Predictive Value Of Immunoscore In Postoperative Prognosis In Patients With Stage Ⅲ Colorectal Cancer

Objectives:The immune score of colorectal cancer patients in this center was calculated,the relationship between the immune score and various clinical and pathological indicators was analyzed,and the predictive value of immune score on the prognosis of colorectal cancer patients was evaluated,so as to guide clinicians to evaluate the prognosis and individualize treatment.Methods:A retrospective examination of the clinicopathological data from patients undergoing major surgery for primary colorectal cancer in the Gastric and Colorectal Surgery Department of Jilin University’s First Hospital was conducted between January 2021 and December 2021,and the postoperative pathological presentation was in line with TNM stage Ⅲ.Analysis using SPSS26.0 statistical software.The chi-square test was used to analyze the relationship between the patient’s immune score and the results of clinical and pathological examination.Univariate analysis and multivariate analysis were performed using Log-rank test and Cox regression for survival data,and significant factors were added to Cox regression for further variable screening.Kaplan-Meier survival curve was used to compare PFS between the two groups.P<0.05 indicates a statistical difference.Results:Of the 68 patients included in the study,50 had high immune scores and 18 had low immune scores.The chi-square test showed that the high immune score was associated with N stage(P=0.041),tumor location(P=0.040)and vascular invasion(P=0.014)in colorectal cancer patients,and there was no correlation with gender,age,T stage,postoperative chemotherapy course,nerve invasion,CA199,CA125,CA724,CEA(P>0.05).Univariate Cox regression analysis showed that the parameters affecting PFS were:chemotherapy course,vascular invasion,immune score,and CA125(all P<0.05).The independent risk factors identified by multivariate Cox regression analysis were chemotherapy course,vascular invasion,immune score,and CA125(all P<0.05).By using the Kaplan-Meier survival curve,there was a significant difference in PFS between different chemotherapy courses in patients with different immune scores and high immune scores,and the P<0.05 indicated that there was a statistically significant significance.Conclusions:(1)The immune score was related to tumor N stage,tumor location and vasculature invasion.(2)Chemotherapy course,vascular invasion,immune score,and CA125 were factors affecting the progression-free survival of patients with stage Ⅲ colorectal cancer,while the independent risk factors affecting progression-free survival were chemotherapy course,vascular invasion,immune score,and CA125.(3)Patients with high immune scores have a better prognosis than patients with low immune scores;Patients with high immune scores had a better prognosis in patients with≥6 sessions of chemotherapy.