摘要
目的分析当前版本华西肠癌数据库(Database from Colorectal Cancer,DACCA)中术前蛋白水平对结直肠癌手术患者生存预后的影响。方法根据制定的筛选条件从2024年4月更新版DACCA中提取患者信息,Kaplan-Meier法绘制术前有和无低蛋白血症患者的生存曲线并采用log-rank检验;同时采用单因素和多因素Cox比例风险回归分析影响术前低蛋白血症对结直肠癌患者手术后生存预后(观察指标为总生存期和疾病特异性生存期)的风险因素,检验水准α=0.05。结果纳入1217例结直肠癌患者,术前有低蛋白血症患者252例,其发病率为20.7%。Kaplan-Meier法绘制的生存曲线经log-rank检验发现,术前有低蛋白血症患者的总生存和疾病特异性生存情况均差于术前无低蛋白血症患者(χ^(2)=43.411,P<0.001;χ^(2)=41.171,P<0.001);但是经多因素Cox比例风险回归分析未发现术前有低蛋白血症是结直肠癌患者手术后生存预后(观察指标为总生存期和疾病特异性生存期)的风险因素[总生存期:HR(95%CI)=1.013(0.741,1.385),P=0.938;疾病特异性生存期:HR(95%CI)=1.003(0.719,1.399),P=0.987]。结论本研究结果提示,结直肠癌患者术前有低蛋白血症发病率较高,生存预后较术前无低蛋白血症结直肠癌患者差。
Objective To analyze the effects of preoperative protein level on the survival prognosis of patients underwent colorectal cancer(CRC)surgery in the current Database from Colorectal Cancer(DACCA).Methods According to the established screening criteria,the patient information was extracted from the updated version of DACCA on April,2024.The survival curves of the patients with and without preoperative hypoproteinemia were plotted by Kaplan-Meier method and the log-rank test was used to compare.The univariate and multivariate Cox proportional hazards regression model were used to analyze the preoperative hypoproteinemia affecting postoperative survival(overall survival and disease-specific survival)of patients with CRC.The test level wasα=0.05.Results A total of 1217 patients with CRC were included,and 252 of 1217 patients with preoperative hypoproteinemia,with an incidence of 20.7%.The survival curves showed that the overall survival and disease-specific survival of the patients with preoperative hypoproteinemia were worse than those without preoperative hypoproteinemia(χ^(2)=43.411,P<0.001;χ^(2)=41.171,P<0.001).However,the multivariate Cox proportional hazards regression model analysis did not find that the preoperative hypoproteinemia was a risk factor for postoperative survival(overall survival and disease-specific survival as observed indicators)in the patients with CRC[overall survival:HR(95%CI)=1.013(0.741,1.385),P=0.938;disease-specific survival:HR(95%CI)=1.003(0.719,1.399),P=0.987].Conclusion The results of this study suggest that the incidence rate of preoperative hypoproteinemia in patients with CRC is higher and its survival prognosis is worse than that in patients without preoperative hypoproteinemia.
作者
张湘琳
王一淇
郑雅芳
叶佳琪
汪晓东
杨烈
ZHANG Xianglin;WANG Yiqi;ZHENG Yafang;YE Jiaqi;WANG Xiaodong;YANG Lie(Division of Gastrointestinal Surgery,Department of General Surgery,West China Hospital,Sichuan University,Chengdu 610041,P.R.China;West China School of Medicine,Sichuan University,Chengdu 610041,P.R.China;West China School of Public Health,Sichuan University,Chengdu 610041,P.R.China)
出处
《中国普外基础与临床杂志》
2025年第1期67-73,共7页
Chinese Journal of Bases and Clinics In General Surgery
基金
四川省科技计划项目(项目编号:2024YFHZ0060)
四川大学华西医院“1·3·5”工程人工智能项目(项目编号:ZYAI24067)。
关键词
结直肠癌
低蛋白血症
生存预后
术前体质状态
colorectal cancer
hypoproteinemia
survival prognosis
preoperative physical conditions
作者简介
通信作者:汪晓东,Email:wangxiaodong@wchscu.cn;张湘琳,四川大学华西胃肠外科医学实力派成员;郑雅芳,四川大学华西胃肠外科医学实力派成员;叶佳琪,四川大学华西胃肠外科医学实力派成员。
