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中华普外科手术学杂志(电子版) ›› 2024, Vol. 18 ›› Issue (05) : 506 -509. doi: 10.3877/cma.j.issn.1674-3946.2024.05.010

论著

尿素-肌酐比值(UCR)可预测结直肠癌患者术后的长期预后
袁庆港1, 刘理想2, 张亮3, 周世振2, 高波4, 丁超2,(), 管文贤1,()   
  1. 1. 210008 南京,徐州医科大学附属南京鼓楼临床学院普通外科
    2. 210008 南京,南京医科大学附属南京鼓楼临床学院普通外科
    3. 221009 江苏 徐州,徐州市中心医院消化外科
    4. 210008 南京,南京大学医学院附属南京鼓楼医院临床营养科
  • 收稿日期:2024-03-31 出版日期:2024-10-26
  • 通信作者: 丁超, 管文贤

Urea-creatinine ratio (UCR) predicts the long-term prognosis of colorectal cancer patients after surgery

Qinggang Yuan1, Lixiang Liu2, Liang Zhang3, Shizhen Zhou2, Bo Gao4, Chao Ding2,(), Wenxian Guan5,()   

  1. 1. Department of General Surgery, Nanjing Drum Tower Hospital Clinical College of Xuzhou Medical University, Nanjing 210008, China
    2. Department of General Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing 210008, China
    3. Department of Gastrointestinal Surgery, Xuzhou Central Hospital, Xuzhou Jiangshu Province 221009, China
    4. Department of Clinical Nutrition, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210008, China
    5. Department of General Surgery, Nanjing Drum Tower Hospital Clinical College of Xuzhou Medical University, Nanjing 210008, China;Department of Clinical Nutrition, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210008, China
  • Received:2024-03-31 Published:2024-10-26
  • Corresponding author: Chao Ding, Wenxian Guan
  • About author:

    Yuan Qinggang and Liu Lixiang contributed equally to this work

  • Supported by:
    National Natural Science Foundation of China(82172645); Pengcheng Talent-Medical Young Reserve Talent Training Program(XWRCHT20220002)
引用本文:

袁庆港, 刘理想, 张亮, 周世振, 高波, 丁超, 管文贤. 尿素-肌酐比值(UCR)可预测结直肠癌患者术后的长期预后[J]. 中华普外科手术学杂志(电子版), 2024, 18(05): 506-509.

Qinggang Yuan, Lixiang Liu, Liang Zhang, Shizhen Zhou, Bo Gao, Chao Ding, Wenxian Guan. Urea-creatinine ratio (UCR) predicts the long-term prognosis of colorectal cancer patients after surgery[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(05): 506-509.

目的

探讨术前尿素-肌酐比值(UCR)预测术后长期预后的能力,并验证尿素-肌酐比值与结直肠癌患者肌肉质量之间的关系。

方法

回顾性分析2015年1月至2019年1月221例结直肠癌患者临床资料,根据UCR最佳临界值2.65,将患者分为两组,探讨 UCR 与患者3年预后之间的关系。采用Kaplan-Meier 法绘制生存曲线,并通过Log-Rank检验进行比较。患者术前 UCR 与肌肉参数之间进行相关性分析。正态分布和非正态分布数据分别采用独立样本t 检验和非参数秩和检验。分类变量采用χ2检验。P<0.05有统计学意义。

结果

在3年内22人死亡,29人复发。多变量分析显示,UCR和肿瘤分期与患者术后总生存率(OS)和无复发生存期(RFS)显著相关(P<0.05)。在所有患者中,预测3年总生存率和复发率的ROC面积分别为0.789(P<0.001)和0.739 (P<0.001);与低UCR组相比,高UCR组患者的死亡及复发风险更显著(P=0.007)。此外,UCR水平与骨骼肌质量显著相关(P<0.01)。

结论

UCR水平可有效预测结直肠癌患者术后的长期预后,UCR较高的患者死亡和肿瘤复发的风险增加。此外,UCR与骨骼肌质量呈正相关。

Objective

To investigate the ability of preoperative urea-creatinine ratio (UCR) to predict long-term postoperative prognosis and to validate the relationship between UCR and muscle mass in patients with colorectal cancer.

Methods

Clinical data of 221 colorectal cancer patients from January 2015 to January 2019 were retrospectively analyzed. The patients were divided into two groups according to the UCR optimal cut-off value of 2.65 to explore the relationship between UCR and 3-year prognosis of the patients. Kaplan-Meier plotting of survival curves was done and compared by Log-Rank test. Correlation analysis was performed between patients' preoperative UCR and muscle parameters. Independent t test and nonparametric rank-sum test were used for normally and non-normally data, respectively. Categorical variables were tested using the χ2 test. P<0.05 was statistically significant.

Results

There were 22 deaths and 29 recurrences within 3 years. Multivariate analysis showed that UCR and tumor stage were significantly associated with postoperative overall survival (OS) and recurrence-free survival (RFS) (P<0.05). In all patients, the ROC area predicting 3-year overall survival and recurrence was 0.789 (P<0.001) and 0.739 (P<0.001), respectively; the risk of death and recurrence was more significant in the high UCR group compared with the low UCR group (P<0.007). In addition, UCR level was significantly associated with skeletal muscle mass (P<0.01).

Conclusion

UCR levels are effective in predicting the long-term prognosis of colorectal cancer patients after surgery. Patients with a higher UCR have an increased risk of death and tumor recurrence. In addition, UCR is positively correlated with skeletal muscle mass.

表1 221例结直肠癌患者根治术后3年预后的基线资料
表2 结直肠癌患者根治术后3年预后相关因素的多变量Logistic回归分析
图1 UCR预测患者3年总生存率和无复发ROC曲线 注:A=生存;B=复发。
图2 UCR分层总生存率和无复发生存期Kaplan-Meier曲线 注:A=总生存率(OS); B=无复发生存期(RFS)。
图3 UCR与L3-CT扫描计算SMA(或SMI)之间相关性 注:A=UCR- SMA; B=UCR- SMI。
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