To analyze the predictive value of preoperative serum alpha-fetoprotein (AFP), plasma fibrinogen to prealbumin ratio (FPR), carcinoembryonic antigen (CEA) and postoperative D-dimer (D-D) for the recurrence of colon cancer patients within one year after operation, and to evaluate their efficacy.

A total of 120 patients with colon cancer admitted to Suzhou Hospital, Affiliated Hospital of Medical School, Nanjing University and Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine from July 2019 to December 2022 were selected and divided into recurrence group and non-recurrence group according to their recurrence one year after operation. The general data, pathological features, preoperative AFP, FPR, CEA and postoperative D-D were compared between the two groups. Logistic multivariate regression model was used to summarize the related factors affecting the recurrence of patients one year after operation. A function model was established based on risk factors, a Nomogram diagram was drawn and a prediction model was established. C index was used to evaluate the model discrimination, decision curve was used to analyze the model income, and X-lite was used to evaluate the disease-free survival time (DFS) of patients with different risks.

All 120 patients were followed up effectively, with a median follow-up time of 17 months. During the follow-up period, 31 patients reached the recurrence standard, and the recurrence rate was 25.83%. Multivariate regression analysis showed that TNM stage Ⅲ-Ⅳ, tumor invading serosa, preoperative AFP≥10 μg/L, FPR≥18, CEA≥9.7 ng/mL and postoperative D-D≥3.1 mg/L were all independent risk factors for recurrence of colon cancer patients within one year after operation (P<0.05). The C index of Nomogram model was 0.868, and the discrimination was good. The analysis of decision curve showed that the model had good net income and was suitable for clinical decision-making. Patients were divided into high-risk group (>75 points) and low-risk group (≤75 points) according to the total score. DFS in high-risk group was significantly shorter than that in low-risk group (P<0.05).

High preoperative AFP, FPR, CEA and postoperative D-D are related to the increased risk of recurrence in patients with colon cancer within one year after operation. Combining the above indexes and pathological features can provide reliable reference for recurrence prediction of patients.