直肠癌术前血清白蛋白水平的预后意义

Prognostic Significance of Preoperative Serum Albumin Levels in Patients with Rectal Carcinoma

目的:观察直肠癌患者术前血清白蛋白水平的预后意义,并探讨其可能机制。方法:依据术前血清白蛋白水平,将2004年1月至2007年6月于哈尔滨医科大学附属第三医院接受直肠癌根治术的338例患者分为两组:A组,血清白蛋白≤35 g/L;B组,血清白蛋白>35 g/L,并对两组的临床病理特征进行统计学分析,以比较两组患者间的预后及临床病理特征差异。结果:统计结果显示血清白蛋白水平与肿瘤直径及浸润深度相关(P<0.05);A组直肠癌患者5年生存率显著低于B组患者(P<0.001);并且在多因素分析模型中,术前血清白蛋白水平是影响接受直肠癌根治术的患者术后生存期的独立预后因素(P<0.001)。结论:术前血清白蛋白水平是影响直肠癌根治术患者总生存期的重要指标。

Objective： The objectives of this study were to determine the relationship between the level of preoperative serum al- bumin in rectal carcinoma patients and their postoperative overall survival as well as discuss the probable underlying mechanism. Meth- ods： Based on their preoperative serum albumin levels, 338 rectal carcinoma patients who underwent radical surgery from 2004 to 2007 in the Third Affiliated Hospital of Harbin Medical University were included in this study. They were divided into two groups （group A： serum albumin, 435 g/L; group B： serum albumin, 〉35 g/L）, which we compared in univariate and multivariate statistical models. We then analyzed differences in their clinical pathological features and prognosis. Results： The statistical results showed that the level of se- rum albumin is correlated with the diameter and the depth of infiltration of the rectal carcinoma （P〈0.05）. The 5-year overall survival of the patients from group A was remarkably shorter than that of the patients from group B （P〈0.001）. According to the multivariate analy- sis, the level of preoperative serum albumin served as an independent prognostic factor in the patients who underwent radical resection of their rectal carcinoma （P〈0.001）. Conclusion： The level of preoperative serum albumin is an independent prognostic factor correlat- ed with the postoperative overall survival of rectal carcinoma patients.