Arak Hacı, Gumusburun Ercan, Seyyar Mustafa, Yesil Cinkir Havva
Department of Medical Oncology, Gaziantep City Hospital, TR-27010 Gaziantep, Turkey.
Department of Internal Medicine, Faculty of Medicine, Şahinbey Training and Research Hospital, Gaziantep University, TR-27470 Gaziantep, Turkey.
J Clin Med. 2025 Jan 29;14(3):901. doi: 10.3390/jcm14030901.
This study aimed to evaluate the prognostic significance of the pre-treatment albumin-to-alkaline phosphatase ratio (AAPR) in early-stage colorectal cancer patients and to compare it with the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) within the same patient cohort. This retrospective study included 540 patients who were followed up after a diagnosis of early-stage colorectal cancer and whose albumin (ALB), alkaline phosphatase (ALP), neutrophil, platelet, and lymphocyte values were measured before treatment. In the receiver operating characteristic (ROC) curve analysis for overall survival (OS), the AAPR index Area Under Curve (AUC):0.560, ( = 0.018), NLR index ( = 0.079), and PLR index ( = 0.692) were evaluated. In the ROC analysis for OS, a cut-off value of the AAPR index of ≤0.423 was found. In the AAPR-low group, the relapse and death rates were higher than in the AAPR-high group ( = 0.004 and = 0.001, respectively). As the AAPR index decreased, the NLR and PLR indexes increased ( = 0.027 and = 0.003, respectively). Median disease-free survival (DFS) was worse in the AAPR-low group (128 versus 156) months ( = 0.015). The AAPR index significantly affected OS with hazard ratio (HR):0.42 (95%CI, 0.18-0.97) ( = 0.044). At 5 years, 68% of the patients in the AAPR-low group and 79% of the patients in the AAPR-high group were alive ( = 0.005). In a multivariate analysis, low AAPR, patient age at diagnosis, TNM stage, and recurrence status were independent factors affecting OS ( = 0.022, < 0.001, = 0.002, and < 0.001, respectively). : In early-stage colorectal cancer patients, the OS was worse in the AAPR-low group than in the AAPR-high group. The AAPR index demonstrated significant prognostic value for OS compared to the NLR and PLR in the same patient cohort.
本研究旨在评估治疗前白蛋白与碱性磷酸酶比值（AAPR）在早期结直肠癌患者中的预后意义，并在同一患者队列中将其与中性粒细胞与淋巴细胞比值（NLR）和血小板与淋巴细胞比值（PLR）进行比较。这项回顾性研究纳入了540例早期结直肠癌诊断后接受随访的患者，这些患者在治疗前测量了白蛋白（ALB）、碱性磷酸酶（ALP）、中性粒细胞、血小板和淋巴细胞值。在总生存期（OS）的受试者工作特征（ROC）曲线分析中，评估了AAPR指数曲线下面积（AUC）：0.560，（P = 0.018），NLR指数（P = 0.079）和PLR指数（P = 0.692）。在OS的ROC分析中，发现AAPR指数的临界值≤0.423。在AAPR低分组中，复发率和死亡率高于AAPR高分组（分别为P = 0.004和P = 0.001）。随着AAPR指数降低，NLR和PLR指数升高（分别为P = 0.027和P = 0.003）。AAPR低分组的无病生存期（DFS）中位数较差（128个月对156个月）（P = 0.015）。AAPR指数对OS有显著影响，风险比（HR）：0.42（95%CI，0.18 - 0.97）（P = 0.044）。5年后，AAPR低分组68%的患者存活，AAPR高分组79%的患者存活（P = 0.005）。在多因素分析中，低AAPR、诊断时患者年龄、TNM分期和复发状态是影响OS的独立因素（分别为P = 0.022，P < 0.001，P = 0.002和P < 0.001）。结论：在早期结直肠癌患者中，AAPR低分组的OS比AAPR高分组更差。在同一患者队列中，与NLR和PLR相比，AAPR指数对OS具有显著的预后价值。
