Bir ön çalışma; mide kanserinde prediktif faktörler*

Amaç: Serum albumin, albumin-globulin oranı (AGR), nötrofil/lenfosit (N/L) değerlerinin mide kanseri hastalarında sağkalım üzerine etkileri araştırıldı.Gereç ve Yöntem: Ön çalışma niteliğindeki bu çalışmaya kemoterapi değerlendirmesindeki 46 hastanın biyokimyasal parametreleri retrospektif olarak arşiv kayıtlarından alındı. AGR=Albumin/Total Protein-Albumin formülüyle AGR değerleri hesaplandı. Büyükten küçüğe doğru sıralanıp, (Receiver Operating Characteristic) ROC analiziyle AGR düşük-yüksek olarak değerlendirildi. Albumin ve N/L oranları da benzer şekilde gruplandırıldı.Bulgular: AGR' nin ROC analiziyle tespit edilen cut-off değeri; 1.295 (% 62.5 duyarlılık, % 50 özgüllük) idi. Kaplan-Meier metoduyla yüksek AGR grubunda düşük AGR grubuna göre daha uzun ortalama genel sağkalım (OS) tespit edildi. Sırasıyla (27 ± 21 aya karşı 26 ± 26 ay), (p: 0.706, % 95 CI: 0.295-0.791). ROC analiziyle albumin için cut-off değeri; 4.05 mg/dl (% 50 duyarlılık, % 58.5 özgüllük) idi. Kaplan-Meier metoduyla düşük albumin seviyeli olan grupda yüksek albumin seviyeli olan grupa göre daha uzun OS tespit edildi. OS; (30 ± 26 aya karşı 22 ± 21 ay), (p: 0.524, % 95 CI:0.195-0.660) dı, sırasıyla. ROC analizine göre N/L' nin cut-off değeri: 2.445 (% 50 duyarlılık, % 60.5 özgüllük) idi. Kaplan-Meier metoduyla OS' si yüksek olan N/L grubunda düşük olan gruba göre daha uzun olarak tespit edildi (32 ± 29 aya karşı 23 ± 19 ay), (p:0.965, % 95 CI: 0.247-0.748) idi. Logistic regression analizi ile AGR, N/L, albumin düzeyleri ile mortalite ve OS arasında istatitiki anlamlı ilişki tespit edilmemiştir.Sonuç: AGR, N/L, albumin düzeyleri mide kanserli hastalardaki mortaliteyi, sağkalımı öngörmede tek başlarına yeterli parametreler olmayabilirler. Vaka sayılarının arttırılmasıyla daha net sonuçlar elde edilebilinir.

Introduction: Serum albumin, albumin-globulin ratio (AGR), neutrophil/lymphocyte (N / L) levels in patients with gastric carcinoma were investigated on survival impact. Methods: This study was planned as a pilot study. Biochemical parameters of 46 patients were obtained from archive retrospectively. AGR levels were calculated by AGR =albumin/Total Protein- Albumin formula. They were sorted by descending, AGR was evaualted with lower and upper by using ROC. Albumin and N/L were divided similarly.Results: AGR cut-off value was 1.295 with ROC, in ROC: 0.543 (62.5% sensitivity, 50% specificity). The mean overall survival's (OS) detected 20 months in lower AGR group, 28 ± 21 months in upper AGR group. A longer OS was detected in upper AGR group by Kaplan-Meier (p = 0.706, 95% CI: 0.295-0.791). According to ROC of level albumin's cut-off value was 4.05 mg/dL in the ROC: 0.545, (50% sensitivity, 58.5% specificity). The OS was detected 22 ± 21 months, in lower albumin group, 30 ± 26 months in upper albumin group. A longer OS was detected in upper albumin group by Kaplan-Meier (p=0.524, 95% CI:0.195-0.660). According to ROC, cut-off value of N/L was 2.445 in ROC:0.495, (50% sensitivity, 60.5% specificity). The OS was detected 32 ± 29 months in upper N/L group, 23 ±19 months in lower N/L group. A longer OS was determined in upper N/L group by Kaplan-Meier (p=0.965, 95% CI:0.247-0.748). There were no statistical significant differences regarding prediction of survival, mortality for patient's AGR, N/L, albumin levels by logistic regression analysis.Discussion: AGR, N/L, albumin levels may be not alone sufficient for prediction of survival, and mortality parameters in gastric cancer. It can be obtained more accurate results by increasing the number of cases.

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