术前白蛋白-胆红素分级在胃癌根治术患者预后评估中的价值
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摘要
目的探讨术前白蛋白-胆红素(ALBI)分级在胃癌(GC)根治术患者预后中的相关性。方法收集284例GC患者的临床病理资料。采用χ~2检验分析ABLI等级与临床病理资料的相关性,采用Log rank检验分析比较不同分组患者的生存率,分析影响患者预后独立风险因素采用多因素COX回归模型。结果 ALBI 1级和2级的GC患者人数分别为206、78;ALBI 2级的GC患者五年生存率(33.3%)低于1级(58.3%)。单因素分析显示肿瘤大小(P=0.015)、分化类型(P<0.01)、癌胚抗原(CEA)(P<0.01)、白蛋白(ALB)(P=0.033)、ALBI分级(P<0.01)、肿瘤分期(P<0.01)为影响GC患者预后的危险因素;多因素分析显示ALBI分级(P=0.027)、分化类型(P<0.01)、CEA(P<0.01)、肿瘤分期(P<0.01)可能为影响GC预后的独立危险因素。结论 ALBI分级可以作为一种简单的预测因子评估患者预后,并且可能为影响预后总生存率的独立危险因素。
Objective To explore the correlation of preoperative albumin-bilirubin(ALBI) grade in the prognosis of patients with gastric cancer after radical gastrectomy. Methods Two hundred and eighty-four gastric cancer patients with complete clinical and pathological data were reviewed. The relationship between ABLI grade and clinicopathological data was analyzed by chi-square test, and the survival rate of patients in different groups was compared by Log rank test. The COX regression model was used to analyze independent risk factors influencing patients' prognosis. Results The number of gastric cancer patients with grade 1 and grade 2 of ALBI was 206,78. The 5-year survival rate(33.3%) of patients with gastric cancer at grade 2 of ALBI was lower than grade 1(58.3%). Single factor analysis: tumor size(P=0.015), the types of differentiation(P<0.01) and CEA(P<0.01), albumin(P=0.033), ALBI grade(P<0.01), tumor stage(P<0.01) as the factors affecting the prognosis of patients with gastric cancer risk; Multivariate analysis showed that ALBI classification(P=0.027), differentiation type(P<0.01), CEA(P<0.01) and tumor staging(P<0.01) may be independent risk factors influencing the prognosis of gastric cancer. Conclusion ALBI score can be used as a simple predictor to evaluate the prognosis of patients, and may be an independent risk factor affecting the overall survival rate of prognosis.
Objective To explore the correlation of preoperative albumin-bilirubin(ALBI) grade in the prognosis of patients with gastric cancer after radical gastrectomy. Methods Two hundred and eighty-four gastric cancer patients with complete clinical and pathological data were reviewed. The relationship between ABLI grade and clinicopathological data was analyzed by chi-square test, and the survival rate of patients in different groups was compared by Log rank test. The COX regression model was used to analyze independent risk factors influencing patients' prognosis. Results The number of gastric cancer patients with grade 1 and grade 2 of ALBI was 206,78. The 5-year survival rate(33.3%) of patients with gastric cancer at grade 2 of ALBI was lower than grade 1(58.3%). Single factor analysis: tumor size(P=0.015), the types of differentiation(P<0.01) and CEA(P<0.01), albumin(P=0.033), ALBI grade(P<0.01), tumor stage(P<0.01) as the factors affecting the prognosis of patients with gastric cancer risk; Multivariate analysis showed that ALBI classification(P=0.027), differentiation type(P<0.01), CEA(P<0.01) and tumor staging(P<0.01) may be independent risk factors influencing the prognosis of gastric cancer. Conclusion ALBI score can be used as a simple predictor to evaluate the prognosis of patients, and may be an independent risk factor affecting the overall survival rate of prognosis.
引文
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[11] Ma X L,Zhou J Y,Gao X H,et al.Application of the albumin-bilirubin grade for predicting prognosis after curative resection of patients with early-stage hepatocellular carcinoma[J].Clin Chim Acta,2016,462:15-22.
