Colorectal cancer (CRC) ranks as the third most prevalent malignancy worldwide, and its incidence rate is on the rise (1). In 2018, there were 18.1 million new cancer cases globally, with CRC ranking fourth among them. Given this prevalence, understanding the pathogenesis of CRC and developing practical treatment approaches is crucial (2, 3). The development of CRC is complex, involving genetic and environmental factors that work together to promote abnormal growth in colorectal tissue, leading to tumor formation. Environmental factors, particularly dietary habits, exposure to radiation, and environmental toxins, significantly influence CRC development. High-calorie, high-fat diets, coupled with disruptions in intestinal microbiota and local inflammation, are critical factors in initiating CRC (4).

The impact of dietary factors on CRC is significant (5). Prolonged consumption of high-calorie, high-fat diets can disrupt the balance of intestinal bacteria and lead to local inflammation, creating an environment conducive to CRC development. Chronic inflammation resulting from prolonged synthesis of pro-inflammatory cytokines is a crucial contributor to autoimmune diseases and cancer (6). Addressing this inflammation and restoring immune balance is critical in preventing complications. In conclusion, given the global burden of CRC and its multifaceted etiology involving genetic and environmental factors, particularly dietary habits and inflammation, there is an urgent need to explore dietary interventions that can mitigate inflammation, prevent associated complications, and restore immune balance effectively (7).

In the context of postoperative care for CRC patients, the role of dietary fiber is pivotal due to its impact on intestinal health (8). Dietary fiber plays a crucial role in safeguarding the intestinal barrier, regulating immune function, and mitigating postoperative inflammatory reactions (9). Despite these benefits, limited research exists on the early integration of dietary fiber into CRC patient management post-surgery. Malnutrition not only hampers recovery but also heightens the risk of complications and mortality rates. Moreover, immune suppression could potentially enhance the chances of tumor metastasis and recurrence. Consequently, providing early nutritional support after CRC surgery is paramount. In recent years, the advancement of machine learning has led to the widespread application of algorithms such as Random Forest (RF), Logistic Regression (LR), Support Vector Machine (SVM), and Neural Network (NN) in clinical research (10). These algorithms facilitate the development of disease diagnosis and prediction models, thereby enhancing decision-making processes (11). This study aimed to investigate the effects of dietary fiber on postoperative immune function and inflammatory responses in CRC patients, identify critical factors influencing CRC, and offer valuable insights for the prevention and management of CRC.

This study analyzed the impact of dietary fiber intake on the postoperative nutritional status of CRC patients. The levels of PCT, β-EP, CRP, IL-1, IL-8, and TNF-α in the observation group were significantly lower compared to those in the control group (p < 0.01). Furthermore, we developed LR, RF, NN, and SVM models, which demonstrated excellent performance in predicting and diagnosing CRC. The NN model outperformed the others, achieving an AUC of 0.851 in training and 0.861 in testing. PCT, PAB, ALB, and IL-1 are key factors for predicting CRC patients.

CRC is a common malignant disease that impacts the digestive system and is frequently managed through laparoscopic surgery to improve patient health and prolong survival (12). Although malnutrition is common among CRC patients, originating from the disease and surgical procedures, as well as the possibility of exacerbation by anesthetic drugs and stress responses during surgery, addressing these concerns is vital (13, 14). Due to the substantial malnutrition rates in CRC patients stemming from the disease and surgical impacts, compounded by possible exacerbation by anesthesia and surgical stress responses, addressing these issues directly is paramount. Changes in the gut microbiota, influenced by factors like surgical anesthesia and surgical stress responses, may result in dysbiosis and worsen malnutrition, increasing the risk of postoperative infections and inflammation, which can hinder patient recovery and long-term outlook (15).

Implementing scientifically proven nutritional support strategies is crucial to improve postoperative nutritional wellbeing in patients (16). These interventions include preoperative nutritional assessments, perioperative nutritional support, and the utilization of appropriate diets and intestinal nutritional supplements. Tailored nutritional plans should be created according to the individual conditions and dietary requirements of each patient. Nutritional improvements can be achieved through dietary modifications, oral supplements, and other appropriate approaches before surgery. Enteral or parenteral nutritional support can be administered during and after surgery to fulfill the patient’s energy, protein, and other dietary needs. Vigilant monitoring of patients’ nutritional statuses and relevant indicators is essential to adjust intervention plans as needed in a timely.

Early intestinal nutritional support is crucial for accelerating gastrointestinal function recovery during postoperative care of CRC patients (17). Research has shown that promptly initiating soluble dietary fiber for enteral nutrition offers advantages, including improved nutritional markers, gradual weight loss, and a lower incidence of gastrointestinal complications. These interventions have significantly improved nutritional wellbeing after surgery, leading to a reduction in complications. Dietary fibers are more than inert plant materials in the human digestive system; they interact actively with nutrients, generating beneficial metabolites, regulating nutrient absorption, and stimulating the growth of small intestine villi (18). This interactive process leads to increased nutrient absorption and an overall enhancement in nutritional status. Categorized as soluble or insoluble, these fibers exhibit specific traits - soluble fibers undergo fermentation easily, unlike insoluble fibers. Recent studies have highlighted the significance of colon dietary fiber fermentation, resulting in the synthesis of short-chain fatty acids (19). These fatty acids, after transportation to the liver through the portal venous system, can be transformed into glutamine, a vital nutrient that directly nourishes the small intestine through the bloodstream, enhancing nutritional absorption and overall wellbeing (20).

Enteral nutrition support containing dietary fiber can prevent the occurrence of intestinal flora disorder, effectively inhibit the reproduction of intestinal pathogenic bacteria, and promote the growth of probiotics (21, 22). The findings of this study indicated that following the intervention, the levels of PCT, β-EP, CRP, IL-1, IL-8, and TNF-α were lower in the observation group compared to the control group. Contrastingly, there was an increase in the levels of Hb, ALB, PA and TRF, particularly notable post-14 days (p < 0.01). This indicates that enteral nutrition support with dietary fiber can reduce the infection stress response and inflammatory factor levels of patients after laparoscopic CRC surgery, promote the improvement of the nutritional status of patients, accelerate the recovery of intestinal function (23, 24).

In response to appropriate dietary fiber intake, gastrointestinal hormones are boosted, aiding in the restoration of intestinal motility following CRC surgery (25). Studies suggest that such fiber intake heightens small intestine activity significantly. Our observations reveal shortened intervals for gas passage post-surgery in the dietary fiber group compared to controls (47.74 ± 5.23 h vs. 59.89 ± 5.11 h, p < 0.01). Similarly, the dietary fiber group displayed quicker recovery of intestinal sounds (25.31 ± 3.36 h vs. 34.26 ± 3.57 h, p < 0.01), indicative of enhanced intestinal peristalsis recovery. Inflammation signifies the body’s acute reaction to tissue injury induced by microbial infections and other harmful triggers (26). This study aims to explore dietary fiber’s impact on postoperative immune function and inflammatory responses in CRC patients. Our findings depict a notable decline in immune parameters for both patient groups by the seventh postoperative day, reflecting a potential compromise in immune functionality. However, by the 14th day, these indices showcased gradual improvement. Notably, on the 14th-day post-surgery, the observation group exhibited significantly elevated levels of CD4+, IgA, and IgG in comparison to the control group (39.21 ± 6.67 vs. 35.15 ± 6.21, 3.19 ± 0.69 vs. 2.53 ± 0.60 g/L, and 10.93 ± 3.53 vs. 9.03 ± 7.78 g/L, respectively, p < 0.01). This underscores the role of dietary fiber in enhancing immune responses and bolstering humoral and cellular immunity postoperatively (27, 28). Moreover, dietary fiber improves postoperative gastrointestinal motility, reducing the chances of abdominal distension and diarrhea (29). This nutritional intervention method ensures patient safety throughout the perioperative phase and promotes swift recovery.

Recently, artificial intelligence has made significant advancements in medicine (30–33). Machine learning utilizes clinical data attributes and algorithms to predict outcomes and develop models (34). Comparing different algorithms can enhance the accuracy of clinical predictions. This technology analyzes diverse data modules to identify outcome-related variables, discover risk factors, and explore patterns, facilitating the iterative refinement of mathematical models. This research seeks to develop a cost-effective and highly accurate diagnostic system for colorectal cancer CRC, with the intention of aiding clinicians in making timely and informed decisions (35). We utilized clinical outcomes from CRC patients to construct four machine learning models—LR, RF, NN, and SVM—to predict the impact of dietary fiber on postoperative immune function and inflammation. The NN model outperformed the others, achieving an AUC of 0.851 in training and 0.861 in testing. Consequently, the NN model was selected as the final model due to its superior performance.

Recently, many experts have used predictive models to assess the impact of variables on outcome indicators, achieved through variable importance scoring (36, 37). The higher the importance score of a variable, the more significant its impact on the model’s prediction results. This study visualized weights using NN model, with the level of variable importance being positively correlated with the length of the bar in the bar chart. The results revealed that the top four variables were PCT, PAB, ALB, and IL-1, indicating that these variables have a significant impact on the prediction of CRC.

Early postoperative intake of dietary fiber is feasible for improving the condition of CRC patients. The LR, RF, NN, and SVM models developed in this study reliably diagnosed CRC, with the NN model showing the highest accuracy. Machine learning models offer considerable clinical value in diagnosing and predicting CRC and are anticipated to serve as supplementary treatment options for patients.