摘要
Abstract
Objective To investigate the levels of serum soluble CD14 subtype(Presepsin)and serum amyloid protein A(SAA)in patients with colorectal cancer after laparoscopic surgery,and their predictive value for early anastomotic leakage.Methods From October 2021 to April 2024,126 patients with laparoscopic colorectal cancer were divided into the non-anastomotic leakage group(control group,n=103)and the anastomotic leakage group(observation group,n=23)based on whether anastomotic leakage occurred within 3 days after the operation.Clinical information was collected from both groups and compared between groups.Enzyme linked immunosorbent assay(ELISA)was applied to detect the postoperative serum levels of Presepsin and SAA in two groups.Pearson method was applied to investigate the correlation between postoperative serum levels of Presepsin and SAA in patients with colorectal cancer after laparoscopic surgery.The multivariate Logistic regression model was applied to analyze the key factors influencing the occurrence of anastomotic leakage in the early postoperative period in patients with colorectal cancer after laparoscopic surgery.The receiver operating characteristic curve(ROC curve)was applied to evaluate the predictive value of serum Presepsin and SAA levels for early anastomotic leakage in colorectal cancer patients after laparoscopic surgery.Results Compared with the control group,the proportion of patients with tumours≥7 cm from the anus was significantly reduced and intraoperative bleeding was significantly increased in the observation group,the differences were statistically significant(P<0.05).The postoperative levels of serum Presepsin and SAA in the observation group were obviously higher than those in the control group,the differences were statistically significant(P<0.05).There was an obvious positive correlation between serum levels of Presepsin and SAA in patients with colorectal cancer after laparoscopic surgery(r=0.749,P=0.016).Serum Presepsin levels higher than 389.23 pg/mL and SAA expression levels higher than 25.10 mg/L were independent risk factors for the occurrence of early anastomotic leakage after surgery in patients with colorectal cancer after laparoscopic surgery.A tumor distance from the anus of≥7 cm was a protective factor.The area under the curve(AUC)of serum Presepsin and SAA alone and in combination for detecting early anastomotic leakage in patients with colorectal cancer after laparoscopic surgery was 0.834(95%CI:0.757～0.894),0.801(95%CI:0.720～0.866),and 0.897(95%CI:0.830～0.944).The combined detection was superior to the separate detection of Presepsin and SAA(Zcombination-Presepsin=2.085,Zcombination-SAA=2.010,both P<0.05).Conclusion Serum levels of Presepsin and SAA are elevated in patients with colorectal cancer after laparoscopic surgery,and their combined detection has high predictive value for early anastomotic leakage.关键词
腹腔镜/结直肠癌/可溶性CD14亚型(Presepsin)/血清淀粉样蛋白A(SAA)/吻合口瘘Key words
laparoscopy/colorectal cancer/soluble CD14 subtype(Presepsin)/serum amyloid protein A(SAA)/anastomotic leakage分类
临床医学
