血清纤维蛋白原及白蛋白/球蛋白比值水平与胃癌患者生存预后的关系

Relationship between serum fibrinogen and albumin/globulin ratio levels and survival prognosis of patients with gastric cancer

目的研究发现术前血清纤维蛋白原(FIB)及白蛋白/球蛋白比值(AGR)与恶性肿瘤的预后相关,目前关于血清FIB及AGR与胃癌患者生存预后的研究较少,本研究探讨术前血清FIB及AGR与胃癌患者生存预后的关系。方法共纳入2013年1月—2016年12月于蚌埠医学院第一附属医院行胃癌根治术的222例患者,回顾性研究胃癌患者术前血清FIB、AGR水平及临床病理特征。通过绘制ROC曲线获取FIB和AGR的最佳截断值,根据截断值将患者分为高FIB组和低FIB组、高AGR组和低AGR组。依次分析血清FIB、AGR分组与胃癌患者临床病理特征的关系,并使用Kaplan-Meier生存曲线进行生存分析,Cox比例风险模型研究影响胃癌患者预后的独立危险因素。结果FIB和AGR的最佳截断值分别为3.33 g/L和1.46。术前血清FIB与胃癌患者的体重指数、分化程度、肿瘤大小、T分期、N分期、TNM分期、CEA、CA19-9有关。术前血清AGR与胃癌患者的年龄、体重指数、分化程度、肿瘤大小、T分期、N分期、TNM分期、CEA、CA19-9有关。生存分析提示低FIB组的OS率和平均OS时间显著高于高FIB组(57.6%vs.14.4%,74.8个月vs.32.9个月,P<0.001)。高AGR组的OS率和平均OS时间也显著高于低AGR组(56.8%vs.18.6%,73.7个月vs.38.5个月,P<0.001)。多因素分析显示低分化程度、肿瘤大小(≥5 cm)、N分期、高FIB和低AGR是影响胃癌患者预后的独立危险因素。结论术前血清FIB及AGR可作为预测胃癌患者生存预后的重要的血液指标。

Objective Studies have found that preoperative serum fibrinogen(FIB)and albumin/globulin ratio(AGR)are correlated with the prognosis of malignant tumors.Currently,there are few studies on the relationship between serum FIB and AGR and the survival prognosis of patients with gastric cancer.This study explores the relationship between preoperative serum FIB and AGR and the survival prognosis of patients with gastric cancer.Methods A total of 222 patients who underwent radical gastritis in the First Affiliated Hospital of Bengbu Medical College from January 2013 to December 2016 were included.The preoperative serum FIB and AGR levels and clinic pathological characteristics of patients with gastric cancer were analyzed retrospectively.The optimal truncation values of FIB and AGR were obtained by drawing ROC curves.According to the truncation values,patients were divided into high FIB group and low FIB group,high AGR group and low AGR group.The relationship between serum FIB,AGR grouping and clinicopathological features of patients with gastric cancer was analyzed successively.Kaplan-Meier survival curve was used for survival analysis,and Cox proportional risk model was used to study independent risk factors affecting prognosis of patients with gastric cancer.Results The optimal truncation values of FIB and AGR were 3.33 g/L and 1.46,respectively.Preoperative serum FIB was correlated with body mass index,differentiation degree,tumor size,T stage,N stage,TNM stage,CEA and CA19-9.Preoperative serum AGR was correlated with age,body mass index,degree of differentiation,tumor size,T stage,N stage,TNM stage,CEA and CA19-9.Survival analysis suggested that the OS rate and mean OS time in the low FIB group were significantly higher than those in the high FIB group(57.6%vs.14.4%,74.8 months vs.32.9 months,P<0.001).The OS rate and mean OS time in the high AGR group were also significantly higher than those in the low AGR group(56.8%vs.18.6%,73.7 months vs.38.5 months,P<0.001).Multivariate analysis showed that low differentiation degree,tumor size(≥5 cm),N stage,high FIB and low AGR were independent risk factors affecting the prognosis of patients with gastric cancer.Conclusion Preoperative serum FIB and AGR can be used as important blood indexes to predict the survival and prognosis of patients with gastric cancer.