Matsumoto Yu, Otsuka Yuichiro, Hosaka Hiroka, Kajiwara Yoji, Okada Rei, Ito Yuko, Tsuchiya Masaru, Ushigome Mitsunori, Matoba Shuichiro, Shimada Hideaki
Department of Surgery, Toho University School of Medicine, Tokyo, JPN.
Department of Surgery, Toho University Sakura Medical Center, Chiba, JPN.
Cureus. 2025 Sep 6;17(9):e91753. doi: 10.7759/cureus.91753. eCollection 2025 Sep.
Although decreased serum creatine kinase (s-CK) levels are observed in some cancers, possibly due to consumption during tumor growth, the relationship between s-CK levels and colorectal liver metastasis remains unclear. This study investigated the prognostic significance of perioperative s-CK levels in patients with metachronous colorectal liver metastasis.
A total of 46 patients who underwent liver resection from 2011 to 2023 were included in this study. The s-CK levels were assessed before liver resection and six months after liver resection. The patients were categorized into low or high s-CK groups, and the lower limit of normal s-CK levels was set as the cutoff value. The prognostic significance for recurrence-free survival (RFS) and overall survival (OS) was analyzed.
There was no significant difference in RFS or OS between the preoperative low and preoperative high s-CK groups (P = 0.089, P = 0.132, respectively). There was a significant difference in RFS between the postoperative low and postoperative high s-CK groups (P = 0.001). However, there was no significant difference in OS between these groups (P = 0.072). Patients with consistently low s-CK levels before and six months after liver resection showed significantly poorer RFS (P = 0.002) and poorer OS (P = 0.038) compared with patients who had consistently high s-CK levels.
Perioperative s-CK levels may be useful as predictors of prognosis in patients with metachronous colorectal liver metastasis. Patients with consistently low perioperative s-CK levels may have a high risk for recurrence and mortality.
尽管在某些癌症中观察到血清肌酸激酶（s-CK）水平降低，这可能是由于肿瘤生长过程中的消耗所致，但s-CK水平与结直肠癌肝转移之间的关系仍不清楚。本研究探讨了异时性结直肠癌肝转移患者围手术期s-CK水平的预后意义。
本研究纳入了2011年至2023年期间接受肝切除术的46例患者。在肝切除术前和肝切除术后6个月评估s-CK水平。将患者分为s-CK水平低或高的组，并将正常s-CK水平的下限作为临界值。分析其对无复发生存期（RFS）和总生存期（OS）的预后意义。
术前s-CK水平低的组与术前s-CK水平高的组在RFS或OS方面无显著差异（分别为P = 0.089，P = 0.132）。术后s-CK水平低的组与术后s-CK水平高的组在RFS方面有显著差异（P = 0.001）。然而，这些组之间的OS无显著差异（P = 0.072）。与s-CK水平持续较高的患者相比，肝切除术前和术后6个月s-CK水平持续较低的患者RFS显著更差（P = 0.002），OS也更差（P = 0.038）。
围手术期s-CK水平可能有助于预测异时性结直肠癌肝转移患者的预后。围手术期s-CK水平持续较低的患者可能具有较高的复发和死亡风险。
