术后 C-反应蛋白/白蛋白比值在胰腺导管腺癌中的临床应用价值。

Clinical usefulness of postoperative C-reactive protein/albumin ratio in pancreatic ductal adenocarcinoma.

机构信息

Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan.

出版信息

Am J Surg. 2018 Jul;216(1):111-115. doi: 10.1016/j.amjsurg.2017.08.016. Epub 2017 Aug 26.

DOI:10.1016/j.amjsurg.2017.08.016

PMID:28859917

Abstract

BACKGROUND

Patients' prognoses have been predicted by the preoperative inflammation-based score, but predicting a patient's risk for operative load remains challenging. This study investigates the usefulness of the postoperative C-reactive protein/albumin (CRP/Alb) ratio in patients with pancreatic ductal adenocarcinoma (PDAC).

METHODS

This study retrospectively assessed 142 patients who underwent pancreatic resection for PDAC between 2004 and 2014. The time at which perioperative CRP/Alb ratio most influences the prognosis was identified, and the correlations among the perioperative CRP/Alb ratio, clinicopathological factors, and patient outcomes were investigated.

RESULTS

Among the perioperative CRP/Alb ratios, only a high CRP/Alb ratio at postoperative day 14 (POD14) was significantly associated with shorter overall survival (OS) and relapse-free survival (RFS). High CRP/Alb ratio at POD 14 was related to high BMI, large amount of intraoperative bleeding, and the presence of complications. Finally, high CRP/Alb at POD14 was an independent prognostic factor of poor OS and RFS.

CONCLUSIONS

The CRP/Alb ratio at POD14 is a useful predictive marker of surgical invasion, biological reaction, and prognosis in PDAC patients.

摘要

背景

术前炎症指标可预测患者预后，但预测患者手术负荷风险仍然具有挑战性。本研究旨在探讨术后 C 反应蛋白/白蛋白（CRP/Alb）比值在胰腺导管腺癌（PDAC）患者中的应用价值。

方法

本研究回顾性分析了 2004 年至 2014 年间接受胰腺切除术治疗的 142 例 PDAC 患者。确定了围手术期 CRP/Alb 比值影响预后的最佳时间，并探讨了围手术期 CRP/Alb 比值与临床病理因素及患者预后的相关性。

结果

在围手术期 CRP/Alb 比值中，只有术后第 14 天（POD14）的高 CRP/Alb 比值与总生存（OS）和无复发生存（RFS）时间显著相关。POD14 时高 CRP/Alb 比值与 BMI 较高、术中出血量较大以及并发症的发生有关。最终，POD14 时高 CRP/Alb 比值是 OS 和 RFS 不良的独立预后因素。