转移性胃/食管胃交界部腺癌合并2型糖尿病患者的FIB和CEA水平及F-CEA评分与生存率的相关性  

Correlation between FIB and CEA Levels,F-CEA Score and Survival Rate in Patients with Metastatic G/GEJ Adenocarcinoma Complicated with Type 2 Diabetes Mellitus

作　　者：李燚 常志伟[1] 王文佳 秦艳茹[1] LI Yi;CHANG Zhi-wei;WANG Wen-jia;QIN Yan-ru(The First Affiliated Hospital of Zhengzhou University,Zhengzhou,China,450052)

机构地区：[1]郑州大学第一附属医院,河南郑州450052

出　　处：《食管疾病》2022年第3期203-209,共7页Journal of Esophageal Diseases

基　　金：国家自然科学基金(81872264)。

摘　　要：目的研究转移性胃/食管胃交界部(gastric/gastroesophageal junction,G/GEJ)腺癌合并2型糖尿病(type2 diabetes mellitus,T2DM)患者纤维蛋白原(fibrinogen,FIB)和癌胚抗原(carcinoembryonic antigen,CEA)水平及F-CEA评分与其临床病理特点以及预后的相关性。方法回顾性收集2014年1月至2019年9月于郑州大学第一附属医院就诊的转移性胃/食管胃交界腺癌患者的临床病例资料。对于高FIB水平(≥4 g·L^(-1))和高CEA水平(≥5 ng·mL^(-1))的患者,F-CEA评分为3分,对于低FIB水平和低CEA水平的患者,F-CEA评分分别为1分。使用Kaplan-Meier法和Cox比例模型开展生存数据分析。结果转移性胃/食管胃交界腺癌合并T2DM组FIB、CEA水平均明显升高(P<0.05)。在合并组患者中,高水平的FIB、CEA和高F-CEA评分与转移部位和分化程度显著相关(P<0.05)。多因素分析结果示,转移部位个数、是否化疗、FIB水平和F-CEA评分是影响总生存期(overall survival,OS)的独立预后因素(P<0.05)。结论转移性胃/食管胃交界腺癌合并T2DM患者的FIB及CEA水平较高。F-CEA评分作为转移性胃/食管胃交界腺癌合并T2DM患者的独立临床预后诊断因素,用于识别晚期具有高预后治疗风险的患者。Objective To study the relationship between the levels of FIB and CEA and the F-CEA score with the clinicopathological characteristics and prognosis of patients with metastatic G/GEJ adenocarcinoma complicated with T2DM.Methods Clinical case data of patients with metastatic G/GEJ adenocarcinoma in our hospital from January 2014 to September 2019 were retrospectively collected.For patients with high FIB level(≥4 g·L^(-1))and high CEA level(≥5 ng·mL^(-1)),the F-CEA score was 3 points,and for patients with low FIB level and low CEA level,the F-CEA score was 1 point.Survival data analysis was performed using Kaplan Meier method and Cox regression.Results The levels of FIB and CEA in patients with metastatic G/GEJ adenocarcinoma combined with T2DM were significantly higher(P<0.05).In the combined group,the high level of FIB,CEA and F-CEA score were significantly correlated with the metastasis site and differentiation degree(P<0.05).Multivariate analysis showed that the number of metastatic sites,chemotherapy or not,FIB level and F-CEA score were independent prognostic factors for OS(P<0.05).Conclusion The levels of FIB and CEA were higher in patients with metastatic G/GEJ adenocarcinoma complicated with T2DM.The F-CEA score,as an independent clinical prognostic diagnostic factor in patients with metastatic G/GEJ adenocarcinoma complicated with T2DM,is used to identify patients with advanced stage and high prognostic treatment risk.

关 键 词：胃/食管胃交界腺癌 2型糖尿病 远处转移 纤维蛋白原 癌胚抗原 预后 

分 类 号：R735.1[医药卫生—肿瘤]