术前血清胆碱酯酶联合白蛋白评分对胃癌根治术后病人预后的预测价值

Predictive value of preoperative serum cholinesterase combined with albumin score for the prognosis of patients after radical resection for gastric cancer

目的探究术前血清胆碱酯酶(ChE)联合白蛋白(Alb)评分对胃癌根治术后病人远期预后评估的临床价值。方法回顾性分析2012年12月至2019年6月于烟台市莱阳中心医院行胃癌根治性手术治疗病人360例的临床病理资料及生存资料,应用ROC曲线计算术前ChE、白蛋白截断值,按高低值进行评分分组,分析比较各组间的临床病理特征及预后关系。结果术前ChE-Alb评分0、1、2分分组病人的年龄[(60.08±9.82)、(63.71±10.89)、(66.39±12.76)岁,F=9.31,P<0.001]、肿瘤长径(H=9.31,P<0.001)、肿瘤浸润深度(χ^(2)=32.22,P<0.001)、淋巴结转移数(χ^(2)=11.44,P=0.003)及术后pTNM分期(χ^(2)=18.69,P<0.001)均差异有统计学意义。生存分析结果显示:术前ChE-Alb不同评分分组病人的总生存(OS)率及中位生存时间之间差异有统计学意义(ChE-Alb评分0、1、2分分别对应生存率70.4%、56.3%、30.8%,P<0.001;对应中位生存时间为93.3个月、81.5个月、62.3个月,P<0.001)。多因素分析结果显示,高ChE-Alb评分是影响病人胃癌根治术后病人总生存期的独立危险因素。结论术前血清胆碱酯酶联合白蛋白评分有助于预测胃癌根治术后病人预后。

Objective To explore the clinical value of preoperative Serum cholinesterase(ChE)combined with Albumin(Alb)score in the long-term prognosis assessment of patients with gastric cancer after radical resection.Methods The clinicopathological data and survival information of 360 patients who underwent radical resection for gastric cancer at Laiyang Central Hospital in Yantai City from December 2012 to June 2019 were analyzed retrospectively.ROC curve was used to calculate preoperative ChE and Alb cutoff val⁃ues,and the scores were grouped according to the high and low values,and the clinicopathological characteristics and prognostic rela⁃tionship between the groups were analyzed and compared.Results There are significant differences in age[(60.08±9.82),(63.71±10.89),(66.39±12.76)year,F=9.31,P<0.001],tumor size(H=9.31,P<0.001),tumor invasion depth(χ^(2)=32.22,P<0.001),number of lymph node metastases(χ^(2)=11.44,P=0.003),and postoperative pTNM staging(χ^(2)=18.69,P<0.001)among patients with with preopera⁃tive ChE-Alb scores 0,1,and 2.The results of survival analysis showed that the difference between overall survival(OS)rate and medi⁃an survival time of preoperative ChE-Alb scores was significant(ChE-Alb score 0,1 and 2 correspond to survival rate 70.4%,56.3%,30.8%,P<0.001;the corresponding median survival time was 93.3 months,81.5 months,and 62.3 months,P<0.001).The results of multivariate analysis showed that high ChE-Alb score was an independent risk factor affecting OS of patients after radical resection for gastric cancer.Conclusion Preoperative Serum cholinesterase combined with Albumin score can help predict the prognosis of pa⁃tients after radical resection for gastric cancer.