乳酸デヒドロゲネーゼ誘導指数および切除可能な胃がん患者の予後
Masayuki Urabe1, Mami Suzuki1, Takahiro Fukai1
1Gastrointestinal Surgery Division, Department of Surgery, Japanese Red Cross Omori Hospital, Tokyo, Japan.
JMA journal
|February 12, 2026
まとめ
術前の乳酸脱水素酵素とリンパ球の比率 (LLR) とLDHとアルブミン比率 (LAR) は,胃がん患者のアウトカムを効果的に予測します. これらの比率は,LDH単独と比較してリスクの階層化を改善し,個別化された治療戦略を支援します.
科学分野:
- 腫瘍学 腫瘍学
- バイオケミストリー バイオケミストリー
- 外科腫瘍学外科腫瘍学
背景:
- 胃がん (GC) は,効果的な患者管理のために堅実なリスク分層化方法を必要とします.
- 乳酸脱水素酵素 (LDH) とその派生比は,様々ながんにおける新興バイオマーカーである.
研究 の 目的:
- 術前乳酸脱水素酶 (LDH),LDH-to-リンパ球比 (LLR),およびLDH-to-アルバミン比 (LAR) の予後的有意性を評価するために,GCのために治癒的切除を受けている患者で.
主な方法:
- R0切除を受けた225人のGC患者の遡及的レビュー.
- 時間依存のROC曲線とコックスの回帰を用いた予測値の評価.
- X-tileソフトウェアを使用して最適なカットオフ値の決定.
主要な成果:
- LLRとLARは,LDH単独よりも,全生存期 (OS) と再発フリー生存期 (RFS) の予測精度が高いことを示した.
- 多変量分析により,LLRとLARがOSとRFSの独立した予測因子であると確認されました.
- 高いLLRとLARは,著しくOSとRFSの劣悪な結果と関連していました.
結論:
- 術前のLLRとLARは,切除可能なGCにおける独立した予後指標として機能します.
- これらの指標は,高リスクのGC患者の早期識別に役立ちます.
- LLRとLARは,胃がんの個別化された治療戦略の開発を支援する可能性があります.
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