Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
Pancreatology. 2022 Mar;22(2):270-276. doi: 10.1016/j.pan.2021.12.006. Epub 2021 Dec 31.
and purpose: Zinc is an essential element for human health and plays an important role in metabolic, immunological and other biological processes. The present study was conducted to investigate the association between zinc deficiency (ZD) and the perioperative clinical course in patients with pancreatic ductal adenocarcinoma (PDAC).
Of 216 patients with PDAC who underwent elective pancreatectomy between 2013 and 2017 at our institution, 206 patients with sufficient clinical data were retrospectively reviewed. The perioperative variables were compared and the risk factors associated with infectious complications were identified.
ZD was preoperatively present in 36 (17.5%) of 206 patients with PDAC. In the patients of the ZD group, a higher proportion of males, higher preoperative modified Glasgow prognostic scores, a higher neutrophil-to-lymphocyte ratio, and a higher occurrence of postoperative infectious complications after pancreatectomy were observed, compared to the non-ZD group. By a univariate analysis, three risk factors were significantly associated with infectious complications after pancreatectomy: ZD (vs non-ZD: p = 0.002), serum albumin <3.5 g/dl (vs ≥ 3.5 g/dl: p = 0.005), and the procedure of pancreaticoduodenectomy (vs others: p = 0.013). By multivariate logistic regression analysis, the occurrence of infectious complications was significantly associated with ZD (OR 3.430, 95%CI 1.570 to 7.490, p = 0.002) and the procedure of pancreaticoduodenectomy (OR 2.030, 95%CI 1.090 to 3.770, p = 0.025).
The current study newly demonstrated that ZD could serve as a preoperative predictor of infectious complications after pancreatectomies in the patients with PDAC.
锌是人体健康所必需的元素，在代谢、免疫和其他生物过程中发挥着重要作用。本研究旨在探讨锌缺乏症（ZD）与胰腺导管腺癌（PDAC）患者围手术期临床病程的关系。
对 2013 年至 2017 年间在我院接受择期胰腺切除术的 216 例 PDAC 患者进行回顾性研究，共纳入 206 例具有充分临床资料的患者。比较围手术期变量，并确定与感染性并发症相关的危险因素。
术前 206 例 PDAC 患者中 36 例（17.5%）存在 ZD。与非 ZD 组相比，ZD 组男性比例较高，术前改良格拉斯哥预后评分较高，中性粒细胞与淋巴细胞比值较高，胰腺切除术后感染性并发症发生率较高。单因素分析显示，有 3 个危险因素与胰腺切除术后感染性并发症显著相关：ZD（与非 ZD 相比：p=0.002）、血清白蛋白<3.5 g/dl（与≥3.5 g/dl 相比：p=0.005）和胰十二指肠切除术（与其他手术相比：p=0.013）。多因素 logistic 回归分析显示，感染性并发症的发生与 ZD（OR 3.430，95%CI 1.570 至 7.490，p=0.002）和胰十二指肠切除术（OR 2.030，95%CI 1.090 至 3.770，p=0.025）显著相关。
本研究首次表明，ZD 可作为 PDAC 患者胰腺切除术后感染性并发症的术前预测指标。
