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Clinical impact of creatine phosphokinase and c-reactive protein as predictors of postgastrectomy complications in patients with gastric cancer

BACKGROUND: Postoperative complications have been linked to the morbidity and mortality of several cancers. However, predicting whether complications will occur in the early period after surgery or not is challenging. Hence, this study aimed to examine the diagnostic accuracy of serum creatine phosp...

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Autores principales: Okubo, Keishi, Arigami, Takaaki, Matsushita, Daisuke, Kijima, Takashi, Shimonosono, Masataka, Uenosono, Yoshikazu, Yanagita, Shigehiro, Kurahara, Hiroshi, Mori, Shinichiro, Ohtsuka, Takao, Natsugoe, Shoji
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7825180/
https://www.ncbi.nlm.nih.gov/pubmed/33485312
http://dx.doi.org/10.1186/s12885-021-07801-z
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author Okubo, Keishi
Arigami, Takaaki
Matsushita, Daisuke
Kijima, Takashi
Shimonosono, Masataka
Uenosono, Yoshikazu
Yanagita, Shigehiro
Kurahara, Hiroshi
Mori, Shinichiro
Ohtsuka, Takao
Natsugoe, Shoji
author_facet Okubo, Keishi
Arigami, Takaaki
Matsushita, Daisuke
Kijima, Takashi
Shimonosono, Masataka
Uenosono, Yoshikazu
Yanagita, Shigehiro
Kurahara, Hiroshi
Mori, Shinichiro
Ohtsuka, Takao
Natsugoe, Shoji
author_sort Okubo, Keishi
collection PubMed
description BACKGROUND: Postoperative complications have been linked to the morbidity and mortality of several cancers. However, predicting whether complications will occur in the early period after surgery or not is challenging. Hence, this study aimed to examine the diagnostic accuracy of serum creatine phosphokinase (CPK) and c-reactive protein (CRP) in predicting the development of postgastrectomy complications. METHODS: We retrospectively analyzed 188 patients with gastric cancer (GC) who underwent gastrectomy. The diagnostic accuracy of serum CPK and CRP was investigated using the areas under the curves (AUC). The CPK ratio was defined as the CPK on postoperative day (POD) 1 to the CPK on a preoperative day. RESULTS: Out of 188 patients, 48 (25.5%) developed postoperative complications. The complications group had a greater operative time (p = 0.037), higher CPK ratio on POD1 (p < 0.0001), and a higher serum CRP level on POD3 (p = 0.001). The AUC for the CPK ratio was 0.772, with an optimal cutoff value of 7.05, whereas that for CRP was 0.659, with an optimal cutoff value of 11.4 mg/L. The CPK ratio on POD1 (p < 0.0001) and the CRP on POD3 (p = 0.007) were independent factors for predicting the development of postgastrectomy complications. The CPK ratio on POD1 and the CRP on POD3 predicted postgastrectomy complications in 41 patients (85.4%). According to combined value of both CPK ratio and CRP level, the positive predictive value and the negative predictive value was 0.70 and 0.829. And sensitivity and specificity were 0.438 and 0.936. CONCLUSION: The CPK ratio on POD1 and the CRP on POD3 after gastrectomy for GC were predictive factors for complication development and may be employed to prevent the development of such complications and improve the prognosis of patients with GC. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12885-021-07801-z.
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spelling pubmed-78251802021-01-25 Clinical impact of creatine phosphokinase and c-reactive protein as predictors of postgastrectomy complications in patients with gastric cancer Okubo, Keishi Arigami, Takaaki Matsushita, Daisuke Kijima, Takashi Shimonosono, Masataka Uenosono, Yoshikazu Yanagita, Shigehiro Kurahara, Hiroshi Mori, Shinichiro Ohtsuka, Takao Natsugoe, Shoji BMC Cancer Research Article BACKGROUND: Postoperative complications have been linked to the morbidity and mortality of several cancers. However, predicting whether complications will occur in the early period after surgery or not is challenging. Hence, this study aimed to examine the diagnostic accuracy of serum creatine phosphokinase (CPK) and c-reactive protein (CRP) in predicting the development of postgastrectomy complications. METHODS: We retrospectively analyzed 188 patients with gastric cancer (GC) who underwent gastrectomy. The diagnostic accuracy of serum CPK and CRP was investigated using the areas under the curves (AUC). The CPK ratio was defined as the CPK on postoperative day (POD) 1 to the CPK on a preoperative day. RESULTS: Out of 188 patients, 48 (25.5%) developed postoperative complications. The complications group had a greater operative time (p = 0.037), higher CPK ratio on POD1 (p < 0.0001), and a higher serum CRP level on POD3 (p = 0.001). The AUC for the CPK ratio was 0.772, with an optimal cutoff value of 7.05, whereas that for CRP was 0.659, with an optimal cutoff value of 11.4 mg/L. The CPK ratio on POD1 (p < 0.0001) and the CRP on POD3 (p = 0.007) were independent factors for predicting the development of postgastrectomy complications. The CPK ratio on POD1 and the CRP on POD3 predicted postgastrectomy complications in 41 patients (85.4%). According to combined value of both CPK ratio and CRP level, the positive predictive value and the negative predictive value was 0.70 and 0.829. And sensitivity and specificity were 0.438 and 0.936. CONCLUSION: The CPK ratio on POD1 and the CRP on POD3 after gastrectomy for GC were predictive factors for complication development and may be employed to prevent the development of such complications and improve the prognosis of patients with GC. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12885-021-07801-z. BioMed Central 2021-01-23 /pmc/articles/PMC7825180/ /pubmed/33485312 http://dx.doi.org/10.1186/s12885-021-07801-z Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Okubo, Keishi
Arigami, Takaaki
Matsushita, Daisuke
Kijima, Takashi
Shimonosono, Masataka
Uenosono, Yoshikazu
Yanagita, Shigehiro
Kurahara, Hiroshi
Mori, Shinichiro
Ohtsuka, Takao
Natsugoe, Shoji
Clinical impact of creatine phosphokinase and c-reactive protein as predictors of postgastrectomy complications in patients with gastric cancer
title Clinical impact of creatine phosphokinase and c-reactive protein as predictors of postgastrectomy complications in patients with gastric cancer
title_full Clinical impact of creatine phosphokinase and c-reactive protein as predictors of postgastrectomy complications in patients with gastric cancer
title_fullStr Clinical impact of creatine phosphokinase and c-reactive protein as predictors of postgastrectomy complications in patients with gastric cancer
title_full_unstemmed Clinical impact of creatine phosphokinase and c-reactive protein as predictors of postgastrectomy complications in patients with gastric cancer
title_short Clinical impact of creatine phosphokinase and c-reactive protein as predictors of postgastrectomy complications in patients with gastric cancer
title_sort clinical impact of creatine phosphokinase and c-reactive protein as predictors of postgastrectomy complications in patients with gastric cancer
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7825180/
https://www.ncbi.nlm.nih.gov/pubmed/33485312
http://dx.doi.org/10.1186/s12885-021-07801-z
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