肿瘤标志物在Ⅰ至Ⅲ期胃癌患者中的预后价值及预测模型
Prognostic value and predictive model of tumor markers in stage I to III gastric cancer patients.
作者信息
Sun Ai-Hua, Zhang Xin-Yu, Huang Yang-Yang, Chen Lei, Wang Qing, Jiang Xiao-Cong
机构信息
Department of Radiotherapy Oncology, Huizhou Municipal Central Hospital, Huizhou 516001, Guangdong Province, China.
Department of Hepatobiliary Surgery, Fujian Provincial Hospital, Fuzhou 350001, China.
出版信息
World J Clin Oncol. 2024 Aug 24;15(8):1033-1047. doi: 10.5306/wjco.v15.i8.1033.
BACKGROUND
Preoperative serum tumor markers have been widely used in the diagnosis and treatment of gastric cancer patients. However, few studies have evaluated the prognosis of gastric cancer patients by establishing statistical models with multiple serum tumor indicators.
AIM
To explore the prognostic value and predictive model of tumor markers in stage I and III gastric cancer patients.
METHODS
From October 2018 to April 2020, a total of 1236 patients with stage I to III gastric cancer after surgery were included in our study. The relationship between serum tumor markers and clinical and pathological data were analyzed. We established a statistical model to predict the prognosis of gastric cancer based on the results of COX regression analysis. Overall survival (OS) was also compared across different stages of gastric cancer.
RESULTS
The deadline for follow-up was May 31, 2023. A total of 1236 patients were included in our study. Univariate analysis found that age, clinical stage, T and N stage, tumor location, differentiation, Borrmann type, size, and four serum tumor markers were prognostic factors of OS ( < 0.05). It was shown that clinical stage, tumor size, alpha foetoprotein, carcinoembryonic antigen, CA125 and CA19-9 ( < 0.05) were independent prognostic factors for OS. According to the scoring results obtained from the statistical model, we found that patients with high scores had poorer survival time ( < 0.05). Furthermore, in stage I patients, the 3-year OS for scores 0-3 ranged from 96.85%, 95%, 85%, and 80%. In stage II patients, the 3-year OS for scores 0-4 were 88.6%, 76.5%, 90.5%, 65.5% and 60%. For stage III patients, 3-year OS for scores 0-6 were 70.9%, 68.3%, 64.1%, 50.9%, 38.4%, 18.5% and 5.2%. We also analyzed the mean survival of patients with different scores. For stage I patients, the mean OS was 55.980 months. In stage II, the mean OS was 51.550 months. The mean OS for stage III was 39.422 months.
CONCLUSION
Our statistical model can effectively predict the prognosis of gastric cancer patients.
背景
术前血清肿瘤标志物已广泛应用于胃癌患者的诊断和治疗。然而，很少有研究通过建立包含多种血清肿瘤指标的统计模型来评估胃癌患者的预后。
目的
探讨肿瘤标志物在Ⅰ期和Ⅲ期胃癌患者中的预后价值及预测模型。
方法
2018年10月至2020年4月，共纳入1236例Ⅰ至Ⅲ期胃癌术后患者。分析血清肿瘤标志物与临床病理资料的关系。基于COX回归分析结果建立预测胃癌预后的统计模型。还比较了不同分期胃癌患者的总生存期（OS）。
结果
随访截止日期为2023年5月31日。本研究共纳入1236例患者。单因素分析发现，年龄、临床分期、T和N分期、肿瘤位置、分化程度、Borrmann分型、大小以及四种血清肿瘤标志物是总生存期的预后因素（P<0.05）。结果显示，临床分期、肿瘤大小、甲胎蛋白、癌胚抗原、CA125和CA19-9（P<0.05）是总生存期的独立预后因素。根据统计模型得到的评分结果，我们发现评分高的患者生存时间较差（P<0.05）。此外，在Ⅰ期患者中，0至3分的3年总生存率分别为96.85%、95%、85%和80%。在Ⅱ期患者中，0至4分的3年总生存率分别为88.6%、76.5%、90.5%、65.5%和60%。对于Ⅲ期患者，0至6分的3年总生存率分别为70.9%、68.3%、64.1%、50.9%、38.4%、18.5%和5.2%。我们还分析了不同评分患者的平均生存期。对于Ⅰ期患者，平均总生存期为55.980个月。在Ⅱ期，平均总生存期为51.550个月。Ⅲ期的平均总生存期为39.422个月。
结论
我们的统计模型能够有效预测胃癌患者的预后。
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