术前白蛋白与碱性磷酸酶比值对非小细胞肺癌患者手术后的预后价值。

The prognostic value of the preoperative albumin to alkaline phosphatase ratio in patients with non-small cell lung cancer after surgery.

机构信息

Department of Lung Cancer, Tianjin Lung Cancer Center, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China.

出版信息

Thorac Cancer. 2019 Jul;10(7):1581-1589. doi: 10.1111/1759-7714.13107. Epub 2019 Jun 3.

DOI:10.1111/1759-7714.13107

PMID:31161711

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6610247/

Abstract

BACKGROUND

To assess the potential prognostic value of the albumin to alkaline phosphatase ratio (AAPR) in patients with non-small cell lung cancer (NSCLC) after surgery.

METHODS

The log-rank and Kaplan-Meier analyses were performed to detect differences in survival levels between different groups. A model of Cox proportional hazards was used to perform univariate and multivariate survival analyses. Comparisons of receiver operating characteristic (ROC) curves and the likelihood ratio test (LRT) were also utilized to compare the prognostic abilities of different systems for overall survival (OS) prediction.

RESULTS

The optimal cut-off value of the preoperative AAPR was 0.64. A decreased AAPR was associated with several clinicopathological and clinicolaboratory variables related to cancer progression. The preoperative AAPR of patients was positively correlated with the poor prognosis of NSCLC. In multivariate analyses, the preoperative AAPR was identified as an independent prognostic factor for disease-free survival (DFS; P = 0.001) and overall survival (OS; P = 0.003). The LRT showed that the AAPR tumor-node-metastasis (TNM) system presented a significantly larger χ value (112.4 vs. 89.2, respectively, P < 0.01) and a relatively smaller Akaike information criterion (AIC) value (2955 vs. 2977, respectively, P < 0.01) than the TNM staging system.

CONCLUSION

Preoperative AAPR was a potentially valuable prognostic factor in NSCLC patients who underwent surgery. Our results further showed that the AAPR-TNM system was superior to the current TNM staging system.

摘要

背景

评估白蛋白与碱性磷酸酶比值（AAPR）在非小细胞肺癌（NSCLC）患者手术后的潜在预后价值。

方法

采用对数秩和 Kaplan-Meier 分析检测不同组间生存水平的差异。采用 Cox 比例风险模型进行单因素和多因素生存分析。比较受试者工作特征（ROC）曲线和似然比检验（LRT），以比较不同系统对总生存（OS）预测的预后能力。

结果

术前 AAPR 的最佳截断值为 0.64。AAPR 降低与癌症进展相关的几个临床病理和临床实验室变量有关。患者术前 AAPR 与 NSCLC 的不良预后呈正相关。多因素分析显示，术前 AAPR 是无病生存（DFS；P = 0.001）和总生存（OS；P = 0.003）的独立预后因素。LRT 显示 AAPR 肿瘤-淋巴结-转移（TNM）系统的 χ 值（分别为 112.4 与 89.2，P < 0.01）和 Akaike 信息准则（AIC）值（分别为 2955 与 2977，P < 0.01）均显著大于 TNM 分期系统。