Correlation Between Preoperative Inflammatory Markers And Clinicopathological Features And Postoperative Complications In Patients With Colorectal Cancer

Objective:To investigate the role of the Prognosis Nutrition Index(OPNI)in preoperative peripheral blood in the nutritional screening of patients with colorectal cancer and the relationship between neutrophil/lymphocyte ratio(NLR)and platelet/lymphocyte ratio(PLR)in colorectal cancer.Correlation between clinicopathological features and postoperative complications in patients undergoing surgery.Methods;A retrospective analysis of the clinical data of 448 consecutive patients who underwent surgical treatment of colorectal malignancies after surgical operation from September 2014 to August 2016 in the Department of Gastrointestinal Surgery,North Jiangsu People's Hospital.Preoperative Nutrition Risk Screening 2002(NRS2002),nutritional risk screening NRS2002 as the gold standard for nutritional risk(screening NRS2002?3 for patients with nutritional risk,NRS2002<3 for patients I think there is no nutritional risk for the time being).Using the blood routine and biochemical test results within one week before surgery,the onion index was calculated using serum albumin value(ALB),neutrophil count(NE),platelet count(PLT),and total peripheral blood lymphocyte count(TLC).(OPNI),neutrophil/lymphocyte ratio(NLR),platelet/lymphocyte ratio(PLR).OPNI=ALB+5 × TLC.Taking the OPNI as the test variable,NRS2002 is the standard grouping result of the nutritional risk and the temporary non-nutrition risk patient as the state variable,making the Receiver Operating Characteristic curve,determining the most cutoff value of OPNI,and according to the cutoff point(OPNI=45.8)were grouped and the consistency of OPNI and NRS2002 in colorectal cancer nutrition screening was analyzed using Kappa test.Patients with colorectal cancer were divided into high OPNI group and low OPNI group,high NLR group and low NLR group,high PLR group and low PLR group with threshold value to analyze OPNI,NLR,PLR,NRS2002 and patient age,gender and tumor location,tumor size,gross tumor type,TNM stage,depth of tumor invasion,lymphatic metastasis and other clinicopathological features and postoperative complications.Results:In patients with colorectal cancer,the total score of NRS2002 before surgery was<3(no nutrition risk group),289(64.5%),NRS2002?3(with nutritional risk group),159(35.5%).NRS2002 was not statistically significant with gender,tumor diameter,tumor type,and metastasis(P>0.05).The NRS2002 was related to the age of the patient,with an X2 value of 56.843,P<0.001,and a Spearman correlation R value of 0.356.The NRS2002 score was associated with the depth of tumor invasion,with an X2 value of 19.912,P<0.001,and a Spearman correlation R value of 0.211;NRS2002 was related to TNM stage,X2 value 11.527,P=0.001,Spearman correlation R value 0.160,associated with lymphatic metastasis,X2 value 12.569,P<0.001,Spearman correlation R value-0.167.The ROC curve was plotted to show that the area under the arc was 0.822(95%CI:0.781 to 0.864),the approximate index was 0.576,and the cutoff point of OPNI was 45.8.The sensitivity for diagnosing nutritional risk was 86.5%and the specificity was 71.1%.OPNI was divided into two groups,296(66.1%)patients with high OPNI group(OPNI?45.8)and 152 patients(33.9%)with low OPNI group(OPNI<45.8).Kappa test analysis showed that kappa=0.582(p<0.001)when OPNI=45.8 was the critical value,which was in good agreement with NRS2002.There were no significant differences in gender,tumor diameter,gross tumor type,TNM stage,lymph node metastasis,and distant metastasis between the two groups(P>0.05).The OPNI was correlated with the age of colorectal cancer patients,with an X2 value of 8.299,P=0.004,and a Spearman correlation R value of 0.136.The OPNI index was associated with tumor sites in patients with colorectal cancer,with an X2 value of 65.175,P<0.001,and a Spearman correlation R value of 0.381.The OPNI index was associated with the depth of tumor infiltration in patients with colorectal cancer.X2 value was 11.628,P=0.001,spearman correlation R The value is-0.161.NLR and PLR were selected as the best cutoff point with median 3 and 163.3,respectively.The preoperative NLR was divided into high and low NLR groups,including 224 patients with NLR2.36 and 22 patients with NLR<2.36.To analyze the clinical pathology of different NLR groups and colorectal cancer patients,whether there is statistical difference.There was no statistically significant difference between NLR and gender,age,tumor diameter,tumor gross classification,TNM stage,lymphatic metastasis and distant metastasis(P>0.05).The relationship between the high NLR group(NLR>2.36)and the low NLRI group(NLR<2.36)was analyzed.The results showed that NLR was associated with the tumor site of colorectal cancer patients,X2 value was 13.069,P<0.001,Spearman correlation.The R value was-0.171.NLR was associated with the depth of tumor invasion in patients with colorectal cancer.The X2 value was 13.708,P<0.001,and the spearman correlation R value was 0.175.The PLR was divided into 224 patients with high PLR group(PLR?163.3)and 224 patients with low PLR group(NLR<163.3).Analyze the clinical and pathological features of patients with different PLR and colorectal cancer,whether there is a statistical difference.The results of the analysis showed that PLR was associated with tumor sites in patients with colorectal cancer,with an X2 value of 15.965,P<0.001,and a Spearman correlation R value of-0.189.PLR was associated with tumor diameter in patients with colorectal cancer,X2 was 12.235,P<0.001,Spearman The correlation R value is 0.165.Analysis of postoperative complications,101 patients had complications after surgery.The number of patients infected with the incision was up to 32(7.1%),and the number of patients with pulmonary infection was 23(5.1%).In addition,there were 20 cases(4.5%)with postoperative intestinal obstruction,10 cases(2.2%)with hemorrhage,8 cases(1.8%)with anastomotic leakage,and 8 cases(1.8%)with incisional dehiscence.Patients with high OPNI,low NLR,and low PLR had relatively few postoperative complications.OPNI,NLR,PLR grouping and postoperative complications were statistically significant(P<0.05).Conclusion:OPNI can reflect the perioperative nutritional status of patients with colorectal cancer.OPNI=45.8 can be the cut-off value of nutritional risk screening for colorectal cancer patients,and it is an important indicator to evaluate the nutritional risk of perioperative period.There is a certain correlation between clinicopathological features and postoperative complications and inflammatory markers in patients with colorectal cancer.