化疗前乳酸脱氢酶水平与中晚期胃癌姑息性化疗患者预后的关系  

Relationship between the level of lactate dehydrogenase before chemotherapy and the prognosis of the patients with medium and advanced gastric cancer who received palliative chemotherapy

作　　者：殷飞 王可武 胡琴 Yin Fei;Wang Kewu;Hu Qin(Department of Oncology,Wuhu Second Hospital,Wuhu,Anhui Province,Wuhu 241000,China)

机构地区：[1]芜湖市第二人民医院肿瘤内科,安徽芜湖241000

出　　处：《海军医学杂志》2021年第3期321-324,共4页Journal of Navy Medicine

摘　　要：目的观察中晚期胃癌姑息性化疗患者的总生存期(OS)及无进展生存期(PFS)与乳酸脱氢酶关系。方法回顾性分析芜湖市第二人民医院2016年1月至2019年1月收治的60例接受姑息性化疗中晚期胃癌患者的临床资料,对患者门诊及住院病史进行查阅,收集患者疾病进展及死亡情况及化疗前乳酸脱氢酶水平。分析患者OS及PFS与乳酸脱氢酶关系。结果受试者工作特征曲线(ROC)分析显示,患者化疗前乳酸脱氢酶水平预测胃癌死亡的曲线下面积为0.75(P=0.002,95%CI:0.66~0.87),特异度为67.8%,灵敏度为80.2%。随访时间为(26.5±4.8)个月,范围13~49个月,中位随访时间为26个月。乳酸脱氢酶增高患者的OS、PFS少于乳酸脱氢酶正常患者(P<0.05)。多因素Cox分析结果显示,乳酸脱氢酶、疗效、腹膜转移是姑息性化疗胃癌患者OS的独立影响因素(P<0.05),乳酸脱氢酶、疗效、腹膜转移、临床分期是姑息性化疗胃癌患者PFS的独立影响因素(P<0.05)。结论化疗前乳酸脱氢酶升高的中晚期胃癌姑息性化疗患者预后较差,OS及PFS缩短。可通过检测化疗前乳酸脱氢酶水平初步预测中晚期胃癌姑息性化疗预后。Objective To investigate the relationship between overall survival(OS)and progression-free survival(PFS)and the levels of the lactate dehydrogenase in the patients with medium and advanced gastric cancer who received palliative chemotherapy.Methods The clinical data of 60 patients with medium and advanced gastric cancer who received palliative chemotherapy from January 2016 to January 2019 in Wuhu Second People′s Hospital were analyzed retrospectively.The outpatient and inpatient medical data were collected and reviewed,and data concerning disease progress,death and the levels of lactate dehydrogenase were also collected and recorded before chemotherapy.Then,the relationship between OS/PFS and the levels of lactate dehydrogenase was analyzed statistically.Results Receiver operator characteristic curve(ROC)analysis showed that the area under the curve of the lactate dehydrogenase level before chemotherapy for the prediction of gastric cancer death was 0.75(P=0.002,95%CI:0.66-0.87),the specificity was 67.8% and sensitivity was 80.2%.The length of follow-up time was 13-49 months,with an average follow-up time of(26.5±4.8)months,and the median follow-up time was 26 months.The OS and PFS of the patients with elevated lactate dehydrogenase(>252 U/L)were lower or shorter as compared with those patients with normal lactate dehydrogenase(≤252 U/L),with statistical significance(P<0.05).Multi-factor Cox analysis showed that lactate dehydrogenase level,therapeutic efficacy and peritoneal metastasis were independent influencing factors of OS in the patients with gastric cancer who underwent palliative chemotherapy(P<0.05),while lactate dehydrogenase level,therapeutic efficacy,peritoneal metastasis and clinical stage were independent influencing factors of PFS in the patients with gastric cancer who underwent palliative chemotherapy(P<0.05).Conclusion The patients with advanced gastric cancer and palliative chemotherapy had poor prognosis,if the lactate dehydrogenase level increased before chemotherapy,and their OS and PF

关 键 词：乳酸脱氢酶 胃癌 姑息性化疗 预后 总生存期 

分 类 号：R735.2[医药卫生—肿瘤]