Firut Andreea, Margaritescu Dragos Nicolae, Turcu-Stiolica Adina, Bica Marius, Rotaru Ionela, Patrascu Ana-Maria, Radu Razvan Ilie, Marinescu Daniela, Patrascu Stefan, Streba Costin Teodor, Surlin Valeriu
Department of Surgery, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.
Pharmacoeconomics and Statistical Analysis in Clinical Trials and Pharmaceutical Research, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.
J Clin Med. 2023 Oct 3;12(19):6338. doi: 10.3390/jcm12196338.
The aim of this study was to assess the role of immunocyte-derived ratios (IDRs), such as the systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR), as markers for the postoperative recovery of gastrointestinal function following colorectal cancer surgery. A retrospective analysis was conducted on a consecutive cohort of 260 patients who underwent radical colorectal cancer surgery within the timeframe spanning from January 2016 to December 2022. Data concerning the postoperative recovery of gastrointestinal function included the I-FEED score, time to pass flatus, toleration for liquids in the first 48 h, and the need for nasogastric tube reinsertion in the immediate postoperative period. A special emphasis was allocated towards the examination of IDRs and their interrelation with the postoperative gastrointestinal functional parameters. The I-FEED score exhibited a positive correlation with the NLR, SII, and PLR. The univariate analysis indicated that all IDRs, multiorgan resection, hemoglobin and protein levels, regional nodal extent of the tumor (N), and obesity significantly affected nasogastric tube reinsertion. The multivariate analysis showed that the SII and N1 stages were risk factors for nasogastric tube reinsertion after colorectal cancer surgery. The SII and multiorgan resection were the only classifiers that remained significant in the multivariable analysis for the toleration for liquids. In summation, certain preoperative IDRs, such as the SII, PLR, and NLR, may hold potential as predictive determinants for postoperative gastrointestinal functional recovery following colorectal cancer surgery.
本研究旨在评估免疫细胞衍生比率(IDRs)的作用,如全身免疫炎症指数(SII)、中性粒细胞与淋巴细胞比率(NLR)、血小板与淋巴细胞比率(PLR)以及淋巴细胞与单核细胞比率(LMR),作为结直肠癌手术后胃肠功能恢复的标志物。对2016年1月至2022年12月期间连续260例行根治性结直肠癌手术的患者进行回顾性分析。胃肠功能术后恢复的数据包括I-FEED评分、排气时间、术后48小时内对液体的耐受性以及术后早期鼻胃管重新插入的必要性。特别强调了对IDRs及其与术后胃肠功能参数的相互关系的检查。I-FEED评分与NLR、SII和PLR呈正相关。单因素分析表明,所有IDRs、多器官切除、血红蛋白和蛋白质水平、肿瘤区域淋巴结范围(N)以及肥胖均显著影响鼻胃管重新插入。多因素分析显示,SII和N1期是结直肠癌手术后鼻胃管重新插入的危险因素。SII和多器官切除是多变量分析中对液体耐受性仍具有显著意义的唯一分类因素。总之,某些术前IDRs,如SII、PLR和NLR,可能作为结直肠癌手术后胃肠功能恢复的预测决定因素具有潜力。