术前纤维蛋白原与白蛋白比值联合全身炎症反应指数对可切除胃癌患者预后的评估价值

Prognostic value of preoperative fibrinogen to albumin ratio combined with systemic inflammation response index in patients with resectable gastric cancer

目的评估术前纤维蛋白原与白蛋白比值(FAR)联合全身炎症反应指数(SIRI)对可切除胃癌(rGC)患者预后的评估价值,分层探讨FAR-SIRI作为胃癌患者预后指标的作用价值。方法选择2014年1月至2016年12月在东南大学附属中大医院溧水分院行胃癌根治术治疗的rGC患者105例,术前计算FAR和SIRI,绘制受试者工作特征(ROC)曲线确定FAR、SIRI界值和分组,结合随访生存情况分析FAR-SIRI与rGC患者临床病理因素及预后的关系。结果FAR、SIRI预测界值分别为0.083、0.740。患者分为三组:FAR-SIRI 2分组29例(FAR≥0.08且SIRI≥0.74),FAR-SIRI 1分组14例(FAR<0.08,且SIRI≥0.74),FAR-SIRI 0分组62例(SIRI<0.74)。FAR-SIRI与性别、年龄、肿瘤直径、TNM分期、CEA水平及组织分化程度有关(均P<0.05)。Cox比例风险回归分析显示,年龄≥60岁(HR=1.957,95%CI:1.015~3.773,P=0.045)、TNM分期(P=0.047、0.003)、组织分化程度差(HR=0.363,95%CI:0.172~0.764,P=0.008)及FAR-SIRI 2分(HR=2.576,95%CI:1.313~5.051,P=0.006)是影响rGC患者预后的独立危险因素。结论FAR-SIRI可作为rGC患者预后的有效预测指标,指导个体化治疗,高FAR-SIRI提示患者预后不良。

Objective To investigate the prognostic value of preoperative fibrinogen to albumin ratio(FAR)combined with systemic inflammation resonance index(SIRI)in patients with resectable gastric cancer(rGC).Methods From January 2014 to December 2016,105 patients with rGC underwent radical gastrectomy were included,followed up to December 31,2019 or patient’s death.The cut-off values for FAR and SIRI were determined by ROC curve.The clinicopathological characteristics of three different groups were compared,and the prognostic factors of rGC patients were analyzed.Results According to the cut-off values of FAR and SIRI,patients were divided into three groups:FAR-SIRI 2 score group(FAR≥0.08,and SIRI≥0.74),FAR-SIRI 1 score group(FAR<0.08,and SIRI≥0.74),FAR-SIRI 0 score group(SIRI<0.74).FAR-SIRI was related to sex,age,tumor diameter,TNM stage,carcinoembryonic antigen and tissue differentiation(all P<0.05).Cox regression multivariate analysis showed that age≥60 years old(HR=1.957,95%CI:1.015-3.773,P=0.045),TNM stage(P=0.047,0.003),poor degree of tissue differentiation(HR=0.363,95%CI:0.172-0.764,P=0.008)and FAR-SIRI 2 score(HR=2.576,95%CI:1.313-5.051,P=0.006)were independent risk factors that affected the prognosis of rGC patients.Conclusions FAR-SIRI can be used as an effective predictor for prognosis in rGC patients,and can guide individualized treatment.High FAR-SIRI indicates that patients have a poor prognosis.