摘要
目的探讨术前及术后白蛋白与球蛋白比值(AGR)变化对结肠癌预后的评估价值。方法收集2011年6月至2013年6月于西南医科大学附属医院胃肠外科收治的215例结肠癌手术患者临床资料,分析患者术前和术后AGR与临床病理资料及生存预后的关系。结果术前AGR与结肠癌临床分期、侵犯深度、淋巴结转移显著相关,临床分期越晚、侵犯深度越深、有淋巴结转移的患者AGR值越低;而术后AGR与各临床病理特征无明显相关。根据术前AGR和术后AGR各自ROC曲线的最佳截点,将215例患者分别划分为术前高AGR组和术前低AGR组,术后高AGR组和术后低AGR组。术前低AGR组5年生存率低于术前高AGR组,术后低AGR组5年生存率亦低于术后高AGR组,差异均有统计学意义(P <0.05)。将术前、术后AGR联合分析,215例患者进一步被分为3个组,分别为术前和术后AGR均高组、术前或术后AGR高组、术前和术后AGR均低组。生存分析提示3组中术前AGR和术后AGR均低组的结肠癌患者生存率最低,术前AGR和术后AGR均高组的结肠癌患者生存率最高(P <0.05)。单因素及多因素分析显示,术前和术后低AGR是影响结肠癌预后的独立危险因素。结论联合检测术前AGR和术后AGR动态变化有助于判断结肠癌的预后,且术前AGR和术后AGR均低的结肠癌患者预后较差。
Objective Evaluation of whether dynamic alteration of the preand postoperative albumin-to-globulin ratio(AGR)predicts the prognosis of patients with colon cancer. Methods The clinicopathologic data of 215 colon cancer patients in Department of Gastrointestinal Surgery of Affiliated Hospital of Southwest Medical University from June 2011 to June 2013 were collected. The relationships between the preand postoperative AGR values of the patients with the clinicopathologic data and postoperative prognosis were analyzed. Results Preoperative AGR is significantly associated with clinical stage,depth of invasion,and lymph node metastasis. The tumor infiltration depth deeper,the later the clinical stage,the larger the tumor volume,and the lymph node metastasis and of the AGR value was significantly higher in patients. However,postoperative AGR had no significant correlation with the clinicopathologic data. According to the cut-off point of the respective ROC curves of pre- and postoperative AGR,215 patients were divided into preoperative high AGR group and preoperative low AGR group,postoperative high AGR group and postoperative low AGR group. The 5-year survival rate of the preoperative low AGR group was lower than that of the preoperative high AGR group,and the 5-year survival rate of the postoperative low AGR group was also lower than that of the postoperative high AGR group(P<0.05). Combined analysis of the pre- and postoperative AGR predicts the outcomes of patients with colon cancer,215 patients were further divided into three groups: preoperative and postoperative AGR high group, preoperative or postoperative AGR high group, preoperative and postoperative AGR low group. Survival analysis showed that the colon cancer patients with low preoperative AGR and low postoperative AGR had the lowest survival rate in the three groups,and the colon cancer patients with high preoperative AGR and postoperative AGR had the highest survival rate(P<0.05).Univariate analysis and multivariate analysis showed that pre? and postoperat
作者
李生平
周业江
LI Shengping;ZHOU Yejiang(Department of Gastrointestinal Surgery,Affiliated Hospital of Southwest Medical University,Luzhou 646000,China)
出处
《实用医学杂志》
CAS
北大核心
2019年第5期783-788,共6页
The Journal of Practical Medicine
关键词
结肠癌
白蛋白与球蛋白比值
生存分析
预后
colon cancer
albumin to globulin ratio
survival analysis
prognosis
