纤维蛋白原和单核细胞与前白蛋白比值在预测胃癌术后复发中的临床意义  

Clinical significance of fibrinogen and monocytes to prealbumin ratio in predicting recurrence after gastric cancer surgery

作　　者：田华开 刘自桃 宗振 刘江[2] 林峻祯 Tian Huakai;Liu Zitao;Zong Zhen;Liu Jiang;Lin Junzhen(Department of General Surgery,The First Affiliated Hospital of Nanchang University,Nanchang,Jiangxi 330006,China;Department of Gastrointestinal Surgery,The Second Affiliated Hospital of Nanchang University,Nanchang,Jiangxi 330006,China)

机构地区：[1]南昌大学第一附属医院普外科,江西南昌330006 [2]南昌大学第二附属医院胃肠外科,江西南昌330006

出　　处：《现代临床医学》2024年第6期401-404,428,共5页Journal of Modern Clinical Medicine

基　　金：江西省教育厅科学技术研究青年项目(GJJ210252);江西省卫生健康委科技计划项目(202310221);江西省卫生计生委中医药管理局科技计划项目(2020B0132)。

摘　　要：目的:探讨纤维蛋白原和单核细胞与前白蛋白比值(FMAR)在预测胃癌术后复发中的临床意义。方法:收集2015年1月至2017年1月南昌大学第二附属医院收治的728例胃癌患者的临床资料,采用logistic回归分析胃癌术后复发的影响因素。绘制ROC曲线,并计算曲线下面积(AUC),判断FMAR最佳截断值。采用R4.1.0软件构建并验证预测模型。结果:共纳入728例胃癌患者,227例(31.18%)出现复发转移。FMAR对术后复发影响的AUC为0.626(95%CI:0.583~0.669),最佳截断值为0.006。肿瘤大小、分化程度、T分期、N分期、化疗、FMAR是胃癌术后复发的影响因素(P<0.05)。基于以上6个影响因素构建的复发预测模型的AUC为0.782(95%CI:0.748~0.818),不包含FMAR值的预测模型AUC为0.767。结论:高FMAR是胃癌术后复发的独立危险因素,基于FMAR构建的预测模型可以预测胃癌术后患者是否复发,模型经过内部验证表现出良好的预测能力。Objective:To explore the clinical significance of fibrinogen and monocytes to prealbumin ratio(FMAR)in predicting recurrence after gastric cancer surgery.Methods:Clinical data of 728 gastric cancer patients admitted to the Second Affiliated Hospital of Nanchang University from January 2015 to January 2017 were collected.Logistic regression was used to analyze the influencing factors of postoperative recurrence of gastric cancer.The ROC curve was drawn and the area under the curve(AUC)was calculated to determine the optimal cut-of value of FMAR.The prediction model was constructed and verified using R 4.1.0 software.Results:A total of 728 gastric cancer patients were included,and 227 cases(31.18%)had recurrence and metastasis.The AUC of FMAR for postoperative recurrence was 0.626(95%CI:0.583-0.669),and the optimal cut-off value was 0.006.Tumor size,differentiation degree,T stage,N stage,chemotherapy,and FMAR were the influencing factors of postoperative recurrence of gastric cancer(P<0.05).The AUC of the recurrence prediction model constructed based on the above six influencing factors was 0.782(95%CI:0.748-0.818),and the AUC of the prediction model without FMAR value was 0.767.Conclusion:High FMAR is an independent risk factor for postoperative recurrence of gastric cancer.The prediction model constructed based on FMAR can predict whether patients with gastric cancer will relapse after surgery.The model shows good predictive ability after internal verification.

关 键 词：胃癌 纤维蛋白原 单核细胞 前白蛋白 复发 预测模型 

分 类 号：R735.2[医药卫生—肿瘤]