Department of Digestive Surgical Oncology, University Hospital and School of Medicine, CHU Dijon Bourgogne, 14, rue Paul-Gaffarel, 21079 Dijon cedex, France.
INSERM CIC-EC 1432 Clinical Investigation, Clinical Epidemiology Unit, Dijon University Hospital, Dijon, France; Department of Internal medicine and systemic disease, Dijon University Hospital, Dijon, France.
J Visc Surg. 2021 Aug;158(4):305-311. doi: 10.1016/j.jviscsurg.2020.08.001. Epub 2021 Jan 11.
We know that inflammation is related to colorectal cancer prognosis and to the onset of postoperative infections.
This study aimed to understand the relationship between preoperative inflammation and the prognosis of colorectal cancer and to elucidate whether the impact of inflammation on cancer prognosis was related to an increased risk of surgical infection or was independent of it.
Patients who underwent elective colorectal cancer surgery between November 2011 and April 2014 were included in a prospective database (IMACORS). Preoperative c reactive protein was collected for each patient. Patients were followed up according to the French national guidelines. A cut-off of preoperative CRP of 5mg/L was chosen. Clinical characteristics were compared according to CRP using Chi and Mann-Whitney tests. The Overall Survival (OS) and Disease-Free-Survival (DFS) were compared by Kaplan-Meier curves. A Cox proportional hazards regression model was applied to perform a multivariate analysis of OS and DFS's predictors.
A total of 254 patients were included. The median age was 68 years old. The median follow up was 41.8 months. The overall median preoperative CRP was 5mg/L. Preoperative CRP was significantly associated with N status; CRP being significantly higher among patients with colonic cancer and with patients who didn't receive a neoadjuvant treatment. Multivariate analyse revealed that preoperative CRP is an independent prognostic factor of OS and DFS respectively (HR=2.34 (1.26-4.31), P=0.006 and HR=1.83 (1.15-2.90), P=0.01).
Preoperative inflammation measured by CRP is independently related with overall and disease-free survival of colorectal cancer.
我们知道炎症与结直肠癌的预后以及术后感染的发生有关。
本研究旨在了解术前炎症与结直肠癌预后之间的关系，并阐明炎症对癌症预后的影响是否与手术感染风险增加有关，或者是否独立于手术感染风险。
纳入 2011 年 11 月至 2014 年 4 月间行择期结直肠癌手术的患者，进入前瞻性数据库（IMACORS）。为每位患者采集术前 C 反应蛋白。根据法国国家指南对患者进行随访。选择术前 CRP 截断值为 5mg/L。根据 CRP 使用卡方和曼-惠特尼检验比较临床特征。通过 Kaplan-Meier 曲线比较总生存（OS）和无病生存（DFS）。应用 Cox 比例风险回归模型对 OS 和 DFS 的预测因素进行多因素分析。
共纳入 254 例患者，中位年龄为 68 岁，中位随访时间为 41.8 个月。总体中位术前 CRP 为 5mg/L。术前 CRP 与 N 分期显著相关；CRP 在结直肠癌患者和未接受新辅助治疗的患者中显著升高。多因素分析显示，术前 CRP 是 OS 和 DFS 的独立预后因素（HR=2.34（1.26-4.31），P=0.006 和 HR=1.83（1.15-2.90），P=0.01）。
CRP 测定的术前炎症与结直肠癌的总生存和无病生存独立相关。
