Takishima Teruyuki, Kobayashi Yasunobu, Matsukida Saya, Kai Wataru, Takano Yasuhiro, Kanno Hironori, Morikawa Toshiaki, Hannyu Nobuyoshi, Eto Ken
Department of Surgery, Tokyo General Hospital, Tokyo, Japan
Division of Lower Gastrointestinal Surgery, Department of Surgery, Jikei University School of Medicine, Tokyo, Japan.
Anticancer Res. 2025 Feb;45(2):743-750. doi: 10.21873/anticanres.17462.
BACKGROUND/AIM: Cholinesterase (ChE) is important for estimating nutritional status and can be easily measured. This study aimed to investigate the effect of ChE on the short- and long-term prognoses of elderly patients with colorectal cancer.
This study included 120 elderly patients who underwent scheduled surgery for colorectal cancer. ChE is a biomarker that can be easily measured using blood tests. The optimal cut-off level of ChE was determined using receiver operating characteristic analysis. We investigated the relationship of ChE with disease-free and overall survival using univariate and multivariate analyses.
Seventy-two (60%) patients had low ChE levels (<255 U/l). In the multivariate analysis, low ChE (p=0.04) was an independent and significant predictor of postoperative complications. Low ChE (p=0.049), low prognostic nutritional index (p=0.04), and lymph node metastasis (p<0.01) were independent and significant prognostic predictors of poor disease-free survival. American Society of Anesthesiologists Physical Status 3 (p<0.01), low ChE (p<0.01), and lymph node metastasis (p<0.01) were independent and significant predictors of poor overall survival.
ChE level is a significant predictor of short- and long-term outcomes in elderly patients undergoing scheduled surgery for colorectal cancer.
背景/目的：胆碱酯酶（ChE）对评估营养状况很重要且易于测量。本研究旨在探讨ChE对老年结直肠癌患者短期和长期预后的影响。
本研究纳入了120例行结直肠癌择期手术的老年患者。ChE是一种可通过血液检测轻松测量的生物标志物。使用受试者工作特征分析确定ChE的最佳临界值。我们通过单因素和多因素分析研究了ChE与无病生存期和总生存期的关系。
72例（60%）患者ChE水平较低（<255 U/l）。在多因素分析中，低ChE水平（p = 0.04）是术后并发症的独立且显著的预测因素。低ChE水平（p = 0.049）、低预后营养指数（p = 0.04）和淋巴结转移（p < 0.01）是无病生存期差的独立且显著的预后预测因素。美国麻醉医师协会身体状况分级为3级（p < 0.01）、低ChE水平（p < 0.01）和淋巴结转移（p < 0.01）是总生存期差的独立且显著的预测因素。
ChE水平是行结直肠癌择期手术的老年患者短期和长期预后的重要预测指标。
