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晚期肺癌炎症指数对接受根治性手术的结直肠癌患者短期结局和预后的预测价值。

The predictive value of advanced lung cancer inflammation index for short-term outcomes and prognosis of colorectal cancer patients who underwent radical surgery.

机构信息

Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.

Department of Gastrointestinal Surgery, Sichuan Mianyang 404 Hospital, Mianyang, 621000, China.

出版信息

Int J Clin Oncol. 2023 Dec;28(12):1616-1624. doi: 10.1007/s10147-023-02410-1. Epub 2023 Sep 12.

Abstract

PURPOSE

The purpose of this study was to investigate the predictive value of advanced lung cancer inflammation index (ALI) for short-term outcomes and prognosis of colorectal cancer (CRC) patients who underwent radical surgery.

METHODS

CRC patients who underwent radical resection were included from Jan 2011 to Jan 2020 in our single clinical centre. Short-term outcomes, overall survival (OS), and disease-free survival (DFS) were compared in different groups. Cox analysis was conducted to identify independent risk factors for OS and DFS.

RESULTS

A total of 4010 patients who underwent radical CRC surgery were enrolled in the current study. As a result, the low ALI group had longer operation time (p = 0.02), more intra-operative blood loss (p < 0.01), longer postoperative hospital stay (p < 0.01), and more overall complications (p < 0.01). Moreover, ALI (p < 0.01, OR = 0.679, 95% CI = 0.578-0.798) was an independent risk factor for overall complications. As for survival, the low ALI group had worse OS in all TNM stages (p < 0.01), stage II (p < 0.01) and stage III (p < 0.01). Similarly, the low ALI group had worse DFS in all TNM stages (p < 0.01), stage II (p < 0.01), and stage III (p < 0.01). In Cox analysis, ALI was an independent risk factors for OS (p < 0.01, HR = 0.707, 95% CI = 0.589-0.849) and DFS (p < 0.01, HR = 0.732, 95% CI = 0.622-0.861).

CONCLUSION

Lower ALI was associated with more postoperative complications, worse OS, and DFS for CRC patients who underwent radical surgery. Furthermore, ALI was an independent risk factor for overall complications, OS, and DFS. Surgeons should pay close attention to patients with low ALI before surgery and make clinical strategies cautiously.

摘要

目的

本研究旨在探讨晚期肺癌炎症指数(ALI)对接受根治性手术的结直肠癌(CRC)患者短期结局和预后的预测价值。

方法

本研究纳入了 2011 年 1 月至 2020 年 1 月在我院单一临床中心接受根治性切除术的 CRC 患者。比较不同组间的短期结局、总生存期(OS)和无病生存期(DFS)。采用 Cox 分析确定 OS 和 DFS 的独立危险因素。

结果

本研究共纳入 4010 例接受根治性 CRC 手术的患者。结果显示,低 ALI 组的手术时间更长(p=0.02),术中出血量更多(p<0.01),术后住院时间更长(p<0.01),总并发症更多(p<0.01)。此外,ALI(p<0.01,OR=0.679,95%CI=0.578-0.798)是总并发症的独立危险因素。就生存而言,所有 TNM 分期(p<0.01)、II 期(p<0.01)和 III 期(p<0.01)患者中,低 ALI 组的 OS 均较差。同样,所有 TNM 分期(p<0.01)、II 期(p<0.01)和 III 期(p<0.01)患者中,低 ALI 组的 DFS 均较差。Cox 分析显示,ALI 是 OS(p<0.01,HR=0.707,95%CI=0.589-0.849)和 DFS(p<0.01,HR=0.732,95%CI=0.622-0.861)的独立危险因素。

结论

对于接受根治性手术的 CRC 患者,较低的 ALI 与更多的术后并发症、较差的 OS 和 DFS 相关。此外,ALI 是总并发症、OS 和 DFS 的独立危险因素。外科医生应在术前密切关注 ALI 较低的患者,并谨慎制定临床策略。

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