LAR与晚期食管鳞癌病人新辅助放化疗预后的关系  

Association between lactate dehydrogenase-albumin ratio and prognosis after neoadjuvant chemoradiotherapy in patients with advanced esophageal squamous cell carcinoma

作　　者：孔垂秀 朱鹏晋 李艳丽 韩娜娜 解晓霞 KONG Chuixiu;ZHU Pengjin;LI Yanli;HAN Nana;XIE Xiaoxia(Digestive Oncology Department 1,Linfen Central Hospital,Linfen 041000,China)

机构地区：[1]临汾市中心医院消化肿瘤一科,山西临汾041000

出　　处：《青岛大学学报（医学版）》2024年第5期733-737,共5页Journal of Qingdao University(Medical Sciences)

基　　金：中华国际科学交流基金会检验检测科技专项基金项目(Z2020LSXB004)。

摘　　要：目的分析乳酸脱氢酶(LDH)和清蛋白(ALB)及其比值(LAR)与晚期食管鳞癌病人新辅助放化疗预后的关系,以及影响预后的危险因素。方法选取2021年12月—2022年12月在临汾市中心医院接受新辅助放化疗的86例晚期食管鳞癌病人为研究对象,并依据预后结果分为预后不良组和预后良好组。比较两组病人治疗后LDH、ALB和LAR;分析LAR与预后的关系及其评估价值,以及影响预后的危险因素。结果预后良好组LDH和LAR显著低于预后不良组,而ALB显著高于预后不良组(t=11.584~14.984,P<0.05);LDH、ALB及LAR评估晚期食管鳞癌病人新辅助放化疗预后的受试者工作特征曲线下面积分别为0.832、0.744和0.919。预后不良组肿瘤为低分化和浸润深度≥5 mm的构成比均显著高于预后良好组(χ^(2)=8.524、10.223,P<0.05)。Logistic回归分析显示,肿瘤分化程度低、浸润深度≥5 mm和LAR≥8.4是影响晚期食管鳞癌病人新辅助放化疗预后不良的危险因素(OR=3.043~4.604,95%CI=(1.468~1.801)^(6.310~11.773),P<0.05)。结论肿瘤分化程度、浸润深度和LAR是影响晚期食管鳞癌病人新辅助放化疗预后的危险因素,对晚期食管鳞癌病人新辅助放化疗预后有一定评估效能。Objective To investigate the association of lactate dehydrogenase(LDH),albumin(ALB),and LDH-ALB ratio(LAR)with the prognosis after neoadjuvant chemoradiotherapy in patients with advanced esophageal squamous cell carcinoma,as well as the risk factors for prognosis.Methods A total of 86 patients with advanced esophageal squamous cell carcinoma who received neoadjuvant chemoradiotherapy in Linfen Central Hospital from December 2021 to December 2022 were enrolled as subjects,and they were divided into poor prognosis group and good prognosis group.The two groups were compared in terms of LDH,ALB,and LAR after treatment,and the association between LAR and prognosis was analyzed,as well as the value of LAR in evaluating prognosis and the risk factors for prognosis.Results Compared with the poor prognosis group,the good prognosis group had significantly lower levels of LDH and LAR and a significantly higher level of ALB(t=11.584-14.984,P<0.05).LDH,ALB,and LAR had an area under the receiver operating characteristic curve of 0.832,0.744,and 0.919,respectively,in predicting the prognosis of patients with advanced esophageal squamous cell carcinoma.Compared with the good prognosis group,the poor prognosis group had a significantly higher constituent ratio of patients with poorly differentiated tumor or a depth of invasion of≥5 mm(χ^(2)=8.524,10.223;P<0.05).The Logistic regression analysis showed that a low degree of tumor differentiation,a depth of invasion of≥5 mm,and LAR≥8.4 were influencing factors for poor prognosis after neoadjuvant chemoradiotherapy in patients with advanced esophageal squamous cell carcinoma(OR=3.043-4.604,95%CI=1.468-1.801 to 6.310-11.773,P<0.05).Conclusion Degree of tumor differentiation,depth of invasion,and LAR are risk factors for prognosis after neoadjuvant chemoradiothe-rapy in patients with advanced esophageal squamous cell carcinoma,with a certain efficacy in predicting the prognosis of patients with advanced esophageal squamous cell carcinoma after neoadjuvant chemoradiotherapy.

关 键 词：食管肿瘤 肿瘤辅助疗法 乳酸脱氢酶类 清蛋白类 危险因素 预后 

分 类 号：R735.1[医药卫生—肿瘤] R345.41[医药卫生—临床医学]