Evaluation of Preoperative Prognostic Inflammatory and Nutritional Index on Short-Term Prognosis of Colorectal Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LIU Dan ¹ , WANG Xiaodong ² , DENG Lei ¹ , LU Donghao ¹ , DONG Hui ¹ , NIU Jie ¹ , NA Feifei ¹ , LI Li ²

1.West China Medical School/MCQ Group of West China Hospital, Sichuan University, Chengdu 610041, China;;
2.Surgery Center of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

Keywords：

Colorectal cancer; Prognostic inflammatory and nutritional index; Preoperative evaluation; Prognosis

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Objective To determine the relationship between preoperative prognostic inflammatory and nutritional index (PINI) value and short-term prognosis in colorectal cancer. Methods Patients with colorectal cancer verified by pathologically examine were prospectively enrolled from April 2009 to June 2009. Serum alpha-1-acid glycoprotein, C-reactive protein, albumin and prealbumin were examined on day 3 before operation, and the value of preoperative PINI was calculated. The relationships between preoperative PINI and patho-TNM stage, complications, quality of life, and recurrence and metastasis after operation were analyzed. Results Total 38 patients with colorectal cancer underwent radical surgery were enrolled. Preoperative PINI value was 2.17±1.27. Preoperative PINI value was correlated with TMN stage and M stage: PINI value in patients of Ⅳ stage or M1 stage, were significantly higher than those in ones of Ⅰ, Ⅱ and Ⅲ stage （P＜0.001） or M0 stage （P＜0.001）. There was no significant correlation between preoperative PINI value and preoperative complications （P gt;0.05）. Preoperative PINI value was correlated with postoperative diet, anorexia and overall quality of life: preoperative PINI value in patients with abnormal diet, anorexia or poor quality of life, were significantly higher than those in ones with normal diet (P=0.020), no-anorexia (P=0.020) or moderate (P=0.025) and well (P=0.020) quality of life. Conclusion Preoperative PINI value is an effective index to assess the short-term prognosis of colorectal cancer.

Citation： LIU Dan,WANG Xiaodong,DENG Lei,LU Donghao,DONG Hui,NIU Jie,NA Feifei,LI Li. Evaluation of Preoperative Prognostic Inflammatory and Nutritional Index on Short-Term Prognosis of Colorectal Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2009, 16(11): 934-938. doi: Copy

