子宫内膜癌患者术前白蛋白检测的临床意义及对预后的评估价值
|
摘要
目的探讨子宫内膜癌患者术前白蛋白(ALB)检测的临床意义及对预后的评估价值。方法回顾性分析本院2003年1月-2013年1月收治的203例子宫内膜癌患者的临床资料。根据术前ALB水平,将患者分为正常水平组(≥35 g/L)和低水平组(<35 g/L)。对2组患者的年龄、绝经状态、淋巴转移情况、国际妇产科联合会(FIGO)分期、肌层浸润及病理类型等临床病理资料进行对比分析,并分析ALB与预后的关系。结果低水平组中,年龄≥60岁、有淋巴转移、FIGO分期(Ⅲ期～Ⅳ期)、深肌层浸润及非子宫内膜样癌的比例高于正常水平组(P<0.05);低水平组3年及5年内存活率均明显低于正常水平组(P<0.05);5年内死亡组患者血清ALB水平均较存活组显著降低(P<0.05)。结论子宫内膜癌患者术前ALB水平能一定程度反应疾病的病理特征,且术前ALB水平越低患者预后不良风险可能越高。
Objective To investigate the clinical significance and prognosis of preoperative serum albumin(ALB) level in patients with endometrial carcinoma. Methods Clinical data of 203 patients with endometrial cancer treated in our hospital from January 2003 to January 2013 were analyzed retrospectively. The patients were divided into normal group(≥35 g/L), and the lower level group(<35 g/L), according to the preoperative detection of ALB level. The clinical and pathological data of patients′ age, menopause, lymphatic metastasis, FIGO staging, myometrium infiltration, pathological type of prognosis were analyzed. And the relationship of ALB with prognostic was analyzed. Results More than 60 years old, lymph node metastasis and FIGO stage(stage III-IV) and deep myometrial invasion and non endometrioid carcinoma in low level group were higher than that in normal level group(P<0.05); The survival rate of low level group in 3 years and 5 years was significantly lower than that in the normal level group(P<0.05). The ALB level of death group was lower than that of survival group(P<0.05). Conclusion The preoperative ALB level in patients with endometrial carcinoma can reflect the pathological features of the disease to a certain extent, and the lower the preoperative ALB level is, the higher the risk of poor prognosis may be.
Objective To investigate the clinical significance and prognosis of preoperative serum albumin(ALB) level in patients with endometrial carcinoma. Methods Clinical data of 203 patients with endometrial cancer treated in our hospital from January 2003 to January 2013 were analyzed retrospectively. The patients were divided into normal group(≥35 g/L), and the lower level group(<35 g/L), according to the preoperative detection of ALB level. The clinical and pathological data of patients′ age, menopause, lymphatic metastasis, FIGO staging, myometrium infiltration, pathological type of prognosis were analyzed. And the relationship of ALB with prognostic was analyzed. Results More than 60 years old, lymph node metastasis and FIGO stage(stage III-IV) and deep myometrial invasion and non endometrioid carcinoma in low level group were higher than that in normal level group(P<0.05); The survival rate of low level group in 3 years and 5 years was significantly lower than that in the normal level group(P<0.05). The ALB level of death group was lower than that of survival group(P<0.05). Conclusion The preoperative ALB level in patients with endometrial carcinoma can reflect the pathological features of the disease to a certain extent, and the lower the preoperative ALB level is, the higher the risk of poor prognosis may be.
引文
[1] 郭桂林, 艾迪拜·木合买提, 阿布杜拉·阿布力孜, 等. 子宫内膜癌相关危险因素的探讨[J].实用老年医学, 2016, 30(3): 199-202.
[2] 王惠霞, 李淑红. 不同手术方式治疗肥胖型子宫内膜癌的疗效、安全性对比分析及对机体炎症因子水平的影响[J]. 湖南师范大学学报: 医学版, 2017, 14(6): 168-171.
[3] Duffy MJ, Bonfrer JM, Kulpa J, et al. CA125 in ovarian cancer: European Group on Tumor Markers guidelines for clinical use[J]. Int J Gynecol Cancer, 2005, 15(5): 679-691.
[4] Manolov V, Marinov B, Vasilev V, et al. HE4--a new tumor marker for ovarian cancer[J]. Akusherstvo I Ginekologiia, 2011, 50(Suppl 2): 11-15.
[5] Weimann A, Braga M, Harsanyi L, et al. ESPEN Guidelines on Enteral Nutrition: Surgery including organ transplantation[J]. Clin Nutr, 2006, 25(2): 224-244.
[6] Takehiro S, Hideto I, Toshihiko M, et al. Low pre-operative levels of serum albumin predict lymph node metastases and ultimately correlate with a biochemical recurrence of prostate cancer in radical prostatectomy patients[J]. Eur Urol, 2013, 66(2): 126-132.
[7] Laky B, Janda M, Cleghorn G, et al. Comparison of different nutritional assessments and body-composition measurements in detecting malnutrition among gynecologic cancer patients[J]. Am J Clin Nutr, 2008, 87(6): 1678-1685.
[8] Olson SH, De VI, Setiawan VW, et al. Symposium on advances in endometrial cancer epidemiology and biology[J]. Gynecol Oncol, 2015, 138(3): 497-500.
[9] de Boer SM, Nout RA, Jürgenliemkschulz IM, et al. Long-term impact of endometrial cancer diagnosis and treatment on health-related quality of life and cancer survivorship: Results from the randomized PORTEC-2 Trial[J]. Int J Radiat Oncol, 2015, 93(4): 797-809.
