摘要
目的探讨白蛋白/纤维蛋白原比值(AFR)、血小板/淋巴细胞比值(PLR)预测非小细胞肺癌患者预后的价值。方法回顾性分析自2010年1月至2013年12月收治的188例非小细胞肺癌患者临床资料。绘制受试者工作特征曲线确定AFR、PLR的截断值,以AFR、PLR截断值将患者分为高水平与低水平,分析不同AFR、PLR表达水平的非小细胞肺癌患者临床病理特征,比较不同AFR、PLR表达水平的非小细胞肺癌患者存活率。采用Cox回归分析对影响非小细胞肺癌患者预后的影响因素进行分析。结果PLR预测非小细胞肺癌患者预后的受试者工作特征曲线下面积为0.784,截断值为132.41,敏感度和特异度分别为0.818、0.806(P<0.05);AFR预测非小细胞肺癌患者预后的受试者工作特征曲线下面积为0.704,截断值为9.54,敏感度和特异度分别为0.795、0.778(P<0.05)。AFR高水平组与AFR低水平组患者的肿瘤直径、肿瘤部位、肿瘤分期、肿瘤分化程度、淋巴结转移情况比较,差异有统计学意义(P<0.05)。PLR高水平组与PLR低水平组患者的吸烟史、肿瘤直径、肿瘤分期、肿瘤分化程度、淋巴结转移情况比较,差异有统计学意义(P<0.05)。随访60个月,AFR低水平组患者存活率高于AFR高水平组,差异有统计学意义(t=4.412,P<0.05);PLR低水平组患者存活率高于PLR高水平组,差异有统计学意义(t=4.711,P<0.05)。多因素分析结果显示,TNM分期为Ⅲ~Ⅳ期、肿瘤低分化、PLR和AFR高水平是影响非小细胞肺癌患者预后的独立危险因素(P<0.05)。结论术前AFR、PLR水平对非小细胞肺癌患者预后有一定预测价值,AFR、PLR低水平的非小细胞肺癌患者生存预后较好。
Objective To investigate the prognostic value of albumin/fibrinogen ratio(AFR)and platelet/lymphocyte ratio(PLR)in patients with non-small cell lung cancer(NSCLC).Methods A retrospective study was performed on 188 cases of patients with NSCLC who were admitted from January 2010 to December 2013.The cut-off values of AFR and PLR were determined by drawing the subject work characteristic curve,and the patients were divided into high and low levels according to the cut-off values of AFR and PLR.The clinicopathological characteristics of NSCLC patients with different AFR and PLR expression levels were analyzed to compare the survival rates of NSCLC patients with different AFR and PLR expression levels.Cox regression analysis was used to analyze the prognostic factors of patients with NSCLC.Results The area under the working characteristic curve of PLR for predicting the prognosis of NSCLC patients was 0.784,the cutoff value was 132.41,and the sensitivity and specificity were 0.818 and 0.806,respectively(P<0.05).AFR predicted the prognosis of NSCLC patients with area under working characteristic curve of 0.704,truncation value of 9.54,sensitivity and specificity was 0.795 and 0.778,respectively(P<0.05).There were statistically significant differences in tumor diameter,tumor site,tumor stage,tumor differentiation degree and lymph node metastasis between patients in the high AFR group and the low AFR group(P<0.05).There were statistically significant differences in smoking history,tumor diameter,tumor stage,tumor differentiation degree and lymph node metastasis between the PLR high level group and the PLR low level group(P<0.05).After 60 months of follow-up,the survival rate of patients in the low-level AFR group was higher than that in the high-level AFR group(t=4.412,P<0.05).The survival rate of patients in the low PLR group was higher than that in the high PLR group(t=4.711,P<0.05).Multiple factors analysis,according to the results of TNM stage isⅢtoⅣlow,tumor differentiation,PLR and AFR high level is independent risk factors for the prognosis of patients with NSCLC(P<0.05).Conclusion Preoperative AFR and PLR levels have certain predictive value for the prognosis of NSCLC patients,and patients with low AFR and PLR levels have a better prognosis.
作者
陈春艳
曹艺
CHEN Chun-yan;CAO Yi(Department of Cardiothoracic Surgery,Chongqing Dazu District People′s Hospital,Chongqing 402360,China)
出处
《创伤与急危重病医学》
2020年第4期281-285,共5页
Trauma and Critical Care Medicine
