Clinical Burden of C-Reactive Protein/Albumin Ratio Before Curative Surgery for Patients with Gastric Cancer
Clinical Burden of C-Reactive Protein/Albumin Ratio Before Curative Surgery for Patients with Gastric Cancer
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DOI：
10.21873/anticanres.11248
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发表时间：
2016-12-01
影响因子：
2
通讯作者：
Kusunoki, Masato
中科院分区：
文献类型：
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作者：
Toiyama, Yuji;Shimura, Tadanobu;Kusunoki, Masato
为探讨C-反应蛋白/白蛋白比值(CAR)与胃癌疗效和手术部位感染(SSI)的关系，我们回顾分析了384例胃癌患者的CAR、SSI、无病生存期(DFS)、总生存期(OS)等因素。我们在42例患者中发现SSIS(10.9%)。病理T分期、肿瘤分期、体重指数、手术时间、出血量和术前CAR与SSI显著相关；在多因素分析中，CAR[风险比(HR)=2.98，p=0.003]和手术时间(HR=2.34，p=0.029)独立预测SSI。年龄、性别、T分期、N分期、肿瘤大小、血清癌胚抗原与高CAR相关，高CAR、高CEA、高CA19-9与较短的OS(p=0.0001)和DFS(p=0.0001)相关。多因素分析还显示高CAR与早期复发(HR=2.21，P=0.011)和预后不良(HR=1.82，P=0.038)有关。我们首次表明，据我们所知，在有治疗意图的GC患者中，高CAR预示SSI、早期复发和不良预后。
To assess the relationship of C-reactive protein/albumin ratio (CAR) to outcomes and surgical site infection (SSI) in gastric cancer (GC) treated with curative intent, we retrospectively assessed 384 patients with GC for CAR, SSIs, disease-free survival (DFS), overall survival (OS) and other factors. We found SSIs in 42 patients (10.9%). Pathological T-stage, TNM classification, body mass index, duration of surgery, blood loss and preoperative CAR were significantly associated with SSIs; in multivariate analyses, CAR [hazard ratio (HR)=2.98, p=0.003] and duration of surgery (HR=2.34, p=0.029) independently predicted SSI. Age, sex, T-and N-stages, tumor size and serum carcinoembryonic antigen (CEA) were associated with high CAR, and high CAR, CEA and CA19-9 combined was associated with shorter OS (p=0.0001) and DFS (p=0.0001). Multivariate analyses also linked high CAR to early recurrence (HR=2.21, p=0.011) and poor prognosis (HR=1.82, p=0.038). We show, for the first time to our knowledge, that a high CAR predicts SSI, early recurrence and poor prognosis in patients with GC treated with curative intent.