Early prediction of anastomotic leakage after rectal cancer surgery: Onodera prognostic nutritional index combined with inflammationrelated biomarkers  

作　　者：Zi-Yi Zhang Ke-Jin Li Xiang-Yue Zeng Kuan Wang Subinur Sulayman Yi Chen Ze-Liang Zhao 

机构地区：[1]Department of Gastrointestinal Surgery,The Affiliated Cancer Hospital of Xinjiang Medical University,Urumqi 830000,Xinjiang Uygur Autonomous Region,China [2]Department of Breast and Thyroid Surgery,The Affiliated Cancer Hospital of Xinjiang Medical University,Urumqi 830000,Xinjiang Uygur Autonomous Region,China

出　　处：《World Journal of Gastrointestinal Surgery》2025年第4期46-57,共12页世界胃肠外科杂志(英文)

基　　金：Supported by Natural Science Foundation of Xinjiang Uygur Autonomous Region,No.2022D01C297.

摘　　要：BACKGROUND Anastomotic leakage(AL)is a serious complication following rectal cancer surgery and is associated with increased recurrence,mortality,extended hospital stays,and delayed chemotherapy.The Onodera prognostic nutritional index(OPNI)and inflammation-related biomarkers,such as the neutrophil-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR),have been studied in the context of cancer prognosis,but their combined efficacy in predicting AL remains unclear.AIM To investigate the relationships between AL and these markers and developed a predictive model for AL.METHODS A retrospective cohort study analyzed the outcomes of 434 patients who had undergone surgery for rectal cancer at a tertiary cancer center from 2016 to 2023.The patients were divided into two groups on the basis of the occurrence of AL:One group consisted of patients who experienced AL(n=49),and the other group did not(n=385).The investigation applied logistic regression to develop a risk prediction model utilizing clinical,pathological,and laboratory data.The efficacy of this model was then evaluated through receiver operating characteristic curve analysis.RESULTS In the present study,11.28%of the participants(49 out of 434 participants)suffered from AL.Multivariate analysis revealed that preoperative levels of the OPNI,NLR,and PLR emerged as independent risk factors for AL,with odds ratios of 0.705(95%CI:0.641-0.775,P=0.012),1.628(95%CI:1.221-2.172,P=0.024),and 0.994(95%CI:0.989-0.999,P=0.031),respectively.These findings suggest that these biomarkers could effectively predict AL risk.Furthermore,the proposed predictive model has superior discriminative ability,as demonstrated by an area under the curve of 0.910,a sensitivity of 0.898,and a specificity of 0.826,reflecting its high level of accuracy.CONCLUSION The risk of AL in rectal cancer surgery patients can be effectively predicted by assessing the preoperative levels of serum nutritional biomarkers and inflammatory indicators,emphasizing their importance in the preoperative evaluat

关 键 词：Platelet-to-lymphocyte ratio Neutrophil-to-lymphocyte ratio Postoperative anastomotic leakage Ondera prognostic nutritional index Rectal cancer surgery 

分 类 号：R73[医药卫生—肿瘤]