Factors influencing analysis of the efficacy of probiotics combined with enteral nutrition in postoperative patients with colorectal cancer

Table 1 Comparison of demographic characteristics between two groups, n (%)

Parameter	Good efficacy group (n = 279)	Poor efficacy group (n = 232)	t/χ²	P value
Age (years)	49.63 ± 8.54	52.66 ± 7.57	4.207	< 0.001
Female/male	128 (45.88)/151 (54.12)	111 (47.84)/121 (52.16)	0.197	0.657
Ethnicity (Han/other)	227 (81.36)/52 (18.64)	183 (78.88)/49 (21.12)	0.492	0.483
BMI (kg/m²)	22.64 ± 2.55	22.24 ± 2.84	1.668	0.096
ECOG performance status (0/≥ 1)	243 (87.1)/36 (12.9)	185 (79.74)/47 (20.26)	5.037	0.025
Smoking history (yes/no)	102 (36.56)/177 (63.44)	83 (35.78)/149 (64.22)	0.034	0.854
Drinking history (yes/no)	69 (24.73)/210 (75.27)	67 (28.88)/165 (71.12)	1.116	0.291
Hypertension (yes/no)	95 (34.05)/184 (65.95)	85 (36.64)/147 (63.36)	0.372	0.542
Diabetes (yes/no)	100 (35.84)/179 (64.16)	78 (33.62)/154 (66.38)	0.275	0.600
Educational level (high school or below/college or above)	38 (13.62)/241 (86.38)	39 (16.81)/193 (83.19)	1.007	0.316
Marital status (married/unmarried)	131 (46.95)/148 (53.05)	120 (51.72)/112 (48.28)	1.154	0.283
RIP (< 1/1-3/3)	71 (25.45)/115 (41.22)/93 (33.33)	64 (27.59)/112 (48.28)/56 (24.14)	5.313	0.070
TNM stage (≤ II/> II)	137 (49.1)/142 (50.9)	91 (39.22)/141 (60.78)	5.004	0.025
Tumour size (cm)	3.38 ± 0.95	3.52 ± 1.09	1.478	0.140

BMI: Body mass index; ECOG: Eastern Cooperative Oncology Group performance status; RIP: The ratio of family income to poverty; TNM: Tumor node metastasis.

Table 2 Comparison of surgical-related factors between the two groups

Parameter	Good efficacy group (n = 279)	Poor efficacy group (n = 232)	t/χ²	P value
Surgery duration (minute)	189.15 ± 25.11	192.35 ± 27.04	1.387	0.166
Blood loss (mL)	153.9 ± 30.75	158.45 ± 50.03	1.208	0.228
Lymph nodes removed	17.32 ± 4.54	16.87 ± 3.78	1.212	0.226
Immediate post-operative complications, n (%)	23 (8.24)/256 (91.76)	23 (9.91)/209 (90.09)	0.431	0.511

Table 3 Comparison of intestinal mucosal barrier function indicators

Index	Good efficacy group (n = 279)	Poor efficacy group (n = 232)	t value	P value
DAO (U/L)
Preoperative	4.27 ± 0.48	4.27 ± 0.39	0.066	0.947
Postoperative day 1	5.73 ± 1.07	5.69 ± 1.06	0.41	0.682
Postoperative day 7	3.98 ± 0.62	4.11 ± 0.58	2.493	0.013
I-FABP (μg/L)
Preoperative	50.53 ± 12.95	51.42 ± 11.07	0.832	0.406
Postoperative day 1	70.65 ± 11.54	69.88 ± 11.92	0.746	0.456
Postoperative day 7	47.54 ± 10.27	50.21 ± 12.83	2.564	0.011
LPS (U/L)
Preoperative	4.53 ± 0.84	4.47 ± 0.62	0.876	0.382
Postoperative day 1	7.64 ± 1.52	7.59 ± 1.97	0.298	0.766
Postoperative day 7	4.59 ± 1.32	4.87 ± 1.55	2.218	0.027
D-Lac (mg/L)
Preoperative	6.89 ± 1.24	6.92 ± 1.48	0.247	0.805
Postoperative day 1	13.27 ± 2.31	13.18 ± 2.24	0.457	0.648
Postoperative day 7	6.63 ± 1.22	7.02 ± 2.37	2.243	0.026

DAO: Diamine oxidase; I-FABP: Intestinal fatty acid binding protein; LPS: Lipopolysaccharide.

