Preoperative Aggregate Index of Systemic Inflammation and Serum 3 Hsa_circ_0076251 are Associated with the 2- Year Recurrence of Stage II/III 4 Colorectal Cancer: A Single- Center
- 1Department of General Surgery
Abstract
Yong Chen,1 Ming Hu,1 Wenming Wang,1 Zhongtao Li,1 Lijia Fan,1 Chengxia Wang,1 Jianxue Wang,1 Yuansheng Tao1,2 1Jiuting Branch of Songjiang District Central Hospital, Jiuting Hospital of Songjiang District of Shanghai, Shanghai, People’s Republic of China; 2Department of General Surgery, Songjiang Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai Songjiang District Central Hospital, Shanghai, People’s Republic of ChinaCorrespondence: Yuansheng Tao, Department of General Surgery, Songjiang Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai Songjiang District Central Hospital, Songjiang District, Shanghai, 201615, People’s Republic of China, Email [email protected]: This retrospective, single-center study evaluated the predictive value of the preoperative Aggregate Index of Systemic Inflammation (AISI) and serum hsa_circ_0076251 for 2-year recurrence in stage II/III colorectal cancer (CRC) patients after radical resection.Methods: In this single-center, retrospective cohort study, we retrospectively analyzed 156 patients. Of these, 148 patients had at least 24 months of recurrence-free follow-up or experienced recurrence/death within 2 years and were included in the 2-year RFS analysis. AISI was calculated from preoperative blood counts, and hsa_circ_0076251 levels were quantified via qRT- PCR. Multivariate Cox regression and ROC curve analyses were used to identify independent predictors and assess diagnostic performance. Adjuvant chemotherapy was included as a covariate in the multivariable analysis. Internal validation was performed using bootstrap resampling and 10-fold cross-validation.Results: Fifty- one patients (32.7%) experienced recurrence. High AISI (≥ 520; 93 HR=2.71, 95% CI: 1.58– 4.66, P< 0.001) and low hsa_circ_0076251 (< 0.65; HR=2.29, 95% CI: 1.32– 3.95, P=0.003) were 94 independent predictors of poor recurrence- free survival after adjustment for T stage, 95 N stage, CEA, and adjuvant chemotherapy. The combined model achieved an apparent AUC of 0.82 (95% CI: 0.75– 0.88) and an optimism-corrected AUC of 0.78 (95% CI: 0.70– 0.85) by bootstrap resampling; these results require external validation before clinical use. High-risk patients, identified by the combination of high AISI and low serum hsa_circ_0076251, had significantly lower 2-year recurrence-free survival rates compared to low-risk patients (45.2% vs 88.9%; P < 0.001). These findings require external validation before any clinical use can be considered.Conclusion: Preoperative AISI and serum hsa circ 0076251 are synergistic, independent biomarkers that may improve early CRC recurrence risk stratification. However, the current model is investigational and should not yet be used to guide adjuvant therapy or surveillance decisions until validated in independent, prospective, multi- center cohorts. These findings are preliminary and hypothesis-generating; they require prospective, multicenter, externally validated studies before routine clinical application. Preoperative AISI and serum hsa_circ_0076251 are synergistic, independent biomarkers that were associated with early CRC recurrence in this retrospective cohort. These findings are preliminary and hypothesis-generating and do not yet support clinical risk stratification or adjuvant therapy planning. However, this conclusion should be interpreted with caution because the present study was retrospective and single-center, and the model has not yet been externally validated.Plain Language Summary: Plain Language Summary This study examined whether two preoperative markers- the Aggregate Index of Systemic Inflammation (AISI) and serum hsa_circ_0076251- can predict the recurrence of stage II/III colorectal cancer within two years after surgery. We found that patients with higher AISI and lower hsa_circ_0076251 levels had a significantly greater risk of recurrence. Combining both markers improved prediction accuracy in this retrospective cohort and helped identify patients who might be considered for future research studies on closer follow- up or more intensive treatment. However, because this was a single-center retrospective study and the model has not been externally validated, these findings should not be used to guide treatment intensification, de-escalation, or surveillance in routine clinical practice. These findings suggest that a simple blood- based test might, after external validation, help inform postoperative risk assessment in colorectal cancer patients; however, clinical utility has not yet been established.Keywords: colorectal cancer, recurrence, systemic inflammation, circular RNA, biomarker
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BibTeX
@article{chen2026preoperative,
title = {{Preoperative Aggregate Index of Systemic Inflammation and Serum 3 Hsa_circ_0076251 are Associated with the 2- Year Recurrence of Stage II/III 4 Colorectal Cancer: A Single- Center}},
author = {Chen Y and Hu M and Wang W and Li Z and Fan L and Wang C and Wang J and Tao Y},
journal = {Cancer Management and Research},
year = {2026},
month = nov,
