吴志军,张 澄,马 泰.血清胆碱酯酶在189例晚期胃癌患者预后预测中的价值分析[J].肿瘤学杂志,2022,28(12):1020-1025. |
血清胆碱酯酶在189例晚期胃癌患者预后预测中的价值分析 |
Analysis of the Value of Serum Cholinesterase Level in Prognosis Prediction of 189 Patients with Advanced Gastric Cancer |
投稿时间:2022-03-16 |
DOI:10.11735/j.issn.1671-170X.2022.12.B008 |
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中文关键词: 胃癌 胆碱酯酶 列线图 预后预测 |
英文关键词:gastric cancer cholinesterase nomogram prognosis prediction |
基金项目:安徽省重点研究与开发计划项目(1804b06020351) |
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中文摘要: |
摘 要:[目的] 探讨血清胆碱酯酶(cholinesterase,CHE)水平在晚期胃癌患者预后预测中的价值,建立晚期胃癌患者预后预测模型并验证。[方法] 回顾性收集2011年5月至2019年12月在马鞍山市人民医院诊治的189例晚期胃癌患者临床资料并进行统计学分析,利用X-tile程序软件计算出CHE的最佳截断值(cut-off值),通过Cox比例风险模型分别评估CHE、白蛋白(albumin,ALB)、血红蛋白(hemoglobin,HB)、中性粒细胞与淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)等临床病理参数对总生存期(overall survival,OS)的影响;采用多因素Cox风险比例回归模型筛选晚期胃癌独立预后影响因素;通过R软件绘制列线图并验证。[结果] CHE的最佳截断值为3 611 U/L,CHE与年龄、ECOG评分、ALB、NLR、HB相关(P<0.05)。单因素Cox回归分析结果显示,CHE、ALB、NLR、ECOG评分、是否接受一线化疗与预后相关。多因素Cox回归分析结果显示,性别、ECOG评分、CHE、NLR、HB以及是否接受一线化疗是影响晚期胃癌预后的独立因素;基于上述6个参数构建的列线图预测OS的C指数为0.753(95%CI:0.722~0.784),校准曲线基本沿45°线分布。[结论] CHE在晚期胃癌患者的预后评估中有一定的临床价值,基于CHE等参数构建的列线图可较为准确地预测晚期胃癌患者预后。 |
英文摘要: |
Abstract: [Objective] To explore the value of serum cholinesterase(CHE) level in the prognosis prediction of patients with advanced gastric cancer, and to construct and validate a nomogram of prognosis prediction for patients with advanced gastric cancer. [Methods] Clinical data of 189 patients with advanced gastric cancer admitted in Ma’anshan People’s Hospital from May 2011 to December 2019 were retrospectively analyzed. Serum cholinesterase(CHE), albumin(ALB) and hemoglobin(HB) levels, neutrophil-to-lymphocyte ratio(NLR) and other clinicopathological parameters were meaured and the optimal cut-off value of CHE was calnculated by X-tile sofware. The factors related to the overall survival(OS) of patients was analyzed with multivariate Cox proportional hazard regression model. A nomogram was developed based on the prognostic factors patients and verified using the R software. [Results] The optimal cut-off value of CHE was 3 611 U/L and CHE was associated with age, ECOG scores, ALB, NLR, HB(P<0.05). Univariate Cox regression analysis revealed that CHE, ALB, NLR, ECOG scores, and first-line chemotherapy were associated with the prognosis. Multivariate Cox regression analysis showed that gender, ECOG score, CHE, NLR, and HB levels, and first-line chemotherapy were independent prognostic factors for advanced gastric cancer. A nomogram was constructed based on these 6 parameters and the c-index for predicting OS as 0.753(95%CI: 0.722~0.784). Moreover, the calibration curve was closed to the 45-degree line. [Conclusion] In this study CHE has been proved its clinical value in prognosis prediction and a nomogram has been developed based on CHE and other 5 parameters, which may be used to predict the prognosis of patients with advanced gastric cancer. |
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