Alshamsan Bader, Aseafan Mohamed, Badran Ahmed, Shaheen Amgad, Elshenawy Mahmoud A, Bazarbashi Shouki, Aljubran Ali H
Section of Medical Oncology, Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia.
Department of Medicine, College of Medicine, Qassim University, Buraidah 51432, Saudi Arabia.
Mol Clin Oncol. 2023 Jan 27;18(3):17. doi: 10.3892/mco.2023.2613. eCollection 2023 Mar.
Small bowel adenocarcinoma (SBA) is an extremely rare cancer type. In the present study, the patient characteristics and clinical outcomes of patients diagnosed and treated for SBA at a single tertiary hospital were reported. All patients diagnosed and managed between 2007 and 2020 were reviewed. Regression analysis was used to assess variables associated with the metastatic stage at diagnosis. The Kaplan-Meier method was used to estimate survival and the log-rank test was used to determine factors associated with survival outcomes. Out of 137 cases of small bowel primary tumor, 43 consecutive patients with SBA were diagnosed with a median age of 53 years and the majority (76.7%) were males. The common initial presenting symptoms were abdominal pain (58.8%) and bowel obstruction (30.2%). The most common primary site was the duodenum (60.5%) and the majority (65.1%) were diagnosed with stage III/IV disease. Patients with a high neutrophil-lymphocyte ratio (NLR) (≥0.85) were more likely to be in the metastatic stage at diagnosis (P=0.01). The 3-year overall survival (OS) rates based on stage were 100% (I), 85% (II), 53% (III) and 33.9% (IV) (P=0.001). In addition to the stage, the Eastern Cooperative Oncology Group Performance Status (P<0.001), NLR (P<0.001), hypoalbuminemia (P=0.02) and chemotherapy in a metastatic setting (P=0.02) were prognostic factors for OS. In conclusion, NLR is a potential prognostic biomarker for a metastatic stage at diagnosis. Advanced stage, lower performance status score, low albumin level and high NLR are associated with short OS.
小肠腺癌（SBA）是一种极其罕见的癌症类型。在本研究中，报告了在一家单一的三级医院诊断和治疗的SBA患者的特征及临床结局。回顾了2007年至2020年间所有诊断和管理的患者。采用回归分析评估与诊断时转移阶段相关的变量。采用Kaplan-Meier方法估计生存率，并使用对数秩检验确定与生存结局相关的因素。在137例小肠原发性肿瘤病例中，连续43例SBA患者被诊断出，中位年龄为53岁，大多数（76.7%）为男性。常见的初始症状为腹痛（58.8%）和肠梗阻（30.2%）。最常见的原发部位是十二指肠（60.5%），大多数（65.1%）被诊断为III/IV期疾病。中性粒细胞与淋巴细胞比值（NLR）高（≥0.85）的患者在诊断时更有可能处于转移阶段（P = 0.01）。基于分期的3年总生存率（OS）分别为100%（I期）、85%（II期）、53%（III期）和33.9%（IV期）（P = 0.001）。除分期外，东部肿瘤协作组体能状态（P < 0.001）、NLR（P < 0.001）、低白蛋白血症（P = 0.02）和转移情况下的化疗（P = 0.02）是OS的预后因素。总之，NLR是诊断时转移阶段的潜在预后生物标志物。晚期、较低的体能状态评分、低白蛋白水平和高NLR与较短的OS相关。