[10] 李美艳. HE4、OPN及uPA检测对子宫内膜癌患者诊断的临床意义[J]. 国际肿瘤学杂志, 2017, 44(5): 351-355.
[11] 于江燕, 张一琼. HER2和BRCA1在子宫内膜癌中的表达及其与预后的关系[J]. 实用肿瘤杂志, 2016, 31(2): 145-149.
[12] 窦磊, 郭科军. 腹腔镜手术在早期子宫内膜癌治疗中的疗效观察[J]. 中国医科大学学报, 2016, 45(3): 241-245.
[13] Ascenzi P, Fasano M. Allostery in a monomeric protein: the case of human serum albumin[J]. Biophys Chem, 2010, 148(1/3): 16-22.
[14] 徐菁. 术前血清白蛋白水平对结直肠癌患者行根治性切除术后发病率和死亡率的预测价值[J]. 中国普外基础与临床杂志, 2016(12): 1529-1529.
[15] 周国超, 杨大刚. 低蛋白血症的研究进展[J]. 贵州医药, 2015, 39(3): 279-281.
[16] Patankar S, Burke WM, Hou JY, et al. Risk stratification and outcomes of women undergoing surgery for ovarian cancer[J]. Gynecol Oncol, 2015, 138(1): 62-69.
[17] Uppal S, Al-Niaimi A, Rice LW, et al. Preoperative hypoalbuminemia is an independent predictor of poor perioperative outcomes in women undergoing open surgery for gynecologic malignancies[J]. Gynecol Oncol, 2013, 131(2): 416-422.
[18] Seebacher V, Grimm C, Reinthaller A, et al. The value of serum albumin as a novel independent marker for prognosis in patients with endometrial cancer[J]. Eur J Obstet Gynecol Reprod Biol, 2013, 171(1): 101-106.
[2] 王惠霞, 李淑红. 不同手术方式治疗肥胖型子宫内膜癌的疗效、安全性对比分析及对机体炎症因子水平的影响[J]. 湖南师范大学学报: 医学版, 2017, 14(6): 168-171.
[3] Duffy MJ, Bonfrer JM, Kulpa J, et al. CA125 in ovarian cancer: European Group on Tumor Markers guidelines for clinical use[J]. Int J Gynecol Cancer, 2005, 15(5): 679-691.
[4] Manolov V, Marinov B, Vasilev V, et al. HE4--a new tumor marker for ovarian cancer[J]. Akusherstvo I Ginekologiia, 2011, 50(Suppl 2): 11-15.
[5] Weimann A, Braga M, Harsanyi L, et al. ESPEN Guidelines on Enteral Nutrition: Surgery including organ transplantation[J]. Clin Nutr, 2006, 25(2): 224-244.
[6] Takehiro S, Hideto I, Toshihiko M, et al. Low pre-operative levels of serum albumin predict lymph node metastases and ultimately correlate with a biochemical recurrence of prostate cancer in radical prostatectomy patients[J]. Eur Urol, 2013, 66(2): 126-132.
[7] Laky B, Janda M, Cleghorn G, et al. Comparison of different nutritional assessments and body-composition measurements in detecting malnutrition among gynecologic cancer patients[J]. Am J Clin Nutr, 2008, 87(6): 1678-1685.
[8] Olson SH, De VI, Setiawan VW, et al. Symposium on advances in endometrial cancer epidemiology and biology[J]. Gynecol Oncol, 2015, 138(3): 497-500.
[9] de Boer SM, Nout RA, Jürgenliemkschulz IM, et al. Long-term impact of endometrial cancer diagnosis and treatment on health-related quality of life and cancer survivorship: Results from the randomized PORTEC-2 Trial[J]. Int J Radiat Oncol, 2015, 93(4): 797-809.
[10] 李美艳. HE4、OPN及uPA检测对子宫内膜癌患者诊断的临床意义[J]. 国际肿瘤学杂志, 2017, 44(5): 351-355.
[11] 于江燕, 张一琼. HER2和BRCA1在子宫内膜癌中的表达及其与预后的关系[J]. 实用肿瘤杂志, 2016, 31(2): 145-149.
[12] 窦磊, 郭科军. 腹腔镜手术在早期子宫内膜癌治疗中的疗效观察[J]. 中国医科大学学报, 2016, 45(3): 241-245.
[13] Ascenzi P, Fasano M. Allostery in a monomeric protein: the case of human serum albumin[J]. Biophys Chem, 2010, 148(1/3): 16-22.
[14] 徐菁. 术前血清白蛋白水平对结直肠癌患者行根治性切除术后发病率和死亡率的预测价值[J]. 中国普外基础与临床杂志, 2016(12): 1529-1529.
[15] 周国超, 杨大刚. 低蛋白血症的研究进展[J]. 贵州医药, 2015, 39(3): 279-281.
[16] Patankar S, Burke WM, Hou JY, et al. Risk stratification and outcomes of women undergoing surgery for ovarian cancer[J]. Gynecol Oncol, 2015, 138(1): 62-69.
[17] Uppal S, Al-Niaimi A, Rice LW, et al. Preoperative hypoalbuminemia is an independent predictor of poor perioperative outcomes in women undergoing open surgery for gynecologic malignancies[J]. Gynecol Oncol, 2013, 131(2): 416-422.
[18] Seebacher V, Grimm C, Reinthaller A, et al. The value of serum albumin as a novel independent marker for prognosis in patients with endometrial cancer[J]. Eur J Obstet Gynecol Reprod Biol, 2013, 171(1): 101-106.