Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Feb 27, 2024; 16(2): 451-462
Published online Feb 27, 2024. doi: 10.4240/wjgs.v16.i2.451
Preoperative blood markers and intra-abdominal infection after colorectal cancer resection
Chang-Qing Liu, Zhong-Bei Yu, Jin-Xian Gan, Tian-Ming Mei
Chang-Qing Liu, Zhong-Bei Yu, Jin-Xian Gan, Tian-Ming Mei, Department of Gastrointestinal Anorectal Surgery, Suzhou Hospital Affiliated to Anhui Medical University, Suzhou 234000, Anhui Province, China
Author contributions: Liu CQ designed and performed the study and wrote the paper; Mei TM designed the study and supervised the report; Gan JX collected the data and contributed to the analysis; Yu ZB provided clinical advice.
Supported by Suzhou Health Scientific Research Project, No. SZWJ2022a001.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Suzhou Hospital affiliated to Anhui Medical University.
Informed consent statement: The Ethics Committee has waived informed consent.
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: Tian-Ming Mei, MBBS, Chief Physician, Department of Gastrointestinal Anorectal Surgery, Suzhou Hospital Affiliated to Anhui Medical University, No. 616 Bianyang Third Road, Yongqiao District, Suzhou 234000, Anhui Province, China. mtm19871018@126.com
Received: November 21, 2023
Peer-review started: November 21, 2023
First decision: December 5, 2023
Revised: December 16, 2023
Accepted: January 23, 2024
Article in press: January 23, 2024
Published online: February 27, 2024
Processing time: 96 Days and 6.6 Hours
Abstract
BACKGROUND

Colorectal cancer (CRC) has one of the highest morbidity and mortality rates among digestive tract tumors. Intra-abdominal infection (IAI) is a common postoperative complication that affects the clinical outcomes of patients with CRC and hinders their rehabilitation process. However, the factors influencing abdominal infection after CRC surgery remain unclear; further, prediction models are rarely used to analyze preoperative laboratory indicators and postoperative complications.

AIM

To explore the predictive value of preoperative blood markers for IAI after radical resection of CRC.

METHODS

The data of 80 patients who underwent radical resection of CRC in the Anorectal Surgery Department of Suzhou Hospital affiliated with Anhui Medical University were analyzed. These patients were categorized into IAI (n = 15) and non-IAI groups (n = 65) based on whether IAI occurred. Influencing factors were compared; general data and laboratory indices of both groups were identified. The relationship between the indicators was assessed. Further, a nomogram prediction model was developed and evaluated; its utility and clinical applicability were assessed.

RESULTS

The risk factors for IAI after radical resection of CRC were neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and carcinoembryonic antigen (CEA) levels. NLR was correlated with PLR and SII (r = 0.604, 0.925, and 0.305, respectively), while PLR was correlated with SII (r = 0.787). The nomogram prediction model demonstrated an area under the curve of 0.968 [95% confidence interval (CI): 0.948-0.988] in the training set (n = 60) and 0.926 (95%CI: 0.906-0.980) in the validation set (n = 20). The average absolute errors of the calibration curves for the training and validation sets were 0.032 and 0.048, respectively, indicating a good model fit. The decision curve analysis curves demonstrated high net income above the 5% threshold, indicating the clinical practicality of the model.

CONCLUSION

The nomogram model constructed using NLR, PLR, SII, and CEA levels had good accuracy and reliability in predicting IAI after radical resection of CRC, potentially aiding clinical treatment decision-making.

Keywords: Radical resection of colorectal cancer; Inflammatory factors; Intra-abdominal infection; Predictive model; Blood markers

Core tip: Intra-abdominal infection (IAI) is a common and serious complication following the radical resection of colorectal cancer (CRC) that affects the efficacy of surgery, prolongs hospital stay, and hinders the postoperative rehabilitation process of patients. In this study, the clinical data of 80 patients who underwent radical resection for CRC were retrospectively analyzed. Based on whether IAI occurred, patients were divided into IAI and non-IAI groups. The relationship between IAI and preoperative neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, systemic immune-inflammation index, and carcinoembryonic antigen levels in patients after radical resection of CRC was studied, and a prediction model with good prediction accuracy was developed.