The predictive value of NLR,Aβ and IGF-1 on early postoperative cognitive function in elderly patients undergoing radical resection of colorectal cancer
Objective To investigate the predictive value of serum neutrophil/lympho cyte ratio (NLR),amyloid β-protein (Aβ) and insulin-like growth factor-1 (IGF-1) on postoperative cognitive dysfunc-tion (POCD) in elderly patients undergoing radical resection of colorectal cancer.Methods The clinical data of 122 patients who underwent laparoscopic radical resection for colorectal cancer at Hefei Eighth People's Hospital from January 2019 to December 2022 were retrospectively analyzed.The cognitive function of these patients was evaluated using mini-mental state examination (MMSE) after the operation.The patients were then divided into two groups:those with POCD and those without (non-POCD).The levels of serum NLR,Aβ and IGF-1 within 24 hours after the operation were compared between the two groups.The influencing fac-tors of POCD after operation were analyzed using binary logistic regression.The receiver operating curve (ROC) was used to evaluate the predictive value of serum NLR,Aβ and IGF-1 levels for POCD in elderly pa-tients undergoing radical resection for colorectal cancer.Results POCD was observed in 54 patients 7 days af-ter their operation.The levels of NLR and Aβ in the POCD group were higher than those in the non-POCD group,while the level of IGF-1 was lower than in the non-POCD group,the differences were statistically sig-nificant (t=5.894,6.108,6.481,P<0.05).Multivariate logistic regression analysis showed that long operation time,increased NLR and Aβ,levels,and decreased IGF-1 were risk factors for postoperative POCD (P<0.05).Additionally,higher years of education were shown to be protective factors against postoperative POCD (P<0.05).ROC curve results showed that the area under the curve of serum NLR,Aβ,IGF-1 alone and com-bined detection in predicting POCD in elderly patients undergoing radical resection of colorectal cancer were 0.774,0.779,0.794 and 0.910,respectively.The combined detection was better than single detection (P<0.05).Conclusion The abnormal levels of serum NLR,Aβ,and IGF-1 may be related to the occurrence of POCD in elderly patients undergoing radical resection of colorectal cancer.The combined detection of these three markers has a significant application value in predicting the occurrence of POCD.