[The Postoperative C-Reactive Protein Level Is an Early Predictor of Infectious Complications after Gastric Cancer Resection].
OBJECTIVE
The aim of this study was to investigate whether postoperative serum C-reactive protein (CRP) levels can be used to predict the risk of postoperative infections in patients undergoing gastric cancer resection.


METHODS
Data from 77 patients who had undergone open gastrectomy for gastric cancer between 2008 and 2014 were retrospectively collected. Clinical details including postoperative white blood cell(WBC)count, CRP levels, and platelet (Plt) counts were obtained. The occurrence of complications as defined by the Clavien-Dindo classification was the outcome, particularly anastomotic leakage or pancreatic fistula. The diagnostic accuracy was determined by measuring the area under the receiver operating characteristic( ROC)curve.


RESULTS
The overall incidence of anastomotic leakage or pancreatic fistula was 9.1%. Using CRP on POD 3 had superior diagnostic accuracy for anastomotic leakage or pancreatic fistula (area under the curve [AUC]: 0.898, 95%CI: 0.809-0.987). A cut off of 20.1 mg/dL for the CRP level on POD 3 yielded a sensitivity of 85.7% and a negative predictive value of 98.3%for the detection of anastomotic leakage or pancreatic fistula.


CONCLUSIONS
Elevated CRP levels on POD 3 may help physicians predict the occurrence of postoperative complications after gastric cancer resection, particularly anastomotic leakage and pancreatic fistula.
Dept. of Surgery, Kamishirane Hospital.
Kazuki
K
Kano
Hiroshi
H
Tamagawa
Sho
S
Sawazaki
Takashi
T
Ohshima
Norio
N
Yukawa
Yasushi
Y
Rino
Munetaka
M
Masuda
D000368:Aged; D057868:Anastomotic Leak; D002097:C-Reactive Protein / Q000032:analysis*; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects; D006801:Humans; D008297:Male; D010185:Pancreatic Fistula; D011183:Postoperative Complications; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000097:blood / Q000601:surgery*
D002097:C-Reactive Protein