Seo Yun Ju, Kim Kyeong Eui, Jeong Woon Kyung, Baek Seong Kyu, Bae Sung Uk
Department of Medicine, Keimyung University School of Medicine, Daegu, Korea.
Department of Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea.
Ann Surg Treat Res. 2024 Mar;106(3):169-177. doi: 10.4174/astr.2024.106.3.169. Epub 2024 Feb 22.
Surgical resection, the primary treatment for colorectal cancer (CRC), is often linked with postoperative complications that adversely affect the overall survival rates (OS). The pan-immune-inflammation value (PIV), a novel biomarker, is promising in evaluating cancer prognoses. We aimed to explore the impact of preoperative immune inflammation status on postoperative and long-term oncological outcomes in patients with CRC.
A retrospective analysis of 203 patients with CRC who underwent surgery (January 2016-June 2020) was conducted. The preoperative PIV was calculated as [(neutrophil count + platelet count + monocyte count) / lymphocyte counts]. The PIV optimal cutoff value was determined based on the OS using the Contal and O'Quigley methods.
A PIV value ≥155.90 was defined as high. Patients were categorized into low-PIV (n = 85) and high-PIV (n = 118) groups. Perioperative clinical outcomes (total operation time, time to gas out, sips of water, soft diet, and hospital stay) were not significantly different between the groups. The high-PIV group exhibited more postoperative complications (P = 0.024), and larger tumor size compared with the low-PIV group. Multivariate analysis identified that American Society of Anesthesiologists grade III (P = 0.046) and high-PIV (P = 0.049) were significantly associated with postoperative complications. The low-PIV group demonstrated higher OS (P = 0.001) and disease-free survival rates (DFS) (P = 0.021) compared with the high-PIV group. Advanced N stage (P = 0.005) and high-PIV levels (P = 0.047) were the identified independent prognostic factors for OS, whereas advanced N stage (P = 0.045) was an independent prognostic factor for DFS.
Elevated preoperative PIV was associated with an increased incidence of postoperative complications and served as an independent prognostic factor for OS.
手术切除是结直肠癌（CRC）的主要治疗方法，但其常与术后并发症相关，这些并发症会对总生存率（OS）产生不利影响。全免疫炎症值（PIV）作为一种新型生物标志物，在评估癌症预后方面具有前景。我们旨在探讨术前免疫炎症状态对CRC患者术后及长期肿瘤学结局的影响。
对203例接受手术治疗（2016年1月至2020年6月）的CRC患者进行回顾性分析。术前PIV计算为[（中性粒细胞计数+血小板计数+单核细胞计数）/淋巴细胞计数]。使用Contal和O'Quigley方法根据OS确定PIV最佳临界值。
PIV值≥155.90被定义为高值。患者被分为低PIV组（n = 85）和高PIV组（n = 118）。两组围手术期临床结局（总手术时间、排气时间、饮水、软食及住院时间）无显著差异。与低PIV组相比，高PIV组术后并发症更多（P = 0.024），肿瘤体积更大。多因素分析确定美国麻醉医师协会III级（P = 0.046）和高PIV（P = 0.049）与术后并发症显著相关。与高PIV组相比，低PIV组的OS（P = 0.001）和无病生存率（DFS）（P = 0.021）更高。晚期N分期（P = 0.005）和高PIV水平（P = 0.047）是确定的OS独立预后因素，而晚期N分期（P = 0.045）是DFS的独立预后因素。
术前PIV升高与术后并发症发生率增加相关，并作为OS的独立预后因素。
