Sun Huiling, He Bangshun, Nie Zhenlin, Pan Yuqin, Lin Kang, Peng Hongxin, Xu Tao, Chen Xiaoxiang, Hu Xiuxiu, Wu Zijuan, Wu Di, Wang Shukui
General Clinical Research Center, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, China.
Laboratory Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, China.
Oncotarget. 2017 Jun 20;8(25):41305-41318. doi: 10.18632/oncotarget.17181.
Decreases in serum bilirubin and albumin levels are associated with poorer prognoses in some types of cancer. Here, we examined the predictive value of serum bilirubin and albumin levels in 778 gastric cancer patients from a single hospital in China who were divided among prospective training and retrospective validation cohorts. X-tile software was used to identify optimal cutoff values for separating training cohort patients into higher and lower overall survival (OS) groups, based on total bilirubin (TBIL) and albumin levels. In univariate analysis, tumor grade and TNM stage were associated with OS. After adjusting for tumor grade and TNM stage, TBIL and albumin levels were still clearly associated with OS. These results were confirmed in the 299 patients in the validation cohort. A nomogram based on TBIL and albumin levels was more accurate than the TNM staging system for predicting prognosis in both cohorts. These results suggest that serum TBIL and albumin levels are independent predictors of OS in gastric cancer patients, and that an index that combines TBIL and albumin levels with the TNM staging system might have more predictive value than any of these measures alone.
血清胆红素和白蛋白水平降低与某些类型癌症的预后较差有关。在此，我们在中国一家医院的778例胃癌患者中研究了血清胆红素和白蛋白水平的预测价值，这些患者被分为前瞻性训练队列和回顾性验证队列。使用X-tile软件根据总胆红素（TBIL）和白蛋白水平确定将训练队列患者分为总体生存期（OS）较高和较低组的最佳临界值。在单变量分析中，肿瘤分级和TNM分期与OS相关。在调整肿瘤分级和TNM分期后，TBIL和白蛋白水平仍与OS明显相关。这些结果在验证队列的299例患者中得到证实。基于TBIL和白蛋白水平的列线图在预测两个队列的预后方面比TNM分期系统更准确。这些结果表明，血清TBIL和白蛋白水平是胃癌患者OS的独立预测因子，并且将TBIL和白蛋白水平与TNM分期系统相结合的指标可能比这些单独措施中的任何一种具有更大的预测价值。
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