术前白蛋白-胆红素对胃癌术后生存预测价值

Predictive value of preoperative albumin-bilirubin for postoperative survival of gastric cancer

目的探讨术前白蛋白-胆红素(ALBI)分级在胃癌患者术后生存率中的预测价值。方法选取2020年3月至2022年3月镇江市第一人民医院胃癌根治术患者135例,根据ALBI分级将其分为ALBI 1级组98例、ALBI 2级组37例。比较两组临床病理特征,采用Kaplan-Meier法进行生存分析,比较不同ALBI分级的1年生存率差异,采用COX比例风险回归模型分析胃癌术后远期生存率的影响因素。结果ALBI 1级生存率高于ALBI 2级[89.80%(88/98)比70.27%(26/37),χ2=8.159,P<0.05]。ALBI分级[风险比(HR)=2.840]、分化程度(HR=1.728)、肿瘤分期(HR=1.764)、CEA水平(HR=1.586)、术后辅助化疗(HR=1.784)是影响胃癌根治术患者预后的独立影响因素(P<0.01)。结论术前ALBI分级用于评估胃癌根治术患者手术风险及预后结局较为可行,具有一定预测价值。

ObjectiveTo explore the predictive value of preoperative albumin-bilirubin(ALBI)grading in the postoperative survival rate of patients with gastric cancer.MethodsFrom March 2020 to March 2022,135 patients with gastric cancer undergoing radical gastrectomy in the First People’s Hospital of Zhenjiang City were selected.According to ALBI classification,98 patients were fallen into ALBI grade 1 group and 37 patients into ALBI grade 2 group.The clinicopathological features of the two groups were compared.Kaplan-Meier method was used for survival analysis.The 1-year survival rate of different ALBI grades was compared.COX proportional hazard regression model was used to analyze the influencing factors of long-term survival rate after gastric cancer surgery.ResultsThe survival rate of ALBI grade 1 was higher than that of ALBI grade 2[89.80%(88/98)vs.70.27%(26/37),χ2=8.159,P<0.05].The survival rate of ALBI grade 1 was 89.80%,higher than that of ALBI grade 2(70.27%,P<0.05).ALBI grade[hazard ratio(HR)=2.840],differentiation degree(HR=1.728),tumor stage(HR=1.764),CEA level(HR=1.586),and postoperative adjuvant chemotherapy(HR=1.784)were independent influencing factors for the prognosis of patients undergoing radical gastrectomy(P<0.01).ConclusionPreoperative ALBI grading is feasible to evaluate the surgical risk and prognosis of patients undergoing radical gastrectomy and has certain predictive value.