Objective To investigate the prognostic value of preoperative neutrophil - to - lymphocyte ratio NLR and carcinoembryonic antigen CEA in patients with concurrent colorectal cancer liver metastases. Method The clinicopathological data of patients with concurrent colorectal cancer liver metastases who underwent liver resection in our hospital from August 2012 to December 2017 were retrospectively analyzed and X-TILE software was used to calculate the best cut-off value of NLR. Kaplan-Meier method and Log-rank test were used to draw and compare different survival curves and COX proportional hazards regression model was used to analyze independent prognostic factors. The time dependent area under ROC curve t - AUC is used to draw and compare the prognostic value of different indicators also in combination. Result A total of 122 patients with concurrent liver metastases from colorectal cancer were included in this study. After calculation the best cut-off value for NLR for prognostic stratification is 2. 1. The preoperative higher NLR was correlated with higher pathological T staging P= 0. 037 but compared with the low NLR group there was no significant difference in other indicators all P > 0. 05 . Univariate survival analysis showed that preoperative NLR level maximum liver metastasis diameter colorectal cancer pT stage lymph node metastasis and preoperative CEA level were correlated with the prognosis of patients with concurrent colorectal cancer liver metastasis all P<0. 05 multivariate Survival analysis the number of liver metastases HR= 1. 644 95%CI = 1. 063-2. 542 P= 0. 025 lymph node metastases HR= 1. 76 95%CI = 1. 045-2. 965 P = 0. 034 CEA≥3. 4 μg / L HR= 1. 611 95%CI = 1. 054-2. 460 P= 0. 028 and NLR≥2. 1 HR= 1. 625 95%CI = 1. 044-2. 539 P= 0. 033 are the prognosis of patients with liver metastases from concurrent colorectal cancer Independent risk factors. When NLR ·80· 肿瘤代谢与营养电子杂志 2023 年 2 月 9 日第 10 卷第 1 期 Electron J Metab Nutr Cancer, Feb. 9, 2023, Vol. 10, No. 1 predicts patient prognosis t-AUC is 60. 89% ~ 66. 41% CEA is 58. 15%-66. 41% and t-AUC is 64. 53%-68. 36% when the two indicates are combined. In addition the C-index of CEA in predicting the prognosis of patients was 0. 648 95%CI = 0. 543-0. 752 and the NLR was 0. 688 95%CI = 0. 583-0. 795 . There was no significant difference between the two indicates P = 0. 29 . When combination CEA and NLR to predict the prognosis the C-index could be increased to 0. 69 95%CI = 0. 586-0. 795 . However there was no statistical difference when compared with CEA P = 0. 12 or NLR P = 0. 52 alone respectively. Conclusion The elevate of preoperative NLR or CEA is closely related to the poor prognosis of patients with concurrent colorectal cancer liver metastases. The combined use of preoperative NLR and CEA can improve the accuracy of predicting the prognosis of patients.