Prognostic role of preoperative inflammatory markers in postoperative patients with colorectal cancer

Periprocedural Changes of Serum Biomarkers in Predicting Complications Following Bariatric Surgery for Obesity: Systematic Review and Meta-analysis

Bariatric surgery is an effective treatment for severe obesity, but complications and peri-operative monitoring are important considerations. We conducted a comprehensive review of studies assessing pre-operative biomarkers and complications in patients undergoing bariatric surgery. A total of 14 studies were included. Gastric leak, infections, bleeding, obstruction or stenosis, hypoglycemia, and hypoalbuminemia were the most common complications observed. Our analysis showed a significant association between lower pre-operative albumin levels and complications (SMD [95%CI] =  - 0.21 [- 0.38; - 0.04]). However, other biomarkers did not have a significant impact on complication occurrence. Changes in C-reactive protein, neutrophil-lymphocyte ratio, and white blood cell levels were observed in certain peri-operative time points and complication subgroups. These findings suggest the potential use of pre-operative biomarkers and peri-operative changes of biomarker's levels for predicting complications.

GLR in Colorectal Cancers: An Easily Accessible Prognostic Marker

Background and Objectives

Colorectal cancer remains a significant health concern, necessitating reliable prognostic indicators for effective management. This study explores the preoperative prognostic significance of the Glucose/Lymphocyte Ratio (GLR) in colorectal cancers.

Methods

The study retrospectively analyzed records of patients who underwent surgery for elective colorectal cancers between January 1, 2013, and December 31, 2021, at the Koşuyolu Training and Research Hospital Gastroenterologic Surgery Department. Demographic, clinicopathological, and follow-up data were comprehensively assessed. A cutoff was established from GLR ratios and patients were divided into two groups for prognosis analysis.

Results

The study enrolled 222 eligible patients, examining variables such as age, sex, ASA score, neoadjuvant treatment, lymphovascular and perineural invasion, tumor grade, TNM stage, and GLR. The groups consisted of 128 patients with low GLR and 94 patients with high GLR. Statistical analyses revealed relations between GLR levels (p ≤ 0.001) and various prognostic factors such as age (p = 0.034), Perineural Invasion (PNI) (p = 0.002), tumor grade (p = 0.017), TNM stage (p = 0.003), and surgery time (p = 0.029), individuals with GLR ≥ 3.04 were observed to show higher mortality rates (p = 0.001). Above GLR cutoff point of 3.04 patients showed better overall survival rates. All survival related parameters were related with prognosis in univariant Cox regression tests. In multivariant cox regression tests GLR ≥ 3.04 significantly increased mortality by 2.9 times. (p = 0.003).

Conclusion

This study demonstrates that GLR, calculated from preoperative glucose and lymphocyte values serves as an independent prognostic factor in colorectal cancers. The findings suggest potential applications for GLR in survival analyses, with significant associations identified in age, PNI, tumor grade, TNM stage, and surgery time. Further investigations are warranted in homogeneous patient populations.

Prognostic value of preoperative combined with postoperative systemic immune-inflammation index for disease-free survival after radical rectal cancer surgery: a retrospective cohort study

Background

Colorectal cancer (CRC) ranks highly in malignant tumor incidence and mortality rates, severely affecting human health. The predictive value of the systemic immune-inflammation index (SII) in CRC prognosis is gaining attention, but there is limited research on the combined preoperative and postoperative SII. This study aims to explore the prognostic value of combined SII on disease-free survival (DFS) in patients undergoing radical surgery for rectal cancer.

Methods

We enrolled 292 patients with rectal cancer who underwent radical resection at the Affiliated Hospital of Xuzhou Medical University from May 2018 to September 2020, along with regular follow-ups to document the DFS. Patients' complete blood cell counts were assessed before surgery and between 21-56 days postoperatively. Calculating preoperative and postoperative SII, patients were categorized into four groups based on the optimal cutoff values: (I) low-low group (preoperative SII <449.325 and postoperative SII <568.13); (II) high-low group (preoperative SII ≥449.325 and postoperative SII <568.13); (III) low-high group (preoperative SII <449.325 and postoperative SII ≥568.13); and (IV) high-high group (preoperative SII ≥449.325 and postoperative SII ≥568.13). The receiver operating characteristic (ROC) curve analysis evaluated the prediction efficacy of preoperative, postoperative, and combined SII. Kaplan-Meier analysis generated DFS curves, and Cox regression analysis determined prognostic factors.

Results

With a median follow-up of 41 months, 65.4% (191/292) patients reached DFS. The clinical pathological features between the four groups are balanced and comparable (P>0.05). The area under the ROC curve for preoperative, postoperative, and combined SII was 0.668 [95% confidence interval (CI): 0.6-0.737], 0.696 (95%CI: 0.63-0.763), and 0.741 (95% CI: 0.681-0.802), respectively. After adjusting for confounding factors such as adjuvant therapy, differentiation, vascular invasion, neural invasion, tumor-node-metastasis (TNM) stage, carcinoembryonic antigen (CEA), and carbohydrate antigen 19-9 (CA19-9), significant differences were observed between the high-low group [hazard ratio (HR) =2.403; 95% CI: 1.255-4.602; P=0.008], low-high group (HR =5.058; 95% CI: 2.389-10.71; P<0.001), and high-high group (HR =6.214; 95% CI: 3.474-11.115; P<0.001) compared to the low-low group, with higher risks of adverse outcomes.

Conclusions

Combined SII has better predictive efficacy than monitoring preoperative or postoperative SII alone in rectal cancer patients undergoing radical surgery.

Prognostic value of preoperative white blood cell to hemoglobin ratio and fibrinogen to albumin ratio in patients with colorectal cancer

The prognostic value of preoperative white blood cell to hemoglobin ratio (WHR) and fibrinogen to albumin ratio (FAR) in colorectal cancer (CRC) is unknown. The purpose of this study was to analyze the correlation between preoperative WHR and FAR and the prognosis of CRC patients. The retrospective study analyzed the medical records of 207 patients with colorectal cancer who were admitted to Linyi People's Hospital between June 1, 2017 and June 1, 2021. The receiver operator curve was used to determine the cutoff value of 4.604 for WHR and 0.086 for FAR, and the patients were divided into high and low groups for comparative analysis of clinical data. Cox proportional hazards regression models were used to assess independent risk factors for disease-free survival (DFS) and overall survival (OS) in univariate and multifactorial analyses. Kaplan-Meier methods were used for survival analysis and logrank tests were used to assess survival differences. Multifactorial Cox analysis showed that tumor pathological stage (HR = 6.224, 95% CI:3.063-12.647, P < .001), and WHR (HR = 3.681, 95% CI:1.768-7.401, P < .001) were the independent risk factors for DFS in CRC patients. Tumor pathological stage (HR = 4.080, 95% CI:1.992-8.360, P < .001), and WHR (HR = 3.397, 95% CI:1.662-6.940, P = .001) were independent risk factors for OS. High levels of WHR and high levels of FAR were associated with lower DFS (P < .001) and OS (P < .001).CRC patients with both higher WHR and FAR had significantly lower DFS (P < .001) and OS (P < .001). DFS and OS may be shorter in CRC patients with high WHR and high FAR, perhaps associated with poor prognosis in CRC patients, and WHR and FAR may be potential CRC prognostic markers.

Association of Complete Blood Cell Count-Derived Inflammatory Biomarkers with Psoriasis and Mortality

Background and Aim

Psoriasis is a persistent inflammatory disorder that affects 3% of the population and is associated with cardiovascular diseases. Therefore, this study aimed to investigate the correlations between complete blood cell count (CBC)-derived inflammatory biomarkers, psoriasis prevalence, and all-cause mortality.

Methods

Data were obtained from the National Health and Nutrition Examination Survey (NHANES) spanning 2003-2006 and 2009-2014. Mortality data up to December 31, 2019 were obtained using the National Death Index. The following CBC-derived inflammatory biomarkers were examined: neutrophil/lymphocyte ratio (NLR), neutrophil/(white blood cells - neutrophils) ratio (dNLR), monocyte count/lymphocyte ratio (MLR), (neutrophil + monocyte)/lymphocyte ratio (NMLR), platelet/lymphocyte ratio (PLR), and systemic inflammatory response index (SIRI). Weighted logistic and Cox regression analyses were used to calculate odds ratios, hazard ratios, and the corresponding 95% confidence intervals. Additionally, the prognostic value of the inflammatory indicators was assessed and ranked using the random survival forest approach.

Results

In total, data from 21,431 participants with average age of 45.02 ± 0.27 years (49.51% male) were included in the study, among which 600 participants were positive for psoriasis (prevalence rate, 2.80%). Additionally, 79 all-cause deaths were recorded during a median follow-up period of 8.83 (6.67-11.00) years. Moreover, NLR, dNLR, NMLR, PLR, and SIRI were positively associated with the prevalence of psoriasis. Furthermore, MLR, NMLR, and SIRI were positively correlated with all-cause mortality in patients with psoriasis, with NMLR being the most valuable predictor of all-cause mortality.

Conclusion

CBC-derived inflammatory biomarkers were associated with psoriasis prevalence, NMLR, SIRI, and MLR values were associated with all-cause mortality in patients with psoriasis. Overall, assessment of these CBC-derived indicators may serve as a simple method for screening high-risk individuals among patients with psoriasis.