.72, 1.27)0.748
Location: Ref0.408
    Proximal
    Middle1.01 (0.83, 1.23) 0.913
    Distal0.89 (0.75, 1.07) 0.214
Lauren: Ref< 0.001
    Intestinal
    Diffuse1.84 (1.43, 2.36) < 0.001
    Mixed1.57 (1.22, 2.03) < 0.001
Histological grade: Ref
    Moderately< 0.001
    Moderately to highly1.71 (1.38, 2.12) < 0.001
    Highly1.9 (1.55, 2.31) < 0.001
AJCC stage: Ref
    I< 0.001
    II2.41 (1.65, 3.5) < 0.001
    III7.35 (5.27, 10.27) < 0.001
    IV12.07 (7.69, 18.96) < 0.001
Invasion depth T: Ref< 0.001
    I
    II1.85 (1.11, 3.1) 0.019
    III4.88 (3.31, 7.19) < 0.001
    IV7 (4.8, 10.21) < 0.001
Vascular invasion: Invasion vs no invasion3.03 (2.59, 3.54) < 0.001
Perineural invasion: Invasion vs no invasion2.5 (2.15, 2.91)< 0.001
Surgical type: Ref
    Laparoscope surgery< 0.001
    Traditional surgery1.21 (1.03, 1.42) 0.018
    Non radical surgery8.1 (5.76, 11.38) < 0.001
Postoperative chemotherapy: Chemotherapy vs no chemotherapy1.13 (0.98, 1.3)0.103
    CEA1.01 (1.01, 1.01)< 0.001
    CA199 1.0029 (1.0022, 1.0036)< 0.001
    CA50 1.0021 (1.0015, 1.0026)< 0.001
    CA724 1.0075 (1.006, 1.009)< 0.001
    CA242 1.0034 (1.0025, 1.0044)< 0.001
    TPS 1.001 (1.0006, 1.0014)< 0.001
    AFP 1 (1, 1.0001)0.001
    NLR 1.1 (1.06, 1.13)< 0.001
    PLR 1.003 (1.0022, 1.0038)< 0.001
NLR: Neutrophil-to-lymphocyte ratio; PLR: Platelet-to-lymphocyte ratio; CEA: Carcinoembryonic antigen; CA: Carbohydrate antigen; TPS: Tissue polypeptide specific antigen; AFP: Alpha-fetoprotein.
Table 3 Cox subgroup analysis of postoperative neoadjuvant chemotherapy among neutrophil-to-lymphocyte ratio, carcinoembryonic antigen and neutrophil-to-lymphocyte ratio-carcinoembryonic antigen combined indicators
Variable
Total
Event, n (%)
Follow up (time)
HR (95%CI)
P value
NLR_Low
No chemotherapy441165 (37.4)200241 (Ref)
Chemotherapy335156 (46.6)144430.64 (0.51-0.82)0
NLR_High
No chemotherapy349191 (54.7)125751 (Ref)
Chemotherapy304180 (59.2)112680.71 (0.56-0.89)0.004
CEA_Low
No chemotherapy252149 (59.1)88471(Ref)
Chemotherapy210125 (59.5)76600.64 (0.49-0.83)0.001
CEA_High
No chemotherapy538207 (38.5)237521 (Ref)
Chemotherapy429211 (49.2)180510.72 (0.59-0.9)0.003
NLR_CEA_
Low
No chemotherapy8352 (62.7)28321 (Ref)
Chemotherapy9747 (48.5)38720.41 (0.26-0.63)0
NLR_CEA_
Middle
No chemotherapy387154 (39.8)167801 (Ref)
Chemotherapy318167 (52.5)131090.69 (0.54-0.87)0.002
NLR_CEA_
High
No chemotherapy231111 (48.1)90891 (Ref)
Chemotherapy199105 (52.8)78440.73 (0.53-0.99)0.042
NLR: Neutrophil-to-lymphocyte ratio; CEA: Carcinoembryonic antigen.
Table 4 Area under the curve
Variable
AUC (95%CI) (%)
Specificity
Sensitivity
CEA59.7769 (56.7646-62.7892)0.78850.3729
CA19960.6168 (57.5979- 63.6356)0.88780.3098
NLR58.9996 (55.9899-62.0094)0.65610.4872
PLR58.89 (55.8704-61.9096)0.52230.6256
CA24259.5793 (56.5495-62.609)0.8360.3549
CA72463.0845 (60.1236-66.0455)0.6590.5714
AUC: Area under the curve; NLR: Neutrophil-to-lymphocyte ratio; PLR: Platelet-to-lymphocyte ratio; CEA: Carcinoembryonic antigen; CA: Carbohydrate antigen.