Abstract: Objective To explore the relationship between estimated glomerular filtration rate （eGFR） and clinical stage and prognosis of primary gastric adenocarcinoma （GA）. Methods A total of 102 patients with GA in Zhengzhou People's Hospital from June 2020 to June 2023 were retrospectively selected as the research objects. Clinical data such as age, gender, tumor location, maximum diameter, histological differentiation, lymph node metastasis, distant metastasis, and clinical stage were recorded. The results of related indicators of renal function within 1 week before surgery were recorded. The eGFR levels and their correlation in patients with different clinical stages were compared. Patients were divided into metastasis group and non-metastasis group according to the presence or absence of distant metastasis, and eGFR levels were compared between the two groups. The diagnostic efficacy of eGFR was analyzed by ROC curve. Kaplan-Meier method and Cox proportional hazard model were used for survival analysis to evaluate the relationship between eGFR level and prognosis. Results There were significant differences in eGFR levels between patients with different clinical stages （P<0.001）, eGFR level was negatively correlated with clinical stage （r=-0.862,P<0.001）. The level of eGFR in patients with metastasis was lower than that in patients of non-metastasis （P<0.001）. The AUC of eGFR in the diagnosis of tumor metastasis was 0.940. By eGFR stratification, the results showed that the survival time of the higher stratification group was longer than that of the lower stratification group. Cox proportional hazards regression analysis showed that eGFR level（P=0.021）, distant metastasis （P=0.038）, and degree of differentiation （P=0.009） were independent factors affecting the prognosis of GA. Conclusion The level of eGFR is closely related to the clinical stage of patients, and it is an independent factor affecting the prognosis of patientsandhas important predictive value in evaluating the metastasis and prognosis of GA.

Key words: primary gastric adenocarcinoma, estimated glomerular filtration rate, clinical staging, prognosis

摘要： 目的 探究估算肾小球滤过率（eGFR）与原发性胃腺癌临床分期及其预后关系。方法 回顾性选取2020年6月至2023年6月郑州人民医院102例原发性胃腺癌患者为研究对象,记录患者年龄、性别、肿瘤位置、最大径、组织学分化、淋巴结转移、远处转移、临床分期等临床资料。记录患者术前1周内肾功能检验结果。比较不同临床分期患者eGFR水平及其相关性。根据有无远处转移将患者分为有转移组与无转移组,比较两组患者eGFR水平并通过ROC曲线分析诊断效能。采用Kaplan-Meier法及Cox比例风险模型进行生存分析评估eGFR水平与其预后关系。结果 不同临床分期患者eGFR水平比较有统计学差异（P<0.001）,eGFR水平与患者临床分期呈负相关（r=-0.862,P<0.001）。有转移组患者eGFR水平低于无转移组（P<0.001）,eGFR诊断肿瘤转移的AUC为0.940。通过eGFR分层,结果显示分层较高组生存期长于较低组。Cox比例风险回归分析显示eGFR水平（P=0.021）、远处转移（P=0.038）及分化程度（P=0.009）是影响GA预后的独立因素。结论 eGFR水平与患者临床分期密切相关,是影响预后的独立因素,对评估GA转移及其预后具有重要预测价值。

关键词: 原发性胃腺癌, 肾小球滤过率, 临床分期, 预后