Effect Of Serum Cholinesterase Level Before And After Chemotherapy On The Efficacy And Prognosis Of Advanced Colorectal Cancer Patients

Objective: The purpose of this study was to explore the relationship between serum cholinesterase and the efficacy of two cycles of fluorouracil based chemotherapy in advanced colorectal cancer.To evaluate whether serum cholinesterase levels and changes before and after first-line chemotherapy and other biochemical indicators can be used as prognostic indicators of advanced colorectal cancer.To provide new evidence for clinicians to judge the progress of the colorectal cancer and the prognosis of patients.Methods: The data of 193 patients with advanced colorectal cancer were retrospectively studied.SPSS 26.0 statistical software was used to analyze the correlation between serum cholinesterase level before and after chemotherapy and its clinical characteristics,chemotherapy efficacy,and the influence of serum cholinesterase and other clinical indicators on the prognosis of patients.Results: The serum cholinesterase level before chemotherapy was related to age(P =0.020),main lesion location(P = 0.024)and operation(P = 0.02).The serum cholinesterase level after chemotherapy was related to age(P = 0.000),gender(P = 0.000),liver metastasis(P = 0.034)and operation(P = 0.030).There was a positive correlation between baseline serum cholinesterase level and albumin level before chemotherapy(r = 0.635,P= 0.000).There were significant differences in the mean values of patients with SD,PR and PD after 2 cycles of chemotherapy(P = 0.000).The mean BCh E of PR patients was the highest before and after chemotherapy,and the mean BCh E of PD patients was the lowest before and after chemotherapy.The mean value of PR group decreased after chemotherapy,and the difference was statistically significant(P = 0.010).There was no significant difference in BCh E between SD group and PD group after 2 cycles of chemotherapy(P = 0.082 and 0.070,respectively).Univariate analysis showed that the main lesion location,liver metastasis or not,degree of differentiation,operation or not,HGB level,D-dimer level,FIB level,serum cholinesterase level before chemotherapy and fibrinogen level after two cycles of chemotherapy were significantly correlated with 0s(P< 0.05).Multivariate analysis showed that operation or not,HGB level,FIB level and serum cholinesterase level before chemotherapy were independent prognostic factors of overall survival(P < 0.05).The increase and decrease of serum cholinesterase before and after chemotherapy had no significant effect on OS(P = 0.396).Conclusion: The serum cholinesterase level of patients with advanced colorectal cancer before and after first-line two cycle chemotherapy can be used as an important indicator to predict the efficacy and prognosis of chemotherapy.The level of serum cholinesterase before chemotherapy is positively correlated with the level of serum albumin,which can reflect the nutritional status of patients.Serum cholinesterase level before chemotherapy can be used as an independent prognostic factor for survival of patients with advanced colorectal cancer.