摘要
目的探讨术前晚期肺癌炎症指数(ALI)与结直肠癌患者预后之间的相关性。方法回顾性分析2012-02-01—2016-12-31在徐州医科大学附属医院接受手术治疗的309例结直肠癌患者临床资料,包括人口学、术前血液学、组织病理学和生存信息。依据ALI最佳截断值将患者分为高ALI组(130例)和低ALI组(179例)。ROC曲线确定ALI的最佳截断值,采用Kaplan-Meier法构建生存曲线,Log-rank检验比较2组患者总生存期(OS)。Cox回归分析研究结直肠癌患者预后影响因素。结果ALI的最佳截断值为25.71。单因素分析表明,ALI、T分期、N分期、分化程度、神经浸润、脉管侵犯、肿瘤大小、术前癌胚抗原(CEA)和远处转移与OS相关,χ^(2)值分别为37.171、39.458、85.041、43.358、59.435、55.496、9.150、15.440和84.201,均P<0.050。多因素分析表明,低ALI(HR=2.620,95%CI为1.874~3.663,P<0.001)、T分期(HR=1.778,95%CI为1.168~2.706,P=0.007)、N分期(N;与N;:HR=2.291,95%CI为1.545~3.399,P<0.001;N;与N;:HR=2.453,95%CI为1.452~4.145,P<0.001)、分化程度(中分化与低分化HR=0.713,95%CI为0.505~1.006,P=0.054;高分化与低分化HR=0.389,95%CI为0.192~0.788,P=0.009)和远处转移(HR=1.985,95%CI为1.351~2.917,P<0.001)是患者OS的独立危险因素。术前低ALI组和高ALI组患者的中位OS分别为40和89个月,差异有统计学意义,χ^(2)=38.234,P<0.001。结论术前低ALI是结直肠癌患者不良预后的独立危险因素,术前ALI可作为结直肠癌患者新的预后评估指标。
Objective To evaluate the relationship between the preoperative advanced lung cancer inflammation index(ALI)and the prognosis of patients with colorectal cancer.Methods A total of 309colorectal cancer patients’information who underwent surgery in the Affiliated Hospital of Xuzhou Medical University between February 1,2012to December 31,2016were retrospectively analyzed.Demographics,preoperative hematology,histopathology and survival information were collected.According to the best cut-off value of ALI,patients were divided into high ALI group(130cases)and low ALI group(179cases).ROC curve was used to determine the best cut-off value of ALI.Kaplan-Meier method was used to construct the survival curve,and log-rank test was used to compare the difference of overall survival(OS)between the two groups.COX regression analysis was applied to study the factors affecting the prognosis of patients with colorectal cancer.Results The best cut-off value of ALI was 25.71.Univariate analysis showed that the ALI,T stage,N stage,degree of differentiation,nerve invasion,vascular invasion,tumor size,preoperative carcinoembryonic antigen(CEA),and distant metastasis were associated with OS,(χ^(2)values were 37.171,39.458,85.041,43.358,59.435,55.496,9.150,15.440and 84.201,all P<0.05).Multivariate analysis showed that low ALI(HR=2.620,95%CI:1.874—3.663,P<0.001),T stage(HR=1.778,95%CI:1.168—2.706,P=0.007),N stage(N;and N;,HR=2.291,95%CI:1.545—3.399,P<0.001,N;and N;,HR=2.453,95%CI:1.452—4.145,P<0.001),degree of differentiation(moderately differentiated and poorly differentiated,HR=0.713,95%CI:0.505—1.006,P=0.054,highly differentiated and poorly differentiated HR=20.389,95%CI:0.192—0.788,P=0.009)and distant metastasis(HR=1.985,95%CI:1.351—2.917,P<0.001)were independent risk factors for OS.The median OS of patients in the low ALI group and the high ALI group was 40months and 89months,and the difference was statistically significant(χ^(2)=38.234,P<0.001).Conclusion Low preoperative ALI is an independent risk factor for poor prognosis of colorectal cancer patients,and preoperative ALI can be used as a new prognostic indicator for patients with colorectal cancer.
作者
陈成
毛帅
李猛
徐维
朱正秋
CHEN Cheng;MAO Shuai;LI Meng;XU Wei;ZHU Zheng-qiu(Department of Oncology,First People's Hospital of Lianyungang,Lianyungang 222000,China;Graduate School of Xuzhou Medical University,Xuzhou 221000,China;Department of Oncology,Affiliated Hospital of Xuzhou Medical University,Xuzhou 221003,China)
出处
《中华肿瘤防治杂志》
CAS
北大核心
2022年第4期285-289,共5页
Chinese Journal of Cancer Prevention and Treatment
关键词
结直肠癌
晚期肺癌炎症指数
炎症
营养
预后
colorectal cancer
advanced lung cancer inflammation index
inflammation
nutrition
prognosis
作者简介
第一作者:陈成,男,江苏宿迁人,硕士,主要从事消化道肿瘤的临床研究工作。E-mail:1439963155@qq.com;通信作者:朱正秋,女,江苏徐州人,主任医师,教授,主要从事消化道肿瘤的临床研究工作。E-mail:js82880999@126.com
