Effect of preoperative NPRI level on the occurrence of short-term complications in patients undergoing laparo-scopic radical surgery for colorectal cancer

XIA Yong; HU Haoran; ZHOU Yaxing; YUAN Yin; WANG Honggang

doi:10.3969/j.issn.1674-3806.2024.07.09

Abstract：Objective To explore the effect of preoperative neutrophil to prealbumin ratio index(NPRI)level on the occurrence of short-term complications in patients undergoing laparoscopic radical surgery for colorectal cancer.Methods The clinical data of 302 patients who were admitted to Jiangsu Taizhou People's Hospital Affiliated to Nanjing Medical University from June 2015 to June 2017 and underwent laparoscopic radical surgery for colorectal cancer were retrospectively analyzed.The patients were divided into complication group(n=49)and non-complication group(n=253)according to the occurrence of short-term complications after surgery.Multivariate logistic regression was used to analyze the factors affecting the occurrence of short-term complications after surgery in the patients.The receiver operating characteristic(ROC)curve was used to analyze the efficacy of preoperative NPRI level in predicting the occurrence of short-term complications after surgery.The relationship between preoperative NPRI level and clinical features,as well as the severity of postoperative complications in the patients was analyzed.Results Of the 302 patients,49 patients developed one complication or more complications for a total of 59 complications.According to the Clavien-Dindo grading system,among the 59 complications,27 complications were grade Ⅰ,and 11 complications were grade Ⅱ,and 6 com-plications were grade Ⅲ a,and 9 complications were grade Ⅲ b,and 6 complications were grade Ⅳ.The results of multivariate logistic regression analysis showed that a history of abdominal surgery[OR(95％CI)=2.708(1.077-6.810)],long operation time[OR(95％CI)=1.060(1.037-1.084)],CEA≥ 5 ng/mL[OR(95％CI)=3.245(1.395-7.549)]and higher preoperative NPRI level[OR(95％CI)=1.530(1.230-1.904)]were independent risk factors for the occur-rence of short-term complications in the patients after receiving laparoscopic radical surgery for colorectal cancer.The results of ROC curve analysis showed that preoperative NPRI level could effectively predict the occurrence of short-term complications in the patients after receiving laparoscopic radical surgery for colorectal cancer[AUC(95％CI)=0.781(0.700-0.848),P＜0.001],and the optimal cut-off value was 3.94,with the corresponding sensitivity and specificity being 59.20％and 85.40％,respectively.Compared with the low NPRI group(＜3.94),the high NPRI group(≥3.94)had older age,lower preoperative hemoglobin level,longer operation time,and a greater proportion of patients with tumor located in the colon,tumor maximum diameter ≥5 cm and tumor pathological stage Ⅲ,and the differences were sta-tistically significant(P＜0.05).Compared with the low NPRI group,the high NPRI group had a higher incidence of post-operative complications(x2=47.725,P＜0.05)and a higher risk of serious complications(x2=4.639,P=0.031).Conclusion Higher preoperative NPRI level is a risk factor for short-term complications in patients undergoing lapa-roscopic radical surgery for colorectal cancer and is associated with the severity of complications.