白蛋白与碱性磷酸酶比值变化对晚期胃癌患者化疗效果及生存的评估作用  

Evaluation of the Effect of Chemotherapy and Survival of Patients with Advanced Gastric Cancer by the Change of Albumin/alkaline Phosphatase

作　　者：黄德峰[1] 郭熔哲 张国耀[1] HUANG Defeng;GUO Rongzhe;ZHANG Guoyao(Luohe Central Hospital,Luohe,462000)

机构地区：[1]河南省漯河市中心医院,462000

出　　处：《实用癌症杂志》2024年第10期1707-1710,共4页The Practical Journal of Cancer

摘　　要：目的探讨白蛋白(ALB)与碱性磷酸酶(ALP)比值变化对晚期胃癌患者化疗效果及生存的评估作用。方法纳入120例晚期胃癌患者为研究对象,所有患者均采用DCF(多西他赛+顺铂+氟尿嘧啶)化疗方案治疗,于化疗2个疗程结束后采用实体瘤的疗效评价标准1.1(RECIST 1.1)评估化疗效果,随访1年,记录患者总体生存时间。于化疗前以及化疗2个疗程结束时采用全自动生化分析仪检测ALB、ALP水平,并计算ALB/ALP(AAPR)值;比较不同化疗效果患者的基线资料、AAPR值,并绘制受试者工作特征(ROC)曲线明确化疗前AAPR预测晚期胃癌患者化疗效果的价值,并分析AAPR值与晚期胃癌患者生存的关系。结果化疗2个疗程结束时,120例晚期患者中化疗有效患者70例(完全缓解0例,部分缓解70例),化疗无效患者50例(疾病稳定32例、疾病进展18例)。有效组年龄、性别、肿瘤部位、分化程度、远处转移、吸烟史、饮酒史与无效组比较,差异无统计学意义(P>0.05);化疗前及化疗2个疗程时,有效组血清ALB及AAPR值均高于无效组,血清ALP低于无效组,差异有统计学意义(P<0.05)。绘制ROC曲线结果显示,化疗前AAPR值评估晚期胃癌患者化疗效果的AUC>0.7,具有一定预测价值;经Log Rank检验,化疗前AAPR升高组生存时间高于AAPR降低组,差异有统计学意义(χ^(2)=5.043,P<0.001)。结论AAPR值与晚期胃癌患者化疗效果及生存时间有关,且化疗前AAPR值对晚期胃癌患者化疗效果以及生存时间具有一定的预测价值。Objective To explore the role of the ratio of albumin(ALB)to alkaline phosphatase(ALP)in evaluating the chemotherapy effect and survival of patients with advanced gastric cancer.Methods 120 patients with advanced gastric cancer who received chemotherapy were included as the study subjects.All patients were treated with DCF(docetaxel+cisplatin+fluorouracil)chemotherapy scheme.After 2 courses of chemotherapy,the chemotherapy effect was evaluated with the efficacy evaluation criteria 1.1(RECIST 1.1)for solid tumors.The patients were followed up for one year to record the overall survival time of the patients.Before and at the end of the 2 courses of chemotherapy,the levels of ALB and ALP were measured using a fully automated biochemical analyzer,and the ALB/ALP(AAPR)values were calculated.The baseline data and AAPR values of patients with different chemotherapy effects were compared.The receiver operating characteristic(ROC)curve was drawn to determine the value of AAPR before chemotherapy in predicting the chemotherapy effect of patients with advanced gastric cancer,and the relationship between AAPR value and survival of patients with advanced gastric cancer was analyzed.Results At the end of 2 courses of chemotherapy,among 120 advanced patients,70 were effective in chemotherapy(0 in complete remission and 70 in partial remission),and 50 were ineffective in chemotherapy(32 in disease stability and 18 in disease progression).There was no statistical significant difference between the effective group and the ineffective group in terms of age,gender,tumor location,degree of differentiation,distant metastasis,smoking history,and alcohol consumption history(P>0.05).Before and after 2 courses of chemotherapy,the serum ALB and AAPR values in the effective group were higher than those in the ineffective group,while the serum ALP was lower than that in the ineffective group,with statistical significant differences(P<0.05).The results of Receiver operating characteristic showed that the AUC of AAPR value for evaluating the c

关 键 词：白蛋白 碱性磷酸酶 晚期胃癌 化疗 生存 

分 类 号：R735.2[医药卫生—肿瘤]