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Current Oncology
Volume 32
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10.3390/curroncol32020117
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Article

Gamma-Glutamyl Transferase Plus Carcinoembryonic Antigen Ratio Index: A Promising Biomarker Associated with Treatment Response to Neoadjuvant Chemotherapy for Patients with Colorectal Cancer Liver Metastases

by
Yanjiang Yin
1,2,
Bowen Xu
1,2,3,
Jianping Chang
1,
Zhiyu Li
1,
Xinyu Bi
1,
Zhicheng Wei
4,
Xu Che
4,* and
Jianqiang Cai
1,2,*
1
Department of Hepatobiliary Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
2
Key Laboratory of Gene Editing Screening and Research and Development (R&D) of Digestive System Tumor Drugs, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
3
Department of Hepatobiliary Surgery, General Surgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
4
Department of Hepatobiliary and Pancreatic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen 518116, China
*
Authors to whom correspondence should be addressed.
Curr. Oncol. 2025, 32(2), 117; https://doi.org/10.3390/curroncol32020117
Submission received: 28 December 2024 / Revised: 16 January 2025 / Accepted: 10 February 2025 / Published: 18 February 2025
(This article belongs to the Section Gastrointestinal Oncology)
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Abstract

Background: Colorectal cancer liver metastasis (CRLM) is a significant contributor to cancer-related illness and death. Neoadjuvant chemotherapy (NAC) is an essential treatment approach; however, optimal patient selection remains a challenge. This study aimed to develop a machine learning-based predictive model using hematological biomarkers to assess the efficacy of NAC in patients with CRLM. Methods: We retrospectively analyzed the clinical data of 214 CRLM patients treated with the XELOX regimen. Blood characteristics before and after NAC, as well as the ratios of these biomarkers, were integrated into the machine learning models. Logistic regression, decision trees (DTs), random forest (RF), support vector machine (SVM), and AdaBoost were used for predictive modeling. The performance of the models was evaluated using the AUROC, F1-score, and external validation. Results: The DT (AUROC: 0.915, F1-score: 0.621) and RF (AUROC: 0.999, F1-score: 0.857) models demonstrated the best predictive performance in the training cohort. The model incorporating the ratio of post-treatment to pre-treatment gamma-glutamyl transferase (rGGT) and carcinoembryonic antigen (rCEA) formed the GCR index, which achieved an AUROC of 0.853 in the external validation. The GCR index showed strong clinical relevance, predicting better chemotherapy responses in patients with lower rCEA and higher rGGT levels. Conclusions: The GCR index serves as a predictive biomarker for the efficacy of NAC in CRLM, providing a valuable clinical reference for the prognostic assessment of these patients.
Keywords: colorectal cancer liver metastases; neoadjuvant chemotherapy; biomarker; machine learning; treatment response colorectal cancer liver metastases; neoadjuvant chemotherapy; biomarker; machine learning; treatment response

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MDPI and ACS Style

Yin, Y.; Xu, B.; Chang, J.; Li, Z.; Bi, X.; Wei, Z.; Che, X.; Cai, J. Gamma-Glutamyl Transferase Plus Carcinoembryonic Antigen Ratio Index: A Promising Biomarker Associated with Treatment Response to Neoadjuvant Chemotherapy for Patients with Colorectal Cancer Liver Metastases. Curr. Oncol. 2025, 32, 117. https://doi.org/10.3390/curroncol32020117

AMA Style

Yin Y, Xu B, Chang J, Li Z, Bi X, Wei Z, Che X, Cai J. Gamma-Glutamyl Transferase Plus Carcinoembryonic Antigen Ratio Index: A Promising Biomarker Associated with Treatment Response to Neoadjuvant Chemotherapy for Patients with Colorectal Cancer Liver Metastases. Current Oncology. 2025; 32(2):117. https://doi.org/10.3390/curroncol32020117

Chicago/Turabian Style

Yin, Yanjiang, Bowen Xu, Jianping Chang, Zhiyu Li, Xinyu Bi, Zhicheng Wei, Xu Che, and Jianqiang Cai. 2025. "Gamma-Glutamyl Transferase Plus Carcinoembryonic Antigen Ratio Index: A Promising Biomarker Associated with Treatment Response to Neoadjuvant Chemotherapy for Patients with Colorectal Cancer Liver Metastases" Current Oncology 32, no. 2: 117. https://doi.org/10.3390/curroncol32020117

APA Style

Yin, Y., Xu, B., Chang, J., Li, Z., Bi, X., Wei, Z., Che, X., & Cai, J. (2025). Gamma-Glutamyl Transferase Plus Carcinoembryonic Antigen Ratio Index: A Promising Biomarker Associated with Treatment Response to Neoadjuvant Chemotherapy for Patients with Colorectal Cancer Liver Metastases. Current Oncology, 32(2), 117. https://doi.org/10.3390/curroncol32020117

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