Preoperative transferrin level is a novel indicator of short- and long-term outcomes after esophageal cancer surgery
Preoperative transferrin level is a novel indicator of short- and long-term outcomes after esophageal cancer surgery
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DOI：
10.1007/s10147-021-02031-6
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发表时间：
2021-09
影响因子：
3.3
通讯作者：
Taishi Yamane;H. Sawayama;N. Yoshida;Takeshi Morinaga;T. Akiyama;K. Eto;K. Harada;K. Ogawa;M. Iwatsuki;S. Iwagami;Y. Baba;Y. Miyamoto;Hideo Baba
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作者：
Taishi Yamane;H. Sawayama;N. Yoshida;Takeshi Morinaga;T. Akiyama;K. Eto;K. Harada;K. Ogawa;M. Iwatsuki;S. Iwagami;Y. Baba;Y. Miyamoto;Hideo Baba
BackgroundThis study aims to examine whether preoperative serum transferrin，a rapid-turnover protein，correlates with short-and-long-term outcomes after esophageoprotectory.MethodsPreoperative transferrin levels，calculated by summing serum iron and unsaturated iron-binding capacity，were evaluated in 224 patients who carried esophageoprotectomy for stage I-III esophageal cancer without preoperative treatment.转铁蛋白水平与总铁结合力（TIBC）成正比，我们将TIBC < 250 μg/dL定义为低转铁蛋白。我们使用单变量和多变量考克斯比例风险analysis.ResultsOf所有患者，25（11.2%）术前转铁蛋白水平低，食管切除术后的短期和长期结果之间的关系进行了评估。术前低转铁蛋白水平与术前体能状态差、病理T分期高和开放性食管切除术多密切相关（分别为p= 0.0078、0.0001和0.013）。在单变量和多变量分析中，术前转铁蛋白水平低的患者发生术后肺炎的频率明显更高[风险比（HR）3.30，95%可信区间（CI）1.032- 10.033，p = 0.0443]。此外，在单变量和多变量分析中，这些患者与较差的总生存期（OS）显著相关（HR 2.75，95%CI 1.018- 7.426，p = 0.0460）。此外，我们研究了OS和术后肺炎之间的关系，以阐明为什么术前低转铁蛋白，这是术后肺炎的独立危险因素，导致预后不良。术后肺炎患者与较短的OS密切相关（p= 0.0099）。结论术前血清转铁蛋白水平可能是食管切除术后肺炎和OS的一个新指标。
BackgroundThis study aimed to examine whether preoperative serum transferrin, a rapid-turnover protein, correlates with short- and long-term outcomes after esophagectomy.MethodsPreoperative transferrin levels, calculated by summing serum iron and unsaturated iron-binding capacity, were evaluated in 224 patients who underwent esophagectomy for stage I–III esophageal cancer without preoperative treatment. Transferrin levels are directly proportional to total iron-binding capacity (TIBC), and we defined TIBC < 250 μg/dL as low transferrin. We evaluated the relationship between preoperative transferrin levels and short- and long-term outcomes after esophagectomy using univariate and multivariate Cox proportional hazards analyses.ResultsOf all patients, 25 (11.2%) had low preoperative transferrin levels. Low preoperative transferrin levels were strongly correlated with worse preoperative performance status, advanced pathological T stage, and more open esophagectomy (p= 0.0078, 0.0001, and 0.013, respectively). Patients with low preoperative transferrin levels experienced significantly more frequent postoperative pneumonia in univariate and multivariate analysis [hazard ratio (HR) 3.30, 95% confidence interval (CI) 1.032–10.033,p= 0.0443]. Additionally, these patients were significantly correlated with worse overall survival (OS) in univariate and multivariate analyses (HR 2.75, 95% CI 1.018–7.426,p= 0.0460). Furthermore, we investigated the relationship between OS and postoperative pneumonia to elucidate why low preoperative transferrin, which is an independent risk factor for postoperative pneumonia, leads to poor prognosis. Patients with postoperative pneumonia were strongly associated with a shorter OS (p= 0.0099).ConclusionPreoperative serum transferrin levels may be a novel indicator of postoperative pneumonia and OS after esophagectomy.