术前血清转氨酶比值联合血清肿瘤标志物对Ⅲ期结直肠癌患者预后的评估价值：一项回顾性研究

Evaluation Value of Preoperative Serum Transaminase Ratio Combined with Serum Tumor Markers for Prognosis of Patients with Stage III Colorectal Cancer: A Retrospective Study.

作者信息

Li Xiaodong, Wu Zhao, Cheng Fei, Yuan Lebin, Xia Weiyang, Li Zhigang, Huang Zeyu, Mao Shengping, Chen Xing, Shen Wei

机构信息

Department of Gastrointestinal Surgery, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China.

Department of General Surgery, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China.

出版信息

Ann Clin Lab Sci. 2025 Jan;55(1):54-63.

PMID:40089288

Abstract

OBJECTIVE

This study utilized data from two hospitals to investigate the relationship between the preoperative serum alanine aminotransferase to aspartate aminotransferase ratio (LSR) combined with preoperative serum tumor markers (TM) and the prognosis of patients with stage III colorectal cancer (CRC).

METHODS

An analysis was performed on the clinical data of 211 patients diagnosed with stage III colorectal cancer (CRC), treated surgically at the Department of Gastrointestinal Surgery of the Second Affiliated Hospital of Nanchang University and the General Surgery Department of the First Affiliated Hospital of Nanchang University between January 2016 and December 2016. Laboratory data were also compiled for these patients. The main follow-up indicators were the five-year disease-free survival (DFS) and the five-year overall survival (OS). Survival analysis was carried out using the log-rank test, and Cox regression analysis was applied to ascertain independent prognostic factors for survival. Rank sum tests were utilized to compare categorical variables, with a -value of less than 0.05 considered statistically significant.

RESULT

Between January 2016 and December 2016, a total of 211 patients were enrolled in the two hospitals, including 113 males and 98 females. Multivariate analysis showed that the independent prognostic factors for five-year disease-free survival of stage III colorectal cancer were LSR (HR: 0.45,95% CI:0.31-0.67, <0.001) and CEA (HR: 2.11,95%CI:1.42-3.13, <0.001). Independent prognostic factors for five-year overall survival of stage III colorectal cancer were LSR (HR:0.48, 95%CI:0.31-0.75, =0.001) and CA199 (HR:1.73, 95%CI:1.11-2.68, =0.015). Kaplan-Meier survival analysis showed that LSR combined with TM could evaluate the five-year DFS and five-year OS of stage III colorectal cancer (DFS, <0.001, OS: =0.002).

CONCLUSION

The prognosis of patients with high preoperative LSR and low CEA, CA199 in perioperative period is better than that of other stage III colorectal cancer patients. 2. Perioperative preoperative serum transaminase ratio combined with CEA, CA199 has a certain reference value in the prognosis assessment of stage III colorectal cancer.

摘要

目的

本研究利用两家医院的数据，探讨术前血清丙氨酸氨基转移酶与天冬氨酸氨基转移酶比值（LSR）联合术前血清肿瘤标志物（TM）与Ⅲ期结直肠癌（CRC）患者预后的关系。

方法

对2016年1月至2016年12月在南昌大学第二附属医院胃肠外科和南昌大学第一附属医院普通外科接受手术治疗的211例诊断为Ⅲ期结直肠癌（CRC）患者的临床资料进行分析。还收集了这些患者的实验室数据。主要随访指标为五年无病生存率（DFS）和五年总生存率（OS）。采用对数秩检验进行生存分析，并应用Cox回归分析确定生存的独立预后因素。采用秩和检验比较分类变量，P值小于0.05被认为具有统计学意义。

结果

2016年1月至2016年12月，两家医院共纳入211例患者，其中男性113例，女性98例。多因素分析显示，Ⅲ期结直肠癌五年无病生存的独立预后因素为LSR（HR：0.45，95%CI：0.31-0.67，P<0.001）和CEA（HR：2.11，95%CI：1.42-3.13，P<0.001）。Ⅲ期结直肠癌五年总生存的独立预后因素为LSR（HR：0.48，95%CI：0.31-0.75，P=0.001）和CA199（HR：1.73，95%CI：1.11-2.68，P=0.015）。Kaplan-Meier生存分析显示，LSR联合TM可评估Ⅲ期结直肠癌的五年DFS和五年OS（DFS，P<0.001，OS：P=0.002）。