Correlations between primary tumour location, biomarkers of inflammation and lung injury, and postoperative pulmonary complications in patients underwent laparoscopic colorectomy: a propensity score matched analysis of 300 patients
IntroductionThe impact of distinct primary colorectal cancer (CRC) sites on lung injury and complications remains largely unexplored, despite the palpable differences in surgical positions, procedures, and the resulting mechanically induced respiratory pressures at each site.Materials and methodsThi...
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Frontiers Media S.A.
2025-01-01
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| author | Hui-xian Li Li Che Yuan Li Tai-hang Wang Fang-di Min Lei Xu Meng Wang Zhao-xu Zheng Shi-ning Qu Fei Wang Wei Tang Shi-jing Wei Yu-lin Sun Hui Zheng Tao Yan |
| author_facet | Hui-xian Li Li Che Yuan Li Tai-hang Wang Fang-di Min Lei Xu Meng Wang Zhao-xu Zheng Shi-ning Qu Fei Wang Wei Tang Shi-jing Wei Yu-lin Sun Hui Zheng Tao Yan |
| author_sort | Hui-xian Li |
| collection | DOAJ |
| description | IntroductionThe impact of distinct primary colorectal cancer (CRC) sites on lung injury and complications remains largely unexplored, despite the palpable differences in surgical positions, procedures, and the resulting mechanically induced respiratory pressures at each site.Materials and methodsThis study employed a forwards-looking approach utilising the propensity score matching (PSM) method; 300 patients with pathological CRC after laparoscopic surgery from April 2019 to May 2023 were enrolled. Two categories were bifurcated based on their surgical locations: the rectosigmoid colon (RSC) group and the descending/ascending colon (DAC) group, with a 2:1 ratio. The occurrence of postoperative pulmonary complications (PPCs) within a 30-day postoperative period was meticulously evaluated. Additionally, assessments have been performed for plasma biomarkers of immune response dynamics and lung injury (plasma soluble advanced glycation end-product receptor [sRAGE], angiopoietin-2 [ANG-2], interleukin-1β/6 [IL-1β/IL-6]) and other parameters.ResultsAlthough the increase in postoperative lung epithelial damage, as indicated by the plasma sRAGE levels, was significant in the RSC group (DAC vs. RSC; 1029.6 [576.8–1365.2] vs. 1271.6 [896.3–1587.6]; odds ratio=0.999; 95% CI: 0.998 to 1.000; P=0.007), a significantly increased percentage of PPCs was observed in the DAC group (DAC vs. RSC; hazard ratio=1.669; 95% CI, 1.141 to 2.439; P=0.008). A univariate Cox proportional hazards model revealed that sRAGE, ANG-2, IL-1β, and IL-6 levels were not correlated with the incidence of time-to-PPCs across the two cohorts (P>0.05). Propensity score-weighted Cox regression and causal mediation analysis further demonstrated that the DAC site directly affected the incidence of PPCs, regardless of the other baseline confounders and clinical covariates related to the tumour site and PPCs.ConclusionThe primary site of CRC is an independent predictor of the development of PPCs. Despite the steep Trendelenburg position of the RSC group inciting more pulmonary stress, inflammation and lung epithelial injury, as indicated by higher sRAGE, it demonstrated a lower PPCs occurrence relative to its DAC counterpart, with a slightly inclined or reversed Trendelenburg position. None of the plasma biomarkers of inflammation or lung injury indicated sufficient prognostic value for PPCs. |
| format | Article |
| id | doaj-art-6ddc9420a9c74e8e95224ca32f511f12 |
| institution | Kabale University |
| issn | 1664-3224 |
| language | English |
| publishDate | 2025-01-01 |
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| series | Frontiers in Immunology |
| spelling | doaj-art-6ddc9420a9c74e8e95224ca32f511f122025-01-30T06:21:49ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-01-011610.3389/fimmu.2025.15461671546167Correlations between primary tumour location, biomarkers of inflammation and lung injury, and postoperative pulmonary complications in patients underwent laparoscopic colorectomy: a propensity score matched analysis of 300 patientsHui-xian Li0Li Che1Yuan Li2Tai-hang Wang3Fang-di Min4Lei Xu5Meng Wang6Zhao-xu Zheng7Shi-ning Qu8Fei Wang9Wei Tang10Shi-jing Wei11Yu-lin Sun12Hui Zheng13Tao Yan14Department of Anesthesiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Cardiology, Central Hospital of Dalian University of Technology, Dalian, ChinaDepartment of Colorectal Surgery, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaDepartment of Anesthesiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Anesthesiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Anesthesiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Anesthesiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Intensive Care Unit, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaOffice of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Anesthesiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaState Key Laboratory of