Perioperative Adiponectin Measurement is Useful for Prediction of Postoperative Infection in Patients with Colorectal Cancer
Adiponectin (ADN) is a key molecule associated with obesity and metabolic syndrome, and functions as an immunomodulator. We have shown that the ADN ratio (i.e., postoperative ADN/preoperative ADN) can predict infection after gastrectomy in patients with gastric cancer . In the present study, we evaluated whether the ADN ratio could reliably predict the incidence of postoperative infection in patients undergoing colorectal cancer surgery.
We retrospectively analyzed 131 consecutive patients who underwent colorectal cancer surgery and measured their preoperative and postoperative ADN values. The outcome was postoperative infection, including surgical site and remote infections. The association between the ADN ratio and postoperative infection was assessed using logistic regression models. For the ADN ratio and other significant predictors, we conducted receiver operating characteristics (ROC) analyses.
Forty-nine patients (37.4 %) experienced postoperative infections. Logistic regression analysis indicated that the ADN ratio was most significantly associated with postoperative infection [odds ratio per one standard deviation (1 SD) decrease 0.36; 95 % confidence interval 0.18–0.71] even after adjustment for diabetes, type of surgery, blood loss, C-reactive protein level, and preoperative ADN level. History of type 2 diabetes mellitus also significantly predicted postoperative infection (odds ratio per 1 SD increase 2.93; 95 % confidence interval 1.03–8.38). When predicting postoperative infection, the area under the ROC curve for the ADN ratio (0.707) was comparable to that for blood loss (0.698; p = 0.975).
ADN ratio is a clinically useful predictor of postoperative infection in patients undergoing colorectal cancer.
KeywordsSurgical Site Infection Receiver Operating Characteristic Receiver Operating Characteristic Curve Postoperative Infection Receiver Operating Characteristic Analysis
We sincerely appreciate the cooperation of Etsuko Tsubakino, Hirofumi Yumoto, Ikuko Arikawa, Ai Kenmochi, and Miho Yamamoto for technical assistance. This work was supported by a Grant-in-Aid for Scientific Research (C), a Grant-in-Aid for the Cooperative Research Project from Joint Usage/Research Center (Joint Usage/Research Center for Science-Based Natural Medicine) Institute of Natural Medicine, University of Toyama, in 2015, as well as, in part, a grant from Otsuka Pharmaceutical Co. Ltd.
Conflict of interest
The authors declare no conflict of interest.