Predictive value of intraoperative rSO2 combined with se-rum CHI3L1 and CXCL16 for postoperative cognitive im-pairment in patients with colorectal cancer
Predictive value of intraoperative rSO2 combined with se-rum CHI3L1 and CXCL16 for postoperative cognitive im-pairment in patients with colorectal cancer
Objective:To explore the predictive value of intraoperative cerebral oxygen satu-ration(rSO2)combined with serum chitinase-3-like protein 1(CHI3L1)and CXC-chemokine ligand 16(CXCL16)for postoperative cognitive dysfunction(POCD)in colorectal cancer patients.Meth-ods:83 patients who developed POCD after colorectal cancer surgery in our hospital from Novem-ber 2021 to September 2023 were selected as the study group,another 83 patients without POCD who underwent colorectal cancer surgery were as control group.Spearman method was applied to analyze the correlation between serum CHI3L1,CXCL16 expression levels and MMSE score;re-ceiver operating characteristic(ROC)curve was applied to analyze the predictive value of intraopera-tive rSO2 combined with serum CHI3L1 and CXCL16 for postoperative POCD in colorectal cancer patients.Results:There was statistically difference in the postoperative MMSE scores between the study group and the control group(P<0.05);there was no statistically difference in rSO2 level between the two groups at T0 and T1 time points(P>0.05),while there was statistically difference in rSO2 level at T2,T3,T4,and T5 time points(P<0.05),and the change rate of rSO2 in the study group was higher than that in the control group(P<0.05);the expression levels of serum CHI3L1 and CXCL16 in the study group were higher than those in the control group(P<0.05);the expres-sion levels of serum CHI3L1 and CXCL16,and the intraoperative change rate of rSO2 were nega-tively correlated with MMSE score(P<0.05);the area under the curve(AUC)of serum CHI3L1,CXCL16 levels,and rSO2 change rate alone for predicting postoperative POCD in colorectal cancer patients was 0.790,0.754,and 0.870,respectively,however,the AUC predicted by the combina-tion of the three was 0.944,which was better than their individual predictions(Zcombination-CHI3L1=4.742,Zcombination-XCL16=5.081,Zcombination-rSO2 change rate=2.986,P<0.05).Conclusion:The combination of intraop-erative rSO2 and serum CHI3L1 and CXCL16 expression have high predictive efficacy for postop-erative POCD in colorectal cancer patients.
关键词
结直肠肿瘤/外科治疗/脑氧饱和度/认知功能障碍/几丁质酶3类蛋白1/CXC型趋化因子配体16
Key words
Colorectal tumors/Surgical treatment/Cerebral oxygen saturation/Cognitive im-pairment/Chitinase class 3 protein 1/CXC-chemokine ligand