Department of Otorhinolaryngology Head and Neck Surgery, Konya Training and Research Hospital, University of Health Sciences, Konya, Turkey.
Department of Otorhinolaryngology, Kulu State Hospital, Konya, Turkey.
Acta Medica (Hradec Kralove). 2020;63(4):159-163. doi: 10.14712/18059694.2020.58.
We aimed to evaluate whether C-reactive protein(CRP)/ Albumin ratio (CAR) performed in the early postoperative period after total laryngectomy could be a predictive factor for the development of pharyngocutaneous fistula (PCF).
The files of patients with laryngeal squamous cell carcinoma who underwent total laryngectomy between January 2005 and January 2019 were retrospectively reviewed. Patients were divided into two groups: patients with PCF (PCF group) and without (Non-PCF group). CAR values and risk factors were compared between groups.
The overall incidence of PCF was 23.2%. There was a statistically significant difference between the two groups in terms of CRP and CAR levels (p = 0.001). The CAR value of 27.05 (sensitivity = 75.0% , specificity 68.2%, area under curve (AUC) = 0.742, 95% confidence interval 0.616-0.868) was determined as a cutoff value to describe the development of fistula in the early postoperative period. In multiple linear regression analysis, there was an independent relationship between presence of PCF and previous RT and CAR value.
CAR, performed in the early postoperative period, may be a new and useful marker for predicting PCF after total laryngectomy.
我们旨在评估在全喉切除术后早期的 C-反应蛋白（CRP）/白蛋白比值（CAR）是否可以作为预测咽皮瘘（PCF）发生的预测因子。
回顾性分析了 2005 年 1 月至 2019 年 1 月期间接受全喉切除术的喉鳞状细胞癌患者的病历。患者分为两组：发生 PCF（PCF 组）和未发生 PCF（非 PCF 组）。比较两组间 CAR 值和危险因素。
PCF 的总发生率为 23.2%。两组间 CRP 和 CAR 水平存在统计学差异（p = 0.001）。CAR 值 27.05（灵敏度为 75.0%，特异性为 68.2%，曲线下面积（AUC）为 0.742，95%置信区间为 0.616-0.868）被确定为描述术后早期瘘管形成的截断值。多元线性回归分析表明，PCF 的存在与既往放疗和 CAR 值之间存在独立关系。
术后早期的 CAR 值可能是预测全喉切除术后 PCF 的一个新的有用标志物。
