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基于术前纤维蛋白原和前白蛋白的累积评分可预测可切除胃癌患者的长期生存。

Cumulative Score Based on Preoperative Fibrinogen and Pre-albumin Could Predict Long-term Survival for Patients with Resectable Gastric Cancer.

作者信息

Wu Zhi-Jun, Xu Hui, Wang Rong, Bu Li-Jia, Ning Jie, Hao Ji-Qing, Sun Guo-Ping, Ma Tai

机构信息

Department of Oncology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, P. R. China.

Department of Oncology, Maanshan People's Hospital, Maanshan, Anhui, 243000, P. R. China.

出版信息

J Cancer. 2019 Oct 17;10(25):6244-6251. doi: 10.7150/jca.35157. eCollection 2019.

Abstract

: To investigate the prognostic significance of the cumulative score based on preoperative fibrinogen and pre-albumin (FP score) in patients with gastric cancer after radical gastrectomy. : Baseline characteristics, preoperative fibrinogen and pre-albumin levels were retrospectively reviewed in patients who underwent radical gastrectomy. The optimal cut-off values for fibrinogen and pre-albumin were defined as 4.0 g/L and 230.0 mg/L, respectively. Patients with elevated fibrinogen (≥ 4.0 g/L) and decreased pre-albumin (< 230.0 mg/L) levels were allocated an FP score of 2, those with only one of these two abnormalities were assigned a score of 1, and those with neither of the two abnormalities were allocated a score of 0. The prognostic value was examined by univariate and multivariate regression analyses. : The preoperative FP score was significantly correlated with age, tumor size, fibrinogen level, pre-albumin level and white blood cell count. No significant differences based on sex, tumor location, degree of differentiation, depth of invasion, lymph node status, tumor-node-metastasis (TNM) stage or adjuvant chemotherapy were identified between the groups. In addition, univariate survival analysis revealed that a high preoperative FP score was significantly associated with unfavorable disease-free survival (DFS) [hazard ratio (HR), 1.482; 95% confidence interval (CI), 1.222-1.796; < 0.001] and overall survival (OS) (HR, 1.623; 95% CI, 1.315-2.002; < 0.001). Moreover, after adjusting for other factors, a high preoperative FP score remained an independent predictor for impaired DFS (HR, 1.434; 95% CI, 1.177-1.747; < 0.001) and OS (HR, 1.413; 95% CI, 1.136-1.758; = 0.002) in multivariate Cox regression analysis. : The preoperative FP score significantly predicts long-term survival for gastric cancer patients who have undergone radical gastrectomy.

摘要

目的

探讨基于术前纤维蛋白原和前白蛋白的累积评分(FP评分)对胃癌根治术后患者的预后意义。

方法

回顾性分析接受胃癌根治术患者的基线特征、术前纤维蛋白原和前白蛋白水平。纤维蛋白原和前白蛋白的最佳截断值分别定义为4.0 g/L和230.0 mg/L。纤维蛋白原水平升高(≥4.0 g/L)且前白蛋白水平降低(<230.0 mg/L)的患者FP评分为2分,仅有这两种异常之一的患者评分为1分,无这两种异常的患者评分为0分。通过单因素和多因素回归分析检验预后价值。

结果

术前FP评分与年龄、肿瘤大小、纤维蛋白原水平、前白蛋白水平和白细胞计数显著相关。两组在性别、肿瘤位置、分化程度、浸润深度、淋巴结状态、肿瘤-淋巴结-转移(TNM)分期或辅助化疗方面无显著差异。此外,单因素生存分析显示,术前高FP评分与无病生存期(DFS)不良显著相关[风险比(HR),1.482;95%置信区间(CI),1.222-1.796;P<0.001]和总生存期(OS)(HR,1.623;95%CI,1.315-2.002;P<0.001)。此外,在调整其他因素后,术前高FP评分在多因素Cox回归分析中仍然是DFS受损(HR,1.434;95%CI,1.177-1.747;P<0.001)和OS(HR,1.413;95%CI,1.136-1.758;P=0.002)的独立预测因素。

结论

术前FP评分显著预测接受胃癌根治术患者的长期生存。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d246/6856731/325f0a36d5e3/jcav10p6244g001.jpg

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