Effect Of 25(OH)D On Short-Term Prognosis Of Patients With Colorectal Cancer

Objective:Comparing the related data of colorectal cancer patients with different levels of 25-hydroxyvitamin D[25(OH)D],the relationship between 25(OH)D and the pathological features of colorectal cancer and its effect on the short-term prognosis of patients with colorectal cancer after operation were studied.Methods : From January,2021 to August,2022,92 colorectal cancer patients underwent radical resection in the same treatment group of colorectal surgery in the General Hospital of Ningxia Medical University.These patients included 71 males and 21 females,aged from 52-83 years,with an average age of(62.15±11.13)years.According to the diagnostic criteria of vitamin D deficiency and patients’ preoperative 25(OH)D level,these patients were divided into two groups(25(OH)D non-deficiency group-25(OH)D≥20ng/ml,25(OH)D deficiency group-25(OH)D < 20 ng/ml).Among them,there were 30 cases in25(OH)D non-deficiency group,including 26 males and 4 females,with an average age of(59.77±11.47)years.There were 62 cases with 25(OH)D deficiency group,including 45 males and 17 females,with an average age of(63.31±10.88)years.The differences between the two groups in maximum transverse diameter of tumor,tumor location,neurovascular invasion,tumor differentiation,lymph node metastasis,clinical stage and other tumor pathological features,as well as postoperative complications,the severity of patients with complications(evaluated by Clavien-Dindo complication classification),postoperative related inflammatory indicators,and the differences in short-term distant metastasis were compared and analyzed.Results:(1)In terms of tumor pathological features,there was no significant difference in tumor location,nerve invasion,tumor differentiation degree,lymph node metastasis,vascular tumor thrombus and clinical stage between the two groups(P > 0.05),but the maximum transverse diameter of the tumor in the 25(OH)D non-deficiency group was smaller than that in the 25(OH)D deficiency group(P=0.022),and there was significant difference.(2)According to the immunohistochemical results,there was no significant difference in the expression of MLH1 and MSH2 between the two groups(P > 0.05),but in the expression of EGFR and VEGF,the number of positive expression cases in the 25(OH)D non-deficiency group was lower than that in the 25(OH)D deficiency group(P=0.026,0.030),and there was significant difference.(3)The incidence,severity and postoperative hospital stay of patients with 25(OH)D non-deficiency group were lower than those with 25(OH)D deficiency group(P=0.041,0.039,0.044),and there was significant difference.In the short-term distant metastasis,there was no significant statistical difference between the two groups(P > 0.05).(4)Logistic regression model analysis showed that SII≥489.45 was a risk factor for postoperative complications(OR = 12.306,95% CI 2.112-71.696,P ≤0.05),and25(OH)D≥20ng/m L was a protective factor to prevent postoperative complications(OR =0.025,95%CI 0.003-0.226,P≤0.05).(5)In the inflammatory indexes of WBC,NLR,MLR,PLR,SII and SIRI,the preoperative and postoperative levels of patients with 25(OH)D non-deficiency group were lower than those of patients with 25(OH)D deficiency group.Among them,the difference of MLR expression level between the two groups was statistically significant(P=0.047),and the difference of NLR,PLR and SII expression level on the third day after operation was statistically significant(P=0.039,0.007 and 0.002).(6)The expression levels of CRP,IL-4 and IL-6 in patients with 25(OH)D non-deficiency group before and after operation were lower than those in patients with 25(OH)D deficiency group at the same time,and the expression level of CRP on the third day after operation was statistically significant(P = 0.039).On the contrary,the expression levels of albumin and IL-10 were higher in patients with 25(OH)D non-deficiency group before and after operation than those in patients with 25(OH)D deficiency group at the same time,and the expression levels of albumin on the third day after operation were statistically significant(P=0.019),and the expression levels of IL-10 before and on the third day after operation were statistically significant(P=0.033,0.027).Conclusion:This study shows that the maximum transverse diameter of colorectal cancer patients in the 25(OH)D non-deficiency group is smaller,the short-term postoperative inflammatory reaction is lighter,the postoperative complications were lower,the postoperative hospitalization time is shortened,and the short-term prognosis is better,suggesting that 25(OH)D has potential clinical value.