目的 分析血清指标纤维蛋白原/白蛋白比值（FAR）联合预后营养指数（PNI）预测可切除胃癌患者根治术后的生存预 后的应用价值，为临床筛选敏感性和准确性更高的简易生化指标。方法 回顾性总结2017年10月至2020年10月入连云港市赣 榆区人民医院确诊可切除胃癌患者共155例，根治术后常规随访3.0~38.0个月，中位时间27.5个月；以总死亡为研究终点采用受 试者操作特征曲线（ROC曲线）获得术前患者基线状态血清FAR和PNI的AUC值和最佳临界值，并作为分组的依据；比较组间患 者的临床资料、生化指标和累积总生存率，单因素和多因素Cox回归分析筛选危险因素。结果 155例患者随访共死亡64例，死 亡率为41.3%（64/155）。ROC曲线分析显示，FAR和PNI预测总死亡的AUC值分别为0.798和0.812，临界值分别为0.112和41.52， FAR联合PNI预测总死亡的AUC值为0.865，高于FAR或者PNI（P<0.05）。155例患者分为A组（FAR≥0.112和PNI≥41.52）共60 例，B组（FAR≥0.112和PNI<41.52，或者FAR<0.112和PNI≥41.52）共45例，C组（FAR<0.112和PNI<41.52）共50例，三组患者年 龄、肿瘤直径、TNM分期、T分期和N分期比较，差异有统计学意义（P<0.05）。Kaplan⁃Meier曲线显示，C组1年和3年的累积生存 率低于A组和B组（P<0.05）。单因素或者多因素Cox回归分析显示，年龄（≥60岁）、TNM分期（Ⅲ期）、FAR（<0.112）和PNI（<41.52） 是死亡的独立危险因素（P<0.05）。结论 可切除胃癌患者术前FAR和PNI水平降低可能提示预后不良，联合FAR和PNI可作为 评估患者生存预后的重要生化指标，有较好的预测效能。

Objective To analyze the application value of serum fibrinogen/albumin ratio (FAR) combined with prognostic nutrition index (PNI) in predicting prognosis of patients with resectable gastric cancer after radical operation, and screen simple biochemical indicator with higher sensitivity and accuracy. Methods A retrospective summary of a total of 155 patients with resectable gastric cancer who were admitted to the Ganyu District People’s Hospital in Lianyungang City from October 2017 to October 2020. The follow⁃up was 3.0⁃38.0 months after radical operation, and the median time was 27.5 months. The AUC and optimal cut⁃off values of the baseline serum FAR and PNI were obtained by receiver operator characteristic curve（ROC curve）as the basis of grouping, then the clinical data, biochemical indicators and cumulative total survival rate of the patients were compared, the risk factors were screened by univariate and multivariate Cox regression analysis. Results There were up to 64 patients of death during the follow⁃up, with a mortality rate of 41.3% (64/155).ROC curve analysis showed that the AUC values for predicting the total death by FAR and PNI were 0.798 and 0.812, the cut⁃off were 0.112 and 41.52 respectively, and the AUC value of FAR combining with PNI was 0.865, higher than FAR or PNI (P<0.05). 155 patients were divided into three groups, 60 patients in group A (FAR≥0.112 and PNI≥41.52), 45 patients in group B (FAR≥0.112 and PNI<41.52, or FAR<0.112 and PNI≥41.52), 50 patients in group C (FAR<0.112 and PNI<41.52),there were significant differences of patients’age, tumor diameter, TNM stage, T stage and N stage among the three groups (P<0.05).Kaplan⁃Meier curve showed that one⁃year and three⁃year cumulative survival rates of group C were lower than group A and group B (P<0.05). The univariate and multivariate Cox regression analysis showed that age (≥60 years), TNM stage (stage Ⅲ),FAR (<0.112)and PNI (<41.52) were independent risk factors to death (P<0.05). Conclusion The decreases of FAR and PNI values before operation may indicate poor prognosis in patients with resectable gastric cancer, combined with FAR and PNI can be used as important biochemical indicator to evaluating the prognosis of patients, which has a good predictive effect.