胃癌根治术前患者C反应蛋白⁃白蛋白比对早期复发的预测价值  

Predictive value of preoperative C‑reactive protein‑albumin ratio for early recurrence in patients with radial gastrectomy

作　　者：王治帮 何宽[1] 谢彝忠 Wang Zhibang;He Kuan;Xie Yizhong(Department of General Surgery,Hainan Cancer Hospital Haikou,Haikou 570000,Hainan,China)

机构地区：[1]海南省肿瘤医院普外科,海口570000

出　　处：《肿瘤代谢与营养电子杂志》2021年第1期58-61,共4页Electronic Journal of Metabolism and Nutrition of Cancer

摘　　要：目的探讨胃癌根治术前患者C反应蛋白‑白蛋白比例(CAR)对早期复发的预测价值。方法回顾分析2016年5月至2018年5月在海南省肿瘤医院接受胃癌根治术的Ⅱ~Ⅲ期患者共160例。根据随访2年内是否复发,分为复发组(n=26)和无复发组(n=134)。比较复发组患者和无复发组患者的病历资料和相关血液学指标;系统性免疫炎症指标(systemic immune-inflammatory index,SII)、中性粒细胞-淋巴细胞比(neutrophil-lymphocyte ratio,NLR)、血小板-淋巴结细胞比(platelet-lymphocyte ratio,PLR)及C反应蛋白-白蛋白比(C-reactive protein-albumin ratio,CAR)对预测早期复发的效能。结果两组患者病例资料比较,复发组的肿瘤大小(t=-2.326,P=0.021)、淋巴脉管侵袭率(χ^(2)=6.674,P=0.010)及淋巴结转移(χ^(2)=6.17.617,P<0.001)显著高于无复发组。但两组患者的年龄、体质指数(BMI)、性别、手术方式、消化道重建方式和病理类型等差异无统计学意义(P>0.05)。两组患者术前血液学指标比较,复发组系统性免疫炎症指标SII(t=-2.951,P=0.004)、NLR(t=-2.245,P=0.026)、PLR(t=-2.885,P=0.004)和CAR(t=-3.960,P<0.001)均显著高于无复发组。CAR预测术后早期复发的AUC为0.719(95%CI:0.620~0.817),当CAR临界值设为0.142时,特异度为0.690,灵敏度0.962。结论胃癌患者术前CAR能够有效地预测胃癌根治术后早期复发的风险。Objective To explore the predictive value of preoperative C⁃reactive protein⁃albumin ratio for early recurrence in patients with radial gastrectomy.Methods A total of 160 patients receiving radical gastrectomy in our hospital from May 2016 to May 2018 were retrospectively analyzed.According to whether recurrence occurred within 2 years of follow⁃up,patients were divided into recurrent group(n=34)and non⁃recurrent group(n=134).The clinical characteristics and related hematological indicators were compared between two groups.The efficacy of the above indexes in predicting early recurrence was analyzed.Results The tumor diameter(t=-2.326,P=0.021),the lymphovascular invasion rate(χ^(2)=6.674,P=0.010)and lymph node metastasis(χ^(2)=617.617,P<0.001)of the recurrent group were significantly higher than those of the non⁃recurrent group.However,there were no statistically significant differences between the two groups in age,body mass index(BMI),gender,surgical method,digestive tract reconstruction method and pathological type(P>0.05).With the comparison of preoperative hematological indicators between the two groups,it showed that systemic immune⁃inflammatory index(t=-2.951,P=0.004),neutrophil⁃lymphocyte ratio(t=-2.245,P=0.026),platelet⁃lymphocyte ratio(t=-2.885,P=0.004)and C⁃reactive protein⁃albumin ratio(t=-3.960,P<0.001)were significantly higher in the recurrent group than in the non⁃recurrent group.When the CAR threshold is set at 0.142,the specificity,sensitivity and AUC are 0.690,0.962 and 0.719 respectively.Conclusion Preoperative CAR can effectively predict the risk of early recurrence after radical gastrectomy for gastric cancer.

关 键 词：胃癌 C‑反应蛋白 白蛋白 C‑反应蛋白‑白蛋白比值 早期复发 

分 类 号：R735.2[医药卫生—肿瘤]