摘要
[目的]探讨术前血小板/淋巴细胞比值(PLR)与原发性肝癌患者临床病理特征及预后生存时间的相关性。[方法]选取我院2009年1月~2011年12月收治原发性肝癌患者64例,收集患者的临床资料、病理学资料、影像学资料等进行回顾性分析。采用ROC曲线设定术前PLR临界值,根据术前PLR水平,分析术前PLR水平与原发性肝癌患者临床病理特征及预后生存时间的相关性。[结果]ROC曲线下面积为0.622(95%CI:0.521~0.723),PLR诊断肿瘤复发的临界值为130.79;高PLR组26例(83.87%)Child-Pugh分级为B级,明显高于低PLR组17例(51.51%)(P<0.01);高PLR组侵犯血管者为16例(51.61%),明显高于低PLR组8例(24.24%)(P<0.05);高PLR组13例(41.93%)TNM分期为Ⅲ级,明显高于低PLR组4例(12.12%)(P<0.01);高PLR组有腹水者为9例(29.03%),明显高于低PLR组3例(9.09%)(P<0.05);高PLR组1年、3年、5年无瘤生存率分别为61.29%(19/31)、32.25%(10/31)、12.90%(4/31),明显低于低PLR组[81.81%(27/33)、54.54%(18/33)、30.30%(10/33)](P<0.01);单因素分析结果显示:Child-Pugh分级、侵犯血管、TNM分期、腹水、术前PLR是影响患者预后生存的单因素(P<0.05),进一步Cox多因素分析发现Child-PughB级、侵犯血管、TNM分期Ⅲ期、术前PLR≥130.79是影响原发性肝癌患者预后生存的独立危险因素(P<0.01)。[结论]术前高血小板/淋巴细胞比值的原发性肝癌患者预后不佳,术前血小板/淋巴细胞比值水平可作为预后评估指标。
[Objective]To investigate the correlation between preoperative platelet to lymphocyte ratio（PLR）and clinicopathological features,prognostic survival time in patients with primary liver cancer.[Methods]A total of 64 patients with primary liver cancer were selected from January 2009 to December2011 in our hospital.The clinical data,pathological data and imaging data of the patients were retrospectively analyzed.The preoperative PLR threshold was set by ROC curve,and the correlation between the preoperative PLR level and the clinicopathological features,prognostic survival time of patients with primary liver cancer were analyzed.[Results]The area under the ROC curve was 0.622（95%CI：0.521~0.723）,the critical value of PLR diagnosis of tumor recurrence was 130.79.There were 51 cases（83.06%）of ChildPugh grade B in the high PLR group,which was significantly higher than that in the low PLR group with35 cases（52.23%）（P〈0.001）.The high PLR group of vascular invasion was 16 cases（51.61%）,signifi-cantly higher than the low PLR group of 8 cases（24.24%）（P〈0.05）;high PLR group 13（41.93%）TNM stage III,significantly higher than the low PLR group of 4 cases（12.12%）（P〈0.001）;high PLR group with ascites was 9（29.03）,significantly higher than the low PLR group of 3 cases（9.09%）（P〈0.05）;PLR group of 1 years,3 years and 5 years disease-free survival rates were 61.29%（19/31）,32.25%（10/31）,12.90%（4/31）,significantly lower than group PLR[81.81%（27/33）,54.54%（18/33）,30.30%（10/33）]（P〈0.001）.The single factor analysis showed that Child-Pugh Grade,vascular invasion,TNM staging,preoperative ascites,PLR were the single influencing prognostic factor（P〈0.05）.Multivariate Cox analysis showed that Child-PughB stage,vascular invasion,TNM stage III and PLR≥130.79 were independent risk factors for patients with primary liver cancer（P〈0.001）.[Conclusion]The primary liver cancer patients with high preoperative platelet to lymphocyte ratio have poor prognosis.The preoperative platelet to lymphocyte ratio can be used as a prognostic indicator.
出处
《中国中西医结合消化杂志》
CAS
2017年第11期823-827,共5页
Chinese Journal of Integrated Traditional and Western Medicine on Digestion
关键词
血小板与淋巴细胞比值
原发性肝癌
病理特征
预后
Platelet to lymphocyte ratio
Primary liver cancer
Clinicopathological features
Prognosis
作者简介
倪如莲，女，本科，主管技师，研究方向：临床检验基础,通讯作者：倪如莲，E—mail：abye567@163．com
