Plasma-Derived Exosomal circGAPVD1 Predicts Malignant Bowel Obstruction in Colorectal Cancer

This study aimed to investigate the predictive value of the hematological parameters WBC, NE, LY, RBC, HGB, RDW, PLT, NLR, PLR, and plasma-derived exosomal circGAPVD1 on postoperative malignant bowel obstruction (MBO) in colorectal cancer (CRC).

A total of 120 CRC patients who underwent surgical treatment were selected. One week after surgery, they were divided into the MBO group (20 cases, 16.67%) and non-MBO group (100 cases, 83.33%). The clinical data, hematological parameters, and plasma-derived exosomal circGAPVD1 were compared between the two groups. Logistic multifactorial regression was conducted to analyze the risk factors for MBO after CRC and to explore the predictive value of plasma-derived exosomal circGAPVD1 and hematological parameters NE, RDW, NLR, and PLR for MBO after CRC.

WBC, NE, LY, RBC, HGB, RDW, PLT, NLR, PLR, and plasma-derived exosomal circGAPVD1 were higher than preoperative levels in CRC patients after surgery (p < 0.05). In total, 20 (16.67%) out of 120 patients developed MBO in the first 2 weeks after surgery. In the MBO group, there was a higher percentage of rectal tumors and clinical stage III cases compared to the non-MBO group, while the percentage of laparoscopic surgeries was lower (p < 0.05). WBC, NE, LY, RBC, HGB, RDW, PLT, NLR, PLR, and plasma-derived exosomal circGAPVD1 were higher in the MBO group than in the non-MBO group. NE, RDW, NLR, and PLR were independent risk factors for MBO after CRC (p < 0.05). The areas under the curve of plasma-derived exosomal circGAPVD1 in combination with hematological parameters NE, RDW, NLR, and PLR were 0.855, 0.609, 0.698, 0.732, 0.832, and 0.832, respectively, higher than that of the single test.

Postoperative plasma-derived exosomal circGAPVD1 and hematological parameters NE, RDW, NLR, and PLR have a predictive value for MBO in CRC patients, and the combined test can largely improve the accuracy of predicting MBO.