基于术前外周血中AFR对胃癌患者预后的价值研究

Based on the Value of AFR in Preoperative Peripheral Blood on the Prognosis of Gastric Cancer Patients

摘要: 目的：通过探究术前外周血中白蛋白与纤维蛋白原比值(AFR)对术后胃癌患者预后的价值。方法：收集在我院胃肠外科就诊并行根治手术的152例胃癌患者的临床病例资料及病理特征，采用受试者工作曲线(ROC)检测AFR的预测价值，根据AFR值分为高AFR组(n = 89)和低AFR组(n = 63)，比较两组间的临床资料及病理特征，采用Kaplan-Meier生存分析比较两组总生存率，采用COX单因素及多因素分析预后影响因素。结果：AFR的曲线下的面积为0.753，(P < 0.001)具有较好的预测胃癌患者的预后。高AFR组与低AFR组相比，在患者的年龄、术前贫血、结局、肿瘤大小、脉管侵犯、分化程度、病理分期、浸润深度、淋巴结转移差异有统计学意义(P < 0.05)。术前高AFR组相比于低AFR组预后较好(P < 0.001)。COX单因素结果显示：AFR、年龄、术前贫血、术后化疗、CEA、CA199、肿瘤大小、脉管侵犯、分化程度、pTNM、神经侵犯、浸润深度、淋巴结转移与患者的预后相关(P < 0.05)。多因素结果显示：AFR、脉管侵犯、pTNM是独立影响胃癌患者预后的危险因素(P < 0.05)。结论：术前外周血中AFR对胃癌患者的预后具有一定的预测价值。

Abstract: Objective: The value of albumin-to-fibrinogen ratio (AFR) in peripheral blood before surgery on the prognosis of postoperative gastric cancer patients was explored. Methods: The clinical case data and pathological characteristics of 152 gastric cancer patients who underwent radical surgery in the Department of Gastrointestinal Surgery in our hospital were collected, and the predictive value of AFR was detected by receiver operating curve (ROC), and the patients were divided into high AFR group (n = 89) and low AFR group (n = 63) according to the AFR value, and the clinical data and pathological characteristics between the two groups were compared, the overall survival rate of the two groups was compared by Kaplan-Meier survival analysis, and COX was used to analyze the prognostic influencing factors by univariate and multivariate. Results: The area under the curve of AFR was 0.753, (P < 0.001), which had a better predictive prognosis for gastric cancer patients. Compared with the low AFR group, there were significant differences in age, preoperative anemia, outcomes, tumor size, vascular invasion, degree of differentiation, pathological stage, depth of invasion, and lymph node metastasis in the high AFR group (P < 0.05). The prognosis of the high AFR group was better than that of the low AFR group (P < 0.001). COX univariate results showed that AFR, age, preoperative anemia, postoperative chemotherapy, CEA, CA199, tumor size, vascular invasion, degree of differentiation, pTNM, nerve invasion, depth of invasion, and lymph node metastasis were associated with the prognosis of patients (P < 0.05). Multivariate results showed that AFR, vascular invasion, and pTNM were risk factors that independently affected the prognosis of gastric cancer patients (P < 0.05). Conclusion: AFR in preoperative peripheral blood has certain predictive value for the prognosis of gastric cancer patients.