摘要
目的探讨术前外周血血小板/淋巴细胞比值(PLR)对胃神经内分泌肿瘤(gNEN)病人预后的影响。方法分析76例确诊的gNEN病人临床资料,使用Kaplan-Meier法计算手术后病人的总体生存率和无复发生存率,采用Cox比例风险模型进行单因素和多因素分析,应用ROC曲线分析术前PLR对病人生存结局及术后复发或转移的预测效能。结果 Cox比例风险模型显示,肿瘤类型、TNM分期、血PLR是病人总体生存的独立危险因素(RR=0.069~1.010,95%CI=0.008~1.455,P<0.05),肿瘤类型、TNM分期、淋巴血管神经浸润、血PLR是病人无复发生存的独立危险因素(RR=0.032~3.522,95%CI=0.004~11.322,P<0.05)。ROC分析表明,PLR预测病人生存结局的灵敏度为0.757,特异度为0.681;PLR预测病人肿瘤复发结局的灵敏度为0.757,特异度为0.681。结论术前PLR是gNEN术后预后评估指标之一,术前PLR高的病人更容易发生复发和转移,术后应加强随访。
Objective To investigate the prognostic value of preoperative platelet-to-lymphocyte ratio（PLR）in patients with gastric neuroendocrine neoplasms（gNEN）. Methods The clinical data of 76 patients who were definitely diagnosed with gNEN and underwent surgical treatment were retrospectively analyzed.The Kaplan-Meier method was used to calculate overall survival（OS）and recurrence-free survival（RFS）rates,the Cox proportional hazards model was used for univariate and multivariate analyses,and the receiver operating characteristic（ROC）curve was used to determine the predictive efficiency of preoperative PLR for survival outcome and postