Jiangsu Cancer Hospital & 26481Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, 210009, PR China.
Huaian Hospital, Huaian, Jiangsu Province, 223200, PR China.
Int J Biol Markers. 2021 Jun;36(2):17246008211036128. doi: 10.1177/17246008211036128.
Serum bilirubin plays an important role in antioxidant and anticancer processes. The inverse association between serum bilirubin and cancer risk have been widely reported in multiple cancers. The aim of this retrospective study was to investigate the prognostic impact of serum bilirubin in colorectal cancer patients undergoing surgical resection.
The value of serum bilirubin including total bilirubin, direct bilirubin, and indirect bilirubin were tested at pre-operatively in 330 colorectal cancer patients. The optimal cut-off values for these three biomarkers were determined by X-tile program. The relationship between serum bilirubin and outcomes were examined using Kaplan-Meier curves log-rank test, univariate and multivariate cox regression. Moreover, a number of risk factors were used to form a nomogram for evaluating risk of survival.
The optimal cut-off points of serum total bilirubin, direct bilirubin, and indirect bilirubin were 19.5 μmol/L, 5.0 μmol/L and 8.1 μmol/L, respectively. Elevated total bilirubin and direct bilirubin were significantly associated with overall survival in surgical colorectal cancer patients. Additionally, predictive nomogram including total bilirubin and direct bilirubin for overall survival was established for predicting overall survival in surgical colorectal cancer patients.
These findings indicated that preoperative elevated total bilirubin and direct bilirubin could be considered as independent prognostic biomarkers for poor overall survival of colorectal cancer patients.
血清胆红素在抗氧化和抗癌过程中起着重要作用。血清胆红素与癌症风险之间的反比关系在多种癌症中得到了广泛报道。本回顾性研究的目的是探讨接受手术切除的结直肠癌患者血清胆红素的预后影响。
在 330 例结直肠癌患者的术前检测血清胆红素（包括总胆红素、直接胆红素和间接胆红素）的值。通过 X-tile 程序确定这三个生物标志物的最佳截断值。使用 Kaplan-Meier 曲线、log-rank 检验、单因素和多因素 cox 回归来检查血清胆红素与结局之间的关系。此外，使用一些风险因素来制定用于评估生存风险的列线图。
血清总胆红素、直接胆红素和间接胆红素的最佳截断点分别为 19.5μmol/L、5.0μmol/L 和 8.1μmol/L。升高的总胆红素和直接胆红素与手术治疗的结直肠癌患者的总生存率显著相关。此外，建立了包括总胆红素和直接胆红素的预测列线图，用于预测手术治疗的结直肠癌患者的总生存率。
这些发现表明，术前升高的总胆红素和直接胆红素可被视为结直肠癌患者总体生存率不良的独立预后生物标志物。
