术前血清肝功能相关指标在结直肠癌的预后价值
Lang Wang1, Jinshan Liu1,2, Can Tan1
1Department of Gastrointestinal Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China, 400016.
Medicine
|December 23, 2025
概括
这项研究发现,手术前肝功能标志物性酸酶 (ALP) 和乳酸脱酶 (LDH) 是结直肠癌 (CRC) 存活率的关键指标. 结合这些标记物的新名录模型改善了患者的预后预测.
科学领域:
- 在瘤学瘤学.
- 临床医学 临床医学
- 生物标志物 生物标志物
背景情况:
- 结肠直肠癌 (CRC) 的预后具有挑战性,需要改进预测工具.
- 反映肝功能的血清生物标志物可能提供有价值的预后见解.
- 当前的预后模型往往缺乏全面整合肝功能指标.
研究的目的:
- 调查手术前肝功能指标对CRC患者整体存活时间 (OS) 的影响.
- 开发和验证一种新型的名录模型,用于准确的,个性化的CRC生存预测.
- 确定CRC的关键预后因素,包括血清肝功能标志物.
主要方法:
- 对3938名手术后CRC患者的回顾性分析,分为发展 (n=2758) 和验证 (n=1180) 队列.
- 单变量和多变量考克斯回归分析以确定独立的预后因素.
- 开发和验证一个包含年龄,瘤阶段,瘤大小,术后并发症,手术前性酸酶 (ALP) 和乳酸脱酶 (LDH) 水平的名录.
主要成果:
- 年龄,瘤阶段,瘤大小,术后并发症,术前ALP和LDH水平被确定为CRC预后的独立风险因素.
- 建立的名录表显示出优异的辨别能力,C指数为0.747 (发展) 和0.749 (验证).
- 时间依赖的ROC曲线和校准曲线证实了该模型的良好预测效用和一致性.
结论:
- 手术前血清性酸酶 (ALP) 和乳酸脱酶 (LDH) 水平是结肠直肠癌的显著独立预后因素.
- 开发的诺米图,整合了临床和肝功能参数,为预测CRC患者的术后生存提供了有价值的工具.
- 这种模型可以帮助临床医生做出更明智的决策,为个性化的患者管理和治疗策略做出更明智的决定.
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