The purpose of this study was to investigate the association between preoperative inflammation and postoperative complications in gastric cancer patients having elective gastrectomy. Participants in this study were those who underwent radical gastrectomy between April 2008 and June 2018 and were diagnosed with stage I–III primary gastric cancer. Preoperative CRP values were used to divide the patients into two groups: the inflammation group comprised individuals having a CRP level of ≥0.5 mg/dL; the other was the non-inflammation group. The primary outcome was overall complications of Clavien–Dindo grade II or higher after surgery. Using propensity score matching to adjust for background, we compared the postoperative outcomes of the groups and conducted a multivariate analysis to identify risk variables for complications. Of 951 patients, 852 (89.6%) were in the non-inflammation group and 99 (10.4%) were in the inflammation group. After matching, both groups included 99 patients, and no significant differences in patient characteristics were observed between both groups. The inflammation group had a significantly greater total number of postoperative complications (p= 0.019). The multivariate analysis revealed that a preoperative CRP level of ≥0.5 mg/dL was an independent risk factor for total postoperative complications in all patients (odds ratio: 2.310, 95% confidence interval: 1.430–3.730,p< 0.001). In conclusion, in patients undergoing curative resection for gastric cancer, preoperative inflammation has been found to be an independent risk factor for overall complications after surgery. Patients with chronic inflammation require preoperative treatment to reduce inflammation because chronic inflammation is the greatest risk factor for postoperative complications.
本研究旨在探讨择期胃切除术胃癌患者术前炎症与术后并发症之间的关联。研究对象为2008年4月至2018年6月期间接受根治性胃切除术、确诊为I-III期原发性胃癌的患者。根据术前C反应蛋白（CRP）水平将患者分为两组：炎症组（CRP≥0.5 mg/dL）与非炎症组。主要观察指标为术后Clavien-Dindo分级II级及以上的总体并发症发生率。通过倾向评分匹配平衡基线特征后，比较两组术后结局，并采用多变量分析确定并发症的危险因素。在951例患者中，非炎症组852例（89.6%），炎症组99例（10.4%）。匹配后两组各纳入99例患者，基线特征无显著差异。炎症组术后总体并发症发生率显著更高（p=0.019）。多变量分析显示，术前CRP≥0.5 mg/dL是所有患者术后总体并发症的独立危险因素（比值比：2.310，95%置信区间：1.430-3.730，p<0.001）。结论表明，接受根治性切除术的胃癌患者中，术前炎症是术后总体并发症的独立危险因素。慢性炎症患者需接受术前抗炎治疗，因其是导致术后并发症的最高风险因素。
肿瘤(癌症)患者之家