Zu Hongliang, Wang Huiling, Li Chunfeng, Xue Yingwei
Department of Gastroenterologic Surgery.
Department of ICU, The First People's Hospital of Zhaoqing, Zhaoqing City, Guangdong Province.
Medicine (Baltimore). 2020 Mar;99(11):e19196. doi: 10.1097/MD.0000000000019196.
To explore the role of preoperative prealbumin levels in predicting the prognosis of patients with gastric cancer.
A total of 989 gastric cancer patients in the Affiliated Tumour Hospital of Harbin Medical University who underwent gastrectomy were included in this retrospective study. The preoperative prealbumin level, clinicopathological data, and follow-up data were recorded. According to the maximum chi-square survival correlation value, the survival of patients with low preoperative prealbumin (<140 mg/L) and high preoperative prealbumin (≥140 mg/L) were compared using the log-rank test and the Cox proportional hazard regression model.
Based on the best cut-off value of 140 mg/L, we divided the patients into the lower prealbumin group (<140 mg/L) and the higher prealbumin group (≥140 mg/L). Compared with the higher prealbumin group, the lower prealbumin group were older and had larger tumor volumes, lower hemoglobin (Hb) levels, and more upper gastric cancer tumors. The univariate analysis showed that prealbumin and other clinicopathological factors, including age, hemoglobin, tumor size, macroscopic type, cell differentiation, liver metastasis, operation type, N stage, and T stage, were significant prognostic factors. The multivariable analysis showed that age, prealbumin, macroscopic type, location, T stage, and N stage were independent prognostic factors.
The preoperative prealbumin level was an independent prognostic factor for patients with gastric cancer. The preoperative prealbumin level can be used to predict the prognosis of patients with gastric cancer and guide clinical practice.
探讨术前前白蛋白水平在预测胃癌患者预后中的作用。
本回顾性研究纳入了哈尔滨医科大学附属肿瘤医院989例行胃切除术的胃癌患者。记录术前前白蛋白水平、临床病理资料及随访数据。根据最大卡方生存相关值，采用对数秩检验和Cox比例风险回归模型比较术前前白蛋白水平低（<140mg/L）和术前前白蛋白水平高（≥140mg/L）患者的生存情况。
根据最佳截断值140mg/L，将患者分为前白蛋白水平较低组（<140mg/L）和前白蛋白水平较高组（≥140mg/L）。与前白蛋白水平较高组相比，前白蛋白水平较低组患者年龄更大，肿瘤体积更大，血红蛋白（Hb）水平更低，且胃上部癌肿瘤更多。单因素分析显示，前白蛋白及其他临床病理因素，包括年龄、血红蛋白、肿瘤大小、大体类型、细胞分化、肝转移、手术类型、N分期和T分期，均为显著的预后因素。多因素分析显示，年龄、前白蛋白、大体类型、部位、T分期和N分期为独立预后因素。
术前前白蛋白水平是胃癌患者的独立预后因素。术前前白蛋白水平可用于预测胃癌患者的预后并指导临床实践。
