Rauduvytė Kornelija, Kazlauskaitė Paulina, Kryžauskas Marius, Ignatavičius Povilas, Poškus Tomas, Sabaliauskaitė Rasa, Mlynska Agata, Šeštokaitė Agnė, Lukšta Martynas, Baušys Rimantas, Jakubauskas Matas, Baušys Augustinas
Laboratory of Experimental Surgery and Oncology, Faculty of Medicine, Translational Health Research Institute, Vilnius, 08406, Lithuania.
Clinic of Gastroenterology, Nephrourology and Surgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, 03101, Lithuania.
Sci Rep. 2025 Jul 1;15(1):21878. doi: 10.1038/s41598-025-06667-6.
The development of novel biomarkers to predict postoperative complications (POCs) after colorectal cancer (CRC) surgery is essential, both for improving treatment outcomes and for facilitating the widespread use of same-day discharge following colectomy. This longitudinal observational study, a sub-study of a previous RCT, investigated the prognostic potential of a panel of novel biomarkers, including inflammatory cytokines (TNF-α, IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12p70, IL-17 A, INF-γ, IP-10, MCP-1, TGF-β1), alongside conventional biomarkers such as CRP and WBC levels, measured preoperatively and on postoperative day 6, for predicting POCs following CRC resection. Among 40 recruited patients, 38 were included in the final analysis. Patients who did not experience POCs had a significantly lower preoperative level of TNF-α (2.28 pg/mL vs. 68.77 pg/mL, p = 0.022). ROC curve analysis showed that TNF-α has significant (p = 0.012) discriminative capacity to distinguish between patients with POCs and those with an uneventful postoperative course, with an AUC of 0.722 (95% CI: 0.555, 0.889). Multivariable analysis suggested that a low preoperative TNF-α level (< 55.35 pg/mL) may be an independent predictor of an uneventful postoperative course (Odds Ratio = 0.137, 95% CI: 0.023, 0.836). This study showed that preoperative levels of TNF-α demonstrates a moderate discriminative capacity to distinguish between patients with POCs and those with an uneventful postoperative course in patients undergoing surgery for left-side CRC, although the findings are limited by the small sample size and should be validated in larger cohorts.Clinical Trial Registration: NCT04013841, date of registration 2019-07-10.
开发用于预测结直肠癌（CRC）手术后术后并发症（POC）的新型生物标志物至关重要，这对于改善治疗效果以及促进结肠切除术后同日出院的广泛应用均有意义。这项纵向观察性研究是先前一项随机对照试验的子研究，调查了一组新型生物标志物的预后潜力，这些生物标志物包括炎性细胞因子（TNF-α、IL-1β、IL-2、IL-4、IL-6、IL-8、IL-10、IL-12p70、IL-17A、INF-γ、IP-10、MCP-1、TGF-β1），以及术前和术后第6天测量的常规生物标志物如CRP和白细胞水平，用于预测CRC切除术后的POC。在40名招募的患者中，38名被纳入最终分析。未发生POC的患者术前TNF-α水平显著较低（2.28 pg/mL对68.77 pg/mL，p = 0.022）。ROC曲线分析表明，TNF-α具有显著（p = 0.012）的鉴别能力，可区分发生POC的患者和术后过程平稳的患者，AUC为0.722（95%CI：0.555，0.889）。多变量分析表明，术前低TNF-α水平（<55.35 pg/mL）可能是术后过程平稳的独立预测因素（比值比 = 0.137，95%CI：0.023，0.836）。本研究表明，术前TNF-α水平在区分左侧CRC手术患者中发生POC的患者和术后过程平稳的患者方面具有中等鉴别能力，尽管研究结果受样本量小的限制，应在更大队列中进行验证。临床试验注册：NCT04013841，注册日期2019年7月10日。
