全身炎症标志物在结直肠癌预后中的研究进展
Research Progress of Systemic Inflammatory Markers in the Prognosis of Colorectal Cancer
摘要: 本文综述了全身炎症标志物在结直肠癌(Colorectal Cancer, CRC)预后评估中的研究进展。结直肠癌是全球常见的恶性肿瘤,预后评估对治疗决策至关重要。近年来,全身炎症反应被证实与肿瘤的发生发展密切相关,多种炎症标志物作为预后指标受到广泛关注。本文系统介绍了C反应蛋白、中性粒细胞/淋巴细胞比值、血小板/淋巴细胞比值、全身免疫炎症指数等主要炎症标志物的特性、检测方法及其在结直肠癌预后中的应用。通过对比分析各标志物的优缺点,探讨了其在临床应用中的价值与局限,为未来研究方向的确定提供了理论依据。
Abstract: This article reviews the research progress of systemic inflammatory markers in the prognosis assessment of colorectal cancer. Colorectal cancer is a common malignant tumor worldwide, and prognosis assessment is crucial for treatment decisions. In recent years, systemic inflammatory responses have been confirmed to be closely related to the occurrence and development of tumors, and multiple inflammatory markers have received extensive attention as prognostic indicators. This article systematically introduces the characteristics, detection methods, and application in prognosis assessment of major inflammatory markers such as C-reactive protein, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and systemic immune-inflammatory index. By comparing and analyzing the advantages and disadvantages of each marker, the value and limitations in clinical application are discussed, providing a theoretical basis for determining future research directions.
文章引用:汪宇婷, 李航宇, 田明. 全身炎症标志物在结直肠癌预后中的研究进展[J]. 临床医学进展, 2025, 15(12): 1547-1554. https://doi.org/10.12677/acm.2025.15123563

参考文献

[1] Mármol, I., Sánchez-de-Diego, C., Pradilla Dieste, A., Cerrada, E. and Rodriguez Yoldi, M. (2017) Colorectal Carcinoma: A General Overview and Future Perspectives in Colorectal Cancer. International Journal of Molecular Sciences, 18, Article No. 197. [Google Scholar] [CrossRef] [PubMed]
[2] Li, J. (2014) TNM Staging of Colorectal Cancer Should Be Reconsidered by T Stage Weighting. World Journal of Gastroenterology, 20, Article No. 5104. [Google Scholar] [CrossRef] [PubMed]
[3] Rossi, S., Basso, M., Strippoli, A., Schinzari, G., D’Argento, E., Larocca, M., et al. (2017) Are Markers of Systemic Inflammation Good Prognostic Indicators in Colorectal Cancer? Clinical Colorectal Cancer, 16, 264-274. [Google Scholar] [CrossRef] [PubMed]
[4] Quaglio, A.E.V., Grillo, T.G., Oliveira, E.C.S.D., Stasi, L.C.D. and Sassaki, L.Y. (2022) Gut Microbiota, Inflammatory Bowel Disease and Colorectal Cancer. World Journal of Gastroenterology, 28, 4053-4060. [Google Scholar] [CrossRef] [PubMed]
[5] Cheng, Y., Ling, Z. and Li, L. (2020) The Intestinal Microbiota and Colorectal Cancer. Frontiers in Immunology, 11, Article ID: 615056. [Google Scholar] [CrossRef] [PubMed]
[6] Hirano, T. (2020) IL-6 in Inflammation, Autoimmunity and Cancer. International Immunology, 33, 127-148. [Google Scholar] [CrossRef] [PubMed]
[7] Kay, J., Thadhani, E., Samson, L. and Engelward, B. (2019) Inflammation-Induced DNA Damage, Mutations and Cancer. DNA Repair, 83, Article ID: 102673. [Google Scholar] [CrossRef] [PubMed]
[8] Gabrilovich, D.I. and Nagaraj, S. (2009) Myeloid-Derived Suppressor Cells as Regulators of the Immune System. Nature Reviews Immunology, 9, 162-174. [Google Scholar] [CrossRef] [PubMed]
[9] Koper-Lenkiewicz, O.M., Dymicka-Piekarska, V., Milewska, A.J., Zińczuk, J. and Kamińska, J. (2021) The Relationship between Inflammation Markers (CRP, IL-6, sCD40L) and Colorectal Cancer Stage, Grade, Size and Location. Diagnostics, 11, Article No. 1382. [Google Scholar] [CrossRef] [PubMed]
[10] Malik, M., Radecka, B., Gełej, M., Jackowska, A., Filipczyk-Cisarż, E., Żurowska, M., et al. (2024) Predictive and Prognostic Role of Systemic Immune-Inflammation Index (SII) in Metastatic Colorectal Cancer Patients Treated with Trifluridine/Tipiracil. Biomedicines, 12, Article No. 2076. [Google Scholar] [CrossRef] [PubMed]
[11] Nakamoto, S., Ohtani, Y., Sakamoto, I., et al. (2023) Systemic Immune-Inflammation Index Predicts Tumor Recurrence after Radical Resection for Colorectal Cancer. The Tohoku Journal of Experimental Medicine, 261, 229-238.
