| 杨朦,朱正秋,高颖,等.术前泛免疫炎症值和白蛋白 -碱性磷酸酶比值对Ⅰ~Ⅲ期胃癌根治术病人预后的预测价值[J].安徽医药,2025,29(11):2282-2287. |
| 术前泛免疫炎症值和白蛋白 -碱性磷酸酶比值对Ⅰ~Ⅲ期胃癌根治术病人预后的预测价值 |
| Predictive value of preoperative pan-immune-inflammation value and albumin-to-alkaline phosphatase ratio in patients with stage Ⅰ-Ⅲ gastric cancer after radical gastrectomy |
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| DOI：10.3969/j.issn.1009-6469.2025.11.035 |
| 中文关键词: 胃肿瘤 胃切除术 泛免疫炎症值 白蛋白 -碱性磷酸酶比值 预后 |
| 英文关键词: Gastric neoplasms Gastrectomy Pan-immune-inflammation value Albumin-to-alkaline phosphatase ratio Prognosis |
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| 中文摘要: |
| 目的探讨术前泛免疫炎症值( PIV)、白蛋白 -碱性磷酸酶比值( AAPR)对 Ⅰ~Ⅲ期胃癌根治术后病人预后的预测价值。方法回顾性分析 2012年 1月至 2020年 3月在徐州医科大学附属医院接受胃癌根治术的 379例Ⅰ~Ⅲ期胃癌病人的病例资料。采用受试者操作特征曲线( ROC曲线)通过计算约登指数确定 PIV、AAPR的最佳临界值，将入组病人划分为 PIV高/低表达亚组及 AAPR高/低表达亚组，比较各组间的，临床病理参数分布差异。通过 Kaplan-Meier法绘制生存曲线，比较不同组间无进展生存期( PFS)和总生存期( OS)的组间差异，通过 Cox比例风险回归模型分析影响病人预后的因素，通过 Pearson相关性分析检验 PIV、AAPR的相关性。结果 PIV、AAPR最佳临界值分别为 321.7、0.546。PIV及 AAPR与病人的肿瘤长径、分化程度、肿瘤浸润深度、淋巴结转移、 TNM分期、神经或脉管侵犯等相关(P<0.05)。 PIV低表达亚组比 PIV高表达亚组的 PFS和 OS更长(41个月比 21个月， P<0.05；48个月比 25个月， P<0.05)。 AAPR高表达亚组比 AAPR低表达亚组 PFS和 OS更长( 44个月比 13个月， P<0.05；49个月比 14个月， P<0.05)。多因素分析结果显示，高 PIV、低 AAPR是 PFS的独立预后不良因素( P<0.05)高 PIV、低 AAPR及肿瘤浸润深度 T3~T4是 OS的独立预后不良因素( P<0.05)。Pearson相关性分析显示， PIV与AAPR呈负相关(r=，.0.17，P<0.05)。结论术前 PIV、AAPR可作为 Ⅰ~Ⅲ期胃癌根治术后病人有效的预后指标， PIV升高和 AAPR降低提示预后不良。 |
| 英文摘要: |
| Objective To explore the prognostic value of preoperative pan-immune-inflammation value (PIV) and albumin-to-alkaline phosphatase ratio (AAPR) in patients with stage Ⅰ-Ⅲ gastric cancer after radical gastrectomy.Methods A retrospective analysis was performed on the clinical data of 379 patients with stage Ⅰ-Ⅲ gastric cancer who underwent radical gastrectomy at the Affiliated Hos-pital of Xuzhou Medical University from January 2012 to March 2020. Receiver operating characteristic (ROC) curve analysis was usedto determine the optimal cutoff values for PIV and AAPR by calculating the Jorden's index. Patients were stratified into high and lowPIV subgroups and high and low AAPR subgroups. Differences in clinicopathological characteristics among subgroups were compared.Kaplan-Meier survival curves were plotted to compare progression-free survival (PFS) and overall survival (OS) between subgroups, and differences were assessed using the log-rank test. Prognostic factors were analyzed using Cox proportional hazards regression model.The correlation between PIV and AAPR was examined using Pearson correlation analysis.Results The optimal cut-off values for PIV and AAPR were 321.7 and 0.546, respectively. PIV and AAPR were significantly associated with tumor size, differentiation degree,depth of tumor invasion, lymph nodes metastasis, TNM stage, and perineural or vascular invasion (P<0.05). The low PIV subgroup had significantly longer PFS and OS than the high PIV subgroup (41 months vs. 21 months, P<0.05; 48 months vs. 25 months, P<0.05). The high AAPR subgroup had significantly longer PFS and OS than the low AAPR subgroup (44 months vs.13 months, P<0.05; 49 months vs. 14 months, P<0.05). Multivariate analysis showed that high PIV and low AAPR were independent poor prognostic factors for PFS (P< 0.05), while high PIV, low AAPR, and depth of tumor invasion (T3-T4) were independent poor prognostic factors for OS (P<0.05). Pear.son correlation analysis revealed a negative correlation between PIV and AAPR (r= .0.17, P<0.05).Conclusions Preoperative PIV and AAPR can serve as effective prognostic indicators for patients with stage Ⅰ-Ⅲ gastric cancer after radical gastrectomy. Elevated PIV and decreased AAPR indicate poor prognosis. |
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