Cumulative Score Based on Preoperative Fibrinogen and Pre-albumin Could Predict Long-term Survival for Patients with Resectable Gastric Cancer
Cumulative Score Based on Preoperative Fibrinogen and Pre-albumin Could Predict Long-term Survival for Patients with Resectable Gastric Cancer
复制标题
基于术前纤维蛋白原和前白蛋白的累积评分可以预测可切除胃癌患者的长期生存率
DOI：
10.7150/jca.35157
复制
发表时间：
2019-01-01
影响因子：
3.9
通讯作者：
Ma, Tai
中科院分区：
文献类型：
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作者：
Wu, Zhi-jun;Xu, Hui;Ma, Tai
背景：探讨胃癌术前纤维蛋白原和前白蛋白(FP)积分(FP积分)对胃癌根治术后患者预后的影响。方法：回顾分析根治性胃切除患者的基线特征、术前纤维蛋白原和前白蛋白水平。纤维蛋白原和前白蛋白的最佳界值分别为4.0g/L和230.0 mg/L。纤维蛋白原升高(≥4.0g/L)和前白蛋白降低(<；230.0 mg/L)的患者FP评分为2，仅有这两种异常之一的患者得分为1，而两种异常均不存在的患者得分为0。对预后进行单因素和多因素回归分析。结果：术前FP评分与年龄、肿瘤大小、纤维蛋白原水平、前白蛋白水平及白细胞计数显著相关。两组间在性别、肿瘤部位、分化程度、侵袭深度、淋巴结状况、肿瘤转移(TNM)分期和辅助化疗方面均无显著差异。单因素生存分析显示，高术前FP评分与不良无病生存(DFS)[风险比(HR)1.482；95%可信区间(CI)1.222~1.796；P<；0.001]和总生存率(OS)(HR，1.623；95%CI，1.315~2.002；P<；0.001)显著相关。此外，在调整其他因素后，在多因素COX回归分析中，高术前FP评分仍然是DFS受损(HR，1.434；95%CI，1.177-1.747；P<；0.001)和OS(HR，1.413；95%CI，1.136-1.758；P=0.002)的独立预测因素。结论：术前FP评分可显著预测接受根治性胃切除术的胃癌患者的长期生存。
Background: To investigate the prognostic significance of the cumulative score based on preoperative fibrinogen and pre-albumin (FP score) in patients with gastric cancer after radical gastrectomy. Methods: Baseline characteristics, preoperative fibrinogen and pre-albumin levels were retrospectively reviewed in patients who underwent radical gastrectomy. The optimal cut-off values for fibrinogen and pre-albumin were defined as 4.0 g/L and 230.0 mg/L, respectively. Patients with elevated fibrinogen (≥ 4.0 g/L) and decreased pre-albumin (< 230.0 mg/L) levels were allocated an FP score of 2, those with only one of these two abnormalities were assigned a score of 1, and those with neither of the two abnormalities were allocated a score of 0. The prognostic value was examined by univariate and multivariate regression analyses. Results: The preoperative FP score was significantly correlated with age, tumor size, fibrinogen level, pre-albumin level and white blood cell count. No significant differences based on sex, tumor location, degree of differentiation, depth of invasion, lymph node status, tumor-node-metastasis (TNM) stage or adjuvant chemotherapy were identified between the groups. In addition, univariate survival analysis revealed that a high preoperative FP score was significantly associated with unfavorable disease-free survival (DFS) [hazard ratio (HR), 1.482; 95% confidence interval (CI), 1.222-1.796; P < 0.001] and overall survival (OS) (HR, 1.623; 95% CI, 1.315-2.002; P < 0.001). Moreover, after adjusting for other factors, a high preoperative FP score remained an independent predictor for impaired DFS (HR, 1.434; 95% CI, 1.177-1.747; P < 0.001) and OS (HR, 1.413; 95% CI, 1.136-1.758; P = 0.002) in multivariate Cox regression analysis. Conclusions: The preoperative FP score significantly predicts long-term survival for gastric cancer patients who have undergone radical gastrectomy.