本研究旨在探讨全免疫炎症值（PIV）对接受新辅助放化疗（nCRT）和全直肠系膜切除的局部晚期直肠癌（LARC）患者的预后价值。我们回顾性收集并分析了215例切除的LARC患者的临床病理资料。 X-tile 软件用于确定 PIV 预测总生存期 (OS) 的最佳阈值。评估了 PIV 对病理完全消退 (pCR)、OS 和无病生存 (DFS) 的预测能力，并与其他炎症标志物进行比较。对 pCR 进行单变量和多变量逻辑回归分析，对 OS 和 DFS 进行 Cox 回归分析。根据 X-tile 软件确定 PIV 的最佳阈值为 454.7。然后将患者分为低 PIV 组 (≤ 454.7) 和高 PIV 组 (> 454.7)，分别由 153 名患者和 62 名患者组成。与其他炎症标志物相比，PIV 对 pCR、OS 和 DFS 表现出卓越的预测能力。与高 PIV 患者相比，低 PIV 的 LARC 患者的 pCR (P = 0.029)、OS (P = 0.002) 和 DFS (P = 0.001) 率显着更高。多变量回归分析将 PIV 确定为 pCR（比值比 = 0.32；95% 置信区间 [CI]，0.10-0.80；P = 0.014）、OS（风险比 = 3.08；95% CI，1.77-5.35；P = 0.014）的独立预后因素。 P = 0.001）和 DFS（风险比 = 2.53；95% CI，1.58-4.06；P = 0.002）。这项研究证实，术前 PIV 可以作为接受 nCRT 治疗的 LARC 患者的一个有用的独立预后因素。

This study aimed to investigate the prognostic value of the pan-immune-inflammation value (PIV) in patients with locally advanced rectal cancer (LARC) who received neoadjuvant chemoradiotherapy (nCRT) followed by total mesorectal excision. We retrospectively collected and analyzed the clinicopathological data of 215 resected LARC patients. X-tile software was used to determine the optimal threshold value for PIV in predicting overall survival (OS). The predictive ability of PIV for pathological complete regression (pCR), OS, and disease-free survival (DFS) was evaluated and compared with other inflammation markers. Univariate and multivariate logistic regression analyses for pCR and Cox regression analyses for OS and DFS were conducted. The optimal threshold value for PIV was determined to be 454.7 based on the X-tile software. Patients were then categorized into low (≤ 454.7) and high (> 454.7) PIV groups comprising 153 and 62 patients, respectively. PIV demonstrated superior predictive ability for pCR, OS, and DFS compared to other inflammation markers. LARC patients with low PIV had significantly higher pCR (P = 0.029), OS (P = 0.002), and DFS (P = 0.001) rates compared to those with high PIV. Multivariate regression analysis identified PIV as an independent prognostic factor for pCR (odds ratio = 0.32; 95% confidence interval [CI], 0.10-0.80; P = 0.014), OS (hazard ratio = 3.08; 95% CI, 1.77-5.35; P = 0.001), and DFS (hazard ratio = 2.53; 95% CI, 1.58-4.06; P = 0.002). This study confirmed that preoperative PIV could serve as a useful independent prognostic factor in LARC patients treated with nCRT.