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磁纳米粒子检测 C 反应蛋白联合中性粒细胞与淋巴细胞比值预测直肠癌术后吻合口瘘的发生。

Magnetic Nanoparticles Detection of C-Reactive Protein Combined with Neutrophil to Lymphocyte Ratio to Predict the Occurrence of Anastomotic Fistula after Rectal Cancer Surgery.

机构信息

First Clinical Medical College, Jinan University, Guangzhou, 510632, Guangdong Province, China.

The Fourth Ward of General Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu, 233004, Anhui Province, China.

出版信息

Cell Mol Biol (Noisy-le-grand). 2022 Aug 31;68(8):116-122. doi: 10.14715/cmb/2022.68.8.21.

Abstract

It aimed to explore the effect of C-reactive protein (CRP) combined with neutrophil to lymphocyte ratio (NLR) in the early prediction of anastomotic leakage (AL) after rectal cancer surgery and to improve the prediction accuracy. In this study, gold (Au)/ferroferric oxide (Fe3O4) magnetic nanoparticles were first synthesized and modified with polyacrylic acid (PAA). After modification, they underwent CRP antibody detection. Then, 120 patients with rectal cancer who underwent Dixon surgery were selected as the research objects to investigate the sensitivity and specificity of CRP combined with NLR in predicting AL. It was found that the diameter of the Au/Fe3O4 nanoparticles prepared in this study was about 45 nm. After adding 60 μg of antibody, the diameter of PAA-Au/Fe3O4 was 226.5 nm, the dispersion coefficient was 0.16, the standard curve between CRP concentration and luminous intensity was y = 8,966.5 x + 2,381.3, and R2 = 0.9944. Besides, the correlation coefficient was R2 = 0.991, and the linear regression equation was y=1.103 x - 0.0022 compared with the nephelometric method. By analyzing the receiver operating characteristic (ROC) curve of CRP combined with NLR to predict AL after Dixon surgery, the cut-off point was 0.11 on the first day after the surgery, the area under the curve was 0.896, the sensitivity was 82.5%, and the specificity was 76.67%. The cut-off point on the third day after the surgery was 0.13, the area under the curve was 0.931, the sensitivity was 86.67%, and the specificity was 90%. On the fifth day after the surgery, the cut-off point, the area under the curve, the sensitivity, and the specificity were 0.16, 0.964, 92.5%, and 95.83% in turn. In conclusion, PAA-Au/Fe3O4 magnetic nanoparticles could be used for clinical examination of patients with rectal cancer, and CRP combined with NLR could improve the prediction accuracy of AL after rectal cancer surgery.

摘要

目的 探讨 C 反应蛋白(CRP)联合中性粒细胞与淋巴细胞比值(NLR)在预测直肠癌术后吻合口漏(AL)中的早期预测作用,并提高预测准确性。本研究首先合成金(Au)/四氧化三铁(Fe3O4)磁性纳米粒子,并进行聚丙烯酸(PAA)修饰,修饰后进行 CRP 抗体检测。然后,选择 120 例接受 Dixon 手术的直肠癌患者作为研究对象,探讨 CRP 联合 NLR 预测 AL 的灵敏度和特异度。结果发现,本研究制备的 Au/Fe3O4 纳米粒子的直径约为 45nm,加入 60μg 抗体后,PAA-Au/Fe3O4 的直径为 226.5nm,分散系数为 0.16,CRP 浓度与发光强度之间的标准曲线为 y=8966.5x+2381.3,R2=0.9944。此外,相关系数 R2=0.991,线性回归方程为 y=1.103x-0.0022,与比浊法相比。通过分析 CRP 联合 NLR 预测 Dixon 术后 AL 的受试者工作特征(ROC)曲线,术后第 1 天的截断点为 0.11,曲线下面积为 0.896,灵敏度为 82.5%,特异性为 76.67%。术后第 3 天的截断点为 0.13,曲线下面积为 0.931,灵敏度为 86.67%,特异性为 90%。术后第 5 天,截断点、曲线下面积、灵敏度和特异性依次为 0.16、0.964、92.5%和 95.83%。结论 PAA-Au/Fe3O4 磁性纳米粒子可用于直肠癌患者的临床检查,CRP 联合 NLR 可提高直肠癌术后 AL 的预测准确性。

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