CAJ | 학술논문

目的探讨术前血清白蛋白水平对胃癌根治术患者的预后评估价值.方法回顾分析天津医科大学附属肿瘤医院2001年1月至2003年12月间行胃癌根治术的146例患者的临床病理资料,其中术前血清白蛋白正常者115例(＞35 g/L,正常组),降低者31例(≤35 g/L,降低组).结果血清白蛋白正常组和降低组术后分别有50例(43.5%)和28例(90.3%)复发,差异有统计学意义(P＜0.01).两组术后5年生存率分别为57.4%和9.7%,差异有统计学意义(P＜0.01).经多因素预后分析显示,术前血清白蛋白水平是胃癌根治术患者的独立预后因素(P＜0.01).进一步分层分析显示,无论有无淋巴结转移,两组患者5年生存率的差异均有统计学意义(P＜0.05);对于胃下部癌,两组患者5年生存率的差异有统计学意义(P＜0.01);但对于胃中上部癌,两组差异则无统计学意义(P＞0.05).结论术前血清白蛋白降低的胃癌患者(尤其胃下部癌者)根治术后预后不佳,应予以积极的术后辅助治疗.
목적 탐토술전혈청백단백수평대위암근치술환자적예후평고개치.방법 회고분석천진의과대학부속종류의원2001년1월지2003년12월간행위암근치술적146례환자적림상병리자료,기중술전혈청백단백정상자115례(＞35 g/L,정상조),강저자31례(≤35 g/L,강저조).결과혈청백단백정상조화강저조술후분별유50례(43.5%)화28례(90.3%)복발,차이유통계학의의(P＜0.01).량조술후5년생존솔분별위57.4%화9.7%,차이유통계학의의(P＜0.01).경다인소예후분석현시,술전혈청백단백수평시위암근치술환자적독립예후인소(P＜0.01).진일보분층분석현시,무론유무림파결전이,량조환자5년생존솔적차이균유통계학의의(P＜0.05);대우위하부암,량조환자5년생존솔적차이유통계학의의(P＜0.01);단대우위중상부암,량조차이칙무통계학의의(P＞0.05).결론 술전혈청백단백강저적위암환자(우기위하부암자)근치술후예후불가,응여이적겁적술후보조치료.
Objective To evaluate the prognostic significance of preoperative serum albumin in patients with gastric cancer undergoing radical resection. Methods A total of 146 patients with gastric cancer underwent radical resection from January 2001 to December 2003. Clinicopathological data were analyzed retrospectively. Patients were divided into two groups, including patients with a normal preoperative serum albumin level (＞35 g/L, n=115) and patients with hypoalbuminemia (≤35 g/L, n=31). Results Patients with a low albumin level were associated with a higher postoperative recurrence rate (90.3% vs. 43.5%, P＜0.01 ). The overall 5-year survival rate in patients with a normal serum albumin level was significantly higher than that in patients with a low serum level (57.4% vs. 9.7%, P＜0.01). On multivariate analysis, preoperative serum albumin level was an independent factor associated with survival (P＜0.01). When stratified by nodal metastasis, normal serum albumin level was still associated with higher survival rate (P＜0.05). Prognostic significance was found in patients with lower stomach cancer(P＜0.01 ), but not in patients with cancer in the upper and middle stomach (P＞0.05). Conclusion Hypoalbuminemia is associated with worse survival in patients with cancer in the lower stomach and adjuvant therapy should be considered.