Department of HBP Surgery, Ehime University, 454 Shitsukawa, Toon 791-0295, Japan.
Nutrients. 2022 Dec 10;14(24):5277. doi: 10.3390/nu14245277.
Postoperative pancreatic fistula (POPF) are major postoperative complications (POCs) following distal pancreatectomy (DP). Notably, POPF may worsen the prognosis of patients with pancreatic cancer. Previously reported risks for POCs include body mass index, pancreatic texture, and albumin levels. Moreover, the C-reactive protein-to-albumin ratio (CAR) is a valuable parameter for prognostication. On the other hand, POCs sometimes lead to a worse prognosis in several cancer types. Thus, we assumed that CAR could be a risk factor for POPFs. This study investigated whether CAR can predict POPF risk in patients with pancreatic cancer following DP. This retrospective study included 72 patients who underwent DP for pancreatic cancer at Ehime University between January 2009 and August 2022. All patients underwent preoperative CAR screening. Risk factors for POPF were analyzed. POPF were observed in 17 of 72 (23.6%) patients. POPF were significantly associated with a higher CAR (p = 0.001). The receiver operating characteristic curve analysis determined the cutoff value for CAR to be 0.05 (sensitivity: 76.5%, specificity: 88.9%, likelihood ratio: 6.88), indicating an increased POPF risk. Univariate and multivariate analysis revealed that CAR ≥ 0.05 was a statistically independent factor for POPF (p < 0.001, p = 0.013). Therefore, CAR has the potential to predict POPF following DP.
术后胰腺瘘（POPF）是胰体尾切除术（DP）后主要的术后并发症（POC）。值得注意的是，POPF 可能会使胰腺癌患者的预后恶化。以前报道的 POC 风险因素包括体重指数、胰腺质地和白蛋白水平。此外，C 反应蛋白与白蛋白比值（CAR）是一种有价值的预后预测参数。另一方面，POC 有时会导致几种癌症类型的预后更差。因此，我们假设 CAR 可能是 POPF 的一个风险因素。本研究调查了 CAR 是否可以预测 DP 后胰腺癌患者的 POPF 风险。这项回顾性研究纳入了 2009 年 1 月至 2022 年 8 月在爱媛大学接受 DP 治疗的 72 例胰腺癌患者。所有患者均接受了术前 CAR 筛查。分析了 POPF 的危险因素。72 例患者中 17 例（23.6%）发生 POPF。POPF 与更高的 CAR 显著相关（p = 0.001）。受试者工作特征曲线分析确定 CAR 的截断值为 0.05（灵敏度：76.5%，特异性：88.9%，似然比：6.88），表明 POPF 风险增加。单因素和多因素分析显示，CAR ≥ 0.05 是 POPF 的统计学独立因素（p < 0.001，p = 0.013）。因此，CAR 有可能预测 DP 后发生的 POPF。
