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根治性切除的胰腺导管腺癌患者术后血清白蛋白水平及恢复率的预后意义

Prognostic significance of the postoperative level and recovery rate of serum albumin in patients with curatively resected pancreatic ductal adenocarcinoma.

作者信息

Nakano Yutaka, Kitago Minoru, Shinoda Masahiro, Yagi Hiroshi, Abe Yuta, Takano Kiminori, Oshima Go, Takeuch Ayano, Endo Yutaka, Kitagawa Yuko

机构信息

Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.

Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo 160-8582, Japan.

出版信息

Mol Clin Oncol. 2019 Sep;11(3):270-278. doi: 10.3892/mco.2019.1883. Epub 2019 Jun 19.

Abstract

The aim of the present study was to investigate the clinicopathological features and prognostic factors associated with pre- and postoperative serum albumin levels in patients with curatively resected pancreatic ductal adenocarcinoma (PDAC). To achieve this, the data of patients who underwent pancreatectomy for PDAC between January 1995 and March 2016 were retrospectively reviewed, and the pre- and postoperative serum albumin levels at postoperative months (POMs) 3, 6, and 12 were evaluated. The serum albumin recovery rate was also investigated. A total of 196 patients were enrolled in the present study. In the multivariate Cox regression analysis, lymph node metastasis [hazard ratio (HR): 1.65; P=0.022], serum albumin level at POM 12 (≥3.9 g/dl; HR: 0.60; P=0.017), and serum albumin recovery rate at POM 12 (≥1.00; HR: 0.60; P=0.017) were independent prognostic factors for disease-free survival. Lymph node metastasis (HR: 1.79; P=0.013) and serum albumin level at POM 12 (≥3.9 g/dl) (HR: 0.60; P=0.033) were independent prognostic factors for overall survival. These results indicated that the postoperative level and recovery rate of serum albumin are potential biomarkers for predicting the prognosis of patients with curatively resected PDAC. However, further studies are required in order to investigate the survival benefit of increasing postoperative serum albumin levels in these patients.

摘要

本研究的目的是调查接受根治性切除的胰腺导管腺癌(PDAC)患者术前和术后血清白蛋白水平相关的临床病理特征及预后因素。为此,我们回顾性分析了1995年1月至2016年3月期间因PDAC接受胰腺切除术患者的数据,并评估了术后3、6和12个月(POMs)的术前和术后血清白蛋白水平。还研究了血清白蛋白恢复率。本研究共纳入196例患者。在多因素Cox回归分析中,淋巴结转移[风险比(HR):1.65;P = 0.022]、术后12个月的血清白蛋白水平(≥3.9 g/dl;HR:0.60;P = 0.017)以及术后12个月的血清白蛋白恢复率(≥1.00;HR:0.60;P = 0.017)是无病生存的独立预后因素。淋巴结转移(HR:1.79;P = 0.013)和术后12个月的血清白蛋白水平(≥3.9 g/dl)(HR:0.60;P = 0.033)是总生存的独立预后因素。这些结果表明,血清白蛋白的术后水平和恢复率是预测根治性切除的PDAC患者预后的潜在生物标志物。然而,需要进一步研究以探讨提高这些患者术后血清白蛋白水平的生存获益情况。

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