The combined prognostic value of MSI, DD, and CA19-9 in colorectal cancer patients who underwent radical resection

Corresponding author: Feng Zhenbo, guanghu1963@126.com

DOI: 10.12201/bmr.202505.00020

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  Abstract: Objective To evaluate the prognostic value of microsatellite instability (MSI), preoperative D-dimer (DD), and CA19-9 level for the prognosis of colorectal cancer (CRC) patients who had undergone radical resection. Methods Retrospectively analyzed the general clinical data, MSI, DD, and CA19-9 levels of 81 CRC patients who underwent radical resection in the First Affiliated Hospital of Guangxi Medical University and Guilin Peoples Hospital between January 2020 and December 2021. Screen and evaluate prognostic factors. Results Chi-square analysis revealed significantly lower MSI and higher preoperative DD/CA19-9 levels in the recurrence group versus non-recurrence group (all P<0.05), with similar patterns observed between death and survival groups (all P<0.05). Univariate and multivariate analyses showed that MSI as a protective factor against recurrence in CRC patients (P=0.018), and high expression of DD and CA19-9 before surgery as independent risk factors for recurrence in CRC patients (P=0.020, P=0.042). MSI as a protective factor against mortality in CRC patients (P=0.036), and high expression of DD and CA19-9 before surgery as independent risk factors for mortality in CRC patients (P=0.010, P=0.017). The ROC curve showed that the AUCROC of MSI, DD, and CA19-9 for predicting recurrence after CRC surgery were 0.643, 0.599, and 0.644 respectively. The AUCROC of MSI, DD, and CA19-9 used alone for predicting mortality were 0.646, 0.642, and 0.693 respectively. The AUCROC of the combined prediction of recurrence and mortality by the three factors were 0.776 and 0.825 respectively. Conclusion MSI is a protective factor for prognosis in CRC patients, whereas high expression of preoperative DD and CA19-9 are risk factors for prognosis. The combined detection of these three factors can optimize the risk stratification of CRC.

  Key words: MSI; D-dimer; CA19-9; Colorectal cancer; Prognosis

  Submit time: 19 May 2025

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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