文献类型：期刊文献

英文题名：Preoperative neutrophil-to-lymphocyte ratio predicts symptomatic anastomotic leakage in elderly colon cancer patients: Multicenter propensity score-matched analysis

作者：Wang, Chao-Yang[1];Li, Xiao-Long[2];Ma, Xiao-Long[3];Yang, Xiong-Fei[4];Liu, Yong-Yong[5];Yu, Yong-Jiang[2]

第一作者：Wang, Chao-Yang

通信作者：Yu, YJ[1]

机构：[1]Lanzhou Univ, Clin Med Coll 1, Dept Clin Med, Lanzhou 730000, Gansu, Peoples R China;[2]Lanzhou Univ, Hosp 1, Dept Gastrointestinal Surg, 1 Donggang West Rd, Lanzhou 730000, Gansu, Peoples R China;[3]Gansu Univ Chinese Med, Dept Clin Med, Lanzhou 730000, Gansu, Peoples R China;[4]Gansu Prov Peoples Hosp, Dept Anorectol, Lanzhou 730000, Gansu, Peoples R China;[5]Lanzhou Univ, Hosp 2, Dept Gen Surg, Lanzhou 730000, Gansu, Peoples R China

第一机构：Lanzhou Univ, Clin Med Coll 1, Dept Clin Med, Lanzhou 730000, Gansu, Peoples R China

通信机构：[1]corresponding author), Lanzhou Univ, Hosp 1, Dept Gastrointestinal Surg, 1 Donggang West Rd, Lanzhou 730000, Gansu, Peoples R China.

年份：2024

卷号：16

期号：2

外文期刊名：WORLD JOURNAL OF GASTROINTESTINAL SURGERY

收录：;WOS:【SCI-EXPANDED(收录号:WOS:001188178400036)】；

基金：Supported by the Natural Science Foundation of Gansu Province, China, No. 21JR1RA075 and No. 22JR5RA895; and Lanzhou Science and Technology Program, China, No. 2021-1-109

语种：英文

外文关键词：Age; Colon cancer; Anastomotic leak; Neutrophil-to-lymphocyte ratio; Propensity score-matched

摘要：BACKGROUND The neutrophil-to-lymphocyte ratio (NLR), a composite inflammatory biomarker, is associated with the prognosis in patients with colorectal tumors. However, whether the NLR can be used as a predictor of symptomatic postoperative anastomotic leakage (AL) in elderly patients with colon cancer is unclear. AIM To assess the role of the NLR in predicting the occurrence of symptomatic AL after surgery in elderly patients with colon cancer. METHODS Data from elderly colon cancer patients who underwent elective radical colectomy with anastomosis at three centers between 2018 and 2022 were retrospectively analyzed. Receiver operating characteristic curve analysis was performed to determine the best predictive cutoff value for the NLR. Twenty-two covariates were matched using a 1:1 propensity score matching method, and univariate and multivariate logistic regression analyses were used to determine risk factors for the development of postoperative AL. RESULTS Of the 577 patients included, 36 (6.2%) had symptomatic AL. The optimal cutoff value of the NLR for predicting AL was 2.66. After propensity score matching, the incidence of AL was significantly greater in the >= 2.66 NLR subgroup than in the < 2.66 NLR subgroup (11.5% vs 2.5%; P = 0.012). Univariate logistic regression analysis revealed statistically significant correlations between blood transfusion intraoperatively and within 2 d postoperatively, preoperative albumin concentration, preoperative prognostic nutritional index, and preoperative NLR and AL occurrence (P < 0.05); multivariate logistic regression analysis revealed that an NLR >= 2.66 [odds ratio (OR) = 5.51; 95% confidence interval (CI): 1.50-20.26; P = 0.010] and blood transfusion intraoperatively and within 2 d postoperatively (OR = 2.52; 95%CI: 0.88-7.25; P = 0.049) were risk factors for the occurrence of symptomatic AL. CONCLUSION A preoperative NLR >= 2.66 and blood transfusion intraoperatively and within 2 d postoperatively are associated with a higher incidence of postoperative symptomatic AL in elderly patients with colon cancer. The preoperative NLR has predictive value for postoperative symptomatic AL after elective surgery in elderly patients with colon cancer.