|Table of Contents|

The value of preoperative free fatty acids levels in predicting postoperative inflammatory response and complications in gastric cancer

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2024 06
Page:
1083-1088
Research Field:
Publishing date:

Info

Title:
The value of preoperative free fatty acids levels in predicting postoperative inflammatory response and complications in gastric cancer
Author(s):
LI Xiaoyong; DING Xiaodong; MAO Weizheng
Qingdao Municipal Hospital,Qingdao University，Shandong Qingdao 266071，China.
Keywords:
free fatty acids; inflammatory indicators; C-reactive protein; gastric cancer prognosis
PACS:
R735.2
DOI:
10.3969/j.issn.1672-4992.2024.06.017
Abstract:
Objective:To investigate the value of preoperative free fatty acid (FFA) in plasma in predicting postoperative inflammatory reactions and complications in gastric cancer.Methods：The clinical data of 200 cases of gastric cancer patients in our hospital from 2017 to 2022 were selected.According to Clavien-Dindo classification，56 cases with grade II or above were in the complication group，and 144 cases were in the no-complication group.The differences in free fatty acids，body mass index (BMI)，albumin and lipid indexes before surgery were compared between the two groups，and the single-factor indexes affecting postoperative complications were screened and analyzed by Logistic regression.The risk factors were included in the receiver operator characteristic (ROC) curve to evaluate the diagnostic value of each factor on postoperative complications of gastric cancer.To compare the diagnostic value of preoperative and postoperative free fatty acid level changes on postoperative complications.The preoperative FFA cutoff value was divided into high FFA group and low FFA group，and the differences in postoperative inflammatory response indexes (C-reactive protein/albumin ratio，C-reactive protein) between the two groups were compared.Results：Univariate results showed that preoperative FFA in the complication group was significantly higher than that in the uncomplicated group，while preoperative cholesterol and HDL were significantly lower than that in the uncomplicated group，and the difference was statistically significant (P＜0.05).BMI was statistically significant in the comparison of the two groups (P＜0.05).Multifactorial Logistic analysis showed that preoperative FFA was an independent risk factor affecting the complications of gastric cancer patients ［OR=7.407(3.610~15.196)，P＜0.05］.ROC curve of the diagnostic value of preoperative FFA and BMI on the postoperative complications of gastric cancer patients was plotted，and the results showed that the area under the curve (AUC) was 0.784 and 0.564,respectively.The area under the ROC curve of preoperative and postoperative free fatty acid levels showed that the AUC of preoperative FFA was greater than the AUC of postoperative FFA and the difference between the two changes,indicating that the diagnostic value of preoperative FFA was greater than the two.Inflammatory response indexes (C-reactive protein/albumin ratio,C-reactive protein) were significantly higher in the high FFA group than in the low FFA group on postoperative day 3 (POD3),and the difference was statistically significant (P＜0.05).Conclusion:Preoperative FFA was more predictive of postoperative complications in gastric cancer than BMI.Elevated preoperative FFA increased the degree of inflammatory response after gastric cancer surgery and increased the likelihood of postoperative complications.

References:

