Man Wenhao, Lin Huajun, Liu Zhao, Jin Lei, Wang Jin, Zhang Jun, Bai Zhigang, Yao Hongwei, Zhang Zhongtao, Deng Wei
Department of General Surgery, Beijing Friendship Hospital, Capital Medical University and National Clinical Research Center for Digestive Diseases, Beijing 100050, People's Republic of China.
Cancer Manag Res. 2020 Feb 11;12:1029-1038. doi: 10.2147/CMAR.S234448. eCollection 2020.
We aimed to investigate the value of inflammation-based prognostic scores for predicting early complications after radical surgery for colorectal carcinoma.
We retrospectively analyzed data of 154 patients who underwent elective resection of colorectal carcinoma between January 2017 and December 2018 at Beijing Friendship Hospital. Univariate, multivariate, and receiver operating characteristic curve analyses were conducted. As inflammation indices, we evaluated the preoperative modified Glasgow Prognostic Score (GPS), as well as the C-reactive protein/albumin ratio (CAR), postoperative GPS, and C-reactive protein levels on postoperative day 3 (POD3).
Within 30 days postoperatively, complications occurred in 80 patients (51.9%). And high levels of preoperative mGPS (P=0.002), preoperative CAR (P=0.019), POD3 CAR (P<0.001) and POD3 poGPS (P<0.001) can significantly affect postoperative complications after surgery for colorectal cancer, with CRP on POD3 (odds ratio, 1.015; 95% confidence interval, 1.006-1.024; P=0.001) as independent risk factors. Among all inflammation-based indicators, POD3 CAR had the highest area under the curve (0.711) and positive predictive value (83.2%). Higher CAR (≥2.6) on POD3 was associated with a higher rate of complications (92.9% vs 36.6%, P<0.001), especially of infectious nature (54.8% vs 16.1%, P<0.001).
CAR≥2.6 on POD3 reflects sustained systemic inflammation and represents a useful predictor of complications after surgery for colorectal carcinoma, facilitating early detection, timely intervention, and enhanced recovery.
我们旨在研究基于炎症的预后评分对预测结肠癌根治术后早期并发症的价值。
我们回顾性分析了2017年1月至2018年12月在北京友谊医院接受择期结肠癌切除术的154例患者的数据。进行了单因素、多因素和受试者工作特征曲线分析。作为炎症指标，我们评估了术前改良格拉斯哥预后评分（GPS）、C反应蛋白/白蛋白比值（CAR）、术后GPS以及术后第3天（POD3）的C反应蛋白水平。
术后30天内，80例患者（51.9%）发生并发症。术前mGPS水平高（P=0.002）、术前CAR水平高（P=0.019）、POD3 CAR水平高（P<0.001）和POD3术后GPS水平高（P<0.001）可显著影响结肠癌手术后的术后并发症，POD3时的CRP（比值比，1.015；95%置信区间，1.006 - 1.024；P=0.001）为独立危险因素。在所有基于炎症的指标中，POD3 CAR的曲线下面积最高（0.711），阳性预测值最高（83.2%）。POD3时较高的CAR（≥2.6）与较高的并发症发生率相关（92.9%对36.6%，P<0.001），尤其是感染性并发症（54.8%对16.1%，P<0.001）。
POD3时CAR≥2.6反映持续的全身炎症，是结肠癌手术后并发症的有用预测指标，有助于早期发现、及时干预和促进康复。
