AUTHOR=Chu Liang , Wang Han , Ling Tao , Feng Shuhan , Ding Yucheng , Zhang Yan , Pan Ying , Wang Cenzhu , Wang Xiaohong , Liu Lei 

TITLE=Prognostic value of positive lymph node ratio, tumor deposit, and perineural invasion in advanced colorectal signet-ring cell carcinoma

JOURNAL=Frontiers in Molecular Biosciences

VOLUME=Volume 12 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/molecular-biosciences/articles/10.3389/fmolb.2025.1617787

DOI=10.3389/fmolb.2025.1617787

ISSN=2296-889X

ABSTRACT=BackgroundThe aim of this study was to assess the prognostic significance of positive lymph node ratio (LNR), tumor deposits (TD), and perineural invasion (PNI) in advanced colorectal signet-ring cell carcinoma (SRCC).MethodsA multicenter retrospective cohort analysis was conducted involving 677 patients with advanced colorectal SRCC. The associations of variables with CSS and OS were analyzed using the Kaplan-Meier method and multivariable Cox proportional hazards models. A nomogram model was developed to predict outcomes.ResultsHigh-LNR, TD-positive, and PNI-positive were associated with poorer CSS and OS in both the training and validation cohorts. Multivariate Cox analysis identified T stage, M stage, TD, CEA, chemotherapy, and LNR as independent prognostic factors. A prognostic nomogram model incorporating these variables demonstrated excellent calibration and satisfactory predictive accuracy. Survival curves generated from individualized nomogram scores effectively discriminated prognostic outcomes (P < 0.001). The combined variable of LNR, TD, and PNI significantly enhanced the predictive performance. Specifically, the combined variable exhibited the highest relative contribution to OS at 23.4%, surpassing that of T and M stages. For CSS, its relative contribution was 21.4%, ranking second only to T and M stages.ConclusionLNR, TD, and PNI served as prognostic factors for advanced colorectal SRCC. The combined analysis demonstrated a higher prognostic predictive value.