术前血浆纤维蛋白原与前白蛋白比值对结直肠癌术后复发的预测价值

Predictive Value of Preoperative Plasma Fibrinogen to Prealbumin Ratio for Postoperative Recurrence in Patients with Colorectal Cancer

目的探讨术前血浆纤维蛋白原(Fib)与血浆前白蛋白(PAB)比值(FPR)对结直肠癌患者术后复发的预测价值,以期为临床预防术后复发提供理论参考。方法采用前瞻性研究,选取河南神火集团总医院2020年1月至2022年1月160例拟接受腹腔镜根治术治疗的结直肠癌患者作为研究对象,检测患者术前Fib、PAB水平,计算FPR,记录一般资料。根据术后1 a内是否复发将患者分为复发组与未复发组,比较两组患者Fib、PAB、FPR及一般资料;采用Cox回归分析检验影响结直肠癌患者术后复发的相关因素,并绘制受试者工作特征(ROC)曲线探讨术前Fib、PAB及FPR对结直肠癌患者术后复发的预测价值。结果160例患者中复发40例,复发率为25.00%。复发组与未复发组患者在Fib、PAB、FPR方面比较,差异有统计学意义(P<0.05)。构建Cox回归模型,结果显示血浆Fib和FPR升高、血浆PAB降低是影响患者术后复发的影响因素(P<0.05)。绘制ROC曲线发现,血浆Fib、PAB对结直肠癌患者术后复发预测价值较低,曲线下面积(AUC)分别为0.630、0.619,而FPR具有中等预测价值,AUC为0.744。结论结直肠癌患者术后具有较高的复发风险,且受到血浆Fib、PAB、FPR影响,其中FPR对患者术后复发具有中等预测价值。

Objective To explore the predictive value of preoperative plasma fibrinogen(Fib)to plasma prealbumin(PAB)ratio(FPR)for postoperative recurrence in colorectal cancer patients,in order to provide theoretical reference for clinical prevention of postoperative recurrence.Methods A prospective cohort study was conducted to select 160 colorectal cancer patients who planned to undergo laparoscopic radical surgery in Henan Shenhuo Group General Hospital from January 2020 to January 2022 as the study subjects.The preoperative Fib and PAB levels of patients were measured,FPR was calculated,and general data were recorded.The patients were divided into recurrence group and non-recurrence group according to whether they relapsed within 1 year after operation.The Fib,PAB,FPR and general data were compared between the two groups.Cox regression analysis was used to examine the relevant factors affecting postoperative recurrence in colorectal cancer patients,and receiver operator characteristic(ROC)curve was drawn to explore the predictive value of preoperative Fib,PAB,and FPR for postoperative recurrence in colorectal cancer patients.Results Among the 160 patients,40 recurred,with a recurrence rate of 25.00%.There was a statistical significant difference in Fib,PAB,and FPR between the recurrence group and the non-recurrence group(P<0.05).The Cox regression model showed that the increase of plasma Fib and FPR and the decrease of plasma PAB were the influencing factors of postoperative recurrence(P<0.05).ROC curve analysis showed that plasma Fib and PAB had low predictive value for postoperative recurrence in patients with colorectal cancer,with area under the curve(AUC)of 0.630 and 0.619,respectively,while FPR had moderate predictive value,with AUC of 0.744.Conclusion Colorectal cancer patients have a high risk of recurrence after surgery and are influenced by plasma Fib,PAB and FPR.FPR has moderate predictive value for postoperative recurrence in patients.