Wu Zhi-Jun, Xu Hui, Wang Rong, Bu Li-Jia, Ning Jie, Hao Ji-Qing, Sun Guo-Ping, Ma Tai
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.
J Cancer. 2019 Oct 17;10(25):6244-6251. doi: 10.7150/jca.35157. eCollection 2019.
: 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.
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。
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。
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。
术前FP评分显著预测接受胃癌根治术患者的长期生存。