The relationship between preoperative serum bile acid levels and clinical indicators and prognosis of patients with colorectal cancer

Shi Pusong; Yu Li; Liu Xuehuan; Gao Weifeng; Liu Jun

doi:10.3760/j.issn.1673-4777.2024.06.012

Abstract：Objective To investigate the correlation between preoperative serum bile acid level and clinical indicators and prognosis in patients with colorectal cancer.Methods A total of 253 patients diagnosed with colorectal cancer in Tianjin Union Medical Center from January 2018 to August 2022 were collected as the observation group.During the same period,248 cases of mixed hemorrhoids without other serious diseases were collected as the control group for retrospective study.According to the clinical data of these patients,Logistic regression method was used to analyze the influencing factors of colorectal cancer occurrence.The changes of serum bile acid levels before and after surgery were compared.Spearman correlation analysis was used to analyze the correlation between preoperative serum bile acid level and tumor markers,lymphocyte subsets,interleukin-6(IL-6),as well as tumor necrosis factor α(TNF-α).The Kaplan-Meier method was used to draw survival curves and compare the prognostic differences of patients with different levels of serum bile acid.The differences of lesion location and pathology in patients with different serum bile acid levels were compared.Results Logistic regression analysis showed that higher serum bile acid level was a risk factor for colorectal cancer(odds ratio=1.102,95％confidence interval:1.022-1.189,P=0.012).The postoperative serum bile acid level was lower than that before operation(P＜0.05).The preoperative serum bile acid levels were positively correlated with carcinoembryonic antigen,IL-6,and TNF-α levels(all P＜0.05).Survival analysis showed that patients with higher levels(≥4.7 μmol/L)of serum bile acid had shorter recurrence free survival time than those with lower levels(＜4.7 µmol/L)(Log-rank x2=9.711,P=0.002),recurrence and metastasis rate was higher[55.6％(15/27)vs 25.8％(17/66)](P＜0.05).The proportion of low and moderate differentiation was higher and the proportion of lesions located in the right colon was lower in the high level of serum bile acid group than those in the low level of serum bile acid group(all P＜0.05).Conclusions Preoperative high level of serum bile acid is a risk factor for colorectal cancer,which is positively correlated with some tumor markers and inflammatory factors,and is related to tumor location,pathology and prognosis of patients.It has certain value in guiding the clinical diagnosis and treatment of patients with colorectal cancer.