ORIGINAL RESEARCH article
Front. Oncol.
Sec. Gastrointestinal Cancers: Colorectal Cancer
Dynamic monitoring of immunoglobulin G as a prognostic indicator after curative resection in high-risk stage II–III colorectal cancer: a retrospective cohort study
Provisionally accepted
- 1Medical Laboratory Center, Hebei Hospital of Traditional Chinese Medicine, Shijiazhuang, China
- 2Nursing Profession, Hebei University of Chinese Medicine, Shijiazhuang, China
- 3Aonrectal Department 1, Hebei Hospital of Traditional Chinese Medicine, Shijiazhuang, China
- 4Gastrointestinal Oncology Surgery, Hebei Hospital of Traditional Chinese Medicine, Shijiazhuang, China
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Background: Reliable markers for predicting postoperative recurrence in high-risk stage II–III colorectal cancer remain limited. Dynamic changes in immunoglobulin G (IgG) may provide prognostic information beyond carcinoembryonic antigen (CEA). Methods: This single-centre retrospective cohort study included 192 patients with high-risk stage II or III colorectal cancer who underwent curative resection between January 2021 and June 2023. The study evaluated whether dynamic postoperative monitoring of serum IgG predicts 2-year disease-free survival (DFS) compared with CEA. Serial IgG and CEA measurements within 24 months were categorized as favorable or unfavorable trajectories based on predefined thresholds and temporal trends. Patients were further stratified into four groups according to combined IgG and CEA dynamics. Survival was assessed using Kaplan–Meier analysis and Cox regression models. Results: Among 192 eligible patients, 60 (31.3%) experienced recurrence or death within 2 years. Unfavorable IgG trajectories (n=82) were associated with significantly lower 2-year DFS than favorable trajectories (55% [95% CI 44–65] vs 82% [95% CI 73–88], log-rank P<0.01). CEA trajectories showed only borderline separation (67% [95% CI 55–77] vs 79% [95% CI 71–85], log-rank P=0.06). Patients with both unfavorable IgG and CEA trajectories had the poorest outcomes (2-year DFS 31% [95% CI 16–47]). In multivariable analysis, an unfavorable IgG trajectory independently predicted recurrence or death (HR 2.05, 95% CI 1.32–3.18), whereas CEA trajectory was not significant. Conclusion: Dynamic postoperative IgG monitoring is independently associated with disease recurrence in high-risk stage II–III colorectal cancer and offers incremental prognostic value beyond CEA. Incorporating serial IgG measurements may enhance postoperative risk stratification, although confirmation in prospective multicentre studies is warranted.
Keywords: colorectal cancer, Disease-Free Survival, dynamic monitoring, Immunoglobulin G, Prognostic biomarkers
Received: 24 Nov 2025; Accepted: 16 Feb 2026.
Copyright: © 2026 Sun, Guo, Guo, Wang and Feng. 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: Jiangxue Feng
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