Table 4 Comparison of gut microbiota indicators (lgCFU/g, mean ± SD)

Index	Good efficacy group (n = 279)	Poor efficacy group (n = 232)	t value	P value
Bifidobacterium
Preoperative	9.27 ± 0.47	9.25 ± 0.49	0.445	0.656
Postoperative day 1	6.33 ± 0.56	6.29 ± 0.58	0.683	0.495
Postoperative day 7	9.01 ± 0.53	8.87 ± 0.68	2.492	0.013
Fusobacterium nucleatum
Preoperative	11.39 ± 0.64	11.46 ± 0.39	1.642	0.101
Postoperative day 1	7.38 ± 0.46	7.41 ± 0.32	0.932	0.352
Postoperative day 7	5.94 ± 0.45	6.03 ± 0.2	3.014	0.003
Lactobacillus
Preoperative	9.07 ± 0.55	9.02 ± 0.59	0.863	0.389
Postoperative day 1	6.27 ± 0.49	6.26 ± 0.5	0.375	0.708
Postoperative day 7	8.75 ± 0.75	8.62 ± 0.53	2.145	0.032
Bacteroides fragilis
Preoperative	12.07 ± 0.68	11.98 ± 0.75	1.381	0.168
Postoperative day 1	8.27 ± 0.59	8.17 ± 0.72	1.721	0.086
Postoperative day 7	5.68 ± 0.29	5.74 ± 0.27	2.75	0.006

Table 5 Comparison of immune indicators

Index	Good efficacy group (n = 279)	Poor efficacy group (n = 232)	t value	P value
IgA (g/L)
Preoperative	2.38 ± 0.42	2.37 ± 0.47	0.241	0.809
Postoperative day 1	2.21 ± 0.57	2.2 ± 0.39	0.008	0.993
Postoperative day 7	2.46 ± 0.48	2.34 ± 0.63	2.472	0.014
IgM (g/L)
Preoperative	1.28 ± 0.24	1.28 ± 0.18	0.073	0.941
Postoperative day 1	1.05 ± 0.12	1.04 ± 0.16	0.551	0.582
Postoperative day 7	1.31 ± 0.22	1.25 ± 0.31	2.553	0.011
IgG (g/L)
Preoperative	9.57 ± 1.62	9.39 ± 1.43	1.312	0.19
Postoperative day 1	8.67 ± 1.36	8.61 ± 1.47	0.449	0.653
Postoperative day 7	11.23 ± 1.89	10.71 ± 1.73	3.216	0.001
CD4+/CD8+
Preoperative	1.56 ± 0.37	1.55 ± 0.39	0.431	0.667
Postoperative day 1	1.43 ± 0.32	1.45 ± 0.3	0.686	0.493
Postoperative day 7	1.65 ± 0.35	1.57 ± 0.33	2.521	0.012

IgA: Immunoglobulin A; IgM: Immunoglobulin M; IgG: Immunoglobulin G.

Table 6 Univariate logistic regression analysis of each influencing factor and efficacy

Factor	Coefficient	SE	Wald	P value	OR	CI lower	CI upper
Age (years)	0.046	0.011	4.074	< 0.001	1.047	1.025	1.071
ECOG performance status (0/≥ 1)	-0.539	0.242	2.228	0.026	0.583	0.361	0.935
TNM stage (≤ II/> II)	-0.402	0.180	2.233	0.026	0.669	0.469	0.951
Caloric intake (kcal/day)	-0.001	0.001	2.444	0.015	0.999	0.998	1.000
Protein intake (g/day)	-0.018	0.007	2.455	0.014	0.982	0.968	0.996
Fiber intake (g/day)	-0.040	0.018	2.243	0.025	0.961	0.928	0.995
DAO (U/L) postoperative day 7	0.371	0.150	2.468	0.014	1.448	1.082	1.951
I-FABP (μg/L) postoperative day 7	0.020	0.008	2.586	0.010	1.020	1.005	1.036
LPS (U/L) postoperative day 7	0.141	0.063	2.233	0.026	1.151	1.018	1.304
D-Lac (mg/L) postoperative day 7	0.115	0.049	2.343	0.019	1.122	1.02	1.237
Bifidobacterium postoperative day 7	-0.376	0.149	2.522	0.012	0.687	0.511	0.917
Fusobacterium nucleatum postoperative day 7	0.705	0.252	2.792	0.005	2.023	1.240	3.341
Lactobacillus postoperative day 7	-0.282	0.137	2.065	0.039	0.754	0.575	0.984
Bacteroides fragilis postoperative day 7	0.876	0.323	2.714	0.007	2.401	1.283	4.555
IgA (g/L) postoperative day 7	-0.407	0.163	2.503	0.012	0.666	0.482	0.913
IgM (g/L) postoperative day 7	-0.884	0.340	2.601	0.009	0.413	0.211	0.800
IgG (g/L) postoperative day 7	-0.158	0.050	3.157	0.002	0.854	0.773	0.941
CD4+/CD8+ postoperative day 7	-0.663	0.266	2.494	0.013	0.515	0.304	0.864
CRP (mg/L) postoperative day 7	0.075	0.034	2.183	0.029	1.078	1.008	1.154
TNF-α (ng/L) postoperative day 7	0.022	0.008	2.725	0.006	1.023	1.006	1.039
IL-6 (pg/mL) postoperative day 7	0.030	0.015	2.050	0.040	1.030	1.001	1.060

