Shiratori Fumiaki, Suzuki Takashi, Yajima Satoshi, Oshima Yoko, Nanami Tatsuki, Funahashi Kimihiko, Shimada Hideaki
Department of Surgery, School of Medicine, Toho University, Tokyo, Japan.
Department of Surgery, Misato Central General Hospital, Misato, Saitama, Japan.
Ann Thorac Cardiovasc Surg. 2023 Oct 20;29(5):215-222. doi: 10.5761/atcs.oa.23-00004. Epub 2023 Mar 1.
The lactate dehydrogenase-to-albumin ratio (LAR) has been reported as a potential prognostic biomarker in various cancers; however, only a few pieces of information have been reported on esophageal cancer. Therefore, this study aimed to evaluate the prognostic significance of preoperative LAR in patients with esophageal cancer.
This study included 236 patients (193 men and 43 women; mean age of 66 years [range, 41-83 years]) with esophageal cancer who underwent curative surgery between September 2008 and March 2020. A total of 107 patients underwent upfront surgery, and 129 patients received neoadjuvant treatment. Patients were assigned into two groups, high and low LAR, based on preoperative LAR using a cutoff value of 6.2. The clinicopathological and prognostic significance of preoperative LAR was evaluated in univariate and multivariate analyses.
Patients with deep tumors and neoadjuvant treatment were significantly associated with high LAR (p <0.05). The high LAR group showed a significantly poorer prognosis than the low LAR group (p <0.01). The multivariate analysis for the overall survival showed that deep tumors, lymph node metastasis, and high LAR were independent poor prognostic factors (p <0.05).
High LAR was a useful poor prognostic biomarker in patients with esophageal cancer.
乳酸脱氢酶与白蛋白比值（LAR）已被报道为多种癌症潜在的预后生物标志物；然而，关于食管癌的相关报道较少。因此，本研究旨在评估术前LAR对食管癌患者的预后意义。
本研究纳入了2008年9月至2020年3月期间接受根治性手术的236例食管癌患者（193例男性和43例女性；平均年龄66岁[范围41 - 83岁]）。其中107例患者接受了直接手术，129例患者接受了新辅助治疗。根据术前LAR，以6.2为临界值将患者分为高LAR组和低LAR组。在单因素和多因素分析中评估术前LAR的临床病理及预后意义。
肿瘤深度较深和接受新辅助治疗的患者与高LAR显著相关（p <0.05）。高LAR组的预后明显比低LAR组差（p <0.01）。总生存的多因素分析显示，肿瘤深度较深、淋巴结转移和高LAR是独立的不良预后因素（p <0.05）。
高LAR是食管癌患者有用的不良预后生物标志物。
