术前CRP/ALB、GPS与炎症相关指标在胃癌预后中的价值

Correlation and Prognostic Importance of Preoperative CRP/ALB Ratio, GPS, Inflammationrelated Indicators for Patients With Gastric Cancer

目的探究术前CRP/ALB比值(CRP/ALB ratio,CAR)、格拉斯哥预后评分(Glasgow prognosis score,GPS)、炎症相关指标与胃癌患者预后的相关性及价值。方法选取2012年11月—2019年11月苏州大学附属第一医院收治的502例胃癌患者。根据临床资料进行统计分析,研究CRP/ALB、GPS与临床病理特征的关系,采用Kaplan-Meier和Cox回归分析评估这两个因素与总生存率(OS)相关性。利用ROC曲线下面积(area under curve,AUC)比较生物标志物的预测效能。结果 (1)与较低CAR组、GPS0、GPS1组相比,较高CAR组及GPS2总生存期均较短;CRP/ALB(HR=1.579,95%CI为1.248-1.996,P <0.01),GPS(HR=1.28,95%CI为1.037-1.579,P=0.022)均是与OS相关的独立预后标志。(2)CRP/ALB(AUC=0.734,P <0.01)较GPS(AUC=0.609,P <0.01)AUC面积更大,提示CRP/ALB对胃癌患者生存的预测能力更好。结论胃癌术前CAR、GPS水平均为胃癌生存率独立危险因素。CAR预测能力优于其他炎症生物标志物。

Objective To investigate preoperative creative protein(CRP)/albumin(CAR), Glasgow prognostic score(GPS), inflammation-related indicators in the prognosis of gastric cancer patients. Methods 502 patients with gastric cancer admitted to the first affiliated hospital of soochow university from November 2012 to November 2019 were selected. Statistical analysis was conducted based on clinical data to study the relationship between CRP/ALB, GPS and clinicopathological features, and kaplan-meier and Cox regression analysis was used to evaluate the correlation between these two factors and overall survival(OS). The predictive efficacy of biomarkers was compared by area under curve(AUC). Results(1) Compared with lower car group, gps0 group and gps1 group, the overall survival time of higher car group and gps2 group was shorter;CRP/ALB(HR=1.579, 95%CI 1.248-1.996, P<0.01) and GPS(HR=1.28, 95%CI 1.037-1.579, P=0.022) were independent prognostic markers associated with OS.(2) The AUC area of CRP/ALB(AUC=0.734, P<0.01) was larger than that of GPS(AUC=0.609, P<0.01), suggesting that CRP/ALB has a better ability to predict the survival of patients with gastric cancer. Conclusion CAR and GPS are independent risk factors for gastric cancer,and their predictive power is better than other inflammatory biomarkers.