[12] Tan, Y., Hu, B., Li, Q. and Cao, W. (2025) Prognostic Value and Clinicopathological Significance of pre-and Post-Treatment Systemic Immune-Inflammation Index in Colorectal Cancer Patients: A Meta-Analysis. World Journal of Surgical Oncology, 23, Article No. 11. [Google Scholar] [CrossRef] [PubMed]
[13] Huang, Q., Cao, Y., Wang, S. and Zhu, R. (2020) Creation of a Novel Inflammation-Based Score for Operable Colorectal Cancer Patients. Journal of Inflammation Research, 13, 659-671. [Google Scholar] [CrossRef] [PubMed]
[14] Naszai, M., Kurjan, A. and Maughan, T.S. (2021) The Prognostic Utility of Pre‐Treatment Neutrophil‐to‐Lymphocyte‐Ratio (NLR) in Colorectal Cancer: A Systematic Review and Meta‐Analysis. Cancer Medicine, 10, 5983-5997. [Google Scholar] [CrossRef] [PubMed]
[15] He, L., Li, H., Cai, J., Chen, L., Yao, J., Zhang, Y., et al. (2018) Prognostic Value of the Glasgow Prognostic Score or Modified Glasgow Prognostic Score for Patients with Colorectal Cancer Receiving Various Treatments: A Systematic Review and Meta-Analysis. Cellular Physiology and Biochemistry, 51, 1237-1249. [Google Scholar] [CrossRef] [PubMed]
[16] 胡旭昊, 孟昆, 狄茂军. 结直肠癌患者手术前后淋巴细胞与单核细胞比值动态变化及其对预后的预测价值[J]. 陕西医学杂志, 2023, 52(6): 719-722+727.
[17] 杨战锋, 郭晓磊, 郭魁元, 等. 炎症标志物对结直肠癌患者预后影响的临床研究[J]. 医学研究杂志, 2023, 52(1): 143-147+142.
