Suchergebnisse

Shuao Xiao,1,* Fan Feng,1,* Ni Liu,2,* Zhen Liu,1 Yinghao Guo,3 Xiao Lian,1 Hongwei Zhang1 1Division of Digestive Surgery, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an 710032, Shaanxi, People's Republic of China; 2Department of Anesthesiology, Weinan Central Hospital, Weinan 714000, Shaanxi, People's Republic of China; 3Health Company, 92667 Army of PLA, Qingdao 266100, Shandong, People's Republic of China*These authors contributed equally to this workCorrespondence: Hongwei Zhang; Fan FengDivision of Digestive Surgery, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, 127 West Changle Road, Xi'an 710032, Shaanxi, People's Republic of ChinaTel/Fax +86-029-84771531Email Zhanghwfmmu@126.com; surgeonfengfan@163.comObjective: The preoperative value of albumin level and albumin/globulin ratio (AGR) has been discovered to be a possibility for predicting gastric cancer. However, their predictive accuracy remains unknown. This study's objective is to evaluate the predictive value of albumin, globulin and AGR in gastric cancer.Methods: A total of 3266 gastric cancer patients in our institution who underwent radical gastrectomy during the period from September 2008 to April 2015 were retrospectively analyzed. Levels of preoperative serum albumin and globulin were recorded. The optimal cut off points of albumin, globulin and AGR were calculated using X-tile software. The association of albumin and AGR with clinicopathological features and eventual prognosis was analyzed. The survival predictive accuracy and prognostic discriminatory ability among different variables were analyzed.Results: This study consisted of 2531 males (77.5%) and 735 females (22.5%). Ages ranged from 20 to 90, with a median age of 58.0 years. The optimal cut off values of albumin, globulin and AGR were set at 42.0, 28.2 and 1.80, respectively. Patients in the high albumin group and high AGR group were both associated with younger age, smaller tumor size, as well as earlier T and N stages. Univariate and multivariate analysis demonstrated that albumin level and AGR value were both significant prognostic factors, while globulin level was not. Furthermore, albumin level displayed a prognostic discriminatory ability and a predictive accuracy superior to that of AGR. The multivariate model based on albumin also revealed a superior predictive accuracy than that based on AGR.Conclusion: Preoperative albumin level is superior to AGR value in the prediction of prognosis of gastric cancer.Keywords: albumin-globulin ratio, albumin, gastric cancer, prognosis

Yinghao Guo,1,2,* Jinqiang Liu,1,3,* Wenming Zhang,1,4,* Shuao Xiao,1 Gaozan Zheng,1 Shushang Liu,1 Man Guo,1 Hongwei Zhang,1 Fan Feng1 1Department of Digestive Surgery, Xijing Hospital of Digestive Diseases, The Fourth Military Medical University, Xi'an 710032, Shaanxi, People's Republic of China; 2Health Company, 92667 Army of PLA, Qingdao 266100, Shandong, People's Republic of China; 3Cadre's Sanitarium, 62101 Army of PLA, Xinyang 464000, Henan, People's Republic of China; 4Department of General Surgery, Linxia People's Hospital, Linxia 731100, Gansu, People's Republic of China*These authors contributed equally to this workCorrespondence: Hongwei Zhang; Fan Feng Email zhanghwfmmu@126.com; surgeonfengfan@163.comPurpose: Data about the prognostic value of fibrinogen concentration and absolute lymphocyte count for the prognosis of gastrointestinal stromal tumors (GISTs) were limited. Thus, the aim of the present study was to investigate the predictive value of preoperative fibrinogen concentration and absolute lymphocyte count in GISTs.Patients and Methods: From March 2002 to December 2017, 143 intermediate and high risk GIST patients treated with R0 resection were enrolled in the present study. Clinicopathological characteristics were recorded. The optimal cut-off values of patients were calculated by X-tile software. Categorical variables were analyzed using Chi-square test or Fisher's exact test. Disease-free survival was analyzed by the Kaplan–Meier method and compared by a Log rank test.Results: There were 71 males (49.65%) and 72 females. The median age was 56 years (range 19– 86). The optimal cut-off value was 4.5 g/L for fibrinogen concentration (P=0.000) and 1.0× 109/L for lymphocyte count (P=0.002). No significant association was found between lymphocyte level and clinicopathological features. However, elevated fibrinogen level was correlated with tumor location, tumor size and NIH risk category. Tumor size, fibrinogen concentration and lymphocyte count were independent risk factors for the prognosis of patients according to the multivariate analysis. The prognosis of patients with high fibrinogen concentration or low lymphocyte count was significantly worse than that with low fibrinogen concentration or high lymphocyte count. Further, combination of fibrinogen concentration and lymphocyte count could increase the prognostic value for GIST patients.Conclusion: Fibrinogen concentration and absolute lymphocyte count were independent prognostic factors for intermediate and high risk GIST patients. The combination of fibrinogen concentration and absolute lymphocyte count could further increase the predictive value for the prognosis of GIST patients.Keywords: gastrointestinal stromal tumors, GIST, mesenchymal tumor, fibrinogen, lymphocyte, prognosis