ORIGINAL RESEARCH article
Front. Gastroenterol.
Sec. Gastroenterology and Cancer
The Value of Preoperative Pan-Immune Inflammatory Value and Serum Transaminase Ratio in Predicting Prognosis in Colorectal Cancer
- LZ
Lirui Zou
- QL
Qidong Li
- ZL
Zheng Lin
- BH
BoSong Huang
- ZL
Ziping Li
- JL
Jiaqi Liu
- SL
Shuping Lin
- XY
Xuan Yang
- FX
Feipeng Xu
- WW
Weiwei Wang
Guangdong Medical University, Zhanjiang, China
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Abstract
Background: This study evaluated the clinical value of preoperative pan-immune-inflammation value (PIV) and serum transaminase ratio (LSR) for predicting 3-year progression-free survival (PFS) in patients with colorectal cancer (CRC). Methods: This single-center retrospective cohort study included 723 patients with CRC who underwent surgery between January 2018 and June 2021. The primary endpoint was 3-year progression-free survival (PFS), defined as the time from surgery to the first documented recurrence or metastasis within 3 years; patients without such events were censored at 36 months. Secondary analyses included ROC-based discrimination and an exploratory comparison of hepatic versus non-hepatic metastatic-site distribution among patients with documented metastatic sites. PIV, LSR, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) were calculated from preoperative laboratory tests. Results: The optimal cutoff values for PIV and LSR were 391.955 and 0.756, respectively. In the clinically adjusted Cox model, high PIV remained associated with worse 3-year PFS (HR = 5.731, 95% CI: 3.860-8.511, P < 0.001), whereas high LSR was associated with better 3-year PFS (HR = 0.063, 95% CI: 0.031-0.131, P < 0.001). The combined PIV-LSR model showed the highest AUC in this cohort (AUC = 0.878), followed by SII (AUC = 0.816), PIV alone (AUC = 0.809), NLR (AUC = 0.792), LSR alone (AUC = 0.792), and PLR (AUC = 0.701). Kaplan-Meier analysis showed better 3-year PFS in patients with low PIV and high LSR. Conclusions: Preoperative PIV and LSR were independently associated with 3-year PFS in patients with CRC. Their combined use may provide incremental prognostic information, but the improvement over either marker alone was modest and requires external validation. These routinely available indices may help refine postoperative risk stratification when used alongside established clinicopathological factors.
Summary
Keywords
colorectal cancer, Pan-Immune-Inflammation Value, prognosis, Progression-free survival, Serum Transaminase Ratio
Received
25 May 2026
Accepted
06 July 2026
Copyright
© 2026 Zou, Li, Lin, Huang, Li, Liu, Lin, Yang, Xu and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Feipeng Xu; Weiwei Wang
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