术前血清淀粉样蛋白A水平对低位局部进展直肠癌手术方案选择的价值

Value of Preoperative Serum Amyloid A Protein Concentration in Choice of Surgical Treatment in Low Locally Advanced Rectal Cancer

目的探讨术前血清淀粉样蛋白A(SAA)水平对低位局部进展直肠癌(LLARC)手术方案选择的价值。方法回顾性分析于四川大学华西医院住院的52例LLARC患者的临床资料,根据手术方式的不同分为根治手术组(n=35)和姑息手术组(n=17)。所有患者术前采静脉血测定SAA水平。结果LLARC手术方案的选择与术前SAA水平有关(P=0.004),而与直肠癌病理学特征和术前影像学分期无关(P>0.05)。术前SAA水平升高(≥10.5 mg/L),显著增加了LLARC选择姑息手术治疗的风险(OR=7.47,95%CI:1.62～34.40,P=0.010)。结论高SAA水平是预测LLARC患者行姑息手术风险的有效指标,这对于指导外科手术决策和辅助治疗的制定具有临床价值。

Objective To investigate the relationship of serum amyloid A protein （SAA） and surgical choice in low locally advanced rectal cancer （LLARC）. Methods Fifty-two patients with LLARC at West China Hospital of Sichuan University were retrospectively analyzed. According to operative methods the patients were divided into 2 groups： curative surgery group （n= 35） and palliative surgery group （n= 17）. Then, venous blood specimens were taken to measure preoperative serum SAA level. Results The analysis showed the option of surgical procedures was associated with preoperative SAA concentration （P= 0. 004） in LLARC, but irrelative with pathological characteristics and preoperative imaginologic staging （P〉0.05）. High concentration of serum SAA （≥10.5 mg/L） significantly increased the odds of palliative surgery [OR：7.47, 95% CI （1.62--34.40）, P=0. 0103. Conclusion High level of SAA is a useful marker to predict the possibility of palliative surgery in LLARC, which is helpful to screen the patients for the surgical decision and adjuvant therapy.