Department of Surgery, Shiga University of Medical Science, Shiga, Japan.
Medical Safety Section, Shiga University of Medical Science Hospital, Shiga, Japan,
Dig Surg. 2021;38(1):80-86. doi: 10.1159/000511908. Epub 2020 Nov 26.
Procalcitonin (PCT) is a well-known marker for bacterial infection; however, the clinical significance of PCT in the long-term prognosis after colorectal cancer (CRC) surgery remains unclear.
This is a retrospective review of 277 patients that underwent CRC surgery to investigate the relationship between preoperative PCT, clinicopathological condition, cancer-specific overall survival (OS), and relapse-free survival (RFS).
Median follow-up interval was 5.0 years in all patients. Thirty-six patients developed recurrence, and 46 patients died due to recurrences or metastases of CRC. Preoperative PCT levels were highest in Stage IV patients. The cancer-specific OS in patients with Stage IV/PCT ≤0.05 ng/mL was significantly higher than those with Stage IV/PCT >0.05 ng/mL (3 years survival; 42.3 vs. 14.3%, p = 0.0413). On multivariate analysis, gender, TNM classification, and PCT were identified as significant risk factors for cancer-specific OS in patients with Stage I-III CRC. The cancer-specific OS rate of these patients with PCT ≥0.08 ng/mL, compared with PCT <0.08 ng/mL, was significantly decreased (5 years survival; 59.1 vs. 92.7%, p < 0.0001). TNM classification was finally identified as an independent risk factor for cancer-specific RFS in these patients by multivariate analysis.
High preoperative PCT values in CRC patients appeared to be associated with poor OS but not RFS following surgical treatments.
降钙素原（PCT）是细菌感染的一个众所周知的标志物；然而，PCT 在结直肠癌（CRC）手术后长期预后中的临床意义尚不清楚。
这是一项对 277 例接受 CRC 手术的患者进行的回顾性研究，旨在探讨术前 PCT 与临床病理状况、癌症特异性总生存（OS）和无复发生存（RFS）之间的关系。
所有患者的中位随访间隔为 5.0 年。36 例患者复发，46 例患者因 CRC 复发或转移而死亡。IV 期患者的术前 PCT 水平最高。IV 期/PCT≤0.05ng/ml 患者的癌症特异性 OS 明显高于 IV 期/PCT>0.05ng/ml 患者（3 年生存率：42.3%vs.14.3%，p=0.0413）。多因素分析显示，性别、TNM 分期和 PCT 是 I-III 期 CRC 患者癌症特异性 OS 的显著危险因素。与 PCT<0.08ng/ml 的患者相比，PCT≥0.08ng/ml 的患者癌症特异性 OS 率显著降低（5 年生存率：59.1%vs.92.7%，p<0.0001）。多因素分析最终确定 TNM 分期是这些患者癌症特异性 RFS 的独立危险因素。
CRC 患者术前 PCT 值较高似乎与手术治疗后 OS 不良有关，但与 RFS 无关。
