Abstract
Relevance: Neutrophil extracellular traps (NET) are considered an important component of tumor-associated inflammation and may contribute to the progression of colorectal cancer (CRC). However, the clinical significance of their perioperative dynamics and inter-individual variability remains insufficiently understood.The study aimed to evaluate the perioperative dynamics of NET formation in patients with CRC and to identify typical patterns of change.Materials and Methods: This single-center, prospective pilot study included 42 patients with histologically confirmed CRC who underwent radical or palliative surgery. NET levels were measured in peripheral blood at three time points: before surgery (T1), on postoperative days 3-4 (T2), and on days 7-10 (T3). Statistical analysis included Friedman’s test, the Wilcoxon test with Bonferroni correction, and k-means cluster analysis.Results: No statistically significant differences in NET levels were observed across the studied time points (p = 0.241), although a trend toward an increase in the early postoperative period followed by a decrease was noted. Cluster analysis identified four distinct patterns of NET dynamics: stable, early peak, delayed increase, and high baseline followed by decline. Inter-cluster differences in NET levels were statistically significant at all follow-up time points (p < 0.01).Conclusion: The perioperative dynamics of NET in patients with CRC exhibit pronounced heterogeneity, which is not captured by averaging indicators. The identified cluster patterns may reflect different variants of the systemic immunoinflammatory response. They may be associated with the clinical and morphological characteristics of the disease. Dynamic assessment of NET may be considered a hypothesis-generating approach for studying tumor-associated inflammation. Further prospective studies are required to determine the clinical and prognostic significance of these findings.