[12] Kanda M,Tanaka C,Kobayashi D,et al.Preoperative albumin-bilirubin grade predicts recurrences after radical gastrectomy in patients with pT2-4 gastric cancer[J].World J Surg,2018,42(3):773-81.
[13] Cohen S,Danzaki K,MacIver N J.Nutritional effects on T-cell immunometabolism[J].Eur J Immunol,2017,47(2):225-35.
[14] González-Torres C,González-Martínez H,Miliar A,et al.Effect of malnutrition on the expression of cytokines involved in Th1 cell differentiation[J].Nutrients,2013,5(2):579-93.
[15] Tiberio G A,Ministrini S,Gardini A,et al.Factors influencing survival after hepatectomy for metastases from gastric cancer[J].Eur J Surg Oncol,2016,42(8):1229-35.
[2] Digklia A,Wagner A D.Advanced gastric cancer:Current treatment landscape and future perspectives[J].World J Gastroenterol,2016,22(8):2403-14.
[3] Johnson P J,Berhane S,Kagebayashi C,et al.Assessment of liver function in patients with hepatocellular carcinoma:a new evidence-based approach-the ALBI grade[J].J Clin Oncol,2015,33(6):550-8.
[4] Hiraoka A,Michitaka K,Kumada T,et al.ALBI score as a novel tool in staging and treatment planning for hepatocellular carcinoma:advantage of ALBI grade for universal assessment of hepatic function[J].Liver Cancer,2017,6(4):377-9.
[5] Dong Z R,Zou J,Sun D,et al.Preoperative albumin-bilirubin score for postoperative solitary hepatocellular carcinoma within the milan riteria and child-pugh a cirrhosis[J].J Cancer,2017,8(18):3862-7.
[6] Zheng H L,Lu J,Li P,et al.Effects of preoperative malnutrition on short- and long-term outcomes of patients with gastric cancer:can we do better?[J].Ann Surg Oncol,2017,24(11):3376-85.
[7] Migita K,Takayama T,Saeki K,et al.The prognostic nutritional index predicts long-term outcomes of gastric cancer patients independent of tumor stage[J].Ann Surg Oncol,2013,20(8):2647-54.
[8] Sakurai K,Tamura T,Toyokawa T,et al.Low preoperative prognostic nutritional index predicts poor survival post-gastrectomy in elderly patients with gastric cancer[J].Ann Surg Oncol,2016,23(11):3669-76.
[9] Kinoshita T,Kinoshita T,Saiura A,et al.Multicentre analysis of long-term outcome after surgical resection for gastric cancer liver metastases[J].Br J Surg,2015,102(1):102-7.
[10] Toyoda H,Kumada T,Tada T,et al.Differences in the impact of prognostic factors for hepatocellular carcinoma over time[J].Cancer Sci,2017,108(12):2438-44.
[11] Ma X L,Zhou J Y,Gao X H,et al.Application of the albumin-bilirubin grade for predicting prognosis after curative resection of patients with early-stage hepatocellular carcinoma[J].Clin Chim Acta,2016,462:15-22.
[12] Kanda M,Tanaka C,Kobayashi D,et al.Preoperative albumin-bilirubin grade predicts recurrences after radical gastrectomy in patients with pT2-4 gastric cancer[J].World J Surg,2018,42(3):773-81.
[13] Cohen S,Danzaki K,MacIver N J.Nutritional effects on T-cell immunometabolism[J].Eur J Immunol,2017,47(2):225-35.
[14] González-Torres C,González-Martínez H,Miliar A,et al.Effect of malnutrition on the expression of cytokines involved in Th1 cell differentiation[J].Nutrients,2013,5(2):579-93.
[15] Tiberio G A,Ministrini S,Gardini A,et al.Factors influencing survival after hepatectomy for metastases from gastric cancer[J].Eur J Surg Oncol,2016,42(8):1229-35.