临床外科杂志 ›› 2020, Vol. 28 ›› Issue (12): 1136-1139.doi: 10.3969/j.issn.1005-6483.2020.12.013

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C-反应蛋白对食管癌术后吻合口瘘的预测价值

  

  1. 471009 郑州大学附属洛阳中心医院胸外科
  • 出版日期:2020-12-20 发布日期:2020-12-20

Predictive value of C-reactive protein for postoperative anastomotic fistula in esophageal cancer

  1. Department of Thoracic Surgery,Luoyang Central Hospital Affiliated to Zhengzhou University,Luoyang 471009,China
  • Online:2020-12-20 Published:2020-12-20

摘要: 目的 探讨食管癌病人术后C-反应蛋白(CRP)水平变化预测吻合口瘘的临床价值。
方法 2017年1月~2019年5月我院胸外科行食管癌根治手术病人127例,根据术后有无发生吻合口瘘分为吻合口瘘组(37例)和无吻合口瘘组(90例),以吻合口瘘组为观察组,无吻合口瘘为对照组。比较两组病人术前和术后7天内CRP水平的变化,并分析其对吻合口瘘的预测价值。
结果 观察组和对照组术后7天的CRP水平均高于术前,差异有统计学意义(P<0.05);术后第1~4天CRP水平在两组间比较差异无统计学意义(P>0.05),术后第5~7天观察组的CRP水平均高于对照组,差异有统计学意义(P<0.05);ROC曲线分析显示,取57.05mg/L为截点值,术后第7天CRP水平预测吻合口瘘发生的敏感度为81.8%,特异度为90.9%,曲线下面积为0.93。
结论 监测食管癌术后CRP水平能较早预测吻合口瘘的发生,可作为预测诊断吻合口瘘的指标。

关键词: C-反应蛋白, 食管癌, 吻合口瘘

Abstract: Objective To explore the predictive value of postoperative C-reactive protein(CRP) levels in patients with esophageal cancer for postoperative anastomotic fistula,in order to provide clues for early detection of esophageal anastomotic fistula after surgery.
Methods The clinical data of 127 patients who underwent esophageal cancer surgery in our hospital from January 2017 to May 2019 were divided into two groups,according to the occurrence of anastomotic fistula after operation.The group with anastomotic fistula(n=37) was the observation group,and the group without anastomotic fistula(n=90) was the control group.We compared the changes of CRP levels before and 7 days after operation,and the predictive value of the anastomotic fistula was further analyzed.
Results The CRP levels in the observation group and the control group during 7 days after operation were higher than those before operation,and the difference was statistically significant(P<0.05).There was no significant difference in CRP levels between the two groups on the first 1-4 days after surgery(P>0.05).The CRP level of the observation group on the 5th-7th day after operation was higher than that of the control group,the difference was statistically significant(P<0.05).The ROC curve analysis showed that 57.05 mg/L was taken as the intercept point,and the sensitivity of the CRP level to predict the occurrence of anastomotic leakage was 81.8% at the 7th day after surgery,the specificity was 90.9%,and the area under the curve was 0.93.
Conclusion The postoperative CRP level of esophageal cancer can predict the occurrence of anastomotic fistula earlier,and it can be used as a useful index for predicting and diagnosing anastomotic fistula.

Key words: C-reactive protein, esophageal cancer, anastomotic fistula

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