Kochi Ryosuke, Suzuki Takashi, Yajima Satoshi, Oshima Yoko, Ito Masaaki, Funahashi Kimihiko, Shimada Hideaki
Department of Surgery, School of Medicine, Toho University, Tokyo, Japan.
Department of Gastroenterological Surgery & Clinical Oncology, Graduate School of Medicine, Toho University, Tokyo, Japan.
Ann Thorac Cardiovasc Surg. 2020 Aug 20;26(4):184-189. doi: 10.5761/atcs.oa.19-00238. Epub 2019 Oct 30.
Although several reports have shown that diabetes is a poor prognostic factor for esophageal cancer, no reports assessed prognostic impact of hemoglobin A1c (HbA1c) in the patients with esophageal cancer. Therefore, we evaluated the prognostic significance of HbA1c in patients with esophageal cancer.
A total of 137 patients with esophageal carcinoma surgically treated at our institute between 2009 and 2017 were enrolled in this retrospective study. We divided these patients into quarters according to pretreatment levels of HbA1c. We used 5.5% as a cutoff for classifying patients into low (Q1; n = 30) and high (Q2, Q3, Q4; n = 107) HbA1c groups. Univariate and multivariate analyses were then used to evaluate the clinicopathological and prognostic significance of pretreatment level of HbA1c.
There was no significant relationship between HbA1c level and clinicopathological factors. The low HbA1c group had a significantly worse survival rate as compared to that of the high HbA1c group (overall survival p = 0.04, relapse-free survival p = 0.02). However, the difference was not confirmed in the multivariate analysis.
Although low level of pretreatment HbA1c might be associated with poor prognosis for patients with esophageal cancer, low HbA1c was not an independent risk factor.
尽管有几份报告表明糖尿病是食管癌的一个不良预后因素，但尚无报告评估血红蛋白A1c（HbA1c）对食管癌患者预后的影响。因此，我们评估了HbA1c在食管癌患者中的预后意义。
本回顾性研究纳入了2009年至2017年间在我院接受手术治疗的137例食管癌患者。我们根据HbA1c的预处理水平将这些患者分为四组。我们将5.5%作为将患者分为低HbA1c组（Q1；n = 30）和高HbA1c组（Q2、Q3、Q4；n = 107）的临界值。然后使用单因素和多因素分析来评估HbA1c预处理水平的临床病理和预后意义。
HbA1c水平与临床病理因素之间无显著关系。低HbA1c组的生存率明显低于高HbA1c组（总生存期p = 0.04，无复发生存期p = 0.02）。然而，在多因素分析中未证实这种差异。
尽管术前HbA1c水平低可能与食管癌患者的预后不良有关，但低HbA1c不是一个独立的危险因素。
