C反应蛋白-白蛋白-淋巴细胞（CALLY）指数是结肠支架置入治疗阻塞性结直肠癌患者术后并发症的有效预测指标：一项日本多中心研究。
The C-reactive protein-albumin-lymphocyte (CALLY) index is a useful predictor of postoperative complications in patients with a colonic stent for obstructive colorectal cancer: a Japanese multicenter study.
作者信息
Shiraishi Toshio, Nonaka Takashi, Tominaga Tetsuro, Takamura Yuma, Oishi Kaido, Hashimoto Shintaro, Noda Keisuke, Ono Rika, Hisanaga Makoto, Takeshita Hiroaki, Ishii Mitsutoshi, Oyama Shosaburo, Ishimaru Kazuhide, Kunizaki Masaki, Sawai Terumitsu, Matsumoto Keitaro
机构信息
Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
Department of Surgery, Sasebo City General Hospital, 9-3 Hirase, Sasebo, Nagasaki, 857-8511, Japan.
出版信息
Surg Today. 2025 Apr;55(4):502-509. doi: 10.1007/s00595-024-02924-9. Epub 2024 Aug 23.
PURPOSE
The C-reactive protein-albumin-lymphocyte (CALLY) index is a novel score that offers a good reflection of nutritional status, inflammatory response, and immune system status. The CALLY index is reported to correlate with the prognosis of various carcinomas. The purpose of the present study was to investigate the association between the CALLY index and the short-term prognosis of obstructive colorectal cancer managed with a colonic stent.
METHODS
The subjects of this retrospective study were 263 patients who underwent colorectal resection after colonic stenting for obstructive colorectal cancer between 2016 and 2023. Patients were classified into a group with a low CALLY index (CALLY-L group, n = 85) and a group with a high (CALLY-H group, n = 178) CALLY index.
RESULTS
The CALLY-L group had greater blood loss (53 mL vs 20 mL, p = 0.002) and higher poor performance status (PS3; 20% vs 10.1%, p = 0.033), open surgery (21.2% vs 7.3%, p = 0.001), distant metastases (41.2% vs 20.8%, p = 0.01), and postoperative complications (30.6% vs. 18.5%, p = 0.039) than the CALLY-H group. Multivariate analysis identified a prolonged operative time (odds ratio 1.983, 95% confidence interval 1.013-3.881; p = 0.045), greater blood loss (odds ratio 2.572, 95% confidence interval 1.291-5.129; p = 0.007) and a low CALLY index (odds ratio 1.961, 95% confidence interval 1.013-3.795; p = 0.045) as independent predictors of complications.
CONCLUSION
The CALLY index may be a useful predictor of postoperative complications of obstructive colorectal cancer.
目的
C反应蛋白-白蛋白-淋巴细胞（CALLY）指数是一种新的评分系统，能很好地反映营养状况、炎症反应和免疫系统状态。据报道，CALLY指数与各种癌症的预后相关。本研究的目的是探讨CALLY指数与结肠支架置入治疗的梗阻性结直肠癌短期预后之间的关系。
方法
本回顾性研究的对象为2016年至2023年间因梗阻性结直肠癌接受结肠支架置入术后行结直肠切除术的263例患者。患者被分为CALLY指数低的组（CALLY-L组，n = 85）和CALLY指数高的组（CALLY-H组，n = 178）。
结果
与CALLY-H组相比，CALLY-L组术中失血量更多（53 mL vs 20 mL，p = 0.002），身体状况较差（PS3；20% vs 10.1%，p = 0.033），接受开放手术的比例更高（21.2% vs 7.3%，p = 0.001），远处转移率更高（41.2% vs 20.8%，p = 0.01），术后并发症发生率更高（30.6% vs 18.5%，p = 0.039）。多因素分析确定手术时间延长（比值比1.983，95%置信区间1.013 - 3.881；p = 0.045）、失血量增加（比值比2.572，95%置信区间1.291 - 5.129；p = 0.007）和CALLY指数低（比值比1.961，95%置信区间1.013 - 3.795；p = 0.045）是并发症的独立预测因素。
结论
CALLY指数可能是梗阻性结直肠癌术后并发症的有用预测指标。
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