Preoperative albumin to carcinoembryonic antigen ratio predicts clinicopathological features and survival in colorectal cancer: a prognostic nomogram study.

Aim: This study examined the association between the preoperative albumin-to-carcinoembryonic antigen ratio (ACR) and clinicopathological characteristics in colorectal cancer (CRC) patients and developed and validated a prognostic model incorporating ACR for patient risk stratification. Methods: A retrospective analysis was performed on the clinical and pathological data of CRC patients who underwent radical surgery at Shanxi Province Cancer Hospital between January 2017 and December 2017. Patient follow-up was conducted, and the Cox proportional hazards model was employed to identify factors influencing overall survival (OS) and disease-free survival (DFS). Additionally, an ACR-based nomogram was developed and its predictive performance was assessed using the concordance index (C-index) and calibration curves. Comparative analyses with the traditional TNM staging system were performed using discriminant indices. Results: A total of 966 patients with CRC were included in the study, of whom 146 (15.1%) were categorized into the low ACR group and 820 (84.9%) into the high ACR group. The low ACR levels were significantly associated with adverse clinicopathological characteristics and an unfavorable prognosis in patients with CRC. The survival analysis demonstrated that OS ( Conclusion: Preoperative low ACR is significantly correlated with aggressive tumor characteristics and unfavorable prognosis in CRC patients. The ACR-based nomogram exhibits good predictive accuracy, offering a valuable tool for risk stratification in clinical practice.