Carcinoembryonic antigen and albumin predict survival in, patients with advanced colon and rectal cancer
Carcinoembryonic antigen and albumin predict survival in, patients with advanced colon and rectal cancer
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DOI：
10.1001/archsurg.138.9.962
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发表时间：
2003-09-01
影响因子：
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通讯作者：
Stamos, MJ
中科院分区：
文献类型：
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作者：
Dixon, MR;Haukoos, JS;Stamos, MJ
假设：IV期结肠癌或直肠癌患者在初步诊断的特点，将预测随后的生存时间。设计：回顾性队列研究设置：城市县教学医院提供三级保健。患者：1991- 1999年期间因IV期结肠癌或直肠癌来研究机构的患者。主要结果测量：诊断后的生存时间（天）。结果：确定了105例患者，中位生存期为225天（四分位数，范围，72688天）。单因素分析确定癌胚抗原（CEA）和白蛋白（ALB）作为可能的生存预测因子。分类和回归树分析，一种二元递归分割的形式，用于确定CEA（275 ng/mL）和ALB（2.7 g/dL）水平的最佳临界点。根据切割点将患者分为以下几组：（1）低CEA、高ALB组，（2）低CEA、低ALB组，（3）高CEA、高ALB组，（4）低CEA、低ALB组，（5）高CEA、高ALB组，（6）低CEA、低ALB组，（7）低CEA、低ALB组，（8）高CEA、高ALB组。高CEA、低ALB组中位生存期为287天（四分位距，150-851天）和39天（四分位距，14-168天）。进行了Kaplan-Meier分析，发现所有分层之间存在统计学显着差异（P = .004）。此外，I组和4组的总生存率差异最大（P
Hypothesis: Patients with stage IV colon or rectal cancer at initial diagnosis have characteristics that will predict subsequent survival time.Design: Retrospective cohort studySetting: Urban county teaching hospital providing tertiary care. Patients: Patients who came to the study institution with stage IV colon or rectal cancer between 1991-1999.Main Outcome Measure: Survival duration (days) after diagnosis.Results: One hundred five patients were identified, with a median survival of 225 days (interquartile, range, 72688 days). Univariate analysis identified carcinoembryonic antigen (CEA) and albumin (ALB) as possible predictors for survival. Classification and regression tree analysis, a form of binary recursive partitioning, was used to identify optimal cut points for CEA (275 ng/mL) and ALB (2.7 g/dL) levels. Based on the cut points, patients were stratified into the following groups: (1) low CEA, high ALB; (2) low CEA, low ALB; (3) high CEA, high ALB; and (4) high CEA, low ALB. The median survival times for the first group and the fourth group were 287 days (interquartile range, 150-851 days) and 39 days (interquartile range, 14-168 days), respectively. A Kaplan-Meier analysis was performed, and a statistically significant difference was identified across all strata (P = .004). Additionally, groups I and 4 demonstrated the largest overall survival difference (P