术前血清ALT/AST值对早期胃癌患者术后复发的预测价值

Predictive Value of Preoperative Serum ALT/AST Ratio for Postoperative Recurrence of Early Gastric Cancer

【目的】探讨术前血清丙氨酸氨基转移酶(ALT)/天冬氨酸氨基转移酶(AST)值(LSR)对早期胃癌患者术后复发的预测价值。【方法】选取本院收治的165例拟行胃癌根治术患者,术前均检测LSR水平。随访6~24个月,失访7例。根据预后情况将158例患者分为复发组(n=25)和未复发组(n=133)。比较两组患者术前LSR水平及相关的临床资料,以Logistic回归分析早期胃癌患者术后复发的危险因素,以受试者工作特征(ROC)曲线下面积(AUC)判定术前血清LSR水平对早期胃癌患者术后预后复发的预测价值。【结果】复发组TNM分期为Ⅲ期、淋巴脉管侵袭例数占比、肿瘤直径及术前NLR、LSR水平均高于未复发组(P<0.05);Logistic多因素分析结果显示,淋巴脉管侵袭、TNM分期为Ⅲ期、术前LSR均为早期胃癌患者术后复发的危险因素(P<0.05);ROC曲线结果显示,术前LSR预测早期胃癌患者复发的AUC值为0.783(P<0.05)。【结论】术前检测LSR对早期胃癌患者术后复发具有一定的预测价值,值得临床推广使用。

【Objective】To investigate the predictive value of preoperative serum alanine aminotransferase(ALT)/aspartate aminotransferase(AST)ratio(LSR)for postoperative recurrence of early gastric cancer.【Methods】LSR levels were detected in 165 patients who were scheduled to undergo radical gastrectomy.Follow up ranged from 6 to 24 months,and 7 cases were lost.According to the prognosis,158 patients were divided into relapse group(n=25)and non relapse group(n=133).The preoperative LSR level and related clinical data of the two groups of patients were compared.Logistic regression analysis was used to analyze the risk factors of postoperative recurrence of early gastric cancer patients.The receiver operating characteristic(ROC)curve was drawn,and the area under the ROC curve(AUC)was used to determine the predictive value of preoperative serum LSR level for postoperative recurrence in patients with early gastric cancer.【Results】The TNM stage,the proportion of lymphatic vessel invasion,tumor diameter and preoperative NLR,LSR level in the recurrent group were higher than those in the non recurrent group(P<0.05);Logistic multivariate analysis showed that lymphatic vessel invasion,TNM stageⅢand preoperative LSR were risk factors for postoperative recurrence of early gastric cancer(P<0.05);ROC curve showed that the AUC value of LSR predicting recurrence of early gastric cancer patients was 0.783(P<0.05).【Conclusion】The preoperative detection of LSR has a certain predictive value for postoperative recurrence of early gastric cancer patients,and is worthy of clinical application.