摘要
目的分析年龄≤35岁宫颈癌患者预后不良的影响因素及术前外周血纤维蛋白原(FIB)、淋巴细胞/单核细胞(LMR)对其预后的预测价值,为临床评估病情、预测预后以及制订精准的治疗方案提供参考依据。方法选取2013年1月至2021年12月在郑州大学第三附属医院诊治的118例年龄≤35岁的宫颈癌患者的临床资料,依据术后第3年的生存状态分为预后良好组(106例)与预后不良组(12例)。比较两组FIB、碱性磷酸酶(ALP)、LMR,并采用logistic回归分析及受试者工作特征(ROC)曲线分析年龄≤35岁宫颈癌患者预后不良影响因素及相关指标的预测价值。结果预后不良组FIB、ALP水平高于预后良好组,LMR低于预后良好组(P<0.05)。单因素分析结果显示,FIGO分期Ⅲ~Ⅳ期、低分化、术前FIB水平升高、ALP水平升高、LMR降低与年龄≤35岁宫颈癌患者预后不良有关(P<0.05)。多因素分析结果显示,FIGO分期Ⅲ~Ⅳ期、组织学分型为其他类型(腺鳞癌、黑色素细胞瘤、肉瘤样癌)、FIB水平升高、LMR降低是年龄≤35岁宫颈癌患者预后不良的独立危险因素(P<0.05)。术前FIB曲线下面积为0.787(95%CI:0.653~0.920),LMR曲线下面积为0.792(95%CI:0.660~0.924),二者联合检测曲线下面积为0.875(95%CI:0.781~0.969),二者联合检测曲线下面积大于单独LMR检测(P<0.05)。结论FIGO分期Ⅲ~Ⅳ期、特殊组织学分型及术前FIB升高、LMR降低是年龄≤35岁宫颈癌患者预后不良的独立危险因素,术前FIB、LMR及二者联合检测预后有较高的预测价值,可作为预测宫颈癌患者预后的重要参考指标。
Objective To analyze the influencing factors of poor prognosis of cervical cancer patients≤35 years old,and the predictive value of preoperative peripheral blood fibrinogen(FIB)and lymphocyte to monocyte ratio(LMR)on the prognosis,so as to provide reference for clinical evaluation,prognosis prediction and accurate treatment plan.Methods The clinical data of 118 patients with cervical cancer aged≤35 years old who were diagnosed and treated in the Third Affiliated Hospital of Zhengzhou University from January 2013 to December 2021 were selected.According to the survival status in the third year after surgery,they were divided into the good prognosis group(106 cases)and the poor prognosis group(12 cases).FIB,alkaline phosphatase(ALP)and LMR were compared between the two groups.The logistic regression analysis and receiver operating characteristic(ROC)curve were used to analyze the influencing factors of poor prognosis of cervical cancer patients aged≤35 years old and the predictive value of related indicators.Results The levels of FIB and ALP in the poor prognosis group were higher than those in the good prognosis group,and LMR was lower than that in the good prognosis group(P<0.05).The results of univariate analysis showed that FIGO stageⅢ-Ⅳ,poor differentiation,elevated preoperative FIB level,elevated ALP level,and decreased LMR were associated with poor prognosis in cervical cancer patients aged≤35 years old(P<0.05).Multivariate analysis showed that FIGO stageⅢ-Ⅳ,other histological types(adenosquamous carcinoma,melanocytoma,sarcomatoid carcinoma),increased FIB level and decreased LMR were independent risk factors for poor prognosis of cervical cancer patients aged≤35 years old(P<0.05).The area under the preoperative FIB curve was 0.787(95%CI:0.653-0.920),the area under the LMR curve was 0.792(95%CI:0.660-0.924),and the area under the combined detection curve was 0.875(95%CI:0.781-0.969),and the area under the curve of combined detection was larger than that of LMR alone(P<0.05).Conclusion FIGO stageⅢ-Ⅳ,special histological types,elevated preoperative FIB and decreased LMR are independent risk factors for poor prognosis in cervical cancer patients aged≤35 years old.Preoperative FIB,LMR and their combined detection have high predictive value for prognosis,and can be used as important reference indicators for predicting prognosis of cervical cancer patients.
作者
李慧琦
石岩玉
马翠艳
田敏
秦巧红
LI Huiqi;SHI Yanyu;MA Cuiyan;TIAN Min;QIN Qiaohong(Department of Gynecological Oncology,the Third Affiliated Hospital of Zhengzhou University,Henan Province,Zhengzhou 450052,China)
出处
《妇儿健康导刊》
2025年第13期51-55,共5页
JOURNAL OF WOMEN AND CHILDREN'S HEALTH GUIDE
作者简介
李慧琦(1999-),女,河南开封人,郑州大学第三临床学院2022级妇产科专业在读硕士研究生,研究方向:妇科肿瘤。▲通讯作者:秦巧红(1983-),女,河南开封人,主任医师,研究方向:妇科肿瘤。
