摘要
目的探讨术前外周血中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)对肝癌患者并发微血管浸润(MVI)的预测价值。方法收集202例肝癌患者的临床资料,其中MVI阳性92例,MVI阴性110例。比较MVI阳性和MVI阴性肝癌患者的术前外周血NLR、PLR,采用受试者工作特征(ROC)曲线分析肝癌患者术前外周血NLR、PLR单独及联合检测对MVI的诊断价值,分析肝癌患者并发MVI的影响因素。结果MVI阳性肝癌患者的术前外周血NLR、PLR均高于MVI阴性肝癌患者,差异均有统计学意义(P﹤0.05)。肝癌患者术前外周血NLR、PLR单独检测诊断MVI的临界值分别为3.75和116.08,曲线下面积(AUC)分别为0.565和0.598,其AUC均低于术前外周血NLR、PLR联合诊断的0.694,差异均有统计学意义(P﹤0.05)。单因素分析结果显示,MVI阳性和MVI阴性肝癌患者的性别、年龄、肝硬化发生情况、慢性病毒性肝炎发生情况、Child-Pugh分级比较,差异均无统计学意义(P﹥0.05)。MVI阳性和MVI阴性肝癌患者的肿瘤直径、分化程度、术前甲胎蛋白(AFP)水平、术前外周血NLR和PLR比较,差异均有统计学意义(P﹤0.05)。多因素分析结果显示,术前AFP水平、术前外周血NLR和PLR均是肝癌患者并发MVI的独立危险因素(P﹤0.05)。结论术前外周血NLR、PLR可对肝癌患者MVI的发生情况进行一定的预测,且联合检测的预测价值高于单一检测。
Objective To study the predictive value of preoperative peripheral blood neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)on microvascular invasion(MVI)in patients with hepatocellular carcinoma(HCC).Method A total of 202 patients with HCC were retrospectively analyzed,among them,92 cases were positive for MVI and 110 cases were negative for MVI.The NLR and PLR in the peripheral blood of patients with HCC were observed before operation,receiver operating characteristic(ROC)curves were plotted to assess the value of NLR,PLR alone or combination in predicting MVI,and the factors influencing the development of MVI were assessed.Result The preoperative peripheral blood NLR and PLR in HCC patients with positive MVI were significantly higher than those in patients with negative MVI(P<0.05).The cut-off values of NLR or PLR in preoperative peripheral blood for diagnosing MVI were 3.75 and 116.08,respectively,with area under the curve(AUC)of 0.565 and 0.598,respectively,which were lower compared to the combined detection of preoperative peripheral blood NLR and PLR at 0.694(P<0.05).Univariate analysis showed that there was no significant difference in gender,age,cirrhosis,chronic viral hepatitis and Child-Pugh grade between MVI-positive and MVI-negative patients(P>0.05);but significant differences in tumor diameter,degree of differentiation,preoperative alpha fetoprotein(AFP)level,preoperative peripheral blood NLR and PLR between MVIpositive and MVI-negative patients were noted(P<0.05).The multivariate analysis indicated that preoperative AFP,preoperative peripheral blood NLR and PLR were independent risk factors for MVI in patients with HCC(P<0.05).Conclusion Preoperative peripheral blood NLR and PLR are predictive for the occurrence of MVI in patients with HCC,besides,the combined detection of the two is of higher predictive value compared to each indicator alone.
作者
车宇
梁静
王蒨
蔡英全
郭俊俊
邵帅
刘伟
CHE Yu;LIANG Jing;WANG Qian;CAI Yingquan;GUO Junjun;SHAO Shuai;LIU Wei(Department of Radiotherapy,Shaanxi Provincial Tumor Hospital,Xi’an 710061,Shaanxi,China;Department of General Surgery,Shaanxi Provincial Tumor Hospital,Xi’an 710061,Shaanxi,China)
出处
《癌症进展》
2020年第14期1438-1441,共4页
Oncology Progress
