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术前低水平前白蛋白增加胃癌切除术后早期或进展期胃癌患者非胃癌死亡率:一项回顾性队列研究

Low preoperative prealbumin increases non-gastric cancer mortality in patients with early or advanced gastric cancer after gastrectomy: a retrospective cohort study.

作者信息

Matsui Ryota, Nunobe Souya, Ri Motonari, Makuuchi Rie, Irino Tomoyuki, Hayami Masaru, Ohashi Manabu, Sano Takeshi

机构信息

Department of Gastroenterological Surgery, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-Ku, Tokyo, 135-8550, Japan.

出版信息

Surg Today. 2025 Aug 23. doi: 10.1007/s00595-025-03112-z.

Abstract

PURPOSE

This study examined the relationship between preoperative prealbumin levels and long-term outcomes in patients with advanced gastric cancer after gastrectomy.

METHODS

This study included patients who underwent radical gastrectomy for primary stage I-III gastric cancer with preoperative prealbumin levels measured from May 2006 to March 2017. The patients were categorized into 3 groups based on their preoperative prealbumin levels: high (≥ 22 mg/dL), moderate (15-22 mg/dL), and low (< 15 mg/dL).

RESULTS

Of the 3,050 pStage I patients, 2488 (81.6%) were classified as high, 511 (16.8%) as moderate, and 51 (1.7%) as low. Of the 1682 patients with pStage II-III, 1161 (69.0%) were classified as high, 414 (24.6%) as moderate, and 107 (6.4%) as low. A comparison of the overall survival (OS) revealed that lower prealbumin levels were associated with a worse prognosis (P < 0.001). A multivariate analysis indicated that prealbumin levels of 15-22 mg/dL and < 15 mg/dL were independent poor prognostic factors for the OS, regardless of the pStage. When stratified by cause of death, prealbumin levels were associated with the other-cause survival but not the cancer-specific survival.

CONCLUSIONS

Preoperative prealbumin levels were correlated with the OS, especially the other-cause survival, in patients with gastric cancer after gastrectomy. (200 words). Data Access Statement: Research data supporting this publication are available from the NN repository at located at www.NNN.org/download/ .

摘要

目的

本研究探讨进展期胃癌患者胃切除术后术前前白蛋白水平与长期预后的关系。

方法

本研究纳入2006年5月至2017年3月期间接受根治性胃切除术的I - III期原发性胃癌患者,术前均测量了前白蛋白水平。根据术前前白蛋白水平将患者分为3组:高(≥22mg/dL)、中(15 - 22mg/dL)、低(<15mg/dL)。

结果

在3050例pStage I患者中,2488例(81.6%)为高,511例(16.8%)为中,51例(1.7%)为低。在1682例pStage II - III患者中,1161例(69.0%)为高,414例(24.6%)为中,107例(6.4%)为低。总生存(OS)比较显示,前白蛋白水平越低,预后越差(P < 0.001)。多因素分析表明,无论pStage如何,15 - 22mg/dL和<15mg/dL的前白蛋白水平是OS的独立不良预后因素。按死亡原因分层时,前白蛋白水平与其他原因生存相关,但与癌症特异性生存无关。

结论

胃切除术后胃癌患者术前前白蛋白水平与OS相关,尤其是与其他原因生存相关。(200字)。数据获取声明:支持本出版物的研究数据可从位于www.NNN.org/download/的NN存储库获得。

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