[18] Dymicka-Piekarska, V., Matowicka-Karna, J., Gryko, M., Kemona-Chętnik, I. and Kemona, H. (2007) Relationship between Soluble P-Selectin and Inflammatory Factors (Interleukin-6 and C-Reactive Protein) in Colorectal Cancer. Thrombosis Research, 120, 585-590. [Google Scholar] [CrossRef] [PubMed]
[19] Rot, A. and von Andrian, U.H. (2004) Chemokines in Innate and Adaptive Host Defense: Basic Chemokinese Grammar for Immune Cells. Annual Review of Immunology, 22, 891-928. [Google Scholar] [CrossRef] [PubMed]
[20] Łukaszewicz-Zając, M. and Mroczko, B. (2021) Circulating Biomarkers of Colorectal Cancer (CRC)—Their Utility in Diagnosis and Prognosis. Journal of Clinical Medicine, 10, Article No. 2391. [Google Scholar] [CrossRef] [PubMed]
[21] Nikiteas, N.I., et al. (2005) Serum IL-6, TNFalpha and CRP Levels in Greek Colorectal Cancer Patients: Prognostic Implications. World Journal of Gastroenterology, 11, 1639-1643. [Google Scholar] [CrossRef] [PubMed]
[22] Yang, J., Guo, X., Wang, M., Ma, X., Ye, X. and Lin, P. (2017) Pre-treatment Inflammatory Indexes as Predictors of Survival and Cetuximab Efficacy in Metastatic Colorectal Cancer Patients with Wild-Type RAS. Scientific Reports, 7, 17166. [Google Scholar] [CrossRef] [PubMed]
[23] Noh, O.K., Oh, S.Y., Kim, Y.B. and Suh, K.W. (2017) Prognostic Significance of Lymphocyte Counts in Colon Cancer Patients Treated with FOLFOX Chemotherapy. World Journal of Surgery, 41, 2898-2905. [Google Scholar] [CrossRef] [PubMed]
[24] Ishizuka, M., Nagata, H., Takagi, K., Iwasaki, Y. and Kubota, K. (2012) Preoperative Thrombocytosis Is Associated with Survival after Surgery for Colorectal Cancer. Journal of Surgical Oncology, 106, 887-891. [Google Scholar] [CrossRef] [PubMed]
[25] Jia, W., Yuan, L., Ni, H., Xu, B. and Zhao, P. (2021) Prognostic Value of Platelet-To-Lymphocyte Ratio, Neutrophil-to-Lymphocyte Ratio, and Lymphocyte-to-White Blood Cell Ratio in Colorectal Cancer Patients Who Received Neoadjuvant Chemotherapy. Technology in Cancer Research & Treatment, 20, 1-10. [Google Scholar] [CrossRef] [PubMed]
[26] Menyhart, O., Fekete, J.T. and Győrffy, B. (2024) Inflammation and Colorectal Cancer: A Meta-Analysis of the Prognostic Significance of the Systemic Immune-Inflammation Index (SII) and the Systemic Inflammation Response Index (SIRI). International Journal of Molecular Sciences, 25, 8441. [Google Scholar] [CrossRef] [PubMed]
[27] Tang, S., Chen, Y., Tian, S. and Wang, Y. (2021) Predictive Nomogram for the Prediction of Early Recurrence of Colorectal Cancer. International Journal of General Medicine, 14, 4857-4866. [Google Scholar] [CrossRef] [PubMed]
[28] Zhang, L., Zhang, Z., Guo, H., Huang, B. and Zhang, H. (2022) Systemic Immune-Inflammation Index: A New Indicator of Predicting 1-, 2-and 3-Year Disease-Free Survival of Patients with Colon Cancer. Advances in Clinical and Experimental Medicine, 32, 13-22. [Google Scholar] [CrossRef] [PubMed]
[29] Bai, X. and Feng, L. (2019) Correlation between Prognostic Nutritional Index, Glasgow Prognostic Score, Systemic Inflammatory Response, and TNM Staging in Colorectal Cancer Patients. Nutrition and Cancer, 72, 1170-1177. [Google Scholar] [CrossRef] [PubMed]
[30] Inamoto, S., Kawada, K., Okamura, R., Hida, K. and Sakai, Y. (2019) Prognostic Impact of the Combination of Neutrophil-to-Lymphocyte Ratio and Glasgow Prognostic Score in Colorectal Cancer: A Retrospective Cohort Study. International Journal of Colorectal Disease, 34, 1303-1315. [Google Scholar] [CrossRef] [PubMed]
[31] Park, J.H., Fuglestad, A.J., Køstner, A.H., Oliwa, A., Graham, J., Horgan, P.G., et al. (2020) Systemic Inflammation and Outcome in 2295 Patients with Stage I-III Colorectal Cancer from Scotland and Norway: First Results from the Scotscan Colorectal Cancer Group. Annals of Surgical Oncology, 27, 2784-2794. [Google Scholar] [CrossRef] [PubMed]
[32] Takamizawa, Y., Shida, D., Boku, N., Nakamura, Y., Ahiko, Y., Yoshida, T., et al. (2020) Nutritional and Inflammatory Measures Predict Survival of Patients with Stage IV Colorectal Cancer. BMC Cancer, 20, 1092. [Google Scholar] [CrossRef] [PubMed]