术前白蛋白与碱性磷酸酶比值对结直肠癌根治术后患者预后的影响  

Effect of Preoperative Albumin⁃to⁃Alkaline Phosphatase Ratio on Prognosis of Patients with Colorectal Cancer after Radical Surgery

作　　者：金爱云 张曙光 王道荣 王鹤林[1] JIN Aiyun;ZHANG Shuguang;WANG Daorong;WANG Hein(Department of General Surgery,Tianchang Hospital of Traditional Chinese Medicine,Tianchang,Anhui 239300,China;Department of Gastrointestinal Surgery,Northern Jiangsu People's Hospital Affiliated to Yangzhou University,Yangzhou,)

机构地区：[1]天长市中医院普外科,安徽天长239300 [2]扬州大学附属苏北人民医院胃肠外科,江苏扬州225001

出　　处：《临床误诊误治》2024年第9期30-33,52,共5页Clinical Misdiagnosis & Mistherapy

基　　金：安徽省自然科学基金项目(180-085MH30)。

摘　　要：目的探讨术前白蛋白(albumin,ALB)与碱性磷酸酶(alkaline phosphatase,ALP)比值(albumin-to-alkaline phosphatase ratio,AAPR)对结直肠癌根治术后患者预后的影响。方法选取2017年5月—2019年5月行结直肠癌根治术的109例。检测患者的ALB和ALP水平,计算AAPR;根据AAPR最佳截断值分为高AAPR组(n=48)和低AAPR组(n=61);采用多因素Cox回归分析影响结直肠癌根治术后患者预后的危险因素。结果术前AAPR预测结直肠癌根治术后患者预后的曲线下面积为0.879,95%CI为(0787,0971),最佳截断值为053,特异度为8106%,敏感度为8325%。低AAPR组1、2、3年生存率低于高AAPR组(P<005,P<001)。TNM分期为Ⅲ~Ⅳ期、有淋巴结转移、AAPR≤053是结直肠癌根治术后患者预后的危险因素(P<001)。结论术前AAPR对结直肠癌根治术后患者预后具有一定的评估价值,且AAPR降低是结直肠癌根治术后患者预后不良的独立危险因素。Objective To explore the effect of preoperative albumin(ALB)-to-alkaline phosphatase(ALP)ratio(AAPR)on the prognosis of patients with colorectal cancer(CRC)after radical surgery.Methods A total of 109 patients who received radical resection of CRC from May 2017 to May 2019 were selected as the subjects of this study.The levels of ALB and ALP were detected and the AAPR ratio was calculated.According to the receiver operating characteristic(ROC)curve,the optimal cutoff point of AAPR was determined,which was divided into high AAPR group(n=48)and low AAPR group(n=61).Multivariate Cox regression analysis was used to analyze the risk factors affecting the prognosis of patients with CRC after radical resection.Results The area under the ROC curve(AUC)of preoperative AAPR in predicting the prognosis of patients after radical resection of CRC was 0.879(95%CI:0.787,0.971),the cut-off value was 0.53,the spe-cificity was 81.06%,and the sensitivity was 83.25%.The 1-,2-and 3-year survival rates of low AAPR group were lower than those of high AAPR group(P<005,P<001).TNM stageⅢ-Ⅳ,lymph node metastasis and AAPR≤0.53 were risk factors for prognosis after radical resection of CRC(P<001).Conclusion Preoperative AAPR has a certain evaluation val-ue for the prognosis of patients with CRC after radical resection,and the reduction of AAPR is an independent risk factor for poor prognosis of patients with CRC after radical resection.

关 键 词：结直肠肿瘤 白蛋白与碱性磷酸酶比值 敏感度 TNM分期 淋巴转移 预后 危险因素 预测 

分 类 号：R735.34[医药卫生—肿瘤]