NLR Combined With PCT,IL-6 And CRP In Early Diagnosis Of AL After Rectal Cancer Surgery

Objective:To investigate the value of Neutrophil to lymphocyte ratio(NLR)combined with procalcitonin(PCT),interleukin-6(IL-6)and C-reactive protein(CRP)in the early diagnosis of anastomotic leakage(AL)in patients with rectal cancer after surgery.Methods: A total of 296 patients who underwent total mesorectal resection from January 2020 to December 2021 in the First Affiliated Hospital of Xinjiang Medical University were collected.The patients were divided into AL group(n=22)and non-AL group(n=274)according to whether they had anastomotic leakage.The levels of NLR and inflammatory factors(PCT,IL-6,CRP)on the 1st and 3rd day after operation were compared between the two groups,and the efficacy of NLR,PCT,IL-6,CRP in predicting early AL was analyzed.Results: The NLR values of AL group were 12.54±3.22 and 11.72±6.8 on day 1 and day 3 after operation.The PCT values were(2.09±1.19)μg/L and 12.11±8.36)μg/L;The values of IL-6 were(57.58±11.04)Pg/ml and(147.11±111.66)Pg/ml;CRP values were(46.79±31.58)mg/L and(217.76±81.25)mg/L.NLR values in non-AL group were 9.3±6.21 and 6.49±5.3;The levels of PCT were(1.93±8.95)μg/L and(1.05±4.72)μg/L,and the levels of IL-6were(39.66±22.97)Pg/ml and(41.75±72.38)Pg/ml.The CRP values were(30.99±40.16)mg/L and(32.59±38.87)mg/L.There were significant differences between AL group and non-AL group(P<0.05)except PCT and CRP on the first day after operation(P>0.05).On the 3rd day after operation,The optimal cut-off values of NLR,PCT,IL-6 and CRP were 4.97,1.62μg/L,85.76Pg/ml and 112.98mg/L.The sensitivities were 100%,100%,72.7% and 90.9%.The specificity were 51.8%,95.3%,89.4% and 97.1%.The negative predictive values were 100.0%,100.0%,97.6% and99.25%.The positive predictive values were 14.3%,62.8%,35.6% and 71.4%.The sensitivity and specificity of combined detection were 95.5% and 93.8%.The combined detection of NLR,PCT,IL-6 and CRP on the third day after operation was better than that of each index alone.Conclusion:Combined detection of NLR,PCT,IL-6 and CRP can effectively diagnose anastomotic leakage in patients undergoing radical resection of rectal cancer.