Schröder W, Vogelsang H, Bartels H, Luppa P, Busch R, Hölscher A H
Klinik und Poliklinik für Visceral- und Gefässchirurgie, Universität zu Köln.
Chirurg. 1998 Jan;69(1):72-6. doi: 10.1007/s001040050377.
In a prospective study the preoperative risk of alcohol addiction was evaluated in 46 patients with squamous cell carcinoma of the esophagus. In all patients the alcohol marker carbohydrate-deficient transferrin (CDT) was measured prior to esophagectomy and correlated with the incidence of postoperative withdrawal symptoms (yes/no) and the postoperative course (good/moderate/poor/fatal). Withdrawal symptoms were more frequently observed in cases of elevated CDT values (median of CDT with withdrawal 17.0 U/l vs without withdrawal 10.7 U/l; P = 0.0006). CDT values were significantly increased in case of a complicated postoperative course (median of CDT for moderate/poor/fatal postoperative course 14.0 U/l vs good course 10.8 U/l; P = 0.02). The CDT value correlated (P = 0.04) with the patient's history of preoperative alcohol consumption (normal/increased/high). In a multivariate logistic regression analysis CDT and preoperative alcohol consumption were independent parameters to predict significantly the postoperative course and withdrawal. The sensitivity was 71.4% and the specificity 84.4% selecting the parameter "postoperative withdrawal" and a CDT cut-off point of < 15.3 U/l. CDT can effectively identify patients with high alcohol consumption prior to esophagectomy.
在一项前瞻性研究中，对46例食管鳞状细胞癌患者术前酒精成瘾风险进行了评估。在所有患者中，于食管切除术前行酒精标志物——缺糖转铁蛋白（CDT）检测，并将其与术后戒断症状发生率（有/无）及术后病程（良好/中等/较差/死亡）进行关联分析。CDT值升高的病例中更常观察到戒断症状（有戒断症状者CDT中位数为17.0 U/l，无戒断症状者为10.7 U/l；P = 0.0006）。术后病程复杂时CDT值显著升高（术后病程为中等/较差/死亡者CDT中位数为14.0 U/l，病程良好者为10.8 U/l；P = 0.02）。CDT值与患者术前饮酒史（正常/增加/高）相关（P = 0.04）。在多因素逻辑回归分析中，CDT和术前饮酒量是显著预测术后病程和戒断症状的独立参数。选择“术后戒断”参数及CDT临界值< 15.3 U/l时，敏感性为71.4%，特异性为84.4%。CDT能够有效识别食管切除术前饮酒量高的患者。
