AI-Assisted Microbiome Analysis for Evaluating the Efficacy of MPRO3 and Gut Environmental Changes in Colon Cancer Surgery Patients

The occurrence of postoperative infectious complications is assessed according to the CDC/NHSN criteria.

Postoperative complications are graded according to the Clavien-Dindo classification and summarized as a Comprehensive Complication Index score ranging from 0 to 100.

Postoperative length of hospital stay is calculated from the date of surgery to hospital discharge based on medical records.

The Glasgow Prognostic Score (GPS) is assessed using inflammatory markers measured in venous blood and is calculated based on serum albumin and high-sensitivity C-reactive protein (HS-CRP) levels. The total score ranges from 0 to 2. A score of 0 is assigned when HS-CRP is ≤10 mg/L and albumin is ≥35 g/L. A score of 1 is assigned when either HS-CRP is >10 mg/L or albumin is <35 g/L. A score of 2 is assigned when HS-CRP is >10 mg/L and albumin is <35 g/L. Higher scores indicate a worse prognostic status.

Inflammation-related markers are assessed using venous blood samples. WBC and Platelets (PLT) are measured in 10^9/L. Neutrophils, lymphocytes, and Monocytes are reported as percentages (%). CRP is measured in mg/dL. The neutrophil-to-lymphocyte ratio (NLR) is reported as a unitless ratio.

Procalcitonin, BC, SAA, Zonulin, Cytokine (TNF-α, IFN-γ, IL-2, IL-6, IL-10, IL-12, IL-17) are assessed using venous blood samples. Procalcitonin is measured in ng/mL, SAA in mg/L, and Zonulin in ng/mL. BC is recorded as a qualitative result (Positive/Negative). Cytokines assessed include TNF-α, IFN-γ, IL-2, IL-6, IL-10, IL-12, and IL-17, measured in pg/mL.

Immune-related markers are assessed using venous blood samples. NK cytotoxicity and NK subset are reported as percentages (%).

The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (QLQ-C30) is used to assess quality of life in patients with cancer. It consists of three domains: global health status/quality of life, functional, and symptom domains, with a total of 30 items. Scores are transformed to a scale ranging from 0 to 100 according to the EORTC QLQ-C30 scoring manual. Higher scores for global health status/quality of life and the functional domain indicate better quality of life, whereas higher scores for the symptom domain indicate worse quality of life.

As part of the bowel function assessment, a bowel diary is used to record the frequency and form of bowel movements.

As part of the bowel function assessment, the Postoperative Bowel Function Questionnaire is used to assess postoperative bowel function and recovery, including time to first passage of flatus, time to first bowel movement, and other related measures.

As part of the nutritional status assessment, the Patient-Generated Subjective Global Assessment (PG-SGA) is used to evaluate nutritional status based on factors including changes in body weight and dietary intake, gastrointestinal symptoms affecting food intake, physical examination findings, and comorbidities.

As part of the nutritional status assessment, the Prognostic Nutritional Index (PNI) is calculated based on Serum Albumin and Total Lymphocyte Count. PNI is calculated as 10 × Serum Albumin (g/dL) + 0.005 × Total Lymphocyte Count (/mm³).

Fecal collection kits are sent to participants, who are instructed to collect stool samples at home within 2 days of each visit. The collected samples are placed in the designated kits and returned by courier to the analytical laboratory.

Normal tissue and tumor tissue are collected during surgery.

Adaptive immunity is assessed using T-cell exhaustion markers and CEA/NY-ESO-1/ST4-specific T-cell responses. These measurements are used to analyze the association between changes in immune status before and after surgery and clinical prognosis, and to evaluate changes in immune response following probiotic intake.