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使用C-反应蛋白水平识别西格结肠癌和直肠癌中术后并发症的鉴定
Taro Munechika1, Gumpei Yoshimatsu2, Takayuki Akasaki1
1Department of Surgery, Fukuoka University Hospital, 7-45-1 Nanakuma, Jonan-Ku, Fukuoka, Fukuoka, 814-0180, Japan.
手术后的C反应蛋白 (CRP) 水平偏差可以预测左侧结直肠癌手术后的外科并发症. 在术后第一和第三天监测CRP有助于识别患有早期干预风险的患者.
科学领域:
- 在瘤学瘤学.
- 外科胃肠道外科手术
- 生物标志物研究 生物标志物研究
背景情况:
- 结直肠癌手术后的术后并发症需要早期检测和干预.
- 外科医生的经验往往决定了诊断测试,缺乏识别并发症的客观标准.
- 炎症标志物C反应性蛋白 (CRP) 水平受到手术压力的影响,使其在诊断并发症中的使用变得复杂.
研究的目的:
- 评估C反应性蛋白 (CRP) 水平在左侧结直肠癌手术后术后并发症的预测值.
- 通过CRP水平和预测模型,建立识别外科并发症的客观标准.
- 通过CRP偏差分析来区分正常的炎症反应和实际并发症.
主要方法:
- 在没有并发症的患者中,使用基于手术前和早期手术后CRP测量 (PODs 1, 3, 5, 7) 的线性回归来开发正常的术后CRP水平的预测模型.
- 对所有患者计算了测量和预测CRP值之间的差异.
- 分析了CRP偏差与测量当天或第二天手术并发症发生的相关性.
主要成果:
- 在498名患者中,47人出现并发症,包括25例手术并发症.
- 在术后第一天 (POD1),测量CRP水平≥12.1 mg/dL与偏差≥+6.7 mg/dL相结合,显著预测了手术并发症.
- 在术后第3天 (POD3),测量CRP水平≥10.8 mg/dL加上偏差≥+4.14 mg/dL与增加的外科并发症发生率显著相关.
结论:
- 术后第一和第三天C反应蛋白 (CRP) 水平与预测值的偏差是早期检测手术并发症的宝贵工具.
- 这种方法提供了客观的标准,以帮助外科医生识别需要进一步调查左侧结直肠癌手术后并发症的患者.
- 使用CRP偏差分析可以导致及时干预,可能改善患者的治疗结果.
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