| 刘涛,余儒意,严航,等.术前纤维蛋白原与前白蛋白比值、纤维蛋白原与白蛋白比值在Ⅱ、Ⅲ期结直肠癌根治术预后评估中的价值[J].安徽医药,2026,30(2):365-371. |
| 术前纤维蛋白原与前白蛋白比值、纤维蛋白原与白蛋白比值在Ⅱ、Ⅲ期结直肠癌根治术预后评估中的价值 |
| Prognostic evaluation value of preoperative fibrinogen to pre-albumin ratio and preoperative fibrinogen to albumin ratio in stage Ⅱ and Ⅲ radical colorectal cancer |
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| DOI：10.3969/j.issn.1009-6469.2026.02.029 |
| 中文关键词: 结直肠肿瘤 纤维蛋白原 前白蛋白 白蛋白 比值 预后评估 |
| 英文关键词: Colorectal neoplasms Fibrinogen Pre-albumin Albumin Ratio Prognostic evaluation |
| 基金项目:四川省教育厅重点项目( 16ZA0197) |
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| 中文摘要: |
| 目的探讨 Ⅱ、Ⅲ期结直肠癌根治术后病人术前纤维蛋白原与前白蛋白比值( FPR)、纤维蛋白原与白蛋白比值( FAR)在预后评估中的价值。方法回顾性分析 2016年 1月至 2018年 3月于西南医科大学附属医院治疗的 350例Ⅱ、Ⅲ期结直肠癌根治术后病人的临床资料，所有病人随访 5年，观察病人 5年总生存期情况，分析术前 FPR、FAR与病人预后的关系。结果用受试者操作特征曲线( ROC曲线)确定术前 FPR、FAR的最佳截断值分别为 13.96和 8.43，根据最佳截断值对病人分组；术前 FPR、FAR预测病人 5年总生存期的曲线下面积( AUC)分别为 0.79和 0.74；用 Kaplan-Meier法进行生存分析，组间比较采用 log-rank检验，提示 FPR>13.96的病人 5年生存率低于 FPR≤13.96的病人( P<0.05)，FAR>8.43的病人 5年生存率低于 FAR≤8.43的病人( P<0.05)； Cox单因素回归分析结果提示年龄、肿瘤长径、 TNM分期、分化程度、脉管浸润、癌胚抗原( CEA)、糖类抗原 19-9(CA19-9)、 FPR、FAR是病人预后的相关因素( P<0.05)； Cox多因素回归分析结果提示年龄、 TNM分期、分化程度、脉管浸润、 CEA、CA19-9、FPR、FAR是病人预后的独立危险因素( P<0.05)；联合检测 FPR、FAR、CEA及 CA19-9的 AUC为 0.83(灵敏度79.5％，特异度 76.5％)高于各项指标单独检测。结论术前 FPR、FAR水平对结直肠癌根治术后病人生存具有良好预测作用，术前 FPR、FAR是肠癌根治术后病人 5年总体生存率的独立危险因素， FPR、FAR、CEA及 CA19-9的联合检测可提高对结直，结直肠癌根治术后病人预后预测的效能。 |
| 英文摘要: |
| Objective To investigate the prognostic evaluation value of preoperative fibrinogen to pre-albumin ratio (FPR) and preop-erative fibrinogen to albumin ratio (FAR) in stage Ⅱ-Ⅲ radical colorectal cancer undergoing radical resection.Methods This study retrospectively analyzed the clinical data of stage Ⅱ -Ⅲ colorectal cancer patients after radical resection in the Affiliated Hospital ofSouthwest Medical University from January 2016 to March 2018. All patients were followed up for 5 years to observe the overall surviv-al of 5 years and analyze the relationship between preoperative FPR, preoperative FAR, and the prognosis of all enrolled patients.Re. sults The optimal cut-off values of preoperative FPR and FAR were determined to be 13.96 and 8.43 by receiver operating character-istic curve(ROC curve) analysis, and the enrolled patients were then grouped based on these cut-off values. The area under curve(AUC) of preoperative FPR and FAR was 0.79 and 0.74 for predicting the 5-year overall survival of the patients. Kaplan-Meier survival analy-sis by Log-rank test showed that the 5-year survival rate of patients with preoperative FPR>13.96 was lower than that of patients with preoperative FPR≤13.96 (P<0.05), and the 5-year survival rate of patients with preoperative FAR>8.43 was lower than that of patients with preoperative FPR≤8.43 (P<0.05). Univariate Cox regression analysis showed that age, tumor size, TNM stage, degree of differentia-tion, vascular invasion, CEA, CA19-9, preoperative FPR and preoperative FAR were prognostic factors (P<0.05). Multivariate Cox re-gression analysis showed that age, TNM stage, degree of differentiation, vascular invasion, carcinoembryonic antigen (CEA), carbohy-drate antigen 19-9 (CA19-9), preoperative FPR and preoperative FAR were independent risk factors for prognosis (P<0.05).AUC for the combination of FPR, FAR, CEA and CA19-9 was 0.83 (sensitivity:79.5%, specificity: 76.5%), which was higher than that of the individ-ual tests.Conclusions Preoperative FPR and FAR is significantly correlated with the survival and prognosis of patients with colorec-tal cancer undergoing radical resection. The preoperative FPR and FAR have important prognostic value and they can be used as inde-pendent prognostic marker for patients with colorectal cancer undergoing radical resection. The combination of FPR, FAR, CEA andCA19-9 can significantly improve the efficacy of prognostic prediction in colorectal cancer undergoing radical resection. |
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