These authors contributed equally to this workPurpose: We aimed to investigate the value of inflammation-based prognostic scores for predicting early complications after radical surgery for colorectal carcinoma. Methods: We retrospectively analyzed data of 154 patients who underwent elective resection of colorectal carcinoma between January 2017 and December 2018 at Beijing Friendship Hospital. Univariate, multivariate, and receiver operating characteristic curve analyses were conducted. As inflammation indices, we evaluated the preoperative modified Glasgow Prognostic Score (GPS), as well as the C-reactive protein/albumin ratio (CAR), postoperative GPS, and C-reactive protein levels on postoperative day 3 (POD3). Results: Within 30 days postoperatively, complications occurred in 80 patients (51.9%). And high levels of preoperative mGPS (P=0.002), preoperative CAR (P=0.019), POD3 CAR (P<0.001) and POD3 poGPS (P<0.001) can significantly affect postoperative complications after surgery for colorectal cancer, with CRP on POD3 (odds ratio, 1.015; 95% confidence interval, 1.006-1.024; P=0.001) as independent risk factors. Among all inflammation-based indicators, POD3 CAR had the highest area under the curve (0.711) and positive predictive value (83.2%). Higher CAR (≥2.6) on POD3 was associated with a higher rate of complications (92.9% vs 36.6%, P<0.001), especially of infectious nature (54.8% vs 16.1%, P<0.001). Conclusion: CAR≥2.6 on POD3 reflects sustained systemic inflammation and represents a useful predictor of complications after surgery for colorectal carcinoma, facilitating early detection, timely intervention, and enhanced recovery.

Introduction: We present the case of an intraductal papillary neoplasm of the bile duct (IPNB) accompanying a small cell neuroendocrine carcinoma. Patient concerns: A 73-year-old male Chinese patient presented with jaundice of unknown origin. A contrast-enhanced computed tomography scan revealed that the wall of the lower common bile duct was thickened and nodular, causing a narrowing in the lumen and upper common bile duct enlargement above the narrow segment. Diagnosis and interventions: The initial diagnosis based on clinical manifestations was IPNB and pancreatoduodenectomy was performed. Pathological examination of the resected bile duct revealed papillary proliferation of biliary-type cells with nuclear atypia, indicating IPNB. Immunohistochemistry was positive for neuroendocrine markers indicative of infiltration and small cell neuroendocrine cancer. Outcomes: The patient died on postoperative day 138. Conclusion: This is the first reported case of its kind, as none has been reported in any published literature so far.