Department of Oncology, Taizhou People's Hospital, No. 399 Hailing South Road, Taizhou, Jiangsu, 225300, China.
BMC Surg. 2022 May 28;22(1):207. doi: 10.1186/s12893-022-01657-1.
The objective of this study was to investigate potential predictors of chemotherapy resistance in patients with advanced gastric cancer (GC) following radical gastrectomy.
Eligible stage II/III GC patients with adjuvant chemotherapy after radical gastrectomy were enrolled in this study. A receiver operating characteristic (ROC) curve analysis was performed to assess the predictive and optimal cut-off values of continuous variables for chemotherapy resistance. Potential risk factors for chemotherapy resistance were determined with binary univariate and multivariate analyses. Potential prognostic factors for overall survival (OS) were determined by COX regression analysis. The association between survival and AFR level was examined using the Kaplan-Meier curve analysis.
A total of 160 patients were included in the data analysis, and 41 patients achieved chemotherapeutic resistance with an incidence of 25.6%. Pretreatment albumin/fibrinogen ratio (AFR) (cut-off value: 10.85, AUC: 0.713, P < 0.001) was a predictor for chemotherapeutic resistance by ROC curve analysis. Low AFR (< 10.85) was an independent risk factor of chemotherapeutic resistance as determined by the univariate and multivariate logistic regression analyses (OR: 2.55, 95%CI: 1.21-4.95, P = 0.005). Multivariate COX regression analyses indicated low AFR as a prognostic factor for 5-year OS (HR: 0.36, 95%CI: 0.15-0.73, P = 0.011). Low AFR was associated with poorer 5-year disease-free survival and overall survival.
This study indicated that a low level of pretreatment AFR could serve as an independent predictor of chemotherapy resistance and postoperative prognosis in GC patients following radical gastrectomy.
本研究旨在探讨根治性胃切除术后接受辅助化疗的晚期胃癌（GC）患者化疗耐药的潜在预测因素。
本研究纳入了接受根治性胃切除术后接受辅助化疗的 II/III 期 GC 患者。采用受试者工作特征（ROC）曲线分析评估连续变量预测化疗耐药的能力和最佳截断值。采用二分类单因素和多因素分析确定化疗耐药的潜在危险因素。采用 COX 回归分析确定总生存期（OS）的潜在预后因素。采用 Kaplan-Meier 曲线分析评估生存与 AFR 水平的关系。
共纳入 160 例患者进行数据分析，41 例患者发生化疗耐药，发生率为 25.6%。ROC 曲线分析显示，治疗前白蛋白/纤维蛋白原比值（AFR）（截断值：10.85，AUC：0.713，P<0.001）是化疗耐药的预测因素。单因素和多因素 logistic 回归分析表明，低 AFR（<10.85）是化疗耐药的独立危险因素（OR：2.55，95%CI：1.21-4.95，P=0.005）。多因素 COX 回归分析表明，低 AFR 是 5 年 OS 的预后因素（HR：0.36，95%CI：0.15-0.73，P=0.011）。低 AFR 与较差的 5 年无病生存率和总生存率相关。
本研究表明，治疗前 AFR 水平较低可作为根治性胃切除术后 GC 患者化疗耐药和术后预后的独立预测因素。
