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血清乳酸脱氢酶水平可预测软组织肉瘤患者的预后。

Serum lactate dehydrogenase levels predict the prognosis of patients with soft tissue sarcoma.

作者信息

Fujibuchi Taketsugu, Imai Hiroshi, Kidani Teruki, Morino Tadao, Miura Hiromasa

机构信息

Department of Bone and Joint Surgery, Ehime University Graduate School of Medicine, Toon, Ehime 791-0295, Japan.

出版信息

Mol Clin Oncol. 2022 Mar;16(3):65. doi: 10.3892/mco.2022.2498. Epub 2022 Jan 19.

Abstract

Several studies have reported the prognostic factors for soft tissue sarcoma. Although serum lactate dehydrogenase (LDH) levels are associated with poor prognosis in several types of cancer, their role in soft tissue sarcomas remains unclear. Therefore, the present study evaluated the association between serum LDH levels and the clinical characteristics and prognosis of soft tissue sarcoma. A total of 103 patients diagnosed with primary soft tissue sarcoma between 2003 and 2019 were retrospectively examined, and the association between serum LDH levels at the first visit and clinical characteristics were analysed. In high-grade soft tissue sarcoma, the association between survival and clinical characteristics, including stratified LDH levels, was also analysed. Serum LDH levels were stratified (>253 and ≤253 IU/l) according to the standard values used at our institution. High serum LDH levels were significantly associated with the presence of metastasis and histological grade (P<0.001 and 0.040, respectively). In both the univariate and multivariate analyses, disease-specific survival (DSS) was significantly worse in patients with high-grade soft tissue sarcoma and high serum LDH levels than in patients with normal serum LDH levels (univariate analysis: P=0.025; multivariate analysis: Hazard ratio, 4.60; 95% confidence interval, 1.16-18.2; P=0.030). In conclusion, high serum LDH levels at the first visit predicted the presence of distant metastasis, high histological grade and worse DSS in patients with high-grade soft tissue sarcoma. Therefore, in patients with high serum LDH levels at the first visit, these risks should be considered during pretreatment examinations and post-treatment follow-up.

摘要

多项研究报告了软组织肉瘤的预后因素。尽管血清乳酸脱氢酶(LDH)水平在几种类型的癌症中与预后不良相关,但其在软组织肉瘤中的作用仍不清楚。因此,本研究评估了血清LDH水平与软组织肉瘤临床特征及预后之间的关联。对2003年至2019年间诊断为原发性软组织肉瘤的103例患者进行回顾性检查,分析首次就诊时血清LDH水平与临床特征之间的关联。在高级别软组织肉瘤中,还分析了生存与包括分层LDH水平在内的临床特征之间的关联。根据本机构使用的标准值对血清LDH水平进行分层(>253和≤253 IU/l)。高血清LDH水平与转移的存在和组织学分级显著相关(分别为P<0.001和0.040)。在单因素和多因素分析中,高级别软组织肉瘤且血清LDH水平高的患者的疾病特异性生存(DSS)明显比血清LDH水平正常的患者差(单因素分析:P=0.025;多因素分析:风险比,4.60;95%置信区间,1.16-18.2;P=0.030)。总之,首次就诊时高血清LDH水平预示着高级别软组织肉瘤患者存在远处转移、高组织学分级及较差的DSS。因此,对于首次就诊时血清LDH水平高的患者,在预处理检查和治疗后随访期间应考虑这些风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f30/8822601/918b0e8fbeac/mco-16-03-02498-g00.jpg

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