1.	Walsh D, Mahmoud F, Barna B. Assessment of nutritional status and prognosis in advanced cancer: interleukin-6, C-reactive protein, and the prognostic and inflammatory nutritional index [Ｊ]. Support Care Cancer, 2003; 11(1): 60-62.
2.	Ingenbleek Y, Carpentier YA. A prognostic inflammatory and nutritional index scoring critically ill patients [Ｊ]. Int J Vitam Nutr Res， 1985; 55(1): 91-101.
3.	Ishizuka M, Nagata H, Takagi K, et al. Inflammation-based prognostic score is a novel predictor of postoperative outcome in patients with colorectal cancer [Ｊ]. Ann Surg, 2007; 246(6): 1047-1051.
4.	Read JA, Choy ST, Beale PJ, et al. Evaluation of nutritional and inflammatory status of advanced colorectal cancer patients and its correlation with survival [Ｊ]. Nutr Cancer, 2006; 55(1): 78-85.
5.	汪晓东, 冯硕, 游小林, 等. 结直肠肿瘤多学科协作诊治模式下的随访体系建设 [Ｊ]. 中国普外基础与临床杂志, 2007; 14(6): 709-712.
6.	Shunyakov L, Ryan CK, Sahasrabudhe DM, et al. The influence of host response on colorectal cancer prognosis [Ｊ]. Clin Colorectal Cancer, 2004; 4(1): 38-45.
7.	Scott HR, McMillan DC, Forrest LM, et al. The systemic inflammatory response, weight loss, performance status and survival in patients with inoperable non-small cell lung cancer [Ｊ]. Br J Cancer, 2002; 87(3): 264-267.
8.	Scott HR, McMillan DC, Brown DJ, et al. A prospective st-udy of the impact of weight loss and the systemic inflammatory response on quality of life in patients with inoperable non-small cell lung cancer [Ｊ]. Lung Cancer, 2003; 40(3): 295-299.
9.	Copeland EM 3rd, Daly JM, Ota DM, et al. Nutrition, cancer, and intravenous hyperalimentation [Ｊ]. Cancer, 1979; 43(5 Suppl): 2108-2116.
10.	Ravasco P, Monteiro-Grillo I, Vidal PM, et al. Dietary co-unseling improves patient outcomes: a prospective, randomized, controlled trial in colorectal cancer patients undergoing radiotherapy [Ｊ]. J Clin Oncol, 2005; 23(7): 1431-1438.
11.	Small W, Carrara R, Danford L, et al. Quality of life and nutrition in the patient with cancer [Ｊ]. Oncology, 2002; 17(suppl): 13-14.
12.	Van Cutsem E, Arends J. The causes and consequences of cancer-associated malnutrition [Ｊ]. Eur J Oncol Nurs, 2005; 9 Suppl 2: S51-S63.
13.	McMillan DC, Wotherspoon HA, Fearon KC, et al. A prospective study of tumor recurrence and the acute-phase response after apparently curative colorectal cancer surgery [Ｊ]. Am J Surg, 1995; 170(4): 319-322.
14.	Dalgleish AG, O’Byrne KJ. Chronic immune activation and inflammation in the pathogenesis of AIDS and cancer [Ｊ]. Adv Cancer Res, 2002; 84: 231-276.
15.	Shunyakov L, Ryan CK, Sahasrabudhe DM, et al. The influence of host response on colorectal cancer prognosis [Ｊ]. Clin Colorectal Cancer, 2004; 4(1): 38-45.
16.	Heriot AG, Marriott JB, Cookson S, et al. Reduction in cytokine production in colorectal cancer patients: association with stage and reversal by resection [Ｊ]. Br J Cancer, 2000; 82(5): 1009-1012.
17.	Shiu YC, Lin JK, Huang CJ, et al. Is C-reactive protein a prognostic factor of colorectal cancer? [Ｊ]. Dis Colon Rectum, 2008, 51(4): 443-449.
18.	Glojnaric＇ I, Casl MT, Simic＇ D, et al. Serum amyloid A protein (SAA) in colorectal carcinoma [Ｊ]. Clin Chem Lab Med, 2001; 39(2): 129-133.
19.	吕东昊, 高强, 汪晓东, 等. 多层螺旋CT联合不同炎性反应指标对直肠癌外科决策的随机对照研究 [Ｊ]. 中国普外基础与临床杂志, 2009； 16(10): 851-855.
20.	汪晓东, 邓磊, 秦昌龙, 等. 术前血清淀粉样蛋白A水平对低位局部进展直肠癌手术方案选择的价值 [Ｊ]. 中国普外基础与临床杂志, 2009； 16(8): 667-670.
21.	汪晓东, 邓磊, 吕东昊, 等. 结直肠癌患者术前SAA、CRP、CEA和CA19-9水平的临床诊断价值 [Ｊ]. 四川医学, 2009; 30(3): 340-342.
22.	汪晓东, 吕东昊, 高命, 等. 结直肠癌患者术前血清CRP与SAA检测的意义 [Ｊ]. 中国肿瘤, 2009; 18(5): 416-419.
23.	Mazhar D, Ngan S. C-reactive protein and colorectal cancer [Ｊ]. QJM, 2006; 99(8): 555-559.
24.	Nielsen HJ, Christensen IJ, Srensen S, et al. Preoperative plasma plasminogen activator inhibitor type-1 and serum C-reactive protein levels in patients with colorectal cancer. The RANX05 Colorectal Cancer Study Group [Ｊ]. Ann Surg Oncol, 2000; 7(8): 617-623.
25.	Staib L, Link KH, Blatz A, et al. Surgery of colorectal cancer: surgical morbidity and five- and ten-year results in 2 400 patients-monoinstitutional experience [Ｊ]. World J Surg, 2002; 26(1): 59-66.
26.	Ouellette JR, Small DG, Termuhlen PM. Evaluation of Ch-arlson-Age Comorbidity Index as predictor of morbidity and mortality in patients with colorectal carcinoma [Ｊ]. J Gastrointest Surg, 2004; 8(8): 1061-1067.
27.	Alvarez JA, Baldonedo RF, Bear IG, et al. Presentation, treatment, and multivariate analysis of risk factors for obstructive and perforative colorectal carcinoma [Ｊ]. Am J Surg, 2005; 190(3): 376-382.
28.	Tsukada K, Miyazaki T, Kato H, et al. Body fat accumulation and postoperative complications after abdominal surgery [Ｊ]. Am Surg, 2004; 70(4): 347-351.
29.	Marusch F, Koch A, Schmidt U, et al. The impact of the risk factor “age” on the early postoperative results of surgery for colorectal carcinoma and its significance for perioperative management [Ｊ]. World J Surg, 2005; 29(8): 1013-1021; discussion 1021-1022.
30.	Mills PJ, Parker B, Dimsdale JE, et al. The relationship between fatigue and quality of life and inflammation during anthracycline-based chemotherapy in breast cancer [Ｊ]. Biol Psychol, 2005; 69(1): 85-96.

