纤维蛋白原与前白蛋白比率及PGⅠ/PGⅡ预测胃癌患者长期预后价值

Prognostic value of fibrinogen prealbumin ratio combined with PGⅠ/PGⅡin gastric cancer patients

目的探究纤维蛋白原与前白蛋白比率(FPR)、胃蛋白酶原Ⅰ/Ⅱ(PGⅠ/PGⅡ)预测胃癌患者长期预后的价值。方法2017年6月至2020年6月苏州市中西医结合医院接诊的胃癌患者89例,收集并整理患者的人口学资料及病理资料,分别采用免疫浊度法和电化学发光法检测血浆FPR、血清PGⅠ/PGⅡ水平。随访24个月并根据预后结局分为死亡组和生存组。采用多因素Cox回归分析模型分析胃癌患者预后的影响因素,以受试者工作特征曲线下面积(AUC)评估血浆FPR、血清PGⅠ/PGⅡ水平对胃癌患者长期预后的预测效能。结果89例患者中死亡27例(30.34%),生存62例(69.66%)。死亡组肿瘤大小、血浆FPR水平及TNMⅢ期所占比例均高于生存组,血清PGⅠ/PGⅡ水平低于生存组(P<0.05)。Cox分析结果显示,肿瘤体积大、TNM分期Ⅲ期、血浆FPR水平升高及血清PGⅠ/PGⅡ水平降低均是胃癌患者预后死亡的危险因素(P<0.05)。ROC分析结果显示,血浆FPR、血清PGⅠ/PGⅡ水平单一及联合预测胃癌患者长期预后的AUC分别为0.737(95%CI:0.626~0.847)、0.751(95%CI:0.643~0.860)、0.834(95%CI:0.778~0.951)。结论血浆FPR、血清PGⅠ/PGⅡ可用于预测胃癌患者的长期预后,且预测效能良好。

Objective To explore the predictive value of fibrinogen prealbumin ratio(FPR)and pepsinogenⅠ/Ⅱ(PGⅠ/PGⅡ)for the long-term prognosis of gastric cancer patients.Methods The clinical data of 89 patients with gastric cancer who were treated in Suzhou Integrated Traditional Chinese and Western Medicine Hospital from June 2017 to June 2020 were analyzed retrospectively.Plasma FPR and serum PGⅠ/PGⅡlevels were detected by immunoturbidimetry and electrochemiluminescence respectively.The patients were followed up for 24 months and divided into death group and survival group according to the prognosis.Multivariate Cox regression analysis model was used to analyze the factors affecting the prognosis of gastric cancer patients.The predictive efficacy of plasma FPR and serum PGⅠ/PGⅡlevels on the long-term prognosis of gastric cancer patients were analyzed by the method of receiver operating characteristic(ROC)analysis.Results Twenty-seven(30.34%)patients died at the end of the observation period.The tumor size,plasma FPR level and the proportion of TNM phaseⅢin the death group were higher than those in the survival group,and the serum PGⅠ/PGⅡlevel was lower than those in the survival group(P<0.05).COX analysis showed that large tumor volume,TNM stageⅢ,increased plasma FPR level and decreased serum PGⅠ/PGⅡlevel were the risk factors for prognosis and death of gastric cancer patients(P<0.05).ROC analysis showed that the AUC for predicting the long-term prognosis of gastric cancer patients with single or combined plasma FPR and serum PGⅠ/PGⅡlevels were 0.737(95%CI:0.626-0.847),0.751(95%CI:0.643-0.860)and 0.834(95%CI:0.778-0.951),respectively.Conclusions Plasma FPR and serum PGⅠ/PGⅡcan be used to predict the long-term prognosis of gastric cancer patients with good effect.