尿素-肌酐比值(UCR)可预测结直肠癌患者术后的长期预后  

Urea-creatinine ratio (UCR) predicts the long-term prognosis of colorectal cancer patients after surgery

作　　者：袁庆港 刘理想 张亮[3] 周世振 高波 丁超[2] 管文贤 Yuan Qinggang;Liu Lixiang;Zhang Liang;Zhou Shizhen;Gao Bo;Ding Chao;Guan Wenxian(Department of General Surgery,Nanjing Drum Tower Hospital Clinical College of Xuzhou Medical University,Nanjing 210008,China;Department of General Surgery,Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University,Nanjing 210008,China;Department of Gastrointestinal Surgery,Xuzhou Central Hospital,Xuzhou Jiangshu Province 221009,China;Department of Clinical Nutrition,Nanjing Drum Tower Hospital,Affiliated Hospital of Medical School,Nanjing University,Nanjing 210008,China)

机构地区：[1]徐州医科大学附属南京鼓楼临床学院普通外科,南京210008 [2]南京医科大学附属南京鼓楼临床学院普通外科,南京210008 [3]徐州市中心医院消化外科,江苏徐州221009 [4]南京大学医学院附属南京鼓楼医院临床营养科,南京210008

出　　处：《中华普外科手术学杂志（电子版）》2024年第5期506-509,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：国家自然科学基金(82172149,82172645);彭城英才-医学青年后备人才(XWRCHT20220002)。

摘　　要：目的:探讨术前尿素-肌酐比值(UCR)预测术后长期预后的能力,并验证尿素-肌酐比值与结直肠癌患者肌肉质量之间的关系。方法:回顾性分析2015年1月至2019年1月221例结直肠癌患者临床资料,根据UCR最佳临界值2.65,将患者分为两组,探讨UCR与患者3年预后之间的关系。采用Kaplan-Meier法绘制生存曲线,并通过Log-Rank检验进行比较。患者术前UCR与肌肉参数之间进行相关性分析。正态分布和非正态分布数据分别采用独立样本t检验和非参数秩和检验。分类变量采用χ^(2)检验。P<0.05有统计学意义。结果:在3年内22人死亡,29人复发。多变量分析显示,UCR和肿瘤分期与患者术后总生存率(OS)和无复发生存期(RFS)显著相关(P<0.05)。在所有患者中,预测3年总生存率和复发率的ROC面积分别为0.789(P<0.001)和0.739(P<0.001);与低UCR组相比,高UCR组患者的死亡及复发风险更显著(P=0.007)。此外,UCR水平与骨骼肌质量显著相关(P<0.01)。结论:UCR水平可有效预测结直肠癌患者术后的长期预后,UCR较高的患者死亡和肿瘤复发的风险增加。此外,UCR与骨骼肌质量呈正相关。Objective:To investigate the ability of preoperative urea-creatinine ratio(UCR)to predict long-term postoperative prognosis and to validate the relationship between UCR and muscle mass in patients with colorectal cancer.Methods:Clinical data of 221 colorectal cancer patients from January 2015 to January 2019 were retrospectively analyzed.The patients were divided into two groups according to the UCR optimal cut-off value of 2.65 to explore the relationship between UCR and 3-year prognosis of the patients.Kaplan-Meier plotting of survival curves was done and compared by Log-Rank test.Correlation analysis was performed between patients'preoperative UCR and muscle parameters.Independent t test and nonparametric rank-sum test were used for normally and non-normally data,respectively.Categorical variables were tested using theχ^(2) test.P<0.05 was statistically significant.Results:There were 22 deaths and 29 recurrences within 3 years.Multivariate analysis showed that UCR and tumor stage were significantly associated with postoperative overall survival(OS)and recurrence-free survival(RFS)(P<0.05).In all patients,the ROC area predicting 3-year overall survival and recurrence was 0.789(P<0.001)and 0.739(P<0.001),respectively;the risk of death and recurrence was more significant in the high UCR group compared with the low UCR group(P<0.007).In addition,UCR level was significantly associated with skeletal muscle mass(P<0.01).Conclusion:UCR levels are effective in predicting the long-term prognosis of colorectal cancer patients after surgery.Patients with a higher UCR have an increased risk of death and tumor recurrence.In addition,UCR is positively correlated with skeletal muscle mass.

关 键 词：尿素-肌酐比值 肌肉质量 结直肠癌 长期预后 

分 类 号：R735.34[医药卫生—肿瘤]