Clinical Course of Vitamin B12 Deficiency and Associated Risk Factors in Patients After Total Gastrectomy for Gastric Cancer
Clinical Course of Vitamin B12 Deficiency and Associated Risk Factors in Patients After Total Gastrectomy for Gastric Cancer
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DOI：
10.21873/anticanres.16207
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发表时间：
2023-02-01
影响因子：
2
通讯作者：
Rino, Yasushi
中科院分区：
文献类型：
--
作者：
Aoyama, Toru;Hara, Kentaro;Rino, Yasushi
背景/目的：由于缺乏内在因素，全胃切除术后患者存在维生素B12缺乏的风险。本研究的目的是阐明胃癌患者全胃切除术后维生素B12缺乏的临床过程和危险因素。患者和方法：从横滨市立大学2000年至2020年的病历中选择了接受胃癌根治性切除术的患者。进行逻辑回归分析，以确定维生素B12缺乏的危险因素。结果：我们评估了47例患者。术前血清维生素B12水平中位数为359 pg/ml，而术后3、6、9和12个月分别为255 pg/ml、197.5 pg/ml、195 pg/ml和206 pg/ml。确定术后6个月维生素B12缺乏相关因素的单变量分析表明，术后并发症的发生是一个重要的风险因素（OR=6.347，95%CI=1.607-25.774，p=0.009），而辅助化疗是一个边缘显著的危险因素（OR=3.562，95%CI=0.877-14.477，p=0.076）。结论：近一半的胃癌患者在全胃切除术后6个月时被诊断为维生素B12缺乏。此外，术后并发症的发生和辅助化疗是术后6个月维生素B12缺乏的危险因素。
Background/Aim: Patients are at-risk for vitamin B12 deficiency after total gastrectomy due to a lack of intrinsic factors. The aim of the study was to clarify the clinical course and risk factors for vitamin B12 deficiency after total gastrectomy for gastric cancer patients. Patients and Methods: Patients who underwent curative resection for gastric cancer were selected from the medical records of the Yokohama City University from 2000 to 2020. A logistic regression analysis was performed to identify risk factors for vitamin B12 deficiency. Results: We evaluated 47 patients. The median serum vitamin B12 levels before surgery were 359 pg/ml, while those at 3, 6, 9, and 12 months after surgery these were 255 pg/ml, 197.5 pg/ml, 195 pg/ml, and 206 pg/ml, respectively. Univariate analyses to identify factors associated with vitamin B12 deficiency at 6 months after surgery showed that the occurrence of postoperative complications was a significant risk factor (OR=6.347, 95%CI=1.607-25.774, p=0.009), while adjuvant chemotherapy was a marginally significantly risk factor (OR=3.562, 95%CI=0.877-14.477, p=0.076). Conclusion: Almost half of the patients were diagnosed with vitamin B12 deficiency at 6 months after total gastrectomy for gastric cancer. In addition, the occurrence of postoperative complications and adjuvant chemotherapy were risk factors for vitamin B12 deficiency at 6 months after surgery.