［1］M ARNOLD,CC ABNET,RE NEALE,et al.Global burden of 5 major types of gastrointestinal cancer［J］.Gastroenterology,2020,159(1):335-349.
［2］H SUNG,J FERLAY,RL SIEGEL,et al.Global cancer statistics 2020:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries［J］.CA Cancer J Clin,2021,71(3):209-249.
［3］WH HAN,YJ OH,BW EOM,et al.Prognostic impact of infectious complications after curative gastric cancer surgery［J］.Eur J Surg Oncol,2020,46(7):1233-1238.
［4］N PURTOLAS,J OSORIO,C JERIC,et al.Effect of perioperative blood transfusions and infectious complications on inflammatory activation and long-term survival following gastric cancer resection［J］.Cancers (Basel),2022,15(1):144.
［5］P YUAN,Z WU,Z LI,et al.Impact of postoperative major complications on long-term survival after radical resection of gastric cancer［J］.BMC Cancer,2019,19(1):833.
［6］B LUO,Q LIAO,J ZHENG,et al.The ratio of serum C-reactive protein level on postoperative day 3 to day 2 is a good marker to predict postoperative complications after laparoscopic radical gastrectomy for gastric cancer［J］.Langenbeck's Archives of Surgery,2022,407(4):1451-1460.
［7］Y SHISHIDO,K FUJITANI,K YAMAMOTO,et al.C-reactive protein on postoperative day 3 as a predictor of infectious complications following gastric cancer resection［J］.Gastric Cancer,2016,19(1):293-301.
［8］I MUNGAN,B DICLE ,�瘙塁 BEKTA�瘙塁,et al.Does the preoperative platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio predict morbidity after gastrectomy for gastric cancer［J］.Mil Med Res,2020,7(1):9.
［9］陆通,房钰,刘浩楠，等.基于术前 PIV、NLR和CEA水平对胃癌根治术后预后列线图预测模型的构建及评价［J］.现代肿瘤医学,2023,31(10):1869-1875. LU T,FANG Y,LIU HN,et al.Construction and evaluation of nomogram prediction model for prognosis after radicalgastrectomy based on preoperative PIV,NLＲ and CEA level［J］.Modern Oncology,2023,31(10):1869-1875.
［10］李世宽,周岩冰,毛伟征,等.肥胖对胃癌患者术后短期结局的影响［J］.中华胃肠外科杂志,2010,13(2):133-136. LI SK,ZHOU YB,MAO WZ,et al.Influence of obesity on short-term surgical outcomein patients with gastric cancer［J］.Chin J Gastrointest Surg,2010,13(2):133-136.
［11］秦啸,毛伟征,李谦，等.胃癌根治术后应激性高血糖与外科感染关系的临床观察［J］.中国现代普通外科进展,2011,14(03):219-221. QIN X,MAO WZ,LI Q,et al.Clinical observation of stress hyperglycemia and surgical infection after radical gastrectomy［J］.Chinese Journal of Current Advances in General Surgery,2011,14(03):219-221.
［12］任文豪,毛伟征.预后营养指数预测胃肠癌预后的临床研究［J］.临床普外科电子杂志,2019,7(03):23-28. REN WH,MAO WZ.Clinical study of prognostic nutritional index in predicting prognosis of patients with gastrointestinal cancer［J］.Journal of General Surgery for Clinicians,2019,7(03):23-28.
［13］G BODEN.Obesity,insulin resistance and free fatty acids［J］.Curr Opin Endocrinol Diabetes Obes,2011,18(2):139-143.
［14］H GOLDER,D CASANOVA,V PAPALOIS.Evaluation of the usefulness of the Clavien-Dindo classification of surgicalcomplications［J］.Cir Esp (Engl Ed),2023,101(9):637-642.
［15］HN CHEN,XZ CHEN,WH ZHANG,et al.The impact of body mass index on the surgical outcomes of patients with gastric cancer:A 10-year,single-institution cohort study［J］.Medicine (Baltimore),2015,94(42):e1769.
［16］WA PAPENFUSS,M KUKAR,J OXENBERG,et al.Morbidity and mortality associated with gastrectomy for gastric cancer［J］.Ann Surg Oncol,2014,21(9):3008-3014.
［17］TK HAUGSTVEDT,A VISTE,GE EIDE,et al.Factors related to and consequences of weight loss in patients with stomach cancer.The Norwegian multicenter experience.Norwegian stomach cancer trial［J］.Cancer,1991,67(3):722-729.
