关键词: 结直肠癌, 腹腔镜根治术, 白蛋白, 碱性磷酸酶, 淋巴结转移, 预测

Abstract: Objective   To investigate the value of serum albumin(ALB) and alkaline phosphatase(ALP) levels in predicting lymph node metastasis in patients with colorectal cancer(CRC) after laparoscopic radical surgery,and to find a method to predict lymph node metastasis in patients with CRC. Methods   The prospective analysis method was used in this study to include 115 CRC patients admitted to the hospital from September 2017 to September 2019.All patients were treated with laparoscopic radical surgery,and were followed up for 3 years.The last follow-up was until September 2022.The clinical data and related laboratory indicators of CRC patients were investigated,and the clinical data and serum ALB and ALP levels of patients in the metastatic group and non metastatic group were compared.The correlation between serum ALB,ALP and postoperative lymph node metastasis of CRC patients was tested by point binary correlation test,bivariate Pearson correlation coefficient and Logistic regression.ROC curve was drawn to analyze the value of serum ALB and ALP in predicting postoperative lymph node metastasis. Results   Of the 110 patients with CRC,29 had lymph node metastasis after operation,with an incidence of 26.36%.The levels of serum carcinoembryonic antigen(CEA),carbohydrate antigen(CA) 199 and ALP and the proportion of differentiation degree(low differentiation) in the developing group were higher than those in the non-developing group,and the level of serum ALB was lower than that in the non-developing group,the difference was statistically significant(P＜0.05).Serum CEA,CA199 and ALP levels were positively correlated with lymph node metastasis in CRC patients(r=0.348,0.469,0.470,P＜0.001),while ALB levels were negatively correlated with lymph node metastasis in CRC patients(r=-0.426,P＜0.001).There was a negative correlation between serum ALB and ALP(r=-0.250,P=0.009).Serum CA199,CEA,ALB,ALP and differentiation degree were related to lymph node metastasis in CRC patients after operation.The AUC(0.839,95% CI:0.758-0.919) of serum ALB and ALP in predicting postoperative lymph node metastasis in CRC patients was higher than that of serum ALB and ALP alone(0.789,95% CI:0.701-0.876),(0.748,95% CI:0.639-0.858),and the value of combined prediction was the highest.Conclusion   Serum ALB and ALP have a certain value in predicting lymph node metastasis in CRC patients after laparoscopic radical surgery,and the value of combined prediction is the highest.

Key words: colorectal cancer, laparoscopic radical operation, albumin, Alkaline phosphatase, lymph node metastasis, forecast