The Association of the Cancer Inflammation Prognostic Index with Microsatellite Instability, Tumor Budding and...

This study aimed to investigate the relationship between the Cancer Inflammation Prognostic Index (CIPI) and microsatellite instability (MSI), tumor budding, and prognosis in colorectal cancer cases.

Patients with stage 1-3 colorectal cancer who underwent curative surgical treatment between May 2020 and January 2022 were included. Serum CIPI was calculated, a cut-off point was established using Receiver Operating Characteristic (ROC) analysis and Patients were divided into two groups according to their CIPI scores: Group 1 (low CIPI) consisted of 94 patients, and Group 2 (high CIPI) consisted of 95 patients.

A CIPI score >8.54 predicted mortality with 82.2% sensitivity and 59.7% specificity (area under the curve (AUC): 0.712). There were differences in tumor localization (p = 0.01). Group 2 had higher C-reactive protein (CRP) levels (4.2 vs 11.7, p < 0.001), lower albumin levels (4.1 vs 4, p = 0.04), higher neutrophil counts (3.76 vs 4.83, p = 0.002), and higher levels of carcinoembryonic antigen (CEA) and carbohydrate antigen 19.9 (Ca 19.9) (2.08 vs 8.27, p < 0.001 and 8.85 vs 13.9, p = 0.014, respectively). Tumor diameter was larger in high CIPI group (3 vs 3.8 cm, p = 0.001) , disease-free survival (37.7 vs 27.6 months, p < 0.001) and overall survival (39.6 vs 30.6 months, p < 0.001) were lower in high CIPI group 2. In the multivariate Cox regression analysis, a high CIPI score remained a strong independent predictor of poor overall survival (hazard ratio (HR) = 3.383, 95% confidence interval (CI): 1.445-7.921, p = 0.005) disease-free survival, a high CIPI score again stood out as a critical prognostic factor (HR = 3.280, 95% CI: 1.695-6.347, p < 0.001).

A high CIPI score is associated with poor histopathological features and decreased survival. Closer monitoring or more aggressive treatment might improve prognosis for patients with high CIPI values.