术前LSR、D-Dime及MMP-9联合检测在胃癌根治术预后中的评估价值

The value of combined detection of preoperative LSR,D-Dime and MMP-9 in the prognosis of gastric cancer after radical gastrectomy

目的 分析术前丙氨酸转氨酶(ALT)与天冬氨酸转氨酶(AST)比值(LSR)、D-二聚体(D-D)及金属基质蛋白酶-9(MMP-9)联合检测在胃癌根治术预后中的评估价值。方法 选取2019年1月到2021年6月于河北省秦皇岛军工医院治疗的108例胃癌患者,比较治疗前后LSR、D-D及MMP-9水平,分析影响胃癌根治术患者预后的危险因素及LSR、D-D及MMP-9联合检测对胃癌根治术患者预后的临床诊断价值。结果 治疗后LSR、D-D、MMP-9水平均低于治疗前,差异均有统计学意义(P<0.05)。通过整理随访资料得知:预后不良26例,预后良好82例,两组临床分期、淋巴结转移、LSR、D-D、MMP-9比较差异有统计学意义(P<0.05)。经非条件多因素logistic回归模型分析得,临床分期、淋巴结转移、LSR、D-D、MMP-9水平为影响胃癌根治术患者预后的独立危险因素(P<0.05)。LSR、D-D、MMP-9单独检测以及三者联合检测AUC分别为0.779、0.786、0.765、0.877,其中以三者联合检测AUC值最大(P<0.05)。结论 LSR、D-D、MMP-9联合检测可有效诊断胃癌根治术预后,为临床提供参考。

Objective To analyze the combined detection of preoperative alanine aminotransferase(ALT)to aspartate aminotransferase(AST)ratio(LSR),D-dimer(D-D)and metalloproteinase-9(MMP-9)in the prognosis of radical gastrectomy for gastric cancer. Methods The clinical data of 108 patients with gastric cancer treated in our hospital from January 2019 to June 2021 were retrospectively analyzed. The levels of LSR,D-D and MMP-9 before and after treatment were compared,and the risk factors affecting the prognosis of patients with radical gastrectomy and the clinical diagnostic value of combined detection of LSR,D-D and MMP-9 for the prognosis of patients with radical gastrectomy were analyzed. Results The levels of LSR,D-D and MMP-9 after treatment were lower than those before treatment(P<0.05). According to the follow-up data,26 patients had a poor prognosis and 82 patients had a good prognosis. There were statistically significant differences in clinical stage,lymph node metastasis,LSR,D-D and MMP-9 between the two groups(P<0.05).Unconditional multivariate logistic regression model analysis showed that clinical stage,lymph node metastasis,LSR,D-D and MMP-9 levels were independent risk factors affecting the prognosis of patients with radical gastrectomy for gastric cancer(P<0.05). The AUCs of LSR,D-D,MMP-9 alone and the combined detection of the three were 0.779,0.786,0.765,and 0.877,respectively,and the AUC of the three combined detection was the highest(P<0.05). Conclusion The combined detection of LSR,D-D and MMP-9 can effectively diagnose the prognosis of gastric cancer after radical resection,and provide a reference for clinical practice.