C-Reactive Protein in Peritoneal Fluid for Predicting Anastomotic Leakage After Colorectal Cancer Surgery: A...

Area of Science:

• Gastroenterology
• Surgical Oncology
• Biomarker Discovery

Background:

• Anastomotic leakage (AL) is a severe complication post-colorectal cancer (CRC) surgery, increasing patient morbidity.
• Serum C-reactive protein (CRP) is a systemic marker, but peritoneal fluid CRP may offer localized, early detection of AL.
• This meta-analysis evaluates peritoneal fluid CRP as a diagnostic biomarker for AL in CRC patients.

Purpose of the Study:

• To assess the diagnostic accuracy of peritoneal fluid CRP for detecting anastomotic leakage after colorectal cancer surgery.
• To enhance postoperative monitoring and patient care strategies for colorectal cancer patients.

Main Methods:

• A systematic literature search adhering to PRISMA guidelines was performed.
• Studies were included based on stringent criteria, and diagnostic accuracy was pooled using a random-effects model.
• Risk of bias was evaluated using the QUADAS-2 tool.

Main Results:

• The meta-analysis demonstrated good diagnostic accuracy for peritoneal fluid CRP, with pooled sensitivity of 0.74, specificity of 0.83, and an AUC of 0.84.
• Diagnostic performance for sensitivity was consistent, but high heterogeneity was noted for specificity.
• Improved diagnostic performance was observed between postoperative days 5-7 and with CRP cut-off values of 70-150 mg/L.

Conclusions:

• Peritoneal fluid CRP is a reliable biomarker for detecting anastomotic leakage following CRC surgery, especially in the later postoperative phase.
• Heterogeneity in study methodologies and patient populations may limit the generalizability of findings.
• Future research should prioritize protocol standardization and the investigation of complementary biomarkers to enhance diagnostic precision.