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首页> 外文期刊>EBioMedicine >Preoperative Metabolic Syndrome Is Predictive of Significant Gastric Cancer Mortality after Gastrectomy: The Fujian Prospective Investigation of Cancer (FIESTA) Study
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Preoperative Metabolic Syndrome Is Predictive of Significant Gastric Cancer Mortality after Gastrectomy: The Fujian Prospective Investigation of Cancer (FIESTA) Study

机译：术前代谢综合征可预测胃切除术后胃癌的重要死亡率：福建癌症前瞻性研究（FIESTA）研究

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Metabolic syndrome (MetS) has been shown to be associated with an increased risk of gastric cancer. However, the impact of MetS on gastric cancer mortality remains largely unknown. Here, we prospectively examined the prediction of preoperative MetS for gastric cancer mortality by analyzing a subset of data from the ongoing Fujian prospective investigation of cancer (FIESTA) study. This study was conducted among 3012 patients with gastric cancer who received radical gastrectomy between 2000 and 2010. The latest follow-up was completed in 2015. Blood/tissue specimens, demographic and clinicopathologic characteristics were collected at baseline. During 15-year follow-up, 1331 of 3012 patients died of gastric cancer. The median survival time (MST) of patients with MetS was 31.3months, which was significantly shorter than that of MetS-free patients (157.1months). The coexistence of MetS before surgery was associated with a 2.3-fold increased risk for gastric cancer mortality (P<0.001). The multivariate-adjusted hazard ratios (HRs) were increased with invasion depth T1/T2 (HR=2.78, P<0.001), regional lymph node metastasis N0 (HR=2.65, P<0.001), positive distant metastasis (HR=2.53, P<0.001), TNM stage I/II (HR=3.00, P<0.001), intestinal type (HR=2.96, P<0.001), negative tumor embolus (HR=2.34, P<0.001), and tumor size @?4.5cm (HR=2.49, P<0.001). Further survival tree analysis confirmed the top splitting role of TNM stage, followed by MetS or hyperglycemia with remarkable discrimination ability. In this large cohort study, preoperative MetS, especially hyperglycemia, was predictive of significant gastric cancer mortality in patients with radical gastrectomy, especially for early stage of gastric cancer.
机译：代谢综合征（MetS）已被证明与胃癌风险增加有关。但是，MetS对胃癌死亡率的影响仍然未知。在这里，我们通过分析正在进行的福建省癌症前瞻性研究（FIESTA）研究的部分数据，前瞻性地检查了术前MetS对胃癌死亡率的预测。本研究针对3012例2000年至2010年间接受胃癌根治术的胃癌患者进行。最新随访于2015年完成。在基线时收集了血液/组织标本，人口统计学和临床​​病理特征。在15年的随访中，3012例患者中有1331例死于胃癌。 MetS患者的中位生存时间（MST）为31.3个月，明显短于无MetS患者的中位生存时间（157.1个月）。术前MetS的共存与胃癌死亡风险增加2.3倍相关（P <0.001）。随浸润深度T1 / T2（HR = 2.78，P <0.001），区域淋巴结转移N0（HR = 2.65，P <0.001），远处转移阳性（HR = 2.53， P <0.001），TNM I / II期（HR = 3.00，P <0.001），肠型（HR = 2.96，P <0.001），肿瘤栓塞阴性（HR = 2.34，P <0.001）和肿瘤大小？ 4.5厘米（HR = 2.49，P <0.001）。进一步的生存树分析证实了TNM分期的最高分裂作用，其次是MetS或高血糖症，具有明显的辨别能力。在这项大型队列研究中，术前MetS（尤其是高血糖症）预示了根治性胃切除术患者（尤其是早期胃癌）的显着胃癌死亡率。

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