摘要
目的探讨人乳头瘤状病毒(HPV)阳性宫颈癌患者根治性放疗后HPV阳性率、血小板/淋巴细胞比值(PLR)的变化及与患者预后结局的关系。方法选取2017年6月-2019年1月三二〇一医院肿瘤放疗科收治的60例HPV阳性宫颈癌患者作为研究对象,根据3年随访患者的生存结局情况将其分为死亡组22例和存活组38例,所有患者均在本院接受肿瘤根治性放疗方式进行治疗,对比患者放疗前、放疗后3、6个月的HPV阳性率、PLR值变化,查阅病案就诊检查资料,分析两组患者人群特征资料、病理学资料、放疗后实验室指标,采用logistic回归模型分析HPV阳性率、PLR值与患者预后结局的关系。结果存活组患者在放疗3、6个月后的HPV阳性率均显著低于死亡组,差异均有统计学意义(χ^(2)=5.249、7.033,P=0.022、0.008)。在放疗3、6个月后,死亡组患者的PLR水平均高于存活组,差异均有统计学意义(t=2.618、3.484,P=0.011、0.001)。死亡组和存活组的年龄、体质量指数(BMI)、合并疾病、病灶直径、浸润深度、同步化疗、放疗并发症的发生情况比较,差异无统计学意义(P>0.05);死亡组的国际妇产科协会(FIGO)分期、淋巴结转移阳性率、病理学分化程度与存活组比较,差异均有统计学意义(χ^(2)=11.340、6.962、4.019,P=0.003、0.008、0.045)。Logistic回归模型结果显示化疗后HPV阳性、PLR值增高、FIGO分期≥Ⅱ期、淋巴结发生转移会显著增大宫颈癌患者根治性放疗后的不良预后结局风险(OR=1.781、1.594、1.848、1.477,P均<0.05)。结论HPV阳性宫颈癌患者根治性放疗后HPV阳性率、PLR水平均会出现降低,放疗后HPV阳性及PLR高水平会增大患者不良预后结局风险。
Objective To investigate the changes of human papilloma virus(HPV)positive rate and platelet/lymphocyte ratio(PLR)in patients with cervical cancer positive for HPV after radical radiotherapy and their relationship with the prognosis of patients.Methods A total of 60 HPV positive cervical cancer patients who were admitted to the Cancer Radiotherapy Department of the 3201 Hospital from June 2017 to January 2019 as the study objects.According to the survival outcome of the patients who were followed up for three years,they were divided into the death group of 22 patients and the survival group of 38 patients.All patients received radical radiotherapy for tumors in our hospital.The changes of HPV positive rate and PLR value before radiotherapy,3 months after radiotherapy,and 6 months after radiotherapy were compared.The medical records and examination data were reviewed.The demographic characteristics,pathological data,and laboratory indicators after radiotherapy of the two groups were analyzed.The relationships between HPV positive rate,PLR value,and the prognosis of the patients were analyzed using logistic regression model.Results The positive rate of HPV in the survival group after 3 months and 6 months of radiotherapy were significantly lower than those in the death group(χ^(2)=5.249,7.033,P=0.022,0.008).After 3 and 6 months of radiotherapy,the PLR values of patients in the death group were higher than those in the survival group,with a statistically significant difference(t=2.618,3.484,P=0.011,0.001).There was no significant difference between the death group and the survival group in age,body mass index(BMI),concomitant diseases,lesion diameter,depth of invasion,complications of concurrent chemotherapy and radiotherapy(P>0.05).The Federation International of Gynecology and Obstetrics(FIGO)stage,positive rate of lymph node metastasis and pathological differentiation in the death group were significantly different from those in the survival group(χ^(2)=11.340,6.962,4.019,P=0.003,0.008,0.045).Logistic regression model showed that positive HPV,increased PLR,FIGO stage≥Ⅱ,and lymph node metastasis after chemotherapy significantly increased the risk of adverse prognosis of cervical cancer patients after radical radiotherapy(OR=1.781,1.594,1.848,1.477,all P<0.05).Conclusion HPV positive rate and PLR level of HPV positive cervical cancer patients decreased after radical radiotherapy,and HPV positive and high PLR level after radiotherapy increased the risk of poor prognosis.
作者
马武
景文江
陈嘉琦
罗若楠
MA Wu;JING Wenjiang;CHEN Jiaqi;LUO Ruonan(Department of Tumor Radiotherapy,3201 Hospital,Hanzhong,Shaanxi 723000,China)
出处
《热带医学杂志》
CAS
2023年第8期1108-1112,共5页
Journal of Tropical Medicine
基金
陕西省自然科学基金(2018JM7017)
作者简介
马武(1967-),男,硕士,主任医师,研究方向为肿瘤的综合治疗,E-mail:13992690936@139.com
