术前贫血、低蛋白及低体质量指数对进展期胃癌预后的影响

目的 探讨术前贫血、低蛋白及低体质量指数（BMI）对进展期胃癌预后的影响.方法 回顾性分析2006年1月至2008年1月有完整临床病理资料的317例进展期胃癌患者的临床资料.选择性别、年龄、肿瘤大小、Borrmann类型、血红蛋白、血清白蛋白、BMI、组织学类型、血管/淋巴管侵犯、浸润程度、淋巴结转移作为临床病理因素进行单因素及多因素分析.结果 单因素分析结果显示,肿瘤大小、Borrmann类型、血红蛋白、血清白蛋白、BMI、组织学类型、血管/淋巴管侵犯、浸润程度、淋巴结转移是影响进展期胃癌患者预后的危险因素（P＜0.01）.多因素分析结果显示血清白蛋白（OR=1.546,95％ CI：1.069～2.237）、浸润程度（OR=1.933,95％ CI：1.182～3.162）、淋巴结转移（OR=1.586,95％ CI：1.358～1.853）是影响进展期胃癌患者预后的独立危险因素.结论 术前贫血及低BMI与进展期胃癌预后密切相关,但不是独立危险因素,而术前低蛋白是影响进展期胃癌患者预后的独立危险因素.

The effect of preoperative anemia,low albumin,low body mass index in the prognosis of advanced gastric cancer

Objective To investigate the relationship between preoperative anemia,low albumin,low body mass index and the prognosis of advanced gastric cancer.Methods Three hundred and seventeen patients diagnosed with advanced gastric cancer as well as complete clinical pathology data from January 2006 to January 2008 were retrospectively analyzed.The clinical pathologic factors including age,gender,tumor size,type of Borrmann,hemoglobin,serum albumin,body mass index,type of histology,blood vessels and lymphatic invasion,infiltration depth,lymph nodes metastasis.The single factor and multiple factors were analyzed.Results Tumor size,type of Borrmann,hemoglobin,serum albumin,body mass index,type of histology,blood vessels and lymphatic invasion,infiltration depth and lymph node metastasis were identified as influencing factors of the prognosis,while independent factors associated with the prognosis of gastric cancer were serum albumin （OR =1.546,95％ CI：1.069-2.237）,infiltration depth （OR =1.933,95％ CI：1.182-3.162） and lymph nodes metastasis （OR =1.586,95％ CI：1.358-1.853）.Conclusion Anemia and low body mass index are the influence factors but not the independent factors in the prognosis of gastric cancer,while low albumin concentration is the independent factor in the prognosis of gastric cancer.