Prognostic value of Creatine Kinase (CK)-MB to total-CK ratio in colorectal cancer patients after curative resection

Abstract

Abstract Objectives: This study aimed to evaluate the prognostic significance of postoperative Creatine Kinase (CK)-MB to total-CK ratio (CK-MB/CK) in colorectal cancer (CRC) patients after radical resection. Methods: This was a single-center retrospective cohort analysis. Subjects were stage I-III CRC patients hospitalized in Sichuan Cancer Hospital from January 2017 to May 2021. The overall survival (OS) and disease-free survival rate (DFS) were analyzed between two groups according to the serum CK-MB/CK levels after surgery. Cox regression analyses, Kaplan-Meier method, and receiver-operating characteristic (ROC) curve were performed. Results: CK-MB/CK was the strongest independent prognostic factor for OS and DFS. Compared to the normal group (n = 1177), the elevated group (n = 95) had worse OS (HR, 5.64; p < 0.0001) and DFS (HR, 8.34; p < 0.0001). For the diagnosis of hepatic metastases after surgery, the ROC area under the curve (AUC) of CK-MB/CK was 0.720 (p < 0.001). When CK-MB/CK > 1.01, the specificity was 94.84% and the negative predictive value (NPV) was 96.7%. Combined CK-MB/CK and CA19-9, the AUC value increased from 0.720 to 0.799 (p = 0.036), with a sensitivity of 77.46% and a specificity of 97.25%. Conclusions: CRC patients with elevated CK-MB/CK had a worse prognosis after radical resection. CK-MB/CK might be a new biomarker for the diagnosis of hepatic metastasis in CRC patients after surgery, with high specificity and NPV.