胃癌患者蛋白尿的发生及其预后意义

The Incidence and Prognostic Significance of Proteinuria in Gastric Carcinoma

目的:探讨胃癌患者蛋白尿的流行病学意义及其对预后的影响。方法:回顾性分析我院具随诊资料的320例胃癌患者蛋白尿发生率及其与胃癌生物学行为、治疗、预后的关系。结果:胃癌患者蛋白尿的发生率为24.06%,明显高于对照组(P<0.01),胃癌晚期患者蛋白尿阳性率高于相对早期患者(P<0.01),有效的治疗措施可使蛋白尿减少(P<0.001),K aplan-M eier生存分析结果表明蛋白尿阳性与胃癌患者生存率显著相关(P<0.05),多因素分析结果表明TNM分期、淋巴结转移和蛋白尿阳性是影响胃癌患者生存率的独立预后因素(P<0.01)。结论:胃癌患者并发肿瘤相关性肾炎出现蛋白尿具有较高的发生率,可作为判断胃癌患者生存预后的有用指标。

Objective: To investigate the prognostic significance of proteinuria in patients with gastric carcinoma. Methods: The frequency of proteinuria in patients with gastric carcinoma and the relation with the biologic characteristic, treatment and survival were reviewed retrospectively. Results: Proteinuria was significantly more frequent in the patients with gastric carcinoma than that in controls (P<0.01) and the frequency of proteinuria was significantly correlated with advanced disease stage (P<0.01); in the treated patients, both pretreatment and posttreatment, the excretion of proteinuria are different significantly (P<0.001). Kaplan-Meier analysis revealed that the patients with gastric carcinoma and proteinuria had significantly poor survival than those with normal urinary protein excretion (P<0.05). By multivariate analysis, it was demonstrated that TNM stage, lymph node metastasis and proteinuria played important roles in survival. Conclusion: A high prevalence of increased urinary protein excretion in patients with malignance, proteinuria may be used as one of the markers of poor prognosis in patients with gastric carcinoma.