Postgraduate Training Base of Dalian Medical University (Taizhou People's Hospital), 366 Taihu Road, Taizhou, Jiangsu, China.
Department of General Surgery, Gaoyou People's Hospital, 10 Dongyuan Road, Gaoyou City, Jiangsu Province, China.
Mediators Inflamm. 2024 Apr 26;2024:4465592. doi: 10.1155/2024/4465592. eCollection 2024.
This study aims to evaluate the impact and predictive value of the preoperative NPRI on short-term complications and long-term prognosis in patients undergoing laparoscopic radical surgery for colorectal cCancer (CRC).
A total of 302 eligible CRC patients were included, assessing five inflammation-and nutrition-related markers and various clinical features for their predictive impact on postoperative outcomes. Emphasis was on the novel indicator NPRI to elucidate its prognostic and predictive value for perioperative risks.
Multivariate logistic regression analysis identified a history of abdominal surgery, prolonged surgical duration, CEA levels ≥5 ng/mL, and NPRI ≥ 3.94 × 10 as independent risk factors for postoperative complications in CRC patients. The Clavien--Dindo complication grading system highlighted the close association between preoperative NPRI and both common and severe complications. Multivariate analysis also identified a history of abdominal surgery, tumor diameter ≥5 cm, poorly differentiated or undifferentiated tumors, and NPRI ≥ 2.87 × 10 as independent risk factors for shortened overall survival (OS). Additionally, a history of abdominal surgery, tumor maximum diameter ≥5 cm, tumor differentiation as poor/undifferentiated, NPRI ≥ 2.87 × 10, and TNM Stage III were determined as independent risk factors for shortened disease-free survival (DFS). Survival curve results showed significantly higher 5-year OS and DFS in the low NPRI group compared to the high NPRI group. The incorporation of NPRI into nomograms for OS and DFS, validated through calibration and decision curve analyses, attested to the excellent accuracy and practicality of these models.
Preoperative NPRI independently predicts short-term complications and long-term prognosis in patients undergoing laparoscopic colorectal cancer surgery, enhancing predictive accuracy when incorporated into nomograms for patient survival.
本研究旨在评估术前 NPRI 对接受腹腔镜结直肠癌根治术患者短期并发症和长期预后的影响及其预测价值。
共纳入 302 例符合条件的结直肠癌患者，评估 5 种炎症和营养相关标志物和各种临床特征对术后结局的预测影响。重点是新指标 NPRI，以阐明其对围手术期风险的预后和预测价值。
多变量逻辑回归分析确定既往腹部手术史、手术时间延长、CEA 水平≥5ng/ml 和 NPRI≥3.94×10 是结直肠癌患者术后并发症的独立危险因素。Clavien-Dindo 并发症分级系统突出了术前 NPRI 与常见和严重并发症之间的密切关联。多变量分析还确定既往腹部手术史、肿瘤直径≥5cm、低分化或未分化肿瘤以及 NPRI≥2.87×10 是总生存期缩短的独立危险因素。此外，既往腹部手术史、肿瘤最大直径≥5cm、肿瘤分化差/未分化、NPRI≥2.87×10 和 TNM 分期 III 期被确定为无病生存期缩短的独立危险因素。生存曲线结果表明，低 NPRI 组患者的 5 年 OS 和 DFS 明显高于高 NPRI 组。通过校准和决策曲线分析验证，将 NPRI 纳入 OS 和 DFS 的列线图中，证明了这些模型具有出色的准确性和实用性。
术前 NPRI 独立预测接受腹腔镜结直肠癌手术患者的短期并发症和长期预后，在纳入患者生存的列线图中时可提高预测准确性。
