Use of inflammatory factors combined with multi-slice spiral computer tomography for preoperative staging and operative strategy in colon cancer

Abstract

To determine the clinical value of C-reactive protein(CRP), fibrinogen (FIB), or serum amyloid A protein (SAA) combined with 64 multi-slice computed tomography (MSCT) for preoperative staging and operative strategy in colon cancer. Patients with colon cancer were prospectively enrolled at the West China Hospital of Sichuan University from November 2007 to July 2009,and were equally randomized into 3 groups undergoing different preoperative evaluation: MSCT combined with CRP(CRP group), MSCT combined with FIB (FIB group), and MSCT combined with SAA (SAA group). The agreement between preoperative staging and postoperative pathologic staging and that between expected surgical procedure and procedure adopted were compared. Baseline characteristics among three groups were similar(P>0.05). In CRP group, the accuracies of preoperative staging T, N, M and TNM were 65.7%, 72.4%, 100% and 66.7%, respectively. In FIB group, the accuracies of preoperative staging T, N, M and TNM were 71.4%, 74.3%, 99.0% and 65.7%, respectively. In SAA group, the accuracies of preoperative staging T, N, M and TNM were 60.0%, 55.2%, 96.2%and 51.4%, respectively. The accuracies of N and TNM staging in CRP group and FIB group were significantly higher than those in SAA group(P<0.05). However, there were no significant differences between FIB and CRP group(P>0.05). There were no significant differences in accuracy of predicting surgical procedures among three groups(93.3%, 92.3% and 87.6%, P>0.05). Combined assessment of MSCT and CRP or FIB may improve the accuracy of preoperative staging and procedure prediction, and is superior to MSCT combined with SAA.