血清PCT、IL-6、CRP/ALB、miR335-5-p对结直肠癌术后肠梗阻的预测价值分析

Predictive value of serum PCT,IL-6,CRP/ALB and miR-335-5p forbowel obstruction after colorectal cancer surgery

目的探讨血清降钙素原(PCT)、白细胞介素-6(IL-6)、C反应蛋白/清蛋白(CRP/ALB)、微小RNA-335-5p(miR-335-5p)对结直肠癌(CRC)术后肠梗阻的预测价值。方法选取2022年7月至2023年7月该院收治并进行手术治疗的100例CRC患者,观察术后1周患者有无肠梗阻情况发生,根据发生情况将其分为肠梗阻组(13例)和非肠梗阻组(87例)。对比两组临床资料及血清PCT、IL-6、CRP/ALB、miR-335-5p水平,采用Logistic多因素回归分析CRC术后发生肠梗阻的危险因素,并分析血清PCT、IL-6、CRP/ALB、miR-335-5p对CRC术后发生肠梗阻的预测价值。结果CRC患者术后血清PCT、IL-6、CRP/ALB、miR-335-5p水平均高于术前(P<0.05)。100例CRC手术患者中,术后2周内发生肠梗阻共13例(13.00%)。肠梗阻组直肠肿瘤、临床分期Ⅲ期占比高于非肠梗阻组,腹腔镜手术占比低于非肠梗阻组(P<0.05)。肠梗阻组血清PCT、IL-6、CRP/ALB水平高于非肠梗阻组,miR-335-5p水平低于非肠梗阻组(P<0.05)。血清PCT、IL-6、CRP/ALB是CRC术后肠梗阻发生的独立危险因素(P<0.05),miR-335-5p是保护因素(P<0.05)。血清PCT、IL-6、CRP/ALB、miR-335-5p及联合预测CRC术后发生肠梗阻的曲线下面积(AUC)为0.818、0.805、0.862、0.938、0.980,联合预测的AUC高于单项检测(Z_(PCT-联合检测)=2.193,Z_(IL-6-联合检测)=2.210,Z_(CRP/ALB-联合检测)=2.188,Z_(miR-335-5p-联合检测)=2.437,P<0.05)。结论CRC患者术后血清PCT、IL-6、CRP/ALB、miR-335-5p对其肠梗阻的发生具有一定预测价值,联合检测很大程度上可提高预测术后肠梗阻发生的准确性。

Objective To investigate the predictive value of serum procalcitonin(PCT),interleukin-6(IL-6),C-reactive protein/albumin(CRP/ALB)and microRNA-335-5p(miR-335-5p)for bowel obstruction after colorectal cancer(CRC)surgery.Methods A total of 100 CRC patients admitted to the hospital and underwent surgical treatment from July 2022 to July 2023 were selected to observe whether intestinal obstruction occurred in patients 1 week after surgery,and they were divided into the intestinal obstruction group(13 cases)and the non-intestinal obstruction group(87 cases)according to the occurrence of intestinal obstruction.The clinical data and serum PCT,IL-6,CRP/ALB,miR-335-5p levels of the two groups were compared,and Multivariate Logistic regression was used to analyze the risk factors for the occurrence of intestinal obstruction after CRC surgery.The predictive value of serum PCT,IL-6,CRP/ALB,miR-335-5p for the occurrence of intestinal obstruction after CRC surgery was analyzed.Results Postoperative serum PCT,IL-6,CRP/ALB and miR-335-5p levels were higher than the preoperative levels in CRC patients(P<0.05).Among 100 patients for CRC surgery,a total of 13(13.00%)developed intestinal obstruction within 2 weeks after surgery.The proportions of rectal tumor and clinical stageⅢ、miR-335-5p were higher in the intestinal obstruction group than those in the non-intestinal obstruction group,and the proportion of laparoscopic surgery was lower than that in the non-intestinal obstruction group(P<0.05).Serum PCT,IL-6,and CRP/ALB levels were higher in the intestinal obstruction group than those in the non-intestinal obstruction group,miR-335-5p level was lower than that in the non-intestinal obstruction group(P<0.05).Serum PCT,IL-6 and CRP/ALB were independent risk factors for the occurrence of intestinal obstruction after CRC surgery(P<0.05),and miR-335-5p was a protective factor(P<0.05).The area under the curve(AUC)of serum PCT,IL-6,CRP/ALB,miR-335-5p and the combined detection for predicting the occurrence of intestinal obstruction after CRC surgery was 0.818,0.805,0.862,0.938,and 0.980,and AUC of the combined detection was higher than that of single detection(Z _(PCT-combined detection)=2.193,Z _(IL-6 combined detection)=2.210,Z _(CRP/ALB combined detection)=2.188,Z _(miR-335-5p combined detection)=2.437,P<0.05).Conclusion Postoperative serum PCT,IL-6,CRP/ALB and miR-335-5p of CRC patients have a certain predictive value for the occurrence of intestinal obstruction in patients,and the combined detection could largely improve the accuracy of predicting the occurrence of postoperative intestinal obstruction.