癌胚抗原联合空腹血糖水平检测评估晚期胃癌预后的价值分析

目的:研究癌胚抗原（carcinoembryonic antigen，CEA）联合空腹血糖（fasting plasma glucose，FPG）水平检测在评估晚期胃癌预后中的应用价值。方法:回顾性分析我院接受化疗的300例晚期胃癌患者的临床资料。收集患者化疗前的人口学资料、血液学指标、病理及影像学资料，并对患者2年生存期进行随访。使用ROC曲线确定CEA、FPG最佳临界值。采用Kaplan－Meier分析法比较不同分组间患者的生存曲线情况。使用多元COX风险回归模型分析CEA、FPG与患者预后的相关性。结果:CEA、FPG评估胃癌预后的最佳临界值分别为5.865 mg/mL、6.845 mmol/L。Log－rank检验显示CEA、FPG与患者总生存期(overall survival，OS)显著相关（CEA组:P=0.000；FPG组:P=0.000）。低CEA-低FPG组2年存活率为67.9%，低CEA-高FPG组为16.9%，高CEA-低FPG组为26.4%，高CEA-高FPG组为6.9%，各组存活率差异具有统计学意义（P=0.00）。COX回归分析显示性别、TNM分期、分化程度、CEA水平、FPG水平、吸烟史、是否手术是影响患者预后的危险因素（HR=0.717、HR=0.162、HR=0.591、HR=1.006、HR=1.097、HR=0.421、HR=2.504，P＜0.05）。结论:联合检测CEA和FPG水平对评估晚期胃癌患者预后具有一定的临床价值。

The value of level detection of carcinoembryonic antigen combined with fasting plasma glucose for evaluating the prognosis of advanced gastric cancer

Objective:To study the value of combined level detection of carcinoembryonic antigen (CEA) and fasting plasma glucose (FPG) in evaluating the prognosis of advanced gastric cancer.Methods:The clinical data of 300 patients with advanced gastric cancer who received chemotherapy in our hospital were analyzed retrospectively.The demographic,hematological,pathological and imaging data were collected before chemotherapy,and the 2-year survival time was followed up.The best critical value of CEA and FPG was determined by ROC curve.The survival curves of patients in different groups were compared by Kaplan-Meier analysis.Multivariate COX risk regression model was used to analyze the correlation between CEA,FPG and prognosis.Results:The best critical values for evaluating the prognosis of gastric cancer in CEA and FPG were 5.865 mg/mL and 6.845 mmol/L.Log-rank test showed that there was a significant correlation between CEA,FPG and overall survival (OS)(CEA group:P=0.000.FPG group:P=0.000).The 2-year survival rate was 67.9% in the low CEA and low FPG group,16.9% in the low CEA and high FPG group,26.4% in the high CEA and low FPG group,and 6.9% in the high CEA and high FPG group.The difference in survival rate among groups was statistically significant （P=0.00）.COX regression analysis showed that gender,TNM stage,degree of differentiation,CEA level,FPG level,smoking history and operation were the risk factors affecting the prognosis of the patients (HR=0.717,HR=0.162,HR=0.591,HR=1.006,HR=1.097,HR=0.421,HR=2.504,P＜0.05).Conclusion:The combined level detection of CEA and FPG has a certain clinical value in evaluating the prognosis of advanced gastric cancer patients.