胃癌病人术前血清前白蛋白与临床病理特征及预后的关系

目的 探讨胃癌病人术前血清前白蛋白(PA)与临床病理特征及预后的关系.方法 回顾性分析230例胃癌病人的临床病理及随访资料.通过χ2检验比较低PA组与正常组胃癌病人的临床病理特征的差异;Kaplan-Meier生存曲线计算胃癌病人5年生存率,通过Log-rank检验比较不同水平PA病人5年生存率的差异,并采用Cox回归模型分析影响胃癌病人预后的因素.结果 PA与胃癌病人的性别、肿瘤部位及分化程度的相关性差异无统计学意义(P>0.05);而与病人的年龄、癌灶的直径及TNM分期的相关性差异有统计学意义(P<0.05).生存分析显示低PA组的胃癌病人5年累积生存率显著低于正常组(P<0.05).单因素分析结果表明,术前PA、肿瘤大小、肿瘤分化程度和TNM分期与胃癌病人总生存率有关(P<0.05),多因素分析显示术前低PA、分化程度及肿瘤TNM分期是病人预后的独立危险因素.结论 术前PA是胃癌病人预后独立影响因素，低水平PA的胃癌病人的生存期较正常病人显著缩短.

The relationship between the level of preoperative serum prealbumin and clinicopathological features and prognosis in patients with gastric cancerPENG Wenxuan,XU Aman,CHEN Zhangming,HAN Wenxiu,WEI Zhijian (Department of General Surgery,The First Affiliated Hospital of Anhui Medical University, Hefei,Anhui 230022,China) Abstract:Objective

Objective To investigate the relations between preoperative prealbumin (PA) and clinicopathologic characteristics and prognosis of patients with gastric cancer.Methods The clinicopathologic and follow-up data of 230 patients with gastric cancer were retrospectively analyzed.The differences of clinical and pathological features of patients with gastric cancer between low prealbumin group and normal group was compared by chi-square test.Through the Kaplan-Meier curve to calculate the 5 years survival rate of patients with different levels of PA.The difference of 5-year survival rates between the two groups were compared by Log-rank test.And the Cox regression model was used to analyze the independent risk factors affecting the prognosis of gastric cancer patients.Results The results showed that there was no significant difference in the correlation between sex,tumor location ,degree of tumor differentiation and PA(P>0.05),but compared with normal PA group,low PA group has tumor diameter was larger,age of gastric cancer patients was elder,and TNM stage was higher (P<0.05).The results of survival analysis showed that the overall survival rate in low PA group was significantly lower than that in normal PA group (P<0.01).Univariate analysis indicated that the overall survival of gastric cancer patients was significantly associated with preoperative PA,tumor size,the degree of tumor differentiation and TNM stage (P<0.05).Multivariate analysis identified that low PA ,the degree of tumor differentiation,TNM stage were independent risk factors for the prognosis of gastric cancer patients(P<0.05).Conclusion Preoperative PA is an independent prognostic factor for gastric cancer patients,and low preoperative PA may associated with unfavorable clinicopathologic conditions and poor prognosis.