Use of the alkaline phosphatase to prealbumin ratio as an independent predictive factor for the prognosis of gastric cancer  

作　　者：Yang Li Jin-Shen Wang Yun Guo Tao Zhang Le-Ping Li 

机构地区：[1]Departments of Gastrointestinal,Shandong Provincial Hospital,Cheeloo College of Medicine,Shandong University,Jinan 250021,Shandong Province,China [2]Center for Reproductive Medicine,Cheeloo College of Medicine,Jinan 250012,Shandong Province,China [3]Department of Biostatistics,School of Public Health,Shandong University,Jinan 250012,Shandong Province,China

出　　处：《World Journal of Gastroenterology》2020年第44期6963-6978,共16页世界胃肠病学杂志（英文版）

基　　金：Supported by the Key Technology Research and Development Program of Shandong,No.2017GSF221018 and No.2017G006007.

摘　　要：BACKGROUND Gastric cancer(GC)is characterized by a low 5-year survival rate.The prognosis is still not satisfactory although it has significantly improved due to developments in medicine.Thus,the identification of more efficient indices for the evaluation of GC prognosis is required.We propose,for the first time,that the alkaline phosphatase(ALP)to prealbumin(PA)ratio(APR)can be used as an independent prognostic factor in GC.AIM To evaluate the prognostic value the APR in GC.METHODS According to the exclusion strategy,we collected the preoperative serologic examination results and clinical information of 409 GC patients treated in Shandong Provincial Hospital from January to December,2016.By calculating the APR,the neutrophil and lymphocyte ratio(NLR),C-reactive protein(CRP)and albumin(ALB)ratio,platelet and lymphocyte ratio,lymphocyte and monocyte ratio,and the relationship with clinical information,we verified the role of preoperative APR ratio in the prognosis of GC.In addition,we used a Cox model combined with the APR and tumor stage to demonstrate its efficacy in assessing the prognosis of GC patients.RESULTS Preoperative APR was an independent prognostic factor for GC.The median age of patients in the APR-high group was greater compared with that in the APR-low group.Patients with a higher APR had a more advanced clinical stage,higher neutrophil to lymphocyte,CRP to ALB,and platelet to lymphocyte ratios,but a lower lymphocyte to monocyte ratio(P<0.05).The APR-high group also had higher glycoprotein antigen 199 and carbohydrate antigen 125 levels than the APR-low group(P<0.05).Median overall survival and disease-free survival were significantly longer in the APR-low group than in the APR-high group.In addition,a Cox model based on the APR and tumor stage was more effective in evaluating the prognosis of patients than models based on stage alone or stage plus the NLR.CONCLUSION A higher APR is an independent and negative prognostic factor for GC.The prognosis of GC can be better evaluated using a Cox model ba

关 键 词：Gastric cancer PROGNOSIS Alkaline phosphatase PREALBUMIN Evaluating efficiency 

分 类 号：R735.2[医药卫生—肿瘤]