1. Walsh D, Mahmoud F, Barna B. Assessment of nutritional status and prognosis in advanced cancer: interleukin-6, C-reactive protein, and the prognostic and inflammatory nutritional index [Ｊ]. Support Care Cancer, 2003; 11(1): 60-62.
2. Ingenbleek Y, Carpentier YA. A prognostic inflammatory and nutritional index scoring critically ill patients [Ｊ]. Int J Vitam Nutr Res， 1985; 55(1): 91-101.
3. Ishizuka M, Nagata H, Takagi K, et al. Inflammation-based prognostic score is a novel predictor of postoperative outcome in patients with colorectal cancer [Ｊ]. Ann Surg, 2007; 246(6): 1047-1051.
4. Read JA, Choy ST, Beale PJ, et al. Evaluation of nutritional and inflammatory status of advanced colorectal cancer patients and its correlation with survival [Ｊ]. Nutr Cancer, 2006; 55(1): 78-85.
5. 汪晓东, 冯硕, 游小林, 等. 结直肠肿瘤多学科协作诊治模式下的随访体系建设 [Ｊ]. 中国普外基础与临床杂志, 2007; 14(6): 709-712.
6. Shunyakov L, Ryan CK, Sahasrabudhe DM, et al. The influence of host response on colorectal cancer prognosis [Ｊ]. Clin Colorectal Cancer, 2004; 4(1): 38-45.
7. Scott HR, McMillan DC, Forrest LM, et al. The systemic inflammatory response, weight loss, performance status and survival in patients with inoperable non-small cell lung cancer [Ｊ]. Br J Cancer, 2002; 87(3): 264-267.
8. Scott HR, McMillan DC, Brown DJ, et al. A prospective st-udy of the impact of weight loss and the systemic inflammatory response on quality of life in patients with inoperable non-small cell lung cancer [Ｊ]. Lung Cancer, 2003; 40(3): 295-299.
9. Copeland EM 3rd, Daly JM, Ota DM, et al. Nutrition, cancer, and intravenous hyperalimentation [Ｊ]. Cancer, 1979; 43(5 Suppl): 2108-2116.
10. Ravasco P, Monteiro-Grillo I, Vidal PM, et al. Dietary co-unseling improves patient outcomes: a prospective, randomized, controlled trial in colorectal cancer patients undergoing radiotherapy [Ｊ]. J Clin Oncol, 2005; 23(7): 1431-1438.
11. Small W, Carrara R, Danford L, et al. Quality of life and nutrition in the patient with cancer [Ｊ]. Oncology, 2002; 17(suppl): 13-14.
12. Van Cutsem E, Arends J. The causes and consequences of cancer-associated malnutrition [Ｊ]. Eur J Oncol Nurs, 2005; 9 Suppl 2: S51-S63.
13. McMillan DC, Wotherspoon HA, Fearon KC, et al. A prospective study of tumor recurrence and the acute-phase response after apparently curative colorectal cancer surgery [Ｊ]. Am J Surg, 1995; 170(4): 319-322.
14. Dalgleish AG, O’Byrne KJ. Chronic immune activation and inflammation in the pathogenesis of AIDS and cancer [Ｊ]. Adv Cancer Res, 2002; 84: 231-276.
15. Shunyakov L, Ryan CK, Sahasrabudhe DM, et al. The influence of host response on colorectal cancer prognosis [Ｊ]. Clin Colorectal Cancer, 2004; 4(1): 38-45.