url = {https://www.dovepress.com/preoperative-aggregate-index-of-systemic-inflammation-and-serum-3-hsac-peer-reviewed-fulltext-article-CMAR},
note = {CC BY},
}
RIS
TY - JOUR
TI - Preoperative Aggregate Index of Systemic Inflammation and Serum 3 Hsa_circ_0076251 are Associated with the 2- Year Recurrence of Stage II/III 4 Colorectal Cancer: A Single- Center
AU - Chen Y
AU - Hu M
AU - Wang W
AU - Li Z
AU - Fan L
AU - Wang C
AU - Wang J
AU - Tao Y
PY - 2026
DA - 2026/11/08
JO - Cancer Management and Research
UR - https://www.dovepress.com/preoperative-aggregate-index-of-systemic-inflammation-and-serum-3-hsac-peer-reviewed-fulltext-article-CMAR
AB - Yong Chen,1 Ming Hu,1 Wenming Wang,1 Zhongtao Li,1 Lijia Fan,1 Chengxia Wang,1 Jianxue Wang,1 Yuansheng Tao1,2 1Jiuting Branch of Songjiang District Central Hospital, Jiuting Hospital of Songjiang District of Shanghai, Shanghai, People’s Republic of China; 2Department of General Surgery, Songjiang Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai Songjiang District Central Hospital, Shanghai, People’s Republic of ChinaCorrespondence: Yuansheng Tao, Department of General Surgery, Songjiang Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai Songjiang District Central Hospital, Songjiang District, Shanghai, 201615, People’s Republic of China, Email [email protected]: This retrospective, single-center study evaluated the predictive value of the preoperative Aggregate Index of Systemic Inflammation (AISI) and serum hsa_circ_0076251 for 2-year recurrence in stage II/III colorectal cancer (CRC) patients after radical resection.Methods: In this single-center, retrospective cohort study, we retrospectively analyzed 156 patients. Of these, 148 patients had at least 24 months of recurrence-free follow-up or experienced recurrence/death within 2 years and were included in the 2-year RFS analysis. AISI was calculated from preoperative blood counts, and hsa_circ_0076251 levels were quantified via qRT- PCR. Multivariate Cox regression and ROC curve analyses were used to identify independent predictors and assess diagnostic performance. Adjuvant chemotherapy was included as a covariate in the multivariable analysis. Internal validation was performed using bootstrap resampling and 10-fold cross-validation.Results: Fifty- one patients (32.7%) experienced recurrence. High AISI (≥ 520; 93 HR=2.71, 95% CI: 1.58– 4.66, P< 0.001) and low hsa_circ_0076251 (< 0.65; HR=2.29, 95% CI: 1.32– 3.95, P=0.003) were 94 independent predictors of poor recurrence- free survival after adjustment for T stage, 95 N stage, CEA, and adjuvant chemotherapy. The combined model achieved an apparent AUC of 0.82 (95% CI: 0.75– 0.88) and an optimism-corrected AUC of 0.78 (95% CI: 0.70– 0.85) by bootstrap resampling; these results require external validation before clinical use. High-risk patients, identified by the combination of high AISI and low serum hsa_circ_0076251, had significantly lower 2-year recurrence-free survival rates compared to low-risk patients (45.2% vs 88.9%; P < 0.001). These findings require external validation before any clinical use can be considered.Conclusion: Preoperative AISI and serum hsa circ 0076251 are synergistic, independent biomarkers that may improve early CRC recurrence risk stratification. However, the current model is investigational and should not yet be used to guide adjuvant therapy or surveillance decisions until validated in independent, prospective, multi- center cohorts. These findings are preliminary and hypothesis-generating; they require prospective, multicenter, externally validated studies before routine clinical application. Preoperative AISI and serum hsa_circ_0076251 are synergistic, independent biomarkers that were associated with early CRC recurrence in this retrospective cohort. These findings are preliminary and hypothesis-generating and do not yet support clinical risk stratification or adjuvant therapy planning. However, this conclusion should be interpreted with caution because the present study was retrospective and single-center, and the model has not yet been externally validated.Plain Language Summary: Plain Language Summary This study examined whether two preoperative markers- the Aggregate Index of Systemic Inflammation (AISI) and serum hsa_circ_0076251- can predict the recurrence of stage II/III colorectal cancer within two years after surgery. We found that patients with higher AISI and lower hsa_circ_0076251 levels had a significantly greater risk of recurrence. Combining both markers improved prediction accuracy in this retrospective cohort and helped identify patients who might be considered for future research studies on closer follow- up or more intensive treatment. However, because this was a single-center retrospective study and the model has not been externally validated, these findings should not be used to guide treatment intensification, de-escalation, or surveillance in routine clinical practice. These findings suggest that a simple blood- based test might, after external validation, help inform postoperative risk assessment in colorectal cancer patients; however, clinical utility has not yet been established.Keywords: colorectal cancer, recurrence, systemic inflammation, circular RNA, biomarker
SN - 1179-1322
ER -