Abstract Background Inflammatory-nutritional deterioration significantly influences the prognosis of Colorectal Cancer (CRC), affecting tolerance to treatment, immune response, and survival 1 The CONUT score, which combines albumin, lymphocytes, and cholesterol, reflects protein and immune reserve3 C-reactive Protein (CRP) is a sensitive marker of systemic inflammation and catabolism 4 and phase angle (PhA) shows cellular integrity 6 . Its integration using multivariate techniques enables a functional approach to the nutritional status of Cancer patients. Methods A cross-sectional study was carried out with CRC patients treated at the General Hospital of Mexico “Dr. Eduardo Liceaga”. The z-scores of CONUT, PCR and PhA were calculated, applying the K-means clustering analysis (k = 3). Groups were compared using ANOVA and the χ² test, and internal validity was assessed using the silhouette index. Results 57 patients were included in the study (54.4% men; mean age 59 ± 12 years; BMI 24.3 ± 3.6 kg/m2; PhA 6.0 ± 1.6°). The CONUT revealed immunonutritional alterations in 73.7% of cases (31.6% mild, 24.6% moderate, 17.5% severe). Multivariate K-means analysis (k = 3) identified three phenotypes: Normal Phenotype (n = 43): Low CONUT, moderate CRP, high PhA. Nutritional/Inflammatory Risk Phenotype (n = 13): High CONUT/CRP, low PhA. Atypical Phenotype (n = 1): Extreme case without clear clinical interpretation. Differences were highly significant for CRP (F = 42.0; p 0.001), CONUT (F = 27.4; p 0.001), and PhA (F = 19.1; p 0.001). The Nutritional/Inflammatory Risk phenotype presented significantly higher CRP (p 0.001), CONUT (p 0.001), and lower PhA (p 0.001) values. The risk phenotype had a much higher frequency of stages III–IV (61.5% vs. 30.2% in the Normal phenotype), showing a progressive gradient of nutritional deterioration associated with tumor progression. The relationship between phenotype and CONUT categories was significant (p 0.001). Conclusion Multivariate phenotyping based on CONUT, CRP and PhA allows the identification of clinically differentiable nutritional-inflammatory profiles applicable to clinical practice. The linear trend between the nutritional/inflammatory risk phenotype and advanced stages reflects progression from systemic inflammation to cellular deterioration. Together, offer a complementary, economical and applicable tool for risk stratification and personalization of nutritional support in oncology. It is recommended to validate the model in prospective studies to confirm its prognostic value and impact on survival. From a nutritional point of view, this model provides a practical tool for early detection of patients at risk for inflammatory-nutritional issues, individualized protein and anti-inflammatory support using PhA. References: 1. Wang Z, Bian J, Yuan J, Zhao S, Huang S, Wu R, et al. Study on the correlation between controlling nutritional status score and clinical biochemical indicators in patients with colorectal cancer. Heliyon. 2024;10. 2. He X-X, Su A, Xu Y, Diaolong, Yang G, Peng Y-C, et al. Prognostic Role of Lymphocyte-C-Reactive Protein Ratio in Colorectal Cancer: A Systematic Review and Meta Analysis. Frontiers in Oncology. 2022;12. 3. Mattiello R, Amaral MA, Mundstock E, Ziegelmann P. Reference values for the phase angle of the electrical bioimpedance: Systematic review and meta-analysis involving more than 250,000 subjects. Clinical nutrition. 2020. Conflict of interest: Mrs. Rivera, Ernestina: No conflict of interest Mendoza Martinez, Viridiana Montsserrat: No conflict of interest Baños Vazquez, Roberto: No conflict of interest Santoyo Chávez, Martha Alison: No conflict of interest De Leon Rendon, Jorge Luis: No conflict of interest Bueno Hernández, Nallely: No conflict of interest
Rivera et al. (Thu,) studied this question.