16. Heriot AG, Marriott JB, Cookson S, et al. Reduction in cytokine production in colorectal cancer patients: association with stage and reversal by resection [Ｊ]. Br J Cancer, 2000; 82(5): 1009-1012.
17. Shiu YC, Lin JK, Huang CJ, et al. Is C-reactive protein a prognostic factor of colorectal cancer? [Ｊ]. Dis Colon Rectum, 2008, 51(4): 443-449.
18. Glojnaric＇ I, Casl MT, Simic＇ D, et al. Serum amyloid A protein (SAA) in colorectal carcinoma [Ｊ]. Clin Chem Lab Med, 2001; 39(2): 129-133.
19. 吕东昊, 高强, 汪晓东, 等. 多层螺旋CT联合不同炎性反应指标对直肠癌外科决策的随机对照研究 [Ｊ]. 中国普外基础与临床杂志, 2009； 16(10): 851-855.
20. 汪晓东, 邓磊, 秦昌龙, 等. 术前血清淀粉样蛋白A水平对低位局部进展直肠癌手术方案选择的价值 [Ｊ]. 中国普外基础与临床杂志, 2009； 16(8): 667-670.
21. 汪晓东, 邓磊, 吕东昊, 等. 结直肠癌患者术前SAA、CRP、CEA和CA19-9水平的临床诊断价值 [Ｊ]. 四川医学, 2009; 30(3): 340-342.
22. 汪晓东, 吕东昊, 高命, 等. 结直肠癌患者术前血清CRP与SAA检测的意义 [Ｊ]. 中国肿瘤, 2009; 18(5): 416-419.
23. Mazhar D, Ngan S. C-reactive protein and colorectal cancer [Ｊ]. QJM, 2006; 99(8): 555-559.
24. Nielsen HJ, Christensen IJ, Srensen S, et al. Preoperative plasma plasminogen activator inhibitor type-1 and serum C-reactive protein levels in patients with colorectal cancer. The RANX05 Colorectal Cancer Study Group [Ｊ]. Ann Surg Oncol, 2000; 7(8): 617-623.
25. Staib L, Link KH, Blatz A, et al. Surgery of colorectal cancer: surgical morbidity and five- and ten-year results in 2 400 patients-monoinstitutional experience [Ｊ]. World J Surg, 2002; 26(1): 59-66.
26. Ouellette JR, Small DG, Termuhlen PM. Evaluation of Ch-arlson-Age Comorbidity Index as predictor of morbidity and mortality in patients with colorectal carcinoma [Ｊ]. J Gastrointest Surg, 2004; 8(8): 1061-1067.
27. Alvarez JA, Baldonedo RF, Bear IG, et al. Presentation, treatment, and multivariate analysis of risk factors for obstructive and perforative colorectal carcinoma [Ｊ]. Am J Surg, 2005; 190(3): 376-382.
28. Tsukada K, Miyazaki T, Kato H, et al. Body fat accumulation and postoperative complications after abdominal surgery [Ｊ]. Am Surg, 2004; 70(4): 347-351.
29. Marusch F, Koch A, Schmidt U, et al. The impact of the risk factor “age” on the early postoperative results of surgery for colorectal carcinoma and its significance for perioperative management [Ｊ]. World J Surg, 2005; 29(8): 1013-1021; discussion 1021-1022.
30. Mills PJ, Parker B, Dimsdale JE, et al. The relationship between fatigue and quality of life and inflammation during anthracycline-based chemotherapy in breast cancer [Ｊ]. Biol Psychol, 2005; 69(1): 85-96.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Evaluation of Preoperative Prognostic Inflammatory and Nutritional Index on Short-Term Prognosis of Colorectal Cancer

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