Zhu SS, Yang T, Cheng LL. Predictive value of systemic immune-inflammation index and serum lactoferrin for postoperative survival in older patients with colon cancer. World J Gastrointest Surg 2025; 17(11): 110879 [DOI: 10.4240/wjgs.v17.i11.110879]
Corresponding Author of This Article
Li-Li Cheng, MBBS, Department of Laboratory, Rugao People's Hospital, No. 278 Ninghai Road, Rugao 226500, Jiangsu Province, China. 18051388531@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Prospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Nov 27, 2025 (publication date) through Nov 25, 2025
Times Cited of This Article
Times Cited (0)
Journal Information of This Article
Publication Name
World Journal of Gastrointestinal Surgery
ISSN
1948-9366
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
Zhu SS, Yang T, Cheng LL. Predictive value of systemic immune-inflammation index and serum lactoferrin for postoperative survival in older patients with colon cancer. World J Gastrointest Surg 2025; 17(11): 110879 [DOI: 10.4240/wjgs.v17.i11.110879]
World J Gastrointest Surg. Nov 27, 2025; 17(11): 110879 Published online Nov 27, 2025. doi: 10.4240/wjgs.v17.i11.110879
Predictive value of systemic immune-inflammation index and serum lactoferrin for postoperative survival in older patients with colon cancer
Sha-Sha Zhu, Tao Yang, Li-Li Cheng
Sha-Sha Zhu, Tao Yang, Li-Li Cheng, Department of Laboratory, Rugao People's Hospital, Rugao 226500, Jiangsu Province, China
Co-first authors: Sha-Sha Zhu and Tao Yang.
Author contributions: Zhu SS and Yang T conceived the project; Cheng LL collected and analyzed the data; Zhu SS and Yang T jointly wrote the initial draft of the manuscript; Cheng LL provided expert advice and revised the manuscript. All the authors contributed to the study and approved the submitted version. Zhu SS and Yang T contributed equally to this work as co-first authors.
Supported by Rugao Science and Technology Research and Development Program (Agriculture and Social Development) Project, No. SRGS (24)061.
Institutional review board statement: This study has been reviewed and approved by the Ethics Committee of Rugao People's Hospital.
Clinical trial registration statement: This study is registered in https://www.researchregistry.com. The registration identification number is [Researchregistry11471].
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: We declare that there is no conflict of interest.
CONSORT 2010 statement: The authors have read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 statement.
Data sharing statement: No data available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Received: July 22, 2025 Revised: August 21, 2025 Accepted: September 15, 2025 Published online: November 27, 2025 Processing time: 125 Days and 20 Hours
Abstract
BACKGROUND
Systemic immune-inflammation index (SII) combined with serum lactoferrin (LF) level can provide a reference for predicting the postoperative survival and prognosis of older patients with colon cancer.
AIM
To evaluate the predictive value of SII combined with serum LF for postoperative survival in older patients with colon cancer.
METHODS
This prospective study included 62 older patients [range, 65-85 years; average age (72.46 ± 6.02) years] with colon cancer who underwent radical surgery at our hospital between January 2023 and September 2024. Colon cancer was confirmed on postoperative pathology. All patients underwent peripheral blood, LF, and tumor marker tests and imaging examinations preoperatively. The ability to predict overall survival (OS) and disease-free survival (DFS) by dynamically monitoring the SII [platelet (PLT) count × neutrophil (NEU) count/lymphocyte (LYM) count] and LF levels in combination with postoperative follow-up data was assessed. SII, LF levels, and postoperative data were analyzed using receiver operating characteristic curves, univariate, and multivariate Cox regression analyses to assess OS and DFS.
RESULTS
All patients were followed up conventionally postoperatively. There were no significant differences in the patients’ baseline data. From 3 months preoperatively until after surgery, the values of routine blood indices (NEUs, LYMs, and PLTs) and SII tended to decrease, but the difference was not statistically significant. The LF level gradually decreased, and there were significant differences at 1 week, 1 month and 3 months postoperatively (P < 0.05). Liver and kidney functions significantly increased 1 week postoperatively and gradually recovered (P < 0.05). The C-reactive protein level significantly increased 1 week postoperatively, whereas the prealbumin level significantly decreased then recovered 3 months postoperatively (P < 0.05). The levels of carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) significantly increased 6 months postoperatively, suggesting an increased risk of recurrence (P < 0.05). Both the OS and DFS showed significant changes over time. Preoperative SII and LF levels had significant predictive values for OS and DFS. In logistics regression analysis, a SII of 585 or greater and LF level less than 185 ng/mL (determined by maximizing the Youden index) correlated with postoperative survival (P < 0.05). Further Cox regression analysis showed that the SII and LF, CA19-9, and CEA levels were independent predictors of postoperative OS (P < 0.05), whereas the tumor, node, metastasis stage; LF level; and SII were independent predictors of DFS.
CONCLUSION
This preliminary analysis suggests that the SII and LF levels may predict the survival and prognosis of older patients with colon cancer postoperatively, when assessing the risk of postoperative recurrence and complications. These two categories of indicators have good prognostic evaluation potential in clinical practice and can provide strong support for the development of individualized treatment strategies.
Core Tip: This study prospectively evaluated the predictive value of systemic immune-inflammation index (SII) combined with serum lactoferrin (LF) levels for survival outcomes in older patients with colon cancer undergoing radical surgery. Dynamic monitoring demonstrated that preoperative SII and LF levels were independent predictors of overall survival and disease-free survival. The findings suggest that SII and LF serve as simple and effective prognostic biomarkers, providing valuable guidance for individualized treatment strategies and postoperative recurrence risk assessment in elderly colon cancer patients.
