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胃切除术后胃癌患者 CALLY 指数的临床意义。

Clinical significance of the CALLY index in patients with gastric cancer undergoing gastrectomy.

机构信息

Department of Gastroenterological Surgery, Osaka City General Hospital, Osaka, Japan.

Department of Gastroenterological Surgery, Osaka Metropolitan University, Osaka, Japan.

出版信息

World J Surg. 2024 Nov;48(11):2749-2759. doi: 10.1002/wjs.12357. Epub 2024 Sep 30.

Abstract

BACKGROUND

The aim of this study was to elucidate the clinical impact of the CALLY index in patients with gastric cancer (GC) undergoing gastrectomy.

METHODS

Between January 2014 and December 2020, 617 patients who underwent gastrectomy for GC at the Osaka City General Hospital were enrolled in this study. The CALLY index was calculated using the following formula: [albumin (g/dL) × lymphocytes (/μl)]/[CRP (mg/dL) × 10]. We compared the predictive value of four biomarkers [CALLY index, modified Glasgow prognostic score (mGPS), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR)] for short- and long-term outcomes and focused on the CALLY index to elucidate its clinical value.

RESULTS

Receiver operating characteristic analysis showed that the area under the curve for the CALLY index was the highest among the four biomarkers. The 5-year overall survival (OS) and cancer-specific survival (CSS) rates in the low and the high CALLY groups were statistically significant. Multivariate analysis identified the CALLY index as an independent factor for OS and CSS but not NLR or PLR. The mGPS was an independent factor for OS but not for CSS in multivariate analysis. Regarding complications, only the CALLY index was an independent predictor of major complications (≧ Clavien-Dindo grade 3) in multivariate analysis but not others.

CONCLUSIONS

The CALLY index may have a clinical value in predicting OS, CSS, and major complications in GC patients undergoing gastrectomy.

摘要

背景

本研究旨在阐明 CALLY 指数在接受胃癌(GC)胃切除术患者中的临床影响。

方法

2014 年 1 月至 2020 年 12 月,在大阪市立医院接受胃切除术治疗 GC 的 617 例患者被纳入本研究。CALLY 指数通过以下公式计算:[白蛋白(g/dL)×淋巴细胞(/μl)]/[CRP(mg/dL)×10]。我们比较了四种生物标志物[CALLY 指数、改良格拉斯哥预后评分(mGPS)、中性粒细胞-淋巴细胞比(NLR)和血小板-淋巴细胞比(PLR)]对短期和长期结局的预测价值,并重点关注 CALLY 指数以阐明其临床价值。

结果

受试者工作特征分析显示,CALLY 指数的曲线下面积在四种生物标志物中最高。低和高 CALLY 组的 5 年总生存率(OS)和癌症特异性生存率(CSS)有统计学意义。多变量分析确定 CALLY 指数是 OS 和 CSS 的独立因素,但不是 NLR 或 PLR。mGPS 是多变量分析中 OS 的独立因素,但不是 CSS 的独立因素。关于并发症,只有 CALLY 指数是多变量分析中主要并发症(≧Clavien-Dindo 分级 3)的独立预测因素,但其他因素不是。

结论

CALLY 指数可能在预测接受胃癌胃切除术的患者的 OS、CSS 和主要并发症方面具有临床价值。

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