Predictive value of serum miR-21 and miR-122 expression on the efficacy of capecitabine combined with transcatheter hepatic arterial embolization chemotherapy for liver metastasis after colorectal cancer surgery in patients with colorectal cancer and construction and verification of nomograms

Wenfang Ma¹Zukuan Chang¹Shixing Li¹Xiuhua Wang¹Guangshao Cao²Youjie Fan^1*

• ¹Xinxiang Central Hospital, Xinxiang, China
• ²Henan Provincial People's Hospital, Zhengzhou, Henan Province, China

Objective: To explore the predictive value of serum miR-21 and miR-122 expressions on the efficacy of capecitabine combined with TACE for the treatment of postoperative liver metastasis in colorectal cancer patients, and to construct a nomogram model for verification. Methods: A total of 252 patients who received this treatment from January 2021 to December 2023 were included in the study. The dataset was randomly split at a 7:3 ratio into a training set (n=181) and a validation set (n=71). Serum levels of miR-21 and miR-122 before treatment were detected and the relationship with clinical pathological characteristics was analyzed. Independent risk factors were screened by multivariate Logistic regression, and a nomogram model was constructed to evaluate efficacy. Results: In the training set, there were 86 cases with effective treatment and 95 cases with ineffective treatment after operation. Multivariate analysis showed that CEA, high serum miR-21 expression, low miR-122 expression, tumor size, BMI, and age were the independent risk factors for efficacy (P<0.05). The nomogram model exhibited C-indexes of 0.809 (training set) and 0.732 (validation set). Additionally, the average absolute errors of the calibration curves were 0.178 and 0.210, respectively. The Hosmer-Lemeshow test result was good. The Receiver operating characteristic (ROC) curve showed that the area under the curve (AUC) of the model in predicting the efficacy was 0.810 (95% CI: 0.734-0.885) and 0.731 (95% CI:0.597-0.866) in the training set and the verification set, respectively. The sensitivities and specificities were 0.820, 0.716 and 0.600 and 0.714, respectively.The expression levels of serum miR-21 and miR-122 have predictive value for the efficacy of liver metastasis after colorectal cancer treatment. The nomogram model has good predictive performance, which can provide a reference for clinical decision-making. Furthermore, the identified predictive value of miR-21 and miR-122 provides a basis for exploring personalized combination therapies with targeted agents in future studies, which may help overcome the limitations of conventional chemotherapy.