术前炎症指标、纤维蛋白原、载脂蛋白B与早期结直肠癌淋巴结转移的关系

Relationship Between Preoperative Inflammatory Markers,Fibrinogen,Apolipoprotein B and Lymph Node Metastasis in Early Colorectal Cancer

背景:随着国民健康意识的提高和一系列筛查方法的普及,早期结直肠癌发生率逐渐增加,准确预测早期结直肠癌淋巴结转移是确定最佳治疗方案的关键。目的:探究术前炎症指标、纤维蛋白原、载脂蛋白B与早期结直肠癌淋巴结转移的关系。方法:回顾性分析2014年1月—2022年12月于江苏大学附属医院接受外科手术治疗的102例早期结直肠癌患者的临床资料,按术后病理结果将患者分为淋巴结转移阳性组和淋巴结转移阴性组,采用单因素和多因素Logistic回归分析评估临床参数与早期结直肠癌淋巴结转移之间的关系。应用ROC曲线评估不同临床参数预测早期结直肠癌淋巴结转移的价值。结果:共102例早期结直肠癌患者纳入本研究中,其中男性53例,女性49例,平均年龄(64.0±10.1)岁,术后病理检查示淋巴结转移13例,无淋巴结转移89例。单因素Logistic回归分析显示,年龄、纤维蛋白原和载脂蛋白B与单核细胞比值(AMR)与早期结直肠癌淋巴结转移相关(P<0.05),多因素Logistic回归分析显示,年龄、纤维蛋白原和AMR是早期结直肠癌患者淋巴结转移的独立预测因素(P<0.05)。临界值分别为62.5岁、34.0 mg/L、2.1时,年龄、纤维蛋白原、AMR预测淋巴结转移的AUC分别为0.741、0.601、0.686,三者联合的AUC为0.804。结论:年龄、纤维蛋白原和AMR可能在预测早期结直肠癌淋巴结转移中扮演重要的角色,可以与病理指标相结合进一步创建新的预测模型,从而为结直肠癌患者治疗方案的抉择提供一些参考。

Background:With the improvement of national health awareness and the popularization of a series of screening methods,the incidence of early colorectal cancer is gradually increasing,accurate prediction of lymph node metastasis of early colorectal cancer is the key to determine the optimal therapeutic regimen.Aims:To investigate the relationship between preoperative inflammatory markers,fibrinogen,apolipoprotein B and lymph node metastasis in patients with early colorectal cancer.Methods:The clinical data of 102 early colorectal cancer patients received surgical treatment from January 2014 to December 2022 at Affiliated Hospital of Jiangsu University were retrospectively analyzed.The patients were divided into lymph node metastasis positive group and lymph node metastasis negative group according to postoperative pathological results.Univariate and multivariate Logistic regression analysis were employed to explore the correlation between lymph node metastasis and clinical parameters in early colorectal cancer.ROC curve was used to assess the value of different clinical parameters for predicting lymph node metastasis in early colorectal cancer.Results:A total of 102 patients with early colorectal cancer were enrolled in this study,including 53 males and 49 females,and the mean age was(64.0±10.1)years.Postoperative pathological examination showed that lymph node metastasis in 13 patients,and 89 patients without lymph node metastasis.The univariate Logistic regression analysis showed that age,fibrinogen and apolipoprotein B⁃to⁃monocyte ratio(AMR)were related to lymph node metastasis in early colorectal cancer(P<0.05).The multivariate Logistic regression analysis showed that age,fibrinogen and AMR were independent predictors of lymph node metastasis in early colorectal cancer(P<0.05).When the cut⁃off value were 62.5 years,34.0 mg/L,2.1,respectively,the AUC of age,fibrinogen and AMR for predicting lymph node metastasis were 0.741,0.601,0.686,respectively.AUC of the combination of the three parameters was 0.804.Conclusions:Age,fibrinogen and AMR may play an important role in predicting lymph node metastasis in early colorectal cancer.They can be combined with pathological factors to further create a new prediction model,so as to provide some reference for patients with colorectal cancer to choose the therapeutic regimen。