［18］Y IMAI,SW LEE,M KAWAI,et al.Visceral fat area is a better indicator of surgical outcomes after laparoscopic gastrectomy for cancer than the body mass index:a propensity score-matched analysis［J］.Surgical Endoscopy,2022,36(5):3285-3297.
［19］SJ YANG,HR LI,WH ZHANG,et al.Visceral fat area (VFA) superior to BMI for predicting postoperative complications after radical gastrectomy:a prospective cohort study［J］.J Gastrointest Surg,2020,24(6):1298-1306.
［20］TS ZHAI,Y KANG,MAO WZ,et al.Elevated visceral fat area is associated with adverse postoperative outcome of radical colectomy for colon adenocarcinoma patients［J］.ANZ Journal of Surgery,2019,89(9):E368-E372.
［21］L OPAZO-ROS,S MAS,G MARíN-ROYO,et al.Lipotoxicity and diabetic nephropathy:novel mechanistic insights and therapeutic opportunities［J］.Int J Mol Sci,2020,21(7):2632.
［22］Y LEE,H HIROSE,M OHNEDA,et al.Beta-cell lipotoxicity in the pathogenesis of non-insulin-dependent diabetes mellitus of obese rats:impairment in adipocyte-beta-cell relationships［J］.Proc Natl Acad Sci USA,1994,91(23):10878-10882.
［23］K LIPKE,A KUBIS-KUBIAK,A PIWOWAR.Molecular mechanism of lipotoxicity as an interesting aspect in the development of pathological states-current view of knowledge［J］.Cells,2022,11(5):844.
［24］C GILLIS,O LJUNGQVIST,F CARLI.Prehabilitation,enhanced recovery after surgery,or both? A narrative review［J］.Br J Anaesth,2022,128(3):434-448.
［25］H GHANIM,A ALJADA,D HOFMEYER，et al.Circulating mononuclear cells in the obese are in a proinflammatory state［J］.Circulation,2004,110(12):1564-1571.
［26］C PATEL,H GHANIM,S RAVISHANKAR，et al.Prolonged reactive oxygen species generation and nuclear factor-kappaB activation after a high-fat,high-carbohydrate meal in the obese［J］.J Clin Endocrinol Metab,2007,92(11):4476-4479.
［27］D TRIPATHY,P MOHANTY,S DHINDSA，et al.Elevation of free fatty acids induces inflammation and impairs vascular reactivity in healthy subjects［J］.Diabetes,2003,52(12):2882-2887.
［28］A SUREDA,M MARTORELL,MDM BIBILONI，et al.Effect of free fatty acids on inflammatory gene expression and hydrogen peroxide production by Ex vivo blood mononuclear cells［J］.Nutrients,2020,12(1):146.
［29］JHM YUNG,A GIACCA.Role of c-Jun N-terminal kinase (JNK) in obesity and type 2 diabetes［J］.Cells,2020,9(3):706.
［30］K WANI,H ALHARTHI,A ALGHAMDI,et al.Role of NLRP3 inflammasome activation in obesity-mediated metabolic disorders［J］.Int J Environ Res Public Health,2021,18(2):511.
［31］T HAYASHI,T YOSHIKAWA,T AOYAMA,et al.Impact of infectious complications on gastric cancer recurrence［J］.Gastric Cancer,2015,18(2):368-374.
［32］JP DESBOROUGH.The stress response to trauma and surgery［J］.Br J Anaesth,2000,85(1):109-117.
［33］M VAN WINSEN,ST MCSORLEY,R MCLEOD,et al.Postoperative C-reactive protein concentrations to predict infective complications following gastrectomy for cancer［J］.Journal of Surgical Oncology,2021,124(7):1060-1069.
［34］X MIAO,Y WANG,W WANG，et al.The mAb against adipocyte fatty acid-binding protein 2E4 attenuates the inflammation in the mouse model of high-fat diet-induced obesity via toll-like receptor 4 pathway［J］.Mol Cell Endocrinol,2015,403:1-9.
［35］A SAALBACH,AT SEITZ,J KOHLMANN,et al.Modulation of dietary fatty acids in an open-label study improves psoriasis and dampens the inflammatory activation status［J］.Nutrients,2023，15(7):1698.

Memo

Memo:
-
Last Update: 1900-01-01