Dolin Troels Gammeltoft, Christensen Ib Jarle, Johansen Astrid Zedlitz, Nielsen Hans Jørgen, Jakobsen Henrik Loft, Klein Mads Falk, Lund Cecilia Margareta, Bojesen Stig Egil, Nielsen Dorte Lisbeth, Jensen Benny Vittrup, Johansen Julia Sidenius
Department of Medicine, Copenhagen University Hospital, DK-2730 Herlev, Denmark.
Department of Gastrointestinal Surgery, Copenhagen University Hospital, DK-2650 Hvidovre, Denmark.
Cancers (Basel). 2021 Dec 29;14(1):161. doi: 10.3390/cancers14010161.
The association between pre- and perioperative inflammatory biomarkers, major complications, and survival rates after resection of colorectal cancer (CRC) in older patients is largely unknown. The aim was to investigate age-dependent differences in these associations. Serum CRP, IL-6, and YKL-40 were measured preoperatively and on the first and second day after resection of CRC (stages I-III) in 210 older (≥70 years) and 191 younger patients (<70 years). The results from the complications was presented as an odds ratio (OR, with a 95% confidence interval (CI)) with logistic regression. Results from the mortality rates were presented as a hazard ratio (HR, with a 95% CI) using Cox proportional hazards regression. The preoperative inflammatory biomarkers were higher in the older vs. the younger patients. The risk of complications was increased in older patients with a high preoperative CRP (OR = 1.25, 95% CI 1.03-1.53), IL-6 (OR = 1.57, 95% CI 1.18-2.08), and YKL-40 (OR = 1.66, 95% CI 1.20-2.28), but not in younger patients. Mortality was higher in younger patients with high preoperative YKL-40 (HR = 1.66, 95% CI 1.06-2.60). This was not found in older patients. Elevated preoperative inflammatory biomarkers among older patients were associated with an increased risk of complications, but not mortality. Preoperative inflammatory biomarkers may be useful in assessing the risk of a complicated surgical course in older patients with CRC.
老年患者结直肠癌（CRC）切除术前和围手术期炎症生物标志物、主要并发症及生存率之间的关联在很大程度上尚不清楚。目的是研究这些关联中与年龄相关的差异。对210名老年（≥70岁）和191名年轻患者（<70岁）在CRC（I - III期）切除术前、术后第一天和第二天测量血清CRP、IL - 6和YKL - 40。并发症结果以逻辑回归的比值比（OR，95%置信区间（CI））表示。死亡率结果以Cox比例风险回归的风险比（HR，95%CI）表示。老年患者术前炎症生物标志物高于年轻患者。术前CRP（OR = 1.25，95%CI 1.03 - 1.53）、IL - 6（OR = 1.57，95%CI 1.18 - 2.08）和YKL - 40（OR = 1.66，95%CI 1.20 - 2.28）水平高的老年患者并发症风险增加，而年轻患者则不然。术前YKL - 40水平高的年轻患者死亡率更高（HR = 1.66，95%CI 1.06 - 2.60）。老年患者未发现此情况。老年患者术前炎症生物标志物升高与并发症风险增加相关，但与死亡率无关。术前炎症生物标志物可能有助于评估老年CRC患者复杂手术过程的风险。
