Cengiz Omer, Kocer Belma, Sürmeli Süleyman, Santicky Mary-Jo, Soran Atilla
Second Surgery Clinic, Ankara Numune Teaching and Research Hospital, Ankara, Turkey.
Med Sci Monit. 2006 Jun;12(6):CR240-7. Epub 2006 May 29.
The purpose of this study was to determine if pretreatment serum albumin and cholesterol levels are prognostic factors in patients with colorectal carcinomas.
MATERIAL/METHODS: Ninety-nine patients with colorectal carcinoma were included in this study. Retrospective data analysis included the clinicopathological parameters of age and gender; emergent surgical intervention; stage at presentation; tumor location, size, and differentiation; lymph node metastases; lymphatic, venous and perineural invasion; preoperative serum albumin, cholesterol, hemoglobin, and CEA levels; the presence of preoperative and postoperative metastases; and tumor recurrence.
Low levels of serum albumin, advanced TNM stage, presence of venous invasion, and high CEA levels were independently correlated with prognosis in multivariate analysis. Advanced stage and low levels of serum cholesterol were found to be a statistically significant parameter for disease free survival. Mean serum albumin levels were found to be decreased in patients with advanced stage, which correlated with increased tumor burden. Although not statistically significant for cholesterol levels, the patients with low serum albumin and low cholesterol levels had shorter overall survival than patients with normal serum albumin and normal cholesterol levels.
These results suggest that a preoperative low level of serum albumin can be an indicator for the malignant potential of the tumor and represents an unfavorable prognosis for patients with colorectal carcinoma.
本研究的目的是确定术前血清白蛋白和胆固醇水平是否为结直肠癌患者的预后因素。
材料/方法：本研究纳入了99例结直肠癌患者。回顾性数据分析包括年龄、性别等临床病理参数；急诊手术干预；就诊时的分期；肿瘤位置、大小和分化程度；淋巴结转移；淋巴管、静脉和神经周围侵犯；术前血清白蛋白、胆固醇、血红蛋白和癌胚抗原水平；术前和术后转移的存在情况；以及肿瘤复发情况。
在多变量分析中，血清白蛋白水平低、TNM分期晚、存在静脉侵犯和癌胚抗原水平高与预后独立相关。晚期和血清胆固醇水平低被发现是无病生存的一个具有统计学意义的参数。发现晚期患者的平均血清白蛋白水平降低，这与肿瘤负荷增加相关。虽然胆固醇水平无统计学意义，但血清白蛋白水平低和胆固醇水平低的患者的总生存期比血清白蛋白水平正常和胆固醇水平正常的患者短。
这些结果表明，术前血清白蛋白水平低可能是肿瘤恶性潜能的一个指标，对结直肠癌患者来说代表预后不良。
