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新辅助放化疗后接受全直肠系膜切除术的局部晚期直肠癌患者，治疗前白蛋白与纤维蛋白原比值可独立预测化疗反应及预后。

Pretreatment Albumin-to-Fibrinogen Ratio Independently Predicts Chemotherapy Response and Prognosis in Patients with Locally Advanced Rectal Cancer Undergoing Total Mesorectal Excision After Neoadjuvant Chemoradiotherapy.

作者信息

Li Hongzhi, Wang Honggang, Shao Shanshan, Gu Yawen, Yao Juan, Huang Junxing

机构信息

Department of Oncology, Taizhou People's Hospital, Taizhou, Jiangsu, People's Republic of China.

Department of General Surgery, Taizhou People's Hospital, Taizhou, Jiangsu, People's Republic of China.

出版信息

Onco Targets Ther. 2020 Dec 23;13:13121-13130. doi: 10.2147/OTT.S288265. eCollection 2020.

DOI:10.2147/OTT.S288265
PMID:33380802
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7767700/
Abstract

BACKGROUND

Neoadjuvant chemoradiotherapy (nCRT) followed by surgery of total mesorectal excision (TME) is currently accepted as the standard treatment for locally advanced rectal cancer (LARC). This study aimed to investigate the potential prognostic factors, including the albumin-to-fibrinogen ratio (AFR) for LARC patients.

METHODS

We retrospectively recruited LARC patients (cT3-4 and/or cN1-2) who underwent nCRT followed by TME between January 2011 and January 2015. The cut-off value of pretreatment AFR for overall survival (OS) was determined by the receiver operating characteristic (ROC) curve. The potential predictive factors for prognosis in the LARC patients were assessed by the univariate and multivariate Cox's proportional hazard regression and Kaplan-Meier curve analyses.

RESULTS

AFR was a significant predictor for OS with a cut-off value of 8.65 and an AUC of 0.882 (P<0.001). The pretreatment AFR level was the only independent risk factor for pathologic response to nCRT (HR: 2.44, 95% CI: 1.43-4.17, P=0.003), 5-year OS (HR: 3.31, 95% CI: 1.51-6.77, P=0.005) and disease-free survival (DFS) (HR: 2.73, 95% CI: 1.34-5.47, P=0.007) in LARC patients. A low pretreatment AFR level was significantly associated with a poor 5-year OS and DFS by the Log rank test (P=0.003 and 0.006, respectively).

CONCLUSION

Pretreatment AFR level was an independent prognostic factor in LARC patients undergoing TME after nCRT.

摘要

背景

新辅助放化疗（nCRT）后行全直肠系膜切除术（TME）目前被公认为局部晚期直肠癌（LARC）的标准治疗方法。本研究旨在探讨LARC患者的潜在预后因素，包括白蛋白与纤维蛋白原比值（AFR）。

方法

我们回顾性纳入了2011年1月至2015年1月期间接受nCRT后行TME的LARC患者（cT3-4和/或cN1-2）。通过受试者工作特征（ROC）曲线确定预处理AFR对总生存期（OS）的截断值。通过单因素和多因素Cox比例风险回归以及Kaplan-Meier曲线分析评估LARC患者预后的潜在预测因素。

结果

AFR是OS的显著预测因子，截断值为8.65，曲线下面积（AUC）为0.882（P<0.001）。预处理AFR水平是LARC患者对nCRT病理反应的唯一独立危险因素（风险比[HR]：2.44，95%置信区间[CI]：1.43-4.17，P=0.003）、5年总生存期（HR：3.31，95%CI：1.51-6.77，P=0.005）和无病生存期（DFS）（HR：2.73，95%CI：1.34-5.47，P=0.007）。通过对数秩检验，低预处理AFR水平与较差的5年总生存期和DFS显著相关（分别为P=0.003和0.006）。

结论

预处理AFR水平是nCRT后行TME的LARC患者的独立预后因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a293/7767700/f94f853990bd/OTT-13-13121-g0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a293/7767700/6c58f82a407b/OTT-13-13121-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a293/7767700/266c24ca72b0/OTT-13-13121-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a293/7767700/3c629b963e28/OTT-13-13121-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a293/7767700/f94f853990bd/OTT-13-13121-g0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a293/7767700/6c58f82a407b/OTT-13-13121-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a293/7767700/266c24ca72b0/OTT-13-13121-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a293/7767700/3c629b963e28/OTT-13-13121-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a293/7767700/f94f853990bd/OTT-13-13121-g0004.jpg

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