C-反应蛋白/白蛋白比值和预后营养指数是切除的胰腺导管腺癌存活率的有力预后指标。

Journal of Pancreatic Cancer Pub Date : 2017-07-01 eCollection Date: 2017-01-01 DOI:10.1089/pancan.2017.0006
Masahide Ikeguchi, Takehiko Hanaki, Kanenori Endo, Kazunori Suzuki, Seiichi Nakamura, Takashi Sawata, Tetsu Shimizu
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引用次数: 0

摘要

目的:我们评估了慢性炎症、营养和免疫的术前血清标志物以及胰腺导管腺癌(PDAC)根治性切除术后血清肿瘤标志物的临床重要性,如术后胰瘘(POPF)的发生或预后。研究方法2006年至2015年期间,鸟取县立中央医院对43例PDAC患者进行了根治性切除术。我们分析了哪些术前指标(即 C 反应蛋白/白蛋白比值[CAR]、中性粒细胞/淋巴细胞比值[NLR]、预后营养指数[PNI]、癌胚抗原[CEA]和碳水化合物抗原 19-9 [CA19-9])是发生 POPF 和患者不良生存率的最相关风险因素。结果:43 例患者中有 8 例(18.6%)发现了 POPF。一名患者在术后 2 个月死于胰瘘。在9个候选因素(手术方式、手术时间、肿瘤分期、术前血清淀粉酶、术前CAR、NLR、PNI、CEA和CA 19-9)中,我们没有发现任何显著的POPF发生风险因素。43例患者的5年总生存率(OS)为22.4%,总生存时间中位数为21个月。多变量 OS 分析表明,与肿瘤分期无关,高 CAR 和低 PNI 是预后不良的术前强标记物。结论术前CAR和PNI是可手术PDAC患者的有用预后标志物。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

C-Reactive Protein/Albumin Ratio and Prognostic Nutritional Index Are Strong Prognostic Indicators of Survival in Resected Pancreatic Ductal Adenocarcinoma.

C-Reactive Protein/Albumin Ratio and Prognostic Nutritional Index Are Strong Prognostic Indicators of Survival in Resected Pancreatic Ductal Adenocarcinoma.

Purpose: We evaluated the clinical importance, such as the occurrence of postoperative pancreatic fistula (POPF) or prognosis, of preoperative serum markers of chronic inflammation, nutrition, and immunity, as well as that of serum tumor markers after curative resection of pancreatic ductal adenocarcinomas (PDACs). Methods: Between 2006 and 2015, 43 patients with PDACs underwent curative resection at Tottori Prefectural Central Hospital. We analyzed which preoperative indicators (i.e., C-reactive protein/albumin ratio [CAR], neutrophil/lymphocyte ratio [NLR], prognostic nutritional index [PNI], carcinoembryonic antigen [CEA], and carbohydrate antigen 19-9 [CA 19-9]) were the most relevant risk factors for occurrence of POPF and poor patient survival. Results: POPF was detected in 8/43 (18.6%) patients. One patient died of pancreatic fistula at 2 months postoperatively. Among nine candidate factors (operative procedure, operation time, tumor stage, preoperative serum amylase, preoperative CAR, NLR, PNI, CEA, and CA 19-9), we did not identify any significant risk factor for the occurrence of POPF. The 5-year overall survival (OS) rate of the 43 patients was 22.4%, and the overall median survival time was 21 months. The multivariate OS analysis demonstrated that high CAR and low PNI were strong preoperative markers of poor prognosis independently of tumor stage. Conclusions: Preoperative CAR and PNI are useful prognostic markers for patients with operable PDACs.

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