血清AIb、PA、NLR水平在直肠癌术后发生吻合口瘘评估中的应用

摘要 目的：探讨血清白蛋白（AIb）、前白蛋白（PA）、中性粒细胞与淋巴细胞比值（NLR）水平在直肠癌术后发生吻合口瘘评估中的应用。方法：选择2018年6月至2019年12月于我院进行直肠癌手术患者90例患者进行研究，其中38例发生术后吻合口瘘，设为研究组， 52例未发生吻合口瘘作为对照组。分析患者术后血清AIb、PA、NLR水平变化情况，采用受试者工作特征曲线分析血清AIb、PA、NLR对术后发生吻合口瘘的评估作用。结果：研究组血清AIb、PA水平显著低于对照组，NLR水平显著高于对照组，差异显著（P＜0.05）；造口组术后血清AIb、PA水平显著高于未造口组，NLR水平显著低于未造口组，差异显著（P＜0.05）；ROC结果显示，血清AIb预测术后吻合口瘘的AUC为0.967，灵敏度为81.25%，特异度为90.14%，截断值为33.06 g/L；血清PA预测术后吻合口瘘的AUC为0.772，灵敏度为80.36%，特异度为89.56%，截断值为119.04 mg/L；血清NLR预测术后吻合口瘘的AUC为0.991，灵敏度为85.62%，特异度为93.23%，截断值为6.86。结论：监测血清AIb、PA、NLR水平有助早期发现直肠癌患者术后吻合口瘘。

Application of Serum AIB, PA and NLR Levels in the Assessment of Anastomotic Fistula after Rectal Cancer Operation

ABSTRACT Objective: To study Application of serum Albumin (AIB), prealbumin (PA), neutrophil to lymphocyte ratio (NLR) levels in the assessment of anastomotic fistula after rectal cancer operation. Methods: 90 patients who underwent rectal cancer surgery in our hospital from June 2018 to December 2019 were selected for this study. Among them, 38 patients with postoperative anastomotic fistula were selected as the study group, and 52 patients without anastomotic fistula were selected as the control group. The changes of serum AIB, PA and NLR levels after operation were analyzed. Receiver operating characteristic curve was used to analyze the evaluation effect of serum AIB, PA and NLR on postoperative anastomotic fistula. Results: Serum AIB and PA levels in the study group were significantly lower than those in the control group, and NLR levels were significantly higher than those in the control group, with significant differences(P<0.05). After operation, the levels of AIB and PA in the stomy group were significantly higher than those in the non-stomy group, and the levels of NLR in the stomy group were significantly lower than those in the non-stomy group(P<0.05). ROC results showed that the AUC of serum AIB for predicting postoperative anastomotic fistula was 0.967, the sensitivity was 81.25%, the specificity was 90.14%, and the cutoff value was 33.06 g/L. The AUC of serum PA for predicting postoperative anastomotic fistula was 0.772, the sensitivity was 80.36%, the specificity was 89.56%, and the cutoff value was 119.04 mg/L. The AUC of serum NLR for predicting postoperative anastomotic fistula was 0.991, the sensitivity was 85.62%, the specificity was 93.23%, and the cutoff value was 6.86. Conclusion: Monitoring serum levels of AIB, PA and NLR is helpful for early detection of postoperative anastomotic fistula in patients with rectal cancer.