C-反应蛋白与白蛋白比值对胰十二指肠切除术后胰瘘的预测意义。
Predictive Significance of C-reactive Protein-to-albumin Ratio for Postoperative Pancreatic Fistula After Pancreaticoduodenectomy.
机构信息
Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan.
出版信息
Anticancer Res. 2019 Nov;39(11):6283-6290. doi: 10.21873/anticanres.13838.
BACKGROUND/AIM: The usefulness of C-reactive protein-to-albumin ratio (CAR) as a predictive indicator for clinically-relevant postoperative pancreatic fistula (CR-POPF) after pancreaticoduodenectomy (PD) is unclear. We performed a retrospective analysis to identify reliable inflammatory indicators for prediction of CR-POPF after PD.
PATIENTS AND METHODS
We enrolled 160 consecutive patients who underwent PD. Multivariate logistic regression analysis was performed. The areas under curves (AUCs) were compared with the discriminatory ability of inflammatory indicators, namely, C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), platelet count multiplied by C-reactive protein (P-CRP), and CAR.
RESULTS
The AUC for CAR on POD 3 to predict CR-POPF was 0.782 (p<0.001) and higher than that for CRP (0.773), NLR (0.652), PLR (0.504), and P-CRP (0.703). Multivariate analysis revealed that CAR on POD 3 was an independent predictive indicator of CR-POPF.
CONCLUSION
CAR on POD 3 is a reliable predictor of CR-POPF after PD.
背景/目的：C 反应蛋白与白蛋白比值（CAR）作为胰十二指肠切除术（PD）后临床相关胰瘘（CR-POPF）的预测指标的实用性尚不清楚。我们进行了一项回顾性分析，以确定预测 PD 后 CR-POPF 的可靠炎症指标。
患者与方法
我们纳入了 160 例连续接受 PD 的患者。进行了多变量逻辑回归分析。比较了炎症指标（C 反应蛋白（CRP）、中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、血小板计数乘以 C 反应蛋白（P-CRP）和 CAR）的 AUC 以评估其预测 CR-POPF 的能力。
结果
术后第 3 天 CAR 的 AUC 预测 CR-POPF 的曲线下面积为 0.782（p<0.001），高于 CRP（0.773）、NLR（0.652）、PLR（0.504）和 P-CRP（0.703）。多变量分析显示，术后第 3 天的 CAR 是 CR-POPF 的独立预测指标。
结论
术后第 3 天的 CAR 是 PD 后 CR-POPF 的可靠预测指标。
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