Abstract: Objective To explore the warning value of expression of phosphoglycerate mutase 1 (PGAM1), microRNA-433-3p (miR-433-3p) and cyclin-dependent kinase 1 (CDK1) in surgical specimens for early recurrence and metastasis after laparoscopic surgery for colorectal cancer (CRC). Methods Clinical materials of 120 patients with laparoscopic surgery for CRC were retrospectively analyzed. Based on the incidence status of recurrence and metastasis within one year after surgery, the patients were divided into recurrence group (n=31) and non-recurrence group (n=89). The clinical materials and the expression levels of PGAM1, miR-433-3p, and CDK1 in surgical specimens were compared between the two groups. Logistic regression analysis was conducted to explore the impacts of PGAM1, miR-433-3p and CDK1 on recurrence and metastasis after laparoscopic surgery for CRC. Receiver operating characteristic (ROC) curve was drawn to analyze the values of PGAM1, miR-433-3p and CDK1 alone as well as their combination for predicting recurrence andmetastasis after laparoscopic surgery, and external validation was performed. Results The levels of PGAM1 mRNA and CDK1 mRNA in the recurrence group were significantly higher than those in the non-recurrence group, while the level of miR-433-3p was significantly lower (P<0.05). Logistic regression analysis showed that PGAM1 mRNA (OR=1.387, 95%CI, 1.025 to 1.877), miR-433-3p (OR=0.543, 95%CI, 0.319 to 0.924), and CDK1 mRNA (OR=1.353, 95%CI, 1.108 to 1.651) were all independent factors associated with recurrence and metastasis after laparoscopic surgery for CRC (P<0.05). ROC curve analysis showed that the area under the curve (AUC) for the combined prediction of recurrence and metastasis after laparoscopic surgery for CRC by PGAM1 mRNA, miR-433-3p, and CDK1 mRNA was 0.904 (95%CI, 0.836 to 0.950), which was superior to the predictive performance of each indicator alone. Individual value prediction results indicated that CRC patients would experience early recurrence and metastasis after laparoscopic surgery under the condition of a diagnostic accuracy rate of 84.17%. External validation showed that the Kappa value between the combined prediction result and the actual clinical result was 0.864 (95%CI, 0.611 to 0.984), indicating good consistency. Conclusion The expression levels of PGAM1, miR-433-3p, and CDK1 in surgical specimens are all independent factors influencing early recurrence and metastasis after laparoscopic surgery for CRC patients, and their combined detection has high predictive value for postoperative recurrence and metastasis.