Correlation of Cholinesterase Levels with Infection Risk and Sarcopenia After Radical Cystectomy

SHAO Sheng; SHAN Mengjun

doi:10.13730/j.issn.2097-2148.2025.10.004

Abstract：Objective To analyze the correlation between the level of cholinesterase(CHE)and the infection risk and sarcopenia in bladder cancer patients after radical cystectomy.Methods A retrospective study was conducted on 120 bladder cancer patients treated at author's hospital from January 2022 to January 2024,all patients underwent radical cys-tectomy,and their CHE levels were detected postoperatively,the correlation between CHE and sarcopenia-related indica-tors(total skeletal muscle mass,appendicular skeletal muscle mass,relative skeletal muscle index,handgrip strength,gait speed)were analyzed using Pearson correlation analysis,6 months after surgery,the patients were divided into infection group(n=36)and non-infection group(n=84)based on whether they developed infec-tions,general data of all patients were collected,multiva-riate Logistic regression models were used to identify in-fluencing factors for postoperative infections in bladder cancer patients after radical cystectomy,and receiver operating characteristic(ROC)analysis was conducted to evaluate the predictive value of these risk factors.Results After bladder cancer surgery,the body mass of skeletal muscle of the patients was(42.58±4.44)kg,the limb mass was(19.36±2.58)kg,the relative skeletal muscle index was(6.64±1.02)kg/m2,the handgrip strength was(27.36±3.25)kg,the gait speed was(0.81±0.12)m/s and the serum CHE level was(3 275.82±132.22)U/L;Pearson correlation analysis showed that there was a positive correlation between and the total skeletal muscle mass,appendicular skeletal muscle mass,relative skeletal muscle index,handgrip strength,gait speed and the serum CHE level in patients with blad-der cancer after surgery(r=0.617,0.668,0.684,0.729,0.701,all P＜0.001);compared with the non-infection group,patients in the infection group were older,had a higher prevalence of diabetes and sarcopenia(all P＜0.05);com-pared with the non-infection group,the CHE level was lower and C-reactive protein(CRP)and interleukin 6(IL-6)levels were higher in the infection group(all P＜0.05);multivariate Logistic regression analysis showed that age[odds ration(OR)=1.892,95％confidence interval(CI):1.228-2.917],diabetes mellitus(OR=5.316,95％CI:1.610-17.554),sarcopenia(OR=2.771,95％CI:1.048-7.326),CRP(OR=4.189,95％CI:1.079-16.264)and IL-6(OR=3.642,95％CI:1.599-8.299)were independent risk factors for postoperative infection in patients with bladder cancer;CHE(OR=0.981,95％CI:0.971-0.992)was an independent protective factor for postoperative infection in patients with bladder cancer(P＜0.05);ROC curve showed that the AUC of age,diabetes mellitus,sarcopenia,CHE,CRP and IL-6 in predicting postoperative infection in patients with bladder cancer were 0.781,0.619,0.627,0.883,0.748 and 0.849,respectively.Conclusion The level of CHE in postoperative patients with bladder cancer is related to the sarcopenia of patients,and age,diabetes mellitus,sarcopenia,CHE,CRP,IL-6 are all the influencing factors of infection in patients after radical cystectomy.