血清载脂蛋白A-Ⅰ水平在远端胃癌D2根治术预后中的意义分析

Significance of serum apolipoprotein A-Ⅰin prognosis of distal gastric cancer after D2 radical gastrectomy

目的探讨术前血清载脂蛋白A-Ⅰ(ApoA-Ⅰ)在远端胃癌D2根治术预后评估中的价值。方法检测行远端胃癌D2根治术的87例胃癌患者的血清ApoA-Ⅰ水平,根据中位值(1.14 g/L)将患者分为低ApoA-Ⅰ组(n=44)和高ApoA-Ⅰ组(n=43),分析比较两组患者病理特征及术后恢复情况的差异,分别采用Kaplan-Meier法、单因素及多因素Cox回归分析ApoA-Ⅰ水平与远端胃癌D2根治术患者术后生存期的关系。结果高ApoA-Ⅰ组和低ApoA-Ⅰ组在TNM分期上差异有统计学意义(P<0.05);高ApoA-Ⅰ组术后并发症发生率低于低ApoA-Ⅰ组(P<0.05),术后总生存期高于低ApoA-Ⅰ组(P<0.05);ApoA-Ⅰ是患者术后总生存期的独立保护因素(P<0.05)。结论血清ApoA-Ⅰ水平可能是远端胃癌D2根治术患者预后的保护因素之一。

【Objective】To study the significance of preoperative serum apolipoprotein A-Ⅰ(ApoA-Ⅰ)on prognosis assessment of distal gastric cancer after D2 radical value.【Methods】The serum ApoA-Ⅰlevels of 87 distal gastric cancer patients who underwent D2 radical operation were detected,and the patients were divided into the low ApoA-Ⅰgroups(n=44)and high ApoA-Ⅰgroup(n=43)according to the median(1.14 g/L),the pathological characteristics and postoperative recovery were compared between the two groups,Kaplan-Meier method,single factor and multiple factors COX regression were used to analyze the correlation of ApoA-Ⅰand postoperative survival in patients with distal gastric cancer after D2 radical operation.【Results】High ApoA-Ⅰgroup and low ApoA-Ⅰgroup had statistically differences in TNM stage(P<0.05).The incidence of postoperative complications in high ApoA-Ⅰgroup was lower than that in low ApoA-Ⅰgroup(P<0.05),the overall survival after surgery in high ApoA-Ⅰgroup was higher than that in ApoA-Ⅰgroup(P<0.05).ApoA-Ⅰwas an independent protective factors of overall survival of distal gastric cancer patients after D2 radical operation(P<0.05).【Conclusion】The level of serum ApoA-Ⅰmay be one of the the protective factors for the prognosis of distal gastric cancer patients after D2 radical operation.