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C-反应蛋白-淋巴细胞比值对结直肠癌手术后院内死亡率的预测作用。

The predictive power of C-reactive protein- lymphocyte ratio for in-hospital mortality after colorectal cancer surgery.

机构信息

Department of Intensive Care Unit, Ankara Eğitim ve Araştırma Şehir Hastanesi, Ankara, Turkey.

Department of Gastrointestinal Surgery, Ankara Eğitim ve Araştırma Şehir Hastanesi, Ankara, Turkey.

出版信息

Cancer Rep (Hoboken). 2021 Jun;4(3):e1330. doi: 10.1002/cnr2.1330. Epub 2021 Feb 15.

Abstract

BACKGROUND

The relation between immunity, inflammation, and tumor development and progression has been emphasized in colorectal cancer widely and the prognosis is linked to the inflammatory reaction of the host as well as the biological behavior of the tumor.

AIM

In this study, we aimed to find out the predictive power of C-reactive protein- lymphocyte ratio (CLR) for in-hospital mortality after colorectal surgery.

METHODS AND RESULTS

A series of 388 CRC patients were enrolled in the present retrospective study which was conducted in a tertiary state Hospital in Ankara, Turkey. In-hospital mortality was the main outcome to evaluate the predictive power of inflammatory markers, while the other outcomes that would be evaluated as separate variables were LOS in hospital and LOS in ICU. In this study, there were 260 males and 128 females, and the mean age was 60.9. The in-hospital mortality rate was 3.4% (n = 13) and age, APACHE II score and Charlson comorbidity index score were related to in-hospital mortality statistically. The mean LOS in the hospital was 13.9 days and LOS in ICU was 4.5 days. The CRP levels and the CLR levels were higher both in the preoperative and postoperative periods in the mortality (+) group and the difference was significant statistically (P = .008/ .002 and .004/ <.001, respectively). CLR in the postoperative period had the best predictive power with AUC: 0.876.

CONCLUSION

In conclusion, within the context of our study there appears to be a relationship between CLR, as measured on day 2 postoperatively, and in-hospital mortality. It is observed to be more effective than NLR, ALC, and CRP.

摘要

背景

免疫、炎症与肿瘤的发生发展之间的关系在结直肠癌中得到了广泛的强调,其预后与宿主的炎症反应以及肿瘤的生物学行为有关。

目的

本研究旨在探讨 C 反应蛋白-淋巴细胞比值(CLR)对结直肠手术后院内死亡率的预测能力。

方法和结果

本回顾性研究纳入了 388 例在土耳其安卡拉的一家三级州立医院接受治疗的 CRC 患者。以院内死亡率作为评估炎症标志物预测能力的主要结局,而 LOS 住院和 LOS ICU 作为单独变量进行评估。本研究中,男性 260 例,女性 128 例,平均年龄为 60.9 岁。院内死亡率为 3.4%(n=13),年龄、APACHE II 评分和 Charlson 合并症指数评分与院内死亡率有统计学关联。住院平均 LOS 为 13.9 天,ICU 平均 LOS 为 4.5 天。在死亡率(+)组中,CRP 水平和 CLR 水平在术前和术后均升高,且差异具有统计学意义(P=0.008/0.002 和 0.004/<0.001)。术后 CLR 具有最佳的预测能力,AUC 为 0.876。

结论

总之,在本研究背景下,术后第 2 天测量的 CLR 与院内死亡率之间似乎存在关联,且比 NLR、ALC 和 CRP 更有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/727a/8222561/3e80ef7b79ca/CNR2-4-e1330-g002.jpg

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