血清C反应蛋白与白蛋白比值对胃癌全胃切除术后早期吻合口瘘的预测价值  

Prognostic value of serum C-reactive protein to albumin ratio for early anastomotic fistula in patients with gastric cancer after total gastrectomy

作　　者：韩洪超 王爱坤 HAN Hong-Chao;WANG Ai-Kun(Department of General Surgery,The Sixth Affiliated Hospital of Nantong University,Yancheng 224000,Jiangsu,China)

机构地区：[1]南通大学第六附属医院普外科,江苏盐城224000

出　　处：《吉林医学》2025年第2期351-354,共4页Jilin Medical Journal

基　　金：盐城市医学科技发展计划项目[项目编号:YK2018129];南通大学医学院专项科研发展基金[项目编号:YXY-Z 2023009]。

摘　　要：目的:探讨血清C反应蛋白与白蛋白比值(CRP/ALB)对胃癌全胃切除术后早期吻合口瘘(AL)的预测价值。方法:回顾性分析南通大学第六附属医院收治的445例行全胃切除术的胃癌患者临床资料,根据是否发生AL,将纳入的胃癌患者102例分为吻合口瘘组(AL+,n=18)与非吻合口瘘组(AL-,n=84),观察并分析两组患者血清中术前1 d、术后1、3、5、7 d血清C反应蛋白与白蛋白比值(CRP/ALB)的差异,绘制受试者工作特征(ROC)曲线,分析CRP/ALB比值对胃癌发生早期AL的预测价值。结果:AL+与AL-患者的性别、年龄、体重指数(BMI)、手术者经验、手术时间、手术方式、手术失血量、Borrmann分型以及合并症等临床特征方面比较差异均无统计学意义(P>0.05)。AL+术后3 d及术后5 d的CRP/ALB比值、PCT水平均高于AL,差异有统计学意义(P<0.05)。术后3 d的CRP/ALB比值(截断值0.435)预测胃癌全胃切除术后发生早期AL的敏感性为77.8%,特异性为83.3%。结论:全胃切除术后血清C反应蛋白持续升高同时伴有血清白蛋白持续低水平的胃癌患者为AL的高危人群,CRP/ALB动态监测有利于胃癌患者术后AL的早期诊断。Objective To explore the predictive value of serum C-reactive protein/albumin ratio(CRP/ALB)for early anastomotic leakage(AL)in gastric cancer patients after total gastrectomy.Method A retrospective analysis was conducted on the clinical data of 445 gastric cancer patients who underwent total gastrectomy at the Sixth Affiliated Hospital of Nantong University.Based on whether AL occurred,102 gastric cancer patients were divided into an anastomotic fistula group(AL+,n=18)and a non anastomotic fistula group(AL-,n=84).The differences in serum CRP/ALB levels between the two groups were observed and analyzed on the preoperative day,postoperative days 1,3,5,and 7.Receiver operating characteristics(ROC)curves were plotted to analyze the predictive value of CRP/ALB ratio for early AL in gastric cancer patients.Results There were no statistically significant differences in clinical characteristics such as gender,age,body mass index(BMI),surgeon experience,surgical time,surgical method,surgical blood loss,Borrmann classification,and comorbidities between AL+and AL-patients(P>0.05).The CRP/ALB ratio and PCT levels at 3 and 5 days after AL+surgery were higher than those in the AL group(P<0.05).The sensitivity and specificity of predicting early AL in gastric cancer patients after total gastrectomy using the CRP/ALB ratio(cut-off value 0.435)3 days after surgery were 77.8%and 83.3%,respectively.Conclusion Gastric cancer patients with sustained elevation of serum C-reactive protein and low levels of serum albumin after total gastrectomy are at high risk for anastomotic leakage.Dynamic monitoring of CRP/ALB is beneficial for early diagnosis of anastomotic leakage in gastric cancer patients after surgery.

关 键 词：胃癌 血清C反应蛋白与白蛋白比值 吻合口瘘 预测价值 

分 类 号：R735.2[医药卫生—肿瘤]