[1]向文采,黄修仿,叶　超,等.老年胃肠道间质瘤肝转移患者术前血清ALT与AST比值与预后的相关性研究[J].现代检验医学杂志,2022,37(02):190-194.[doi:10.3969/j.issn.1671-7414.2022.02.038]
　XIANG Wen-cai,HUANG Xiu-fang,YE Chao,et al.Correlation between Preoperative Serum Alanine Aminotransferase to Aspartate Aminotransferase Ratio and Prognosis in Elderly Patients with Liver Metastasis from Gastrointestinal Stromal Tumor[J].Journal of Modern Laboratory Medicine,2022,37(02):190-194.[doi:10.3969/j.issn.1671-7414.2022.02.038]
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老年胃肠道间质瘤肝转移患者术前血清ALT与AST比值与预后的相关性研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第37卷
期数:
2022年02期
页码:
190-194
栏目:
检验与临床
出版日期:
2022-03-15

文章信息/Info

Title:
Correlation between Preoperative Serum Alanine Aminotransferase to Aspartate Aminotransferase Ratio and Prognosis in Elderly Patients with Liver Metastasis from Gastrointestinal Stromal Tumor
文章编号:
1671-7414（2022）02-190-06
作者:
向文采;  黄修仿; 叶　超; 刘　俊
（汉川市人民医院普外科, 湖北汉川 431600）
Author(s):
XIANG Wen-cai;  HUANG Xiu-fang;  YE Chao;  LIU Jun
（Department of General Surgery, Hanchuan People’s Hospital, Hubei Hanchuan 431600, China）
关键词:
丙氨酸氨基转移酶; 天门冬氨酸氨基转移酶; 老年胃肠道间质瘤; 肝转移
分类号:
R735；R730.43
DOI:
10.3969/j.issn.1671-7414.2022.02.038
文献标志码:
A
摘要:
目的　探讨术前血清丙氨酸氨基转移酶（alanine aminotransferase, ALT）与天门冬氨酸氨基转移酶（aspartate aminotransferase, AST）比值(LSR) 对老年胃肠道间质瘤(gastrointestinal stromal tumor, GIST) 肝转移患者预后的影响。方法　选取2010 年1 月～ 2016 年5 月在湖北省汉川市人民医院治疗的189 例老年GIST 肝转移患者的临床资料进行回顾性分析。分析其临床病理特征及与生存预后的关系。根据ROC 曲线得到LSR 最佳截点为1.39，根据此截点将患者分为LSR<1.39 组(n=132) 和LSR ≥ 1.39 组(n=57)，比较各组患者的生存率，用Kaplan-Meier 法进行生存分析，并进行COX单因素和多因素分析。结果　所有患者随访期为8~68 个月，中位数21.3 个月。所有患者1 年、3 年和5 年生存率（OS）分别为89.95%，71.43% 和50.26%。LSR<1.39 组1 年、3 年和5 年OS 分别为93.18%，77.27% 和56.82%，LSR ≥ 1.39组1 年，3 年和5 年OS 分别为82.46%，57.89% 和35.09%。两组间1 年、3 年和5 年OS 差异均有统计学意义(χ2=5.065，7.325，7.520，均P <0.05)。LSR<1.39 组与LSR ≥ 1.39 组患者的肿瘤大小、核分裂数、淋巴结转移及NIH 危险度分级差异均有统计学意义(χ2=5.011~15.452，均P <0.05)，性别及肿瘤位置差异无统计学意义(χ2=0.268, 0.611, 均P>0.05)。COX 单因素分析结果显示，肿瘤位置(OR=1.514，95％ CI：1.081~2.121，P=0.016)，肿瘤大小(OR=2.201，95％ CI：1.373~3.530，P=0.001)，核分裂数(OR=1.505，95％ CI：1.117~2.028，P=0.007)，淋巴结转移(OR=1.744，95％ CI：1.338~2.272，P=0.000)，NIH 危险度分级(OR=2.678，95％ CI：2.146~3.342，P=0.000) 和LSR(OR=2.344，95％ CI：1.839~2.989，P=0.000) 是老年GIST 肝转移患者预后的影响因素；COX 多因素分析结果显示，肿瘤大小(OR=1.610，95％ CI：1.209~2.143，P=0.001)，淋巴结转移(OR=1.564，95％ CI：1.181~2.069，P=0.002)，NIH 危险度分级(OR=2.565，95％ CI：2.072~3.176，P=0.000) 和LSR(OR=2.206，95％ CI：1720~2.829，P=0.000) 是老年GIST 肝转移患者预后的独立影响因素(P<0.05)。结论　术前LSR 是老年GIST 肝转移患者预后的独立危险因素。
Abstract:
Objective　To investigate the effect of preoperative serum alanine aminotransferase(ALT) and aspartate aminotransferase(AST) ratio (LSR) on liver metastasis prognosis in elderly gastrointestinal stroma (GIST) patients. Methods　 The clinical data of 189 elderly patients with GIST liver metastasis treated from January 2010 to May 2016 in Hanchuan City People’s Hospital of Hubei Province were selected for retrospective analysis. Clinicopathological characteristics and their relationship with survival prognosis were analyzed. The best LSR from ROC curve was 1.39, which divided patients into LSR <1.39 (n=132) and LSR ≥ 1.39 (n=57). Survival rate was compared in each groups. Survival analysis was performed by Kaplan- Meier and COX single and multifactor analysis. Results　All patient follow-up period was 8~68 months, with a median of 21.3 months. All patients were 1-year OS 89.95% (170/189), 3-year OS 71.43% (135/189), and 5-year OS 50.26% (95/189). In LSR<1.39 group 1-year, 3-year and 5-year OS were 93.18%, 77.27% and 56.82% respectively. In LSR ≥ 1.39 group 1-year, 3-year and 5-year OS were 82.46%, 57.89% and 35.09%, respectively. The 1-year, 3-year and 5-year OS differences between the two groups had statistical significance(t=5.065, 7.325, 7.520, all P<0.05). Tumor size, nuclear division, lymph node metastasis, and NIH risk classification had statistical significance in LSR<1.39 and LSR ≥ 1.39 (χ2=5.011 ～15.452, all P<0.05), gender and tumor location differences had no statistical significance (χ2=0.268, 0.611, all P>0.05). The results of COX singlefactor analysis showed that tumor location(OR=1.514，95%CI：1.081~2.121，P=0.016), tumor size(OR=2.201，95%CI： 1.373~3.530，P=0.001), nuclear division number(OR=1.505，95%CI：1.117~2.028，P=0.007), lymph node metastasis(OR=1.744, 95%CI:1.338~2.272, P=0.000), NIH risk classification(OR=2.678, 95%CI:2.146~3.342, P=0.000) and LSR(OR=2.344, 95%CI:1.839~2.989, P=0.000) were the influencing factors affecting the prognosis of elderly patients with GIST liver metastasis (all P<0.05). The results of COX multi-factor analysis showed that tumor size(OR=1.610, 95%CI：1.209~2.143, P=0.001), lymph node metastasis (OR=1.564, 95%CI:1.181~2.069, P=0.002), NIH risk classification (OR=2.565, 95%CI: 2.072~3.176, P=0.000) and LSR(OR=2.206, 95%CI:1720~2.829, P=0.000) were the independent influencing factors for the prognosis in elderly patients with GIST liver metastasis (all P<0.05). Conclusion　LSR is an independent risk factor for elderly patients with GIST liver metastasis, and suggests that their liver function should be improved to improve their prognosis and prolong survival.

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备注/Memo

备注/Memo:
作者简介：向文采（1986-），男，本科，主治医师。研究方向：胃肠道及肛管疾病、急腹症、腹壁疝等疾病的治疗及研究。
通讯作者：刘俊，E-mail:liujun198502@sina.com。
更新日期/Last Update: 1900-01-01