Predictive value of preoperative routine examination for the prognosis of patients with pT2N0M0 or pT3N0M0 colorectal cancer

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS

ACS Applied Bio Materials Pub Date : 2024-06-15 DOI:10.4251/wjgo.v16.i6.2429

Peng-Fei Jing, Jin Chen, En-Da Yu, Chao-Yu Miao

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引用次数: 0

Abstract

BACKGROUND In recent years, the incidence of colorectal cancer (CRC) has been increasing. With the popularization of endoscopic technology, a number of early CRC has been diagnosed. However, despite current treatment methods, some patients with early CRC still experience postoperative recurrence and metastasis. AIM To search for indicators associated with early CRC recurrence and metastasis to identify high-risk populations. METHODS A total of 513 patients with pT2N0M0 or pT3N0M0 CRC were retrospectively enrolled in this study. Results of blood routine test, liver and kidney function tests and tumor markers were collected before surgery. Patients were followed up through disease-specific database and telephone interviews. Tumor recurrence, metastasis or death were used as the end point of study to find the risk factors and predictive value related to early CRC recurrence and metastasis. RESULTS We comprehensively compared the predictive value of preoperative blood routine, blood biochemistry and tumor markers for disease-free survival (DFS) and overall survival (OS) of CRC. Cox multivariate analysis demonstrated that low platelet count was significantly associated with poor DFS [hazard ratio (HR) = 0.995, 95% confidence interval (CI): 0.991-0.999, P = 0.015], while serum carcinoembryonic antigen (CEA) level (HR = 1.008, 95%CI: 1.001-1.016, P = 0.027) and serum total cholesterol level (HR = 1.538, 95%CI: 1.026-2.305, P = 0.037) were independent risk factors for OS. The cutoff value of serum CEA level for predicting OS was 2.74 ng/mL. Although the OS of CRC patients with serum CEA higher than the cutoff value was worse than those with lower CEA level, the difference between the two groups was not statistically significant (P = 0.075). CONCLUSION For patients with T2N0M0 or T3N0M0 CRC, preoperative platelet count was a protective factor for DFS, while serum CEA level was an independent risk factor for OS. Given that these measures are easier to detect and more acceptable to patients, they may have broader applications.

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术前常规检查对 pT2N0M0 或 pT3N0M0 结直肠癌患者预后的预测价值

背景近年来，结直肠癌（CRC）的发病率不断上升。随着内窥镜技术的普及，许多早期 CRC 已被确诊。然而，尽管采用了现有的治疗方法，一些早期 CRC 患者仍会出现术后复发和转移。目的寻找与早期 CRC 复发和转移相关的指标，以确定高危人群。方法本研究回顾性纳入了 513 例 pT2N0M0 或 pT3N0M0 CRC 患者。手术前收集了血常规检查、肝肾功能检查和肿瘤标志物的结果。通过特定疾病数据库和电话访谈对患者进行随访。以肿瘤复发、转移或死亡为研究终点，寻找与早期 CRC 复发和转移相关的风险因素和预测价值。结果我们全面比较了术前血常规、血液生化指标和肿瘤标志物对 CRC 无病生存期（DFS）和总生存期（OS）的预测价值。Cox 多变量分析表明，血小板计数低与 DFS 差显著相关 [危险比 (HR) = 0.995，95% 置信区间 (CI)：0.991-0.999，P = 0.015]，而血清癌胚抗原（CEA）水平（HR = 1.008，95%CI：1.001-1.016，P = 0.027）和血清总胆固醇水平（HR = 1.538，95%CI：1.026-2.305，P = 0.037）是OS的独立危险因素。预测OS的血清CEA水平临界值为2.74纳克/毫升。虽然血清 CEA 水平高于临界值的 CRC 患者的 OS 比 CEA 水平较低的患者差，但两组之间的差异无统计学意义（P = 0.075）。结论对于 T2N0M0 或 T3N0M0 CRC 患者，术前血小板计数是 DFS 的保护因素，而血清 CEA 水平是 OS 的独立危险因素。鉴于这些指标更容易检测，患者也更容易接受，它们可能会有更广泛的应用。

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来源期刊

ACS Applied Bio Materials Chemistry-Chemistry (all)

CiteScore

9.40

自引率

2.10%

发文量

464

期刊介绍： ACS Applied Bio Materials is an interdisciplinary journal publishing original research covering all aspects of biomaterials and biointerfaces including and beyond the traditional biosensing, biomedical and therapeutic applications. The journal is devoted to reports of new and original experimental and theoretical research of an applied nature that integrates knowledge in the areas of materials, engineering, physics, bioscience, and chemistry into important bio applications. The journal is specifically interested in work that addresses the relationship between structure and function and assesses the stability and degradation of materials under relevant environmental and biological conditions.