Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Nov 27, 2023; 15(11): 2456-2462
Published online Nov 27, 2023. doi: 10.4240/wjgs.v15.i11.2456
Correlation between pre-treatment serum total blood bilirubin and unconjugated bilirubin and prognosis in patients with colorectal cancer
Hui Tong, Peng Xing, Zhao-Ning Ji
Hui Tong, Peng Xing, Department of Medicine Oncology, Anhui Jingxian Hospital, Xuancheng 242500, Anhui Province, China
Zhao-Ning Ji, Department of Medicine Oncology, The First Affiliated Hospital of Wannan Medical College-Yijishan Hospital, Wuhu 241000, Anhui Province, China
Author contributions: Ji ZN designed the research; Tong H performed the research; Ji ZN and Xing P contributed new reagents or analytic tools; Tong H analyzed data and wrote the paper.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Jingxian Hospital in Anhui Province.
Informed consent statement: As the study used anonymous and pre-existing data, the requirement for informed consent from patients was waived.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhao-Ning Ji, Doctor, MD, Chief Doctor, Department of Medicine Oncology, The First Affiliated Hospital of Wannan Medical College-Yijishan Hospital, No. 2 Zheshan West Road, Wuhu 241000, Anhui Province, China. jzn18963705636@163.com
Received: August 9, 2023
Peer-review started: August 9, 2023
First decision: August 24, 2023
Revised: August 29, 2023
Accepted: September 20, 2023
Article in press: September 20, 2023
Published online: November 27, 2023
Processing time: 110 Days and 1.2 Hours
Abstract
BACKGROUND

Epidemiological studies have found that unconjugated bilirubin (UCB) levels are positively correlated with the incidence of colorectal cancer (CRC). Therefore, bilirubin may also play an important role in the prognosis of CRC.

AIM

To investigate the predictive value of total bilirubin (TBIL) and UCB in the prognosis of patients with CRC.

METHODS

A total of 142 CRC patients were selected as the research subjects in Jingxian Hospital, from October 2014 to May 2021. General and tumour-related clinical data at admission and the overall survival at 3 years after surgery were collected. The optimal cut-off values of TBIL and UCB were determined by receiver operating characteristic curve analysis. Univariate and multivariate Cox regression were used to analyse the effect of bilirubin level on the survival of CRC patients. The Kaplan–Meier method was used to assess the survival time.

RESULTS

The 3-year overall survival rate of CRC patients was significantly higher in the high TBIL (> 13.45 μmol/L) group than in the low TBIL (≤ 13.45 μmol/L) group (76.4% vs 37.1%; P < 0.05). The 3-year overall survival rate of CRC patients in the high UCB (> 10.75 μmol/L) group was significantly higher than that in the low UCB (≤ 10.75 μmol/L) group (83.3% vs 34.2%; P < 0.05). Multivariate Cox regression analysis showed that higher TBIL levels were an independent predictor of better prognosis in CRC patients (hazard ratio = 0.360, 95% confidence interval: 0.159-0.812, P = 0.014).

CONCLUSION

TBIL levels can be used as a prognostic indicator for CRC patients.

Keywords: Bilirubin; Colorectal neoplasms; Prognosis

Core Tip: In this study, we demonstrated that bilirubin levels may be used as a prognostic indicator in colorectal cancer (CRC) patients. Higher total bilirubin (TBIL) and unconjugated bilirubin levels were negatively correlated with 3-year survival in CRC patients. TBIL may be used as a protective prognostic indicator in patients with CRC.