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首页> 外文期刊>Annals of Surgery >A Longitudinal Investigation of Inflammatory Markers in Colorectal Cancer Patients Perioperatively Demonstrates Benefit in Serial Remeasurement
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A Longitudinal Investigation of Inflammatory Markers in Colorectal Cancer Patients Perioperatively Demonstrates Benefit in Serial Remeasurement

机译：结肠直肠癌患者炎症标志物的纵向调查围手术经症表明在连续重量中的益处

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Objective: To characterize the longitudinal course of the systemic inflammatory response (SIR) throughout the perioperative period. To investigate whether postoperative changes in the neutrophil-to-lymphocyte ratio (NLR) or lymphocyte-to-monocyte ratio (LMR) when compared with preoperative levels (‘conversion’) are associated with survival differences in colorectal cancer patients undergoing resection. Background: Recent evidence suggests that preoperative measurements of markers of the SIR including the NLR and LMR are prognostic. However, a few data exist evaluating longitudinal changes in the SIR especially in regards to their association with surgical interventions, optimal timing of assessment, and their effect on patient survival. Methods: Data from 6 hospitals from January 1998 to December 2012 were retrospectively collected. We examined 2280 patients with complete data. For the subgroup analysis investigating conversion, we examined 587 patients with full preoperative and postoperative data from 21 to 56 days postoperative. Patients were stratified into 4 groups for analysis of conversion in a multivariate Cox-regression model. Results: A longitudinal profile for the perioperative NLR and LMR was clearly characterized identifying an optimal period of remeasurement at 21 to 56 days postoperation. In multivariate analysis both NLR change group ( P < 0.001) and LMR change group ( P < 0.001) were independently associated with overall survival. For both biomarkers, patients with both a low preoperative and postoperative inflammatory state had the best survival. A change from the preoperative to postoperative inflammatory state was associated with a survival difference. Conclusions: This study characterizes the perioperative SIR profile and provides evidence for the remeasurement of SIR biomarkers postoperatively at 21 to 56 days for further prognostication.
机译：目的：在整个围手术期整个围手术期纵向过程中表征全身炎症反应（先生）的纵向过程。为了研究中性粒细胞到淋巴细胞比（NLR）或淋巴细胞与单核细胞比（LMR）与术前水平相比（'转化'）的术后变化是否与接受切除分离的结肠直肠癌患者的存活差异有关。背景：最近的证据表明，包括NLR和LMR在内的SIR标记的术前测量是预后的。然而，存在少数数据评估先生的纵向变化，特别是与手术干预，评估的最佳时间及其对患者存活的影响以及它们对患者存活的影响。方法：回顾性收集1998年1月至2012年12月的6家医院的数据。我们检查了2280名完整数据的患者。对于调查转化的亚组分分析，我们术后21至56天检查了587名术前和术后数据的患者。患者分层成4组，用于分析多元COX回归模型中的转化。结果：围手术期NLR和LMR的纵向轮廓清楚地表征术后21至56天的最佳再释放时间。在多变量分析中，NLR变化组（P <0.001）和LMR变化组（P <0.001）与总存活有关。对于两种生物标志物，术前和术后炎症状态低的患者都有最好的存活率。从术前到术后炎症状态的变化与生存差异有关。结论：本研究表征了围手术期SIR概况，并在术后术后术后21至56天术后提供了证据，以进一步预后。

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