直肠癌患者术后血清C反应蛋白、白蛋白、单核细胞趋化蛋白的表达及对吻合口瘘的预测价值

摘要 目的：探讨直肠癌患者术后血清C反应蛋白、白蛋白、单核细胞趋化蛋白的表达及对吻合口瘘的预测价值。方法：选择2017年4月至2019年4月于我院进行直肠癌手术患者102例患者进行研究，其中42例发生术后吻合口瘘，设为试验组，剩余60例未发生吻合口瘘作为对照组。分析患者术后血清C反应蛋白、白蛋白、单核细胞趋化蛋白水平变化情况，采用受试者工作特征曲线分析血清C反应蛋白、白蛋白、单核细胞趋化蛋白对术后发生吻合口瘘的预测价值。结果：试验组术后血清C反应蛋白、单核细胞趋化蛋白水平显著高于对照组，白蛋白水平显著低于对照组，差异显著（P＜0.05）；行预防性造口组术后血清C反应蛋白、单核细胞趋化蛋白水平显著低于未预防性造口组，白蛋白水平显著高于未预防性造口组，差异显著（P＜0.05）；血清C反应蛋白预测术后吻合口瘘的临界值为39.69 mg/L，灵敏度为71.47%，特异度为83.14%，AUC为0. 824，血清白蛋白预测术后吻合口瘘的临界值为29.76 g/L，灵敏度为61.20%，特异度为79.40%，AUC为0. 746，血清单核细胞趋化蛋白预测术后吻合口瘘的临界值为200.09 pg/mＬ，灵敏度为61.18%，特异度为80.45%，AUC为0. 605，联合检测较单独检测具有更高的灵敏度和特异度，分别为77.56%、86.38%。结论：术后血清C反应蛋白、白蛋白、单核细胞趋化蛋白水平对直肠癌患者术后吻合口瘘具有较好的预测价值。

Analysis of the Expression of Serum C-reactive Protein, Albumin and Monocyte Chemoattractant Protein in Postoperative Patients with Rectal Cancer and Its Predictive Value for Anastomotic Leakage

ABSTRACT Objective: To study Analysis of the expression of serum C-reactive protein, albumin and monocyte chemoattractant protein in postoperative patients with rectal cancer and its predictive value for anastomotic leakage. Methods: 102 patients with rectal cancer who underwent surgery in our hospital from April 2017 to April 2019 were selected for the study. Among them, 42 patients with postoperative anastomotic fistula were set as the experimental group, while the remaining 60 patients without anastomotic fistula were set as the control group. The changes of serum C-reactive protein, albumin, and monocyte chemotaxis protein levels after operation were analyzed, and the predictive value of serum C-reactive protein, albumin, and monocyte chemotaxis protein for postoperative anastomotic fistula was analyzed using the subject work characteristic curve. Results: The serum c-reactive protein and monocyte chemotaxis protein levels in the experimental group were significantly higher than those in the control group, and albumin levels were significantly lower than those in the control group, with significant differences (P<0.05). The serum c-reactive protein and monocyte chemotactic protein levels in the prophylactic stoma group were significantly lower than those in the non-prophylactic stoma group, and albumin levels were significantly higher than those in the non-prophylactic stoma group (P<0.05). Serum c-reactive protein predict the critical value of postoperative anastomotic fistula was 39.69 mg/L, the sensitivity was 71.47%, 83.14%, AUC is 0. 824, the critical value of serum albumin predicted postoperative anastomotic fistula was 29.76 g/L, the sensitivity was 61.20%, 79.40%, AUC is 0. 746, serum levels of monocyte chemotactic protein to predict the critical value of postoperative anastomotic fistula is 200.09 pg/mL, the sensitivity was 61.18%, 80.45%, AUC is 0.605. The combined detection has higher sensitivity and specificity than the single detection, which are 77.56% and 86.38% respectively. Conclusion: Postoperative serum C-reactive protein, albumin and monocyte chemotactic protein levels have good predictive value for postoperative anastomotic fistula in patients with rectal cancer.