预测结直肠肿瘤患者术后并发症的术前 C 反应蛋白和其他炎症生物标志物

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY
Accounts of Chemical Research Pub Date : 2024-08-01
Yuchao Zhang, Guangyu Zhong, Kaihu Fan, Jialun He, Ying Sun, Linping Li
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引用次数: 0

摘要

研究目的本研究旨在探讨术前C反应蛋白(CRP)及其他炎症生物标志物:血小板与淋巴细胞比值(PLR)和中性粒细胞与淋巴细胞比值(NLR)对结直肠肿瘤患者术后并发症(感染、腹泻等)的预测价值:选取2021年1月至2022年12月在该院接受结直肠癌手术切除的109例结直肠肿瘤患者作为研究对象。对患者的术后并发症进行追踪,并将其分为并发症组和非并发症组。所有患者均接受术前生化检验。比较两组患者血清中 CRP、PLR 和 NLR 的水平。分析了这些指标与结直肠肿瘤患者术后并发症之间的关系。建立了逻辑回归模型来分析这些指标对术后并发症的影响,并绘制了接收者操作特征曲线(ROC)来评估预测值:109例结直肠肿瘤患者中,31例(28.44%)出现术后并发症。与非并发症组相比,并发症组的肿瘤直径更大,开腹手术比例更高(P < .05)。与非并发症组相比,并发症组的血清 CRP、PLR 和 NLR 水平更高(P < .05)。相关性分析表明,血清 CRP、PLR 和 NLR 值与结直肠肿瘤患者术后并发症呈正相关(r > 0,P < .05)。逻辑回归模型显示,高血清 CRP 水平(95%CI:1.253-2.503)、PLR(95%CI:1.005-1.041)和 NLR 值(95%CI:2.702-20.533)是结直肠肿瘤患者术后并发症的危险因素(OR>1,P < .05)。ROC 曲线显示,血清 CRP 水平、PLR 和 NLR 值对结直肠肿瘤患者术后并发症有一定的预测价值(AUC=0.811、0.789、0.870),当截断值分别设定为 5.400 mg/L、142.790 和 2.485 时,预测价值最佳,联合检测显示出更高的预测价值(AUC=0.913)。术后一周,患者的 CRP 水平、PLR 值和 NLR 值均显著低于术前(P < .05):结论:术前血清CRP、PLR和NLR值与结直肠肿瘤患者术后并发症密切相关,可用于预测结直肠肿瘤患者术后并发症的风险。在临床上,通过测量上述指标可实现对患者术后并发症的早期预测,从而采取适当的预防措施,如排毒和感染控制,改善患者预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Preoperative C-reactive Protein and Other Inflammatory Biomarkers as Predictors of Postoperative Complications in Colorectal Tumor Patients.

Objective: This study aims to explore the predictive value of preoperative C-reactive protein (CRP) and other inflammatory biomarkers: platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) for postoperative complications (infection, diarrhea, etc.) in colorectal tumor patients.

Methods: A cohort of 109 colorectal tumor patients who underwent surgical resection for colorectal cancer at the hospital from January 2021 to December 2022 were selected as the research subjects. Patients' postoperative complications were tracked, and they were split into the complication group and the non-complication group. All patients underwent preoperative biochemical tests. Serum levels of CRP, PLR, and NLR were compared between the two groups. The relationship between these markers and postoperative complications in colorectal tumor patients was analyzed. A Logistic regression model was established to analyze their impact on postoperative complications, and a Receiver Operating Characteristic (ROC) curve was drawn to assess predictive value.

Results: Among the 109 colorectal tumor patients, 31 cases (28.44%) experienced postoperative complications. The complication group had larger tumor diameters and a higher proportion of open surgeries compared to the non-complication group (P < .05). Serum levels of CRP, PLR, and NLR were higher in the complication group compared to the non-complication group (P < .05). Correlation analysis showed that serum CRP, PLR, and NLR values were positively correlated with postoperative complications in colorectal tumor patients (r > 0, P < .05). The Logistic regression model revealed that high serum CRP levels (95%CI: 1.253-2.503), PLR (95%CI: 1.005-1.041), and NLR values (95%CI: 2.702-20.533) were risk factors for postoperative complications in colorectal tumor patients (OR>1, P < .05). The ROC curve demonstrated that serum CRP levels, PLR, and NLR values had certain predictive values for postoperative complications in colorectal tumor patients (AUC=0.811, 0.789, 0.870), the optimal predictive values were obtained when the cut-off values were set at 5.400 mg/L, 142.790, and 2.485, respectively and combined detection showed even higher predictive values (AUC=0.913). At 1 week post-surgery, the patient's CRP levels, PLR value, and NLR value were significantly lower than pre-surgery (P < .05).

Conclusion: Preoperative serum CRP, PLR, and NLR values are closely related to postoperative complications in colorectal tumor patients, and they can be used to predict the risk of postoperative complications in colorectal tumor patients. Clinically, early prediction of postoperative complications in patients can be achieved by measuring the aforementioned indicators, allowing for the implementation of appropriate preventive measures such as detoxification and infection control to improve patient outcomes.

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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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