Effects Of Preoperative Inflammation And Nutritional Indexes On Postoperative Complications Of Colorectal Cancer

Objective:To investigate the predictive value of preoperative Glasgow prognostic score(GPS)controlling nutrition score(CONUT)prognostic nutrition index(PNI)and neutrophils/lymphocyte ratio(NLR)in postoperative complications of patients undergoing colorectal cancer resection.Methods:The total number of peripheral blood lymphocytes,serum ALB,neutrophilic granulocyte count,platelet count,C-reactive protein,and total cholesterol were collected from patients 1 week before surgery,and m GPS,CONUT,NLR,PNI and other indicators were calculated.NLR= Total neutrophils/total lymphocytes;PNI= preoperative serum ALB(g/L)+5× total peripheral blood lymphocytes(×109/L);GPS(0/1/2)was C-reactive protein(CRP)≤10mg/L+ serum albumin(ALB)≥35g/L,respectively,0 points,C-reactive protein(CRP)> 10mg/L+ serum albumin(ALB)≥ 35g/L,or C-reactive protein(CRP)≤10mg/L+ serum albumin(ALB)< 35g/L,calculated as 1 point.C-reactive protein(CRP)> 10mg/L+ serum albumin(ALB)< 35g/L,2 points;CONUT score:(1)Serum albumin concentration > 35,30-34.9,25-29.9 and < 25g/L were 0,2,4and 6,respectively;(2)Total lymphocyte count > 1.6,1.2-1.59,0.8-1.19 and < 0.8×109/L were 0,1,2 and 3,respectively;(3)Total cholesterol concentrations > 180,140-179,100-139 and < 100mg/d L were 0,1,2 and 3,respectively,and CONUT scores were defined as the sum of(1),(2)and(3).According to postoperative laboratory examination,imaging examination and medical history,the occurrence of complications was determined,including anastomotic leakage,abdominal bleeding,digestive tract bleeding,pulmonary infection,abdominal infection,etc.,the incidence of complications,laboratory examination indicators,NLR,PNI,m GPS,CONUT and intraoperative differences were counted and their correlation was analyzed.Results:PNI group,CONUT group,m GPS group and NLR were independent influencing factors of complications.PNI group ≥45 was independent protective factor of complications,and the risk of complications was reduced by 74.1% compared with < 45 group.CONUT group was an independent risk factor for complications.The risk of complications in ≥3 group was 4.541 times that in < 3 group.m GPS grouping was an independent risk factor for complications.With the increase of m GPS score,the risk of complications increased gradually.NLR is an independent risk factor for complications,and the risk of complications increases with the increase of NLR.Conclusion:Preoperative PNI,CONUT score,m GPS score and NLR can be used clinically to evaluate the risk of postoperative complications of patients with colorectal cancer.Combining the four preoperative indicators of patients can better manage the perioperative period of patients,improve the preoperative nutritional status and inflammatory status of patients according to the indicators,and reduce the incidence of postoperative complications.