C反应蛋白与前白蛋白比值在评估胃癌病人预后中的临床价值  

Clinical value of the ratio of C reactive protein to prealbumin in evaluating the prognosis of gastric cancer patients

作　　者：马亚辉 杨琪 朱洪波[1] 刘冬良 MA Ya-hui;YANG Qi;ZHU Hong-bo;LIU Dong-liang(Department of General Surgery,Lianyungang Oriental Hospital,Lianyungang Jiangsu 222042,China)

机构地区：[1]江苏省连云港市东方医院普外科,222042

出　　处：《蚌埠医学院学报》2021年第2期214-217,221,共5页Journal of Bengbu Medical College

摘　　要：目的:观察胃癌病人术前血清中C反应蛋白(CRP)与前白蛋白(PA)水平比值(CRP/PA)对预后的影响。方法:随访并记录经过根治性手术治疗的胃癌病人的生存期和实验室指标,计算所有病人的CRP/PA和C反应蛋白/白蛋白(CRP/ALB)值,分别绘制两者的受试者工作特征曲线(ROC),比较曲线下面积。计算Youden指数,得出CRP/PA的最佳界值。以最佳界值为标准,将病人分为高CRP/PA(HCP)组和低CRP/PA(LCP)组,分析2组病人的临床病理特征、术后并发症及预后。结果:根据5年生存作为终点绘制CRP/PA与CRP/ALB的ROC曲线,AUC分别为0.704及0.656。当CRP/PA值为18.8×10^(-3)时,Youden指数最大,灵敏度为0.828,特异度为0.562。年龄、贫血、肿瘤直径、浸润深度、淋巴结转移、TNM分期均与CRP/PA值水平有关(P<0.05~P<0.01)。214例病人并发症的发生率为28.9%,HCP组并发症发生率为37.64%,高于LCP组发率23.26%(P<0.05)。214例胃癌病人中有125人死亡,所有病人5年累积生存率为35.5%。病人的中位生存时间是43个月。HCP组和LCP组病人的5年累积生存率分别是29.4%和46.3%,LCP组病人5年生存率高于HCP组的病人(P<0.05)。Cox比例风险模型分析发现,CRP/PA水平(HR=3.117)、TNM分期(HR=4.053)是胃癌病人术后的独立预后因素(P<0.01)。结论:CRP/PA水平、TNM分期是影响胃癌病人预后的独立因素。处于CRP/PA高值水平的病人术后并发症发生率会增加,预后差。Objective:To observe the effects of the ratio of preoperative serum C reactive protein to prealbumin(CRP/PA)on the prognosis of gastric cancer patients.Methods:The survival and laboratory indicators in gastric cancer patients treated with radical operation were followed up and recorded.The ratio CRP to ALB and CRP/PA in all patients were calculated,the receiver operating characteristic curves(ROC)were plotted,and the area under the curve(AUC)was compared.The Youden index was calculated to obtain the optimal cutoff value of CRP/PA.The patients were divided into the high CRP/PA(HCP)group and low CRP/PA(LCP)group according to the optimal cutoff value.The clinical and pathological features,postoperative complications and prognosis in two groups were analyzed.Results:The ROC curves of the CRP/PA and CRP/ALB were plotted based on the 5-year survival as the end point,and the AUC of which were 0.704 and 0.656,respectively.When the CRP/PA value was 18.8×10^(-3),the Youden index was the largest,the sensitivity was 0.828,and the specificity was 0.562.The age,anemia,tumor diameter,infiltration depth,lymph node metastasis and TNM stage were related to the level of CRP/PA(P<0.05 to P<0.01).The incidence rate of complication in 214 patients was 28.9%,and which in HCP group(37.64%)was higher than that in LCP group(23.26%)(P<0.05).Among the 214 patients with gastric cancer,125 cases died,the 5-year cumulative survival rate of all patients was 35.5%,and the median survival time was 43 months.The 5-year cumulative survival rate in HCP group and LCP group was 29.4%and 46.3%,respectively.The 5-year survival rate in HCP group was higher than that in LCP group(P<0.05).The results of Cox proportional hazards model showed that the level of CRP/PA and TNM stage were the independent prognostic factors for postoperative gastric cancer patients(P<0.01).Conclusions:The CRP/PA level and TNM stage are the independent factors affecting the prognosis of gastric cancer patients.The incidence rate of postoperative complications in patients with hi

关 键 词：胃肿瘤 C反应蛋白 前白蛋白 预后 

分 类 号：R735.2[医药卫生—肿瘤]