Objective: To study the value of serum albumin / globulin ratio (AGR), carcinoembryonic antigen (CEA), glycoantigen (CA) 199 and macrophage inhibitory cytokine-1 (MIC-1) expression in the diagnosis and prognostic evaluation of elderly colorectal cancer. Methods: 60 cases of elderly colorectal cancer patients admitted to our hospital from March 2020 to December 2022 were selected as the observation group. According to the prognosis of patients, they were divided into good prognosis group (36 cases) and poor prognosis group (24 cases), and 58 healthy patients to our hospital for physical examination in the same period were selected as the control group. We compared AGR, CEA, CA199 and MIC-1 expression levels in the observation and control groups, compared the AGR, CEA, CA199,1 and MIC-1 expression levels, general clinical data between the good and poor prognosis groups, and analyzed the relationship between AGR, CEA, CA199 and MIC-1 expression and prognostic outcome in elderly colorectal cancer patients by Logistic regression model. Results: Comparison of previous targeted therapy, gender, age, tumor family history, tumor location, distance between tumor and anal margin in patients with poor prognosis, Not statistically significant difference (P>0.05), Patients in the good prognosis group with high differentiation, TNM stage ⅠⅡ and lymph node metastasis were lower than the poor prognosis group, Statistically significant difference (P<0.05), The AGR in the good prognosis group was higher than that in the poor prognosis group, Statistically significant difference (P<0.05), CA199, CEA level, and positive MIC-1 expression were lower than those in the poor prognosis group, Statistically significant (P<0.05) observation group patients had lower AGR than the control group, Statistically significant difference (P <0.05), The proportion of CA199, CEA level and positive MIC-1 expression were higher than those in the control group, Statistically significant difference (P<0.05), Logistic The regression analysis showed TNM stage, AGR, CEA, and CA199 as the factors influencing the prognosis of elderly colorectal cancer patients (P<0.05). The ROC area under the curve of Logistic regression model jointly predicting poor prognosis in elderly colorectal cancer patients was 0.954, which was significantly higher than the area of 0.683, 0.866, 0.918, and 0.909 (P<0.05). Conclusion: Decreased serum AGR and increased CEA and CA199 levels are related to poor prognosis in elderly colorectal cancer, and the combination of various indicators can predict poor prognosis in elderly colorectal cancer patients. [ABSTRACT FROM AUTHOR]