Predictive value of C-reactive protein, procalcitonin, and total bilirubin levels for pancreatic fistula after gastrectomy for gastric cancer

Table 1 Comparison of serum C-reactive protein, procalcitonin, and total bilirubin levels on day 1 post-surgery between the two groups, mean ± SD

Groups	n	PCT (μg/mL)	CRP (mg/L)	TBil (μmol/L)
Non-pancreatic fistula group	127	0.71 ± 0.11	106.69 ± 20.46	17.69 ± 4.13
Pancreatic fistula group	31	0.99 ± 0.33	173.14 ± 32.45	20.83 ± 4.18
t value		8.020	14.266	3.786
P value		0.000	0.000	0.000

CRP: C-reactive protein; PCT: Procalcitonin; TBil: Total bilirubin.

Table 2 Comparison of serum C-reactive protein, pro-calcitonin, and total bilirubin levels on day 1 post-surgery in patients with different grades of pancreatic fistula, mean ± SD

Grade	n	PCT (μg/mL)	CRP (mg/L)	TBil (μmol/L)
Grade A	13	0.74 ± 0.14	145.69 ± 25.13	18.69 ± 1.66
Grade B	7	0.96 ± 0.161	176.58 ± 22.691	21.59 ± 1.141
Grade C	11	1.37 ± 0.171,2	191.56 ± 36.251,2	24.15 ± 1.371,2
F value		49.375	7.682	41.902
P value		< 0.001	0.002	< 0.001

¹P < 0.05 compared with grade A.

²P < 0.05 compared with grade B.

CRP: C-reactive protein; PCT: Procalcitonin; TBil: Total bilirubin.

Table 3 Univariate analysis of factors affecting the development of a pancreatic fistula following radical gastrectomy for gastric cancer, mean ± SD

Factors	Groups	Pancreatic fistula group (n = 31)	Non-pancreatic fistula group (n = 127)	t/χ2 value	P value
Age (years)	≥ 60	20	71	0.756	0.384
	< 60	11	56
Sex	Male	18	70	0.088	0.767
	Female	13	57
Diabetes	Yes	16	30	9.460	0.002
	No	15	97
Hypertension	Yes	6	21	0.140	0.708
	No	25	106
Hyperlipidemia	Yes	13	16	14.311	0.000
	No	18	111
Hemoglobin (g/L)	Normal	29	117	0.012	0.912
	Descend	2	10
Albumin (g/L)	Normal	29	121	0.004	0.949
	Descend	2	6
History of abdominal surgery	Yes	3	7	0.196	0.658
	No	28	120
Operative time (hour)	≤ 3	19	84	0.258	0.611
	> 3	12	43
Intraoperative pancreatic injury	Yes	14	16	17.177	0.000
	No	17	111
Combined splenectomy	Yes	4	2	4.785	0.029
	No	27	125
Combined splenectomy and partial pancreatectomy	Yes	2	2	0.832	0.362
	No	29	125
Retro-pancreatic lymph node dissection	Yes	19	60	1.967	0.161
	No	12	67
Scope of gastric resection	Proximal stomach	4	18	0.080	0.961
	Distal stomach	18	75
	Whole stomach	9	34
Post-operative pathological staging	I-II	12	51	0.022	0.883
	III-IV	19	76
Serum PCT level on day 1 post-surgery (g/mL)		0.99 ± 0.33	0.71 ± 0.11	8.020	0.000
Serum CRP level on day 1 post-surgery (mg/L)		173.14 ± 32.45	106.69 ± 20.46	14.266	0.000
Serum TBil level on day 1 post-surgery (μmol/L)		20.83 ± 4.18	17.69 ± 4.13	3.786	0.000

Hemoglobin levels are considered normal at ≥ 110 g/L; Albumin levels are considered normal at ≥ 35 g/L. CRP: C-reactive protein; PCT: Procalcitonin; TBil: Total bilirubin.

Table 4 Multivariate analysis of factors affecting the development of a pancreatic fistula following radical gastrectomy for gastric cancer

Factors	β	SE	Wald χ2 value	OR	P value	95%CI
Diabetes	1.336	0.453	8.698	3.804	0.003	1.565-9.243
Hyperlipidemia	1.016	0.337	9.089	2.762	0.003	1.427-5.347
Intraoperative pancreatic injury	1.559	0.336	18.144	21.528	0.000	2.461-9.185
Serum PCT level on day 1 post-surgery	0.841	0.216	15.159	2.319	0.000	1.518-3.541
Serum CRP level on day 1 post-surgery	0.461	0.049	88.514	1.586	0.000	1.440-1.745

CRP: C-reactive protein; PCT: Procalcitonin; CI: Confidence interval; OR: Odds ratio; SE: Standard error.

Table 5 The predictive value of serum C-reactive protein, procalcitonin, and total bilirubin levels for post-surgical pancreatic fistula on day 1 post-surgery

Indicators	Critical value	AUC	95%CI	P value	Sensitivity	Specificity
Serum PCT level on day 1 post-surgery	0.84	0.803	0.718-0.889	0.000	74.2	83.5
Serum CRP level on day 1 post-surgery	133.83	0.792	0.697-0.887	0.000	67.7	87.3
Serum TBil level on day 1 post-surgery	20.16	0.683	0.581-0.785	0.002	64.5	63.8
Combination of the three indices		0.857	0.784-0.929	0.000	87.1	76.4

CRP: C-reactive protein; PCT: Procalcitonin; TBil: Total bilirubin; AUC: Area under the curve; CI: Confidence interval.