Prognostic Value Of Preoperative Serum Albumin To Alkaline Phosphatase Ratio In Patients With Advanced Colon Cancer

Objective: To investigate the value of preoperative serum albumin to alkaline phosphatase ratio(AAPR)in evaluating the prognosis of advanced colon cancer patients after radical resection of colon cancer.Method: The clinicopathologic data of patients with advanced colon cancer(stage II and III)who underwent radical resection of colon cancer in the Second Affiliated Hospital of Nanchang University,the First Affiliated Hospital of Nanchang University,Jiangxi Provincial People’s Hospital and Jiangxi Provincial Cancer Hospital from August 2017 to September 2019 were retrospectively analyzed.AAPR were calculated by parameters obtained from the last biochemical test one week before surgery.Median was used as the cut-off point,and the effects of different clinicopathological features on 3-year disease-free survival(DFS)and 3-year overall survival(OS)were analyzed by Kaplan-Meier method and log-rank test.Multivariate Cox regression analysis of the independent risk factors affecting the prognosis of patients.The relationship between AAPR and postoperative clinicopathologic features of advanced colon cancer patients was analyzed by chi-square test.Results: Kaplan-Meier survival analysis showed that compared with perioperative preoperative AAPR<0.416,progressive colon cancer patients with preoperative AAPR≥0.416 had significantly better DFS 3 years after surgery(24.909 months versus 29.430 months,P<0.001),OS was significantly better 3 years after surgery(27.915 months versus 30.952 months,P=0.020).Multivariate COX analysis showed that the independent prognostic factors of DFS 3 years after surgery in advanced colon cancer patients were preoperative AAPR,TNM stage,neurological invasion and preoperative CA199(P<0.05).Independent prognostic factors for OS in advanced colon cancer patients 3 years after surgery were preoperative AAPR,TNM staging,neurological invasion,preoperative CEA and preoperative CA199(P<0.05).According to the chi-square test,AAPR were correlated with maximum tumor diameter,nerve invasion,preoperative SII,LMR and PLR(P<0.05).Conclusion: 1.Advanced colon cancer patients with high AAPR before perioperative surgery have better 3-year DFS and 3-year OS than patients with low AAPR;2.AAPR before perioperative period was significantly correlated with the maximum tumor diameter and nerve invasion in advanced colon cancer patients;3.Perioperative AAPR was significantly correlated with perioperative levels of SII,NLR and LMR in patients with advanced colon cancer.