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: < 0.001) among patients with CRC. The ACR-based nomogram demonstrated superior predictive performance, with C-index values of 0.786 for OS and 0.772 for DFS, outperforming the traditional TNM staging system. 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.