Study On The Relationship Between Prealbumin And Clinicopathological Features And Prognosis In Patients With Gastric Cancer

Objective: To investigate the relations between preoperative Prealbumin(PA)and clinicopathologic characteristics and prognosis of patients with gastric cancer.Methods:The clinicopathologic and follow-up data of 230 patients with gastric cancer treated in the First Affiliated Hospital of Anhui Medical University from January 2010 to December 2010 were retrospectively analyzed.The correlation between PA and clinical pathological characteristics of gastric cancer patients was analyzed by chi-square test and logistic multivariate analysis model.Through the Kaplan-Meier curve to calculate the 5 years survival rate of patients with different levels of PA and the difference of 5 year survival rates between the two groups were compared by Log-rank test.And the Cox regression model was used to analyze the independent risk factors affecting the prognosis of gastric cancer patients.Results: There was no significant difference between the gender,tumor location and differentiation degree of the patients with gastric cancer and the prealbumin(P>0.05);When the patients were older than 60 years old when,the proportion of[77.6%(66/85)] prealbumin decreased rather than the proportion of [77.6%(66/85)]patients with gastric cancer aged <60 years,the difference was statistically significant(x2 = 2 12.341,P=0.217);When the patients with gastric cancer tumor diameter greater than 5cm,the ratio of prealbumin decreased is 55.3%(47/85),higher than the proportion of prealbumin decreased [44.7%(38/85)] in patients with gastric cancer who,s tumor diameter smaller than 5cm,the difference was statistically significant(x2= 2 10.187,P<0.01);The proportion of prealbumin decreased in early gastric cancer patients is 22.7%(5/22),was significantly lower than that of Borrmann type?~?[33.6%(51/152)] and Borrmann III ~ IV type [51.8%(29/56)] in patients with gastric cancer,the difference was statistically significant(x2 = 2 10.187,P<0.01);The proportion of prealbumin decreased in patients with stage III(TNM stage)gastric cancer was 50.4%(60/119),was significantly higher than that of stage I and stage II patients with gastric cancer[22.5%(25/111)],the difference was statistically significant(x2 = 2 19.184,P<0.01);The proportion of gastric cancer patients with anemia with prealbumin decreased was 24.8%(32/129),rather than that was 52.5%(53/101)in patients without anemia,the difference was statistically significant(x2 = 218.614,P<0.01).Logistic multivariate analysis showed that age,tumor TNM stage and anemia were the independent factors affecting the occurrence of prealbumin decreased in patients with gastric cancer.Survival analysis showed that the 5 year cumulative survival rate of patients with low albumin was about 31.8%,significantly lower than 68.3% of normal group,the difference was statistically significant(P<0.05);Univariate analysis showed that PA concentration,tumor size,tumor type,depth of tumor invasion,lymph node metastasis and TNM stage were associated with overall survival(P<0.05);Multivariate analysis showed that serum prealbumin(P<0.001)and tumor TNM stage(P<0.05)were independent prognostic factors in patients with gastric cancer.Conclusion: Prealbumin was associated with age,tumor size,tumor type,tumor TNM stage,and anemia in patients with gastric cancer.Age,tumor TNM stage and anemia are independent factors affecting the occurrence of hypoalbuminemia in patients with gastric cancer.The prognosis of patients with gastric cancer is related to tumor size,tumor type,TNM stage and prealbumin.Prealbumin and TNM staging are independent prognostic factors in patients with gastric cancer.Whether prealbumin can be used as a new indicator for assessing the prognosis of patients with gastric cancer requires a multicenter,large sample of clinical studies to be confirmed.Early detection,timely treatment,and actively improve the nutritional status of patients,the prognosis of patients with gastric cancer is of great significance.