胃癌患者术前血清丙氨酸氨基转移酶及天冬氨酸氨基转移酶比值与其预后的关联

Association of preoperative serum alanine aminotransferase and asparagine aminotransferase ratio and prognosis in patients with gastric cancer

目的探讨胃癌根治术患者术前血清丙氨酸氨基转移酶与天冬氨酸氨基转移酶比值(LSR)对其远期预后的影响。方法收集滁州市第一人民医院2014年1月-2018年12月收治的106例胃癌患者临床资料进行整理分析,根据患者术前LSR水平进行分组,分析患者术前LSR与临床病理因素之间的关系,并通过Cox回归分析胃癌患者术前LSR对其远期预后的影响。结果本次研究的106例胃癌患者术前LSR的最佳截点为1.48,其中LSR<1.48组患者81例,LSR≥1.48组患者25例。单因素分析结果表明吸烟、TNM分期较高以及存在联合脏器切除的胃癌患者LSR较高(均P<0.05)。共随访患者98例(92.45%),随访时间为22~86(中位数43)个月,5年生存率为39.80%。LSR<1.48组患者及LSR≥1.48组患者5年生存率分别为44.44%及12.00%,差异有统计学意义(P<0.05)。多因素Cox回归分析结果显示肿瘤大小、TNM分期及LSR为影响胃癌根治术患者预后的独立因素(均P<0.05)。结论胃癌患者术前LSR可能是预测其预后效果的独立因素,因此临床上对胃癌患者进行治疗时,可以通过恢复和提高患者肝功能状态来改善其预后状况及延长生存时间。

Objective To analyze the effect of preoperative serum alanine aminotransferase(ALT) and asparagine aminotransferase(AST) ratio(LSR) on long-term prognosis in patients with gastric cancer undergoing radical gastrectomy. Methods Clinical data of 106 patients with gastric cancer in our hospital from January 2014 to December 2018 were analyzed. Patients were divided into two groups according to the level of LSR. The relationship between preoperative LSR and clinic pathological factors were analyze. The influence of preoperative LSR on long-term prognosis of gastric cancer patients was analyzed by Cox regression. Results The best cut-off point of LSR in ROC curve was 1.48, and 81 cases in LSR<1.48 group, 25 cases in LSR ≥ 1.48 group. Single factor results showed that the LSR was higher in patients with smoking, higher TNM staging and combined visceral resection(all P<0.05). A total of 98 patients(92.45%) were followed up for 22-86(median 43) months, and the 5-year survival rate was 39.80%. The 5-year survival rate of patients with LSR<1.48 was 44.44%, and patients with LSR ≥ 1.48 was 12.0%, with statistically significant difference(P<0.05). Multivariate Cox regression analysis showed that tumor size, TNM staging and LSR were independent factors affecting the prognosis of patients with gastric cancer(all P<0.05). Conclusion Preoperative LSR may be an independent factor to predict the prognosis of patients with gastric cancer. Therefore, the prognosis and survival time of patients with gastric cancer can be improved by restoring and improving their liver function.