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頁籤選單縮合
題名 | Preoperative Laboratory Neutrophil-lymphocyte Ratio, Serum Carcinoembryonic Antigen Level, and Serum Albumin Level Predict Overall Survival in Stage II Colon Cancer=術前檢驗資料,包括中性粒細胞-淋巴細胞比值、血清癌胚抗原和血清白蛋白預測Ⅱ.期結腸癌患者術後整體生存率 |
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作 者 | 何寬助; 黃政義; 陳志榕; 郭益宏; 游正府; 靳志堅; 黃文詩; | 書刊名 | 中華民國大腸直腸外科醫學會雜誌 |
卷期 | 29:4 2018.12[民107.12] |
頁次 | 頁168-179 |
分類號 | 416.245 |
關鍵詞 | 第二期結腸癌; 嗜中性粒細胞-淋巴細胞比值; 癌胚抗原; 低血漿白蛋白; 總體生存; Stage II colon cancer; Neutrophil-lymphocyte ratio; Carcinoembryonic antigen; Hypoalbuminemia; Overall survival; |
語文 | 英文(English) |
中文摘要 | 背景:全身炎症和免疫反應與第二期結腸癌的常見的風險因子可能存在相關性,對癌症治療至關重要。術前嗜中性粒細胞-淋巴細胞比值(NLR)、低血漿白蛋白和癌胚抗原增高對第二期結腸癌預後可能可以提供客觀的評估。方法:在這個觀察性研究中,我們分析了1180位第二期結腸癌患者,他們在1995年1月到2005年12月間於單一醫學中心進行結腸癌手術。所有患者持續追蹤直到2009年12月。結果:高術前嗜中性粒細胞-淋巴細胞比值的患者(≥ 3.5)有在結腸癌TNM分期中較容易有更深的侵犯深度(T4)、術前貧血、低血漿白蛋白(3.5 g/dl)和超出標準值的癌胚抗原(≥ 5 ng/ml)。與其他術前嗜中性粒細胞-淋巴細胞比值< 3.5的患者相比,這一類病患也有較高的可能性面臨術後發病率較高的急診手術。多因素分析顯示,高術前嗜中性粒細胞-淋巴細胞比值,高於標準的癌胚抗原,以及存在低血漿白蛋白是所有本研究納入患者和其中接受選擇性結腸癌手術的患者5年存活率的獨立風險因素。我們根據獨立風險因素存在與否(如高術前嗜中性粒細胞-淋巴細胞比值、超標的癌胚抗原水準和存在低血漿白蛋白)來進一步分層研究的患者。當患者有任一獨立的不利因素時,接受輔助化療的人的總體生存率明顯高於未進行輔助治療的人(p = 0.024)。當患者沒有這些因素時,接受與未接受輔助化療的組別之間沒有顯著差異(p = 0.654)。結論:高於3.5的術前嗜中性粒細胞-淋巴細胞比值、癌胚抗原水準和存在低血漿白蛋白是成本效益高的客觀資料,可用於預測第二期結腸癌患者的整體生存。這些因素的不良影響在施行輔助化療後可產生顯著的改善。 |
英文摘要 | Background. Systemic inflammation and immune response may be associated with the conventional high-risk features of stage II colon cancer and are crucial in cancer treatment. High preoperative neutrophil-lymphocyte ratio (NLR), carcinoembryonic antigen (CEA) level, and preoperative hypoalbuminemia may facilitate the objective assessment of stage II colon cancer prognosis. Methods. In this observational study, we analyzed 1180 patients with stage II colon cancer who had undergone curative colon cancer surgery between January 1995 and December 2005 at a single institution. All the patients were followed up until December 2009. Results. The patients with high preoperative NLR (≥ 3.5) had a higher tendency to develop T4-stage cancer; higher probability of exhibiting preoperative anemia, hypoalbuminemia (< 3.5 g/dL), and high CEA level (≥ 5 ng/mL); and a higher possibility of requiring emergency surgery with a higher postoperative morbidity rate than the other patients. Multivariate analysis revealed that postoperative morbidity and preoperative characteristics - high NLR, high CEA level, and hypoalbuminemia - were independent risk factors for low 5-year overall survival in all patients with colon cancer and in patients who had undergone elective colon cancer surgery. We stratified the patients into subgroups according to the presence or absence of independent factors such as postoperative morbidity and preoperative characteristics (high NLR, high CEA level, and hypoalbuminemia). Among the patients who exhibited independent adverse factors, those who had received adjuvant chemotherapy showed significantly higher overall survival than did those who had not received adjuvant therapy (p = .024). Among the patients who did not exhibit the adverse factors, the overall survival did not differ significantly between those who had and had not received adjuvant chemotherapy (p = .654). Conclusion. High NLR, high CEA level, and hypoalbuminemia are cost-effective objective data that can efficiently predict the overall survival of patients with stage II colon cancer. The adverse effects of these factors may be normalized after adjuvant chemotherapy. |
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