ECOG: Eastern Cooperative Oncology Group performance status; TNM: Tumor node metastasis; DAO: Diamine oxidase; I-FABP: Intestinal fatty acid binding protein; LPS: Lipopolysaccharide; D-Lac: D-lactate; IgM: Immunoglobulin M; IgG: Immunoglobulin G; IgA: Immunoglobulin A; CRP: C-reactive protein; TNF-α: Tumor necrosis factor-alpha; IL-6: Interleukin-6.

Table 7 Multivariate logistic regression analysis of each influencing factor and efficacy

Factor	Coefficient	SE	Wald Stat	P value	OR	OR CI lower	OR CI upper
Age (years)	0.049	0.013	3.670	< 0.001	1.050	1.023	1.078
ECOG performance status (0/≥ 1)	-0.498	0.281	-1.774	0.076	0.607	0.350	1.054
TNM stage (≤ II/> II)	-0.427	0.209	-2.047	0.041	0.653	0.434	0.982
Caloric intake (kcal/day)	-0.001	0.001	-1.954	0.051	0.999	0.998	1.000
Protein intake (g/day)	-0.018	0.008	-2.193	0.028	0.982	0.966	0.998
Fiber intake (g/day)	-0.038	0.020	-1.863	0.062	0.963	0.925	1.002
DAO (U/L) postoperative day 7	0.408	0.176	2.317	0.020	1.504	1.065	2.125
I-FABP (μg/L) postoperative day 7	0.017	0.009	1.886	0.059	1.017	0.999	1.036
LPS (U/L) postoperative day 7	0.204	0.073	2.802	0.005	1.226	1.063	1.414
D-Lac (mg/L) postoperative day 7	0.099	0.056	1.768	0.077	1.104	0.989	1.231
Bifidobacterium postoperative day 7	-0.451	0.174	-2.592	0.010	0.637	0.453	0.896
Fusobacterium nucleatum postoperative day 7	0.808	0.287	2.814	0.005	2.244	1.278	3.941
Lactobacillus postoperative day 7	-0.256	0.157	-1.633	0.102	0.774	0.569	1.053
Bacteroides fragilis postoperative day 7	0.842	0.373	2.257	0.024	2.322	1.117	4.824
IgA (g/L) postoperative day 7	-0.330	0.187	-1.765	0.078	0.719	0.498	1.037
IgM (g/L) postoperative day 7	-0.926	0.388	-2.387	0.017	0.396	0.185	0.847
IgG (g/L) postoperative day 7	-0.183	0.058	-3.152	0.002	0.832	0.743	0.933
CD4+/CD8+ postoperative day 7	-0.619	0.301	-2.056	0.040	0.539	0.299	0.971
CRP (mg/L) postoperative day 7	0.094	0.040	2.324	0.020	1.098	1.015	1.188
TNF-α (ng/L) postoperative day 7	0.017	0.010	1.805	0.071	1.018	0.999	1.037
IL-6 (pg/mL) postoperative day 7	0.036	0.017	2.124	0.034	1.037	1.003	1.072

ECOG: Eastern Cooperative Oncology Group performance status; TNM: Tumor node metastasis; DAO: Diamine oxidase; I-FABP: Intestinal fatty acid binding protein; LPS: Lipopolysaccharide; D-Lac: D-lactate; IgM: Immunoglobulin M; IgG: Immunoglobulin G; IgA: Immunoglobulin A; CRP: C-reactive protein; TNF-α: Tumor necrosis factor-alpha; IL-6: Interleukin-6.