Molecular Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Anesthesiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Anesthesiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaIntroductionThe impact of distinct primary colorectal cancer (CRC) sites on lung injury and complications remains largely unexplored, despite the palpable differences in surgical positions, procedures, and the resulting mechanically induced respiratory pressures at each site.Materials and methodsThis study employed a forwards-looking approach utilising the propensity score matching (PSM) method; 300 patients with pathological CRC after laparoscopic surgery from April 2019 to May 2023 were enrolled. Two categories were bifurcated based on their surgical locations: the rectosigmoid colon (RSC) group and the descending/ascending colon (DAC) group, with a 2:1 ratio. The occurrence of postoperative pulmonary complications (PPCs) within a 30-day postoperative period was meticulously evaluated. Additionally, assessments have been performed for plasma biomarkers of immune response dynamics and lung injury (plasma soluble advanced glycation end-product receptor [sRAGE], angiopoietin-2 [ANG-2], interleukin-1β/6 [IL-1β/IL-6]) and other parameters.ResultsAlthough the increase in postoperative lung epithelial damage, as indicated by the plasma sRAGE levels, was significant in the RSC group (DAC vs. RSC; 1029.6 [576.8–1365.2] vs. 1271.6 [896.3–1587.6]; odds ratio=0.999; 95% CI: 0.998 to 1.000; P=0.007), a significantly increased percentage of PPCs was observed in the DAC group (DAC vs. RSC; hazard ratio=1.669; 95% CI, 1.141 to 2.439; P=0.008). A univariate Cox proportional hazards model revealed that sRAGE, ANG-2, IL-1β, and IL-6 levels were not correlated with the incidence of time-to-PPCs across the two cohorts (P>0.05). Propensity score-weighted Cox regression and causal mediation analysis further demonstrated that the DAC site directly affected the incidence of PPCs, regardless of the other baseline confounders and clinical covariates related to the tumour site and PPCs.ConclusionThe primary site of CRC is an independent predictor of the development of PPCs. Despite the steep Trendelenburg position of the RSC group inciting more pulmonary stress, inflammation and lung epithelial injury, as indicated by higher sRAGE, it demonstrated a lower PPCs occurrence relative to its DAC counterpart, with a slightly inclined or reversed Trendelenburg position. None of the plasma biomarkers of inflammation or lung injury indicated sufficient prognostic value for PPCs.https://www.frontiersin.org/articles/10.3389/fimmu.2025.1546167/fullcolorectal cancerTrendelenburg positioninflammatory biomarkerlung injurypostoperative pulmonary complications |
| spellingShingle | Hui-xian Li Li Che Yuan Li Tai-hang Wang Fang-di Min Lei Xu Meng Wang Zhao-xu Zheng Shi-ning Qu Fei Wang Wei Tang Shi-jing Wei Yu-lin Sun Hui Zheng Tao Yan Correlations between primary tumour location, biomarkers of inflammation and lung injury, and postoperative pulmonary complications in patients underwent laparoscopic colorectomy: a propensity score matched analysis of 300 patients Frontiers in Immunology colorectal cancer Trendelenburg position inflammatory biomarker lung injury postoperative pulmonary complications |
| title | Correlations between primary tumour location, biomarkers of inflammation and lung injury, and postoperative pulmonary complications in patients underwent laparoscopic colorectomy: a propensity score matched analysis of 300 patients |
| title_full | Correlations between primary tumour location, biomarkers of inflammation and lung injury, and postoperative pulmonary complications in patients underwent laparoscopic colorectomy: a propensity score matched analysis of 300 patients |
| title_fullStr | Correlations between primary tumour location, biomarkers of inflammation and lung injury, and postoperative pulmonary complications in patients underwent laparoscopic colorectomy: a propensity score matched analysis of 300 patients |
| title_full_unstemmed | Correlations between primary tumour location, biomarkers of inflammation and lung injury, and postoperative pulmonary complications in patients underwent laparoscopic colorectomy: a propensity score matched analysis of 300 patients |
| title_short | Correlations between primary tumour location, biomarkers of inflammation and lung injury, and postoperative pulmonary complications in patients underwent laparoscopic colorectomy: a propensity score matched analysis of 300 patients |
| title_sort | correlations between primary tumour location biomarkers of inflammation and lung injury and postoperative pulmonary complications in patients underwent laparoscopic colorectomy a propensity score matched analysis of 300 patients |
| topic | colorectal cancer Trendelenburg position inflammatory biomarker lung injury postoperative pulmonary complications |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2025.1546167/full |
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