血清白蛋白表达水平在结直肠癌化疗患者预后评估中的应用价值

摘要

Objective To study the value of serum albumin (Alb) expression in evaluation of prognosis in patients colorectal cancer undergoing chemotherapy.Methods 80 patients with colorectal cancer who received 6 periodic chemotherapy of 5-fluorouracil plus calcium folate and oxaliplatin in our hospital from October 2013 to October 2014 were included in this study and were followed up for 2 years.The overall survival (OS) was recorded.The correlation between Alb expression and OS and explanatory variables for OS before and after chemotherapy were analyzed by multivariate Logistic.Results During the follow-up period,4 cases were lost to follow-up,and there were 47 cases of death and 29 cases of survival.The OS rate was 38.16％.The level of Alb before and after chemotherapy in the death group was significantly lower than that in the survival group (P ＜ 0.05).The was significant difference in Alb levels before and after chemotherapy in the death group (P ＜ 0.05).The median OS was 17.57 months in hypoproteinemia group before chemotherapy,and it was 21.07 months in the normal Alb group,with significant between-group difference (Log-rank =8.193,P =0.004).The median OS of hypoproteinemia group after chemotherapy was 17.06 months and it was 22.53months in the normal Alb group,with significant between-group difference (Log-rank =17.170,P =0.000).Multivariate Logistic analysis showed that TNM stage and Alb after chemotherapy were independent predictors for OS (P ＜ 0.05).Conclusion The expression level of Alb before and after chemotherapy have value in predicting the overall survival rate of colorectal cancer.The prognostic value of Alb after chemotherapy was better than that before chemotherapy.%目的 探讨血清白蛋白(albumin,Alb)表达水平在结直肠癌化疗患者预后评估中的应用价值.方法 纳入本院2013年10月至2014年10月80例接受5-氟尿嘧啶+亚叶酸钙+奥沙利铂6周期化疗的结直肠癌患者作为研究对象,化疗结束后随访2年.记录患者总生存期(OS),分析化疗前后Alb表达水平与OS的相关性,采用Logistic多因素法分析影响患者OS的因素.结果 随访期间,失访4例,死亡47例,29例存活,总生存率为38.16％.死亡组化疗前后Alb水平显著低于存活组(P＜0.05),死亡组化疗前后Alb水平差异显著(P＜0.05).化疗前低蛋白血症组中位OS为17.57月,Alb水平正常组中位OS为21.07月.两组中位OS差异有统计学意义(Log-rank检验值=8.193,P=0.004).化疗后低蛋白血症组中位OS为17.06月,Alb正常组中位OS为22.53月,两组中位OS差异有统计学意义(Log-rank检验值=17.170,P=0.000).Logistic多因素分析显示TNM分期与化疗后Alb是影响患者OS的独立因素(均P＜ 0.05).结论 化疗前后Alb表达水平对预测结直肠癌患者总生存率均具有一定应用价值,化疗后Alb水平预测价值优于化疗前.