Department of Surgery, Tokyo Women's Medical University Adachi Medical Center.
J Nippon Med Sch. 2024 Mar 9;91(1):37-47. doi: 10.1272/jnms.JNMS.2024_91-103. Epub 2023 Aug 8.
Perioperative factors are useful for predicting postoperative infectious complications (PIC) in gastric cancer. Specifically, postoperative inflammatory response indicators (PIRI), [C-reactive protein (CRP) level, body temperature (BT), and white blood cell (WBC) count], are widely used in clinical practice. We investigated predictive factors for PIC, including PIRI, to establish a simple and practical indicator of postoperative complications after gastrectomy.
We retrospectively collected clinical data from 200 patients with fStage I-III gastric cancer. Univariate/multivariate analysis was performed to evaluate the relationship of predictive factors [host factors, clinicopathological factors, and PIRI (BT, WBC count, and CRP level on postoperative day (POD) 1 and 3) ]. Cut-off values of the predictive factors were analyzed using receiver operating characteristic (ROC) curve modulated by the presence/absence of PIC Grade II, III (Clavien-Dindo classification).
Age [Odds ratio (OR): 5.67], smoking history (OR: 3.51), and CRP level (OR: 5.65), WBC count (OR: 8.96), and BT (OR: 3.37) on POD3 were selected as independent factors from multivariate analysis. Cut-off values were 77 years, 14.8 mg/dL, 116.0×10/μL, and 37.4°C, respectively.
Predictive factors relative to PIC in gastric cancer were CRP level ≥ 14.8 mg/dL, WBC count ≥ 116.0×10/μL, and BT ≥ 37.4°C all on POD3. Age ≥ 77 years, and history of smoking were relative to PIC, suggesting a simple and practical indicator applicable in clinical practice.
围手术期因素可用于预测胃癌术后感染性并发症（PIC）。具体而言，术后炎症反应指标（PIRI）[C 反应蛋白（CRP）水平、体温（BT）和白细胞（WBC）计数]广泛应用于临床实践。我们研究了 PIC 的预测因素，包括 PIRI，以建立一种简单实用的胃切除术后并发症指标。
我们回顾性收集了 200 例 fStage I-III 胃癌患者的临床资料。采用单因素/多因素分析评估预测因素[宿主因素、临床病理因素和 PIRI（术后第 1 天和第 3 天的 BT、WBC 计数和 CRP 水平）]与 PIC 分级 II、III（Clavien-Dindo 分级）之间的关系。使用 ROC 曲线分析预测因素的截断值，ROC 曲线由 PIC 的有无进行调制。
多因素分析中选择年龄[比值比（OR）：5.67]、吸烟史（OR：3.51）和 CRP 水平（OR：5.65）、WBC 计数（OR：8.96）和 BT（OR：3.37）为独立因素。截断值分别为 77 岁、14.8mg/dL、116.0×10/μL 和 37.4°C。
与胃癌 PIC 相关的预测因素为 CRP 水平≥14.8mg/dL、WBC 计数≥116.0×10/μL 和 BT≥37.4°C，均在术后第 3 天。年龄≥77 岁和吸烟史与 PIC 相关，提示一种简单实用的临床实用指标。
