术前LSR联合FAR对可切除胃癌患者预后的预测价值-现代医学

术前LSR联合FAR对可切除胃癌患者预后的预测价值

单位：淮安市洪泽区人民医院普外科, 江苏淮安 223100

分类号：R735

出版年·卷·期（页码）：2022·50·第八期（1003-1008）

摘要：

目的：评估术前外周血丙氨酸转氨酶与天冬氨酸转氨酶比值(LSR)联合纤维蛋白原与白蛋白比值(FAR)对可切除胃癌(rGC)患者预后的预测价值。方法：选取2014年1月至2016年12月在淮安市洪泽区人民医院普外科行胃癌根治术治疗的rGC患者155例，随访截止时间为2019年12月或患者死亡。通过受试者工作特征(ROC)曲线计算LSR、FAR的最佳截点，分析LSR-FAR与临床病理指标的关系，采用Cox回归模型分析各临床病理指标对患者预后的影响。结果：(1) LSR、FAR判断rGC患者预后的最佳截点分别为1.03、0.084。患者分为三组：2分组(LSR<1.03，且FAR≥0.084)；1分组[(LSR≥1.03，且FAR≥0.084)或(LSR<1.03，且FAR < 0.084)]；0分组(LSR≥1.03，且FAR<0.084)。(2) LSR-FAR不同评分与患者性别、年龄、肿瘤直径、TNM分期及组织分化程度均有关(均P＜0.05)。(3)年龄(≥60岁vs.＜60岁，HR：2.050，95%CI：1.098～3.830, P=0.024)、TNM分期(Ⅲ期vs.Ⅰ期，HR：3.009，95%CI：1.455～6.222，P=0.003)、分化程度(中等或好vs.差，HR：0.555，95%CI：0.311～0.989，P=0.046)及LSR-FAR(2分组vs. 0分组，HR：2.932，95%CI：1.516～5.671，P=0.001；1分组vs. 0分组，HR：2.319，95%CI：1.225～4.392， P=0.010)均是影响rGC患者预后的独立危险因素。结论：LSR-FAR或可成为rGC患者预后的有效预测指标，LSR＜1.03，且FAR≥0.084可能提示预后不良。

Objective: To investigate the prognostic value of combined peripheral alanine aminotransferase to aspartate aminotransferase ratio (LSR) and fibrinogen to albumin ratio (FAR) in patients with resectable gastric cancer (rGC).Methods: From January 2014 to December 2016,155 patients with rGC who underwent radical gastrectomy in the Department of Surgery,Hongze District People's Hospital were selected.The follow-up deadline was December 2019 or the patient died.The cut-off values of LSR and FAR were calculated by receiver operating characteristic (ROC) curve,and the relationship between LSR-FAR and clinicopathological indicators was analyzed.Cox regression model was used to analyze the influence of clinicopathological indicators on the prognosis of patients.Results: (1) The cut-off values for LSR and FAR were 1.03 and 0.084 respectively.Patients were divided into three groups:2 score group (LSR<1.03,and FAR ≥ 0.084);1 score group[(LSR ≥ 1.03,and FAR ≥ 0.084) or (LSR<1.03,and FAR<0.084)];0 score group (LSR ≥ 1.03,and FAR<0.084).(2) LSR-FAR were related to the patient's gender,age,tumor diameter,TNM stage,and tissue differentiation (all P<0.05).(3) Age (≥ 60 years old vs. <60 years old,HR:2.050,95%CI:1.098~3.830,P=0.024),TNM stage (stage Ⅲ vs. stage Ⅰ,HR:3.009,95%CI:1.455~6.222,P=0.003),the degree of differentiation (moderate or good vs. poor,HR:0.555,95%CI:0.311~0.989,P=0.046) and LSR-FAR (2 score group vs. 0 score group,HR:2.932,95%CI:1.516~5.671, P=0.001;1 score group vs. 0 score group,HR:2.319,95%CI:1.225~4.392,P=0.010) were independent risk factors on the prognosis of rGC patients.Conclusion: LSR-FAR might be an effective prognostic indicator for rGC patients.LSR<1.03and FAR ≥ 0.084 might indicate poor prognosis.

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