The advanced lung cancer inflammation index predicts outcomes in patients with Crohn’s disease after surgical resection
K. Kusunoki, Yuji Toiyama, Yoshinaga Okugawa, Akira Yamamoto, Y Omura, Yoshiki Kusunoki, Chengzeng Yin, Satoru Kondo, Yoshiki Okita, Masaki Ohi, Hirofumi Sasaki, Tomohiro Bando, Motoi Uchino, Hiroki Ikeuchi, M. Kusunoki
Abstract
AIM: Precise biomarkers for predicting prognosis could help to identify high-risk Crohn's disease (CD) patients to facilitate better follow-up during the postoperative course. In this study, the primary aim is the identification of the most reliable nutrition marker that predicts surgical relapse in CD patients. METHOD: We first evaluated the predictive value of various nutrition markers for postoperative surgical relapse in CD patients and identified the advanced lung cancer inflammation index (ALI) as a promising biomarker. Then, we assessed the clinical significance of preoperative ALI in CD patients using two cohorts. RESULTS: Preoperative ALI showed the highest correlation with reoperation rate compared with other nutritional parameters in CD patients receiving surgical resection (sensitivity 53%, specificity 86%, area under the curve 0.71). Lower levels of preoperative ALI were significantly correlated with the presence of perianal disease. A lower level of preoperative ALI was an independent prognostic factor for reoperation rate after an intestinal resection (hazard ratio 3.37, 95% CI 1.38-10.12, P = 0.006), and the prognostic impact of preoperative ALI was successfully validated in an independent cohort using the same cut-off value. CONCLUSION: Preoperative ALI might be useful for postoperative management of CD patients.