血浆纤维蛋白原水平及清蛋白/球蛋白比值与直肠癌患者预后的关系

Plasma fibrinogen level and albumin/globulin ratio with prognosis of rectal cancer

目的探讨血浆纤维蛋白原(Fg)水平和清蛋白与球蛋白比值(A/G)对直肠癌患者生存预后的影响。方法选取80例直肠癌患者作为直肠癌组,选取80例同期健康体检者作为正常组。比较两组受试者Fg、A/G的表达情况及不同临床特征直肠癌患者的生存情况,并分析直肠癌患者预后的影响因素。结果直肠癌组中Fg的高表达率、A/G的低表达率均明显高于正常组,差异均有统计学意义(P﹤0.01)。80例直肠癌患者的5年总生存率为77.5%(62/80)。单因素分析结果显示,TNM分期为Ⅰ~Ⅱ期、无淋巴结转移、Fg≤4.0 g/L、A/G﹥1.5的直肠癌患者的术后5年平均生存时间均长于TNM分期为Ⅲ~Ⅳ期、有淋巴结转移、Fg﹥4.0 g/L、A/G≤1.5的患者(P﹤0.05);多因素分析结果显示,TNM分期为Ⅲ~Ⅳ期、有淋巴结转移、Fg﹥4.0 g/L、A/G≤1.5均是直肠癌患者预后的独立危险因素(P﹤0.05)。TNM分期为Ⅰ~Ⅱ期、无淋巴结转移、Fg≤4.0 g/L、A/G﹥1.5的直肠癌患者的生存结局均优于TNM分期为Ⅲ~Ⅳ期、有淋巴结转移、Fg﹥4.0 g/L、A/G≤1.5的直肠癌患者(P﹤0.05)。结论Fg高水平、A/G低、TNM分期为Ⅲ~Ⅳ期、有淋巴结转移均是直肠癌患者预后的独立危险因素,Fg≤4.0 g/L、A/G﹥1.5的直肠癌患者的生存结局相对较优。

Objective To investigate the effect of plasma fibrinogen(Fg)level and albumin/globulin(A/G)ratio on survival prognosis of rectal cancer patients.Method Eighty cases of patients with rectal cancer and 80 healthy participants were selected into the rectal cancer group and normal group respectively.The expression of Fg and A/G in the two groups and survival of rectal cancer patients with different clinical characteristics were compared;the factors influencing prognosis of rectal cancer patients were analyzed.Result The high expression of Fg and low expression of A/G in rectal cancer group were significantly higher than those in normal group(P<0.01).5-year overall survival rate of 80 rectal cancer patients was 77.5%(62/80).Univariate analysis showed that 5-year mean survival time of patients with TNM stage III,no lymph node metastasis,Fg≤4.0 g/L and A/G>1.5 was longer than those with TNM stage III-IV,lymph node metastasis,Fg>4.0 g/L and A/G≤1.5(P<0.05).Multivariate analysis showed that TNM stage III-IV,lymph node metastasis,Fg>4.0 g/L and A/G≤1.5 were independent risk factors influencing prognosis of rectal cancer patients(P<0.05).The survival outcome of rectal cancer patients with TNM stage I-II,no lymph node metastasis,Fg≤4.0 g/L and A/G>1.5 were better than those with TNM stage III-IV,lymph node metastasis,Fg>4.0 g/L and A/G≤1.5(P<0.05).Conclusion High expression of Fg,low expression of A/G,TNM stage III-IV and lymph node metastasis are the independent risk factors influencing prognosis of patients with rectal cancer,in which the survival outcome of patients with Fg≤4.0 g/L and A/G>1.5 is comparatively superior.