Zhang Xiao-Jie, Fei He, Sun Chong-Yuan, Li Ze-Feng, Li Zheng, Guo Chun-Guang, Zhao Dong-Bing
Department of Pancreatic and Gastric Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
World J Gastrointest Surg. 2023 Oct 27;15(10):2247-2258. doi: 10.4240/wjgs.v15.i10.2247.
The preoperative total bilirubin-albumin ratio (TBAR) and fibrinogen-albumin ratio (FAR) have been proven to be valuable prognostic factors in various cancers.
To detect the prognostic value of TBAR and FAR in ampullary adenocarcinoma (AC) patients who underwent curative pancreaticoduodenectomy.
AC patients who underwent curative pancreaticoduodenectomy in the National Cancer Center of China between 1998 and 2020 were retrospectively reviewed. The prognostic cutoff values of TBAR and FAR were determined through the best survival separation model. Then, a novel prognostic score combining TBAR and FAR was calculated and validated through the logistic regression analysis and Cox regression analysis.
A total of 188 AC patients were enrolled in the current study. The best cutoff values of TBAR and FAR for predicting overall survival were 1.7943 and 0.1329, respectively. AC patients were divided into a TBAR-low group (score = 0) a TBAR-high group (score = 1) and a FAR-low group (score = 0) a FAR-high group (score = 1). The total score was calculated as a novel prognostic factor. Multivariable logistic regression analysis revealed that a high score was an independent protective factor for recurrence [score = 1 score = 0: Odds ratio (OR) = 0.517, = 0.046; score = 2 score = 0 OR = 0.236, = 0.038]. In addition, multivariable survival analysis also demonstrated that a high score was an independent protective factor in AC patients (score = 2 score = 0: Hazard ratio = 0.230, = 0.046).
A novel prognostic score based on preoperative TBAR and FAR has been demonstrated to have good predictive power in AC patients who underwent curative pancreaticoduodenectomy. However, more studies with larger samples are needed to validate this conclusion.
术前总胆红素与白蛋白比值（TBAR）和纤维蛋白原与白蛋白比值（FAR）已被证明是多种癌症中有价值的预后因素。
检测TBAR和FAR在接受根治性胰十二指肠切除术的壶腹腺癌（AC）患者中的预后价值。
回顾性分析1998年至2020年在中国国家癌症中心接受根治性胰十二指肠切除术的AC患者。通过最佳生存分离模型确定TBAR和FAR的预后临界值。然后，计算并通过逻辑回归分析和Cox回归分析验证了一种结合TBAR和FAR的新型预后评分。
本研究共纳入188例AC患者。TBAR和FAR预测总生存的最佳临界值分别为1.7943和0.1329。AC患者分为TBAR低分组（评分 = 0）、TBAR高分组（评分 = 1）以及FAR低分组（评分 = 0）、FAR高分组（评分 = 1）。计算总分作为一种新型预后因素。多变量逻辑回归分析显示，高分是复发的独立保护因素[评分 = 1对评分 = 0：比值比（OR）= 0.517，P = 0.046；评分 = 2对评分 = 0，OR = 0.236，P = 0.038]。此外，多变量生存分析也表明，高分是AC患者的独立保护因素（评分 = 2对评分 = 0：风险比 = 0.230，P = 0.046）。
基于术前TBAR和FAR的新型预后评分已被证明在接受根治性胰十二指肠切除术的AC患者中具有良好的预测能力。然而，需要更多大样本研究来验证这一结论。
