| 陈智良,费素娟,郭雅慧,等.术前血清白蛋白-碱性磷酸酶比值在胃癌预后评估中的价值[J].安徽医药,2022,26(8):1570-1575. |
| 术前血清白蛋白-碱性磷酸酶比值在胃癌预后评估中的价值 |
| Clinical value of preoperative serum albumin - alkaline phosphatase ratio in the prognosis of patients with gastric cancer |
| |
| DOI：10.3969/j.issn.1009-6469.2022.08.020 |
| 中文关键词: 胃肿瘤 白蛋白-碱性磷酸酶比值 预后 |
| 英文关键词: Stomach neoplasms Albumin to alkaline phosphatase ratio Prognosis |
| 基金项目:徐州市科技项目(KC17184) |
|
| 摘要点击次数: 842 |
| 全文下载次数: 260 |
| 中文摘要: |
| 目的探讨术前血清白蛋白-碱性磷酸酶比值(AAPR)在胃癌预后评估中的临床价值。方法选取2016年3月至2019年12月在徐州医科大学附属医院接受根治性手术切除治疗的胃腺癌病人396例。通过5年时依性ROC曲线分析最佳截断值，将AAPR分为升高组和降低组，比较两组临床病理特征的关系；通过Kaplan Meier法和Log-rank检验进行单因素分析，将差异有统计学意义的因素引入Cox回归模型，从而得出影响胃癌病人生存预后的独立危险因素；通过5年时依性ROC曲线比较AAPR、血小板与淋巴细胞之比(PLR)、中性白细胞与淋巴细胞比率(NLR)以及联合诊断评估胃癌预后的价值。结果AAPR的截断值为0.586。AAPR与胃癌病人的肿瘤浸润程度、淋巴结转移、TNM分期、神经或脉管侵犯、肿瘤长径、年龄、白蛋白、碱性磷酸酶、中性粒细胞、淋巴细胞、血小板、NLR、PLR 均有关(χ2=19.68、9.96、15.03、12.76、18.81、11.06、13.91、137.02、7.03、10.81、8.90、16.87、5.21，均P<0.05)。多因素分析结果显示术后有无化疗、手术方式、TNM分期、肿瘤浸润程度、PLR、AAPR均是影响胃癌病人预后生存的独立危险因素(均P<0.05)。AAPR≥0.586的病人5年累积生存率高于AAPR<0.586的病人(86.7%比41.7%)，差异有统计学意义(χ2=47.57，P<0.05)，AAPR预测胃癌的AUC值为0.637，PLR预测胃癌的AUC值为0.584，NLR预测胃癌的AUC值为0.554，AAPR预测胃癌的AUC值高于PLR与NLR，同时将AAPR、PLR、NLR综合成为联合指标时，联合诊断的AUC值为0.645。结论术前AAPR有助于预测胃癌病人预后，且AAPR对胃癌生存结果的评估价值高于PLR与NLR。 |
| 英文摘要: |
| Objective To investigate the clinical value of preoperative serum albumin-alkaline phosphatase ratio (AAPR) in the prognosis evaluation of patients with gastric cancer.Methods The clinicopathological data of 396 patients who were diagnosed with gastric adenocarcinoma in Affiliated Hospital of Xuzhou Medical University from March 2016 to December 2019 and underwent radical resection were selected. The optimal truncation value was analyzed according to the time-dependent ROC curve at 5 years, and the APR was divided into the elevated group and the decreased group, and the relationship between the clinicopathological characteristics of the two groups was compared. Univariate analysis was performed by Kaplan Meier method and Log-rank test, and statistically significant factors were introduced into Cox regression model to obtain independent risk factors affecting the survival prognosis of gastric cancer pa?tients. The prognostic value of AAPR, PLR, NLR and combined diagnosis for gastric cancer was compared by the time-dependent ROC curve at 5 years.Results The cut-off value of AAPR was 0.586. AAPR was associated with the degree of tumor invasion, lymph node metastasis, TNM stage, nerve or vascular invasion, tumor diameter, age, albumin, alkaline phosphatase, neutrophils, lymphocytes, plate?lets, NLR and PLR in patients with gastric cancer (χ2=19.68,9.96,15.03,12.76,18.81,11.06,13.91,137.02,7.03,10.81,8.90,16.87,5.21,all P<0.05). Multivariate analysis showed that postoperative chemotherapy, surgical method, TNM stage, tumor invasion degree, PLR,AAPR were independent risk factors affecting the prognosis and survival of gastric cancer patients (All P<0.05). The 5-year cumulative survival rate of patients with AAPR≥0.586 was higher than that of patients with AAPR<0.586 (86.7% versus 41.7%), and the difference was statistically significant (χ2=47.57, P<0.05). The AUC value predicted by AAPR for gastric cancer was 0.637, 0.584 for gastric can?cer by PLR, 0.554 for gastric cancer by NLR, and higher than that predicted by PLR and NLR. When AAPR, PLR and NLR were com?bined into joint indexes, the AUC value of combined diagnosis was 0.645.Conclusion Preoperative AAPR is helpful for predicting the prognosis of gastric cancer patients, and its evaluation value of survival results of gastric cancer is higher than that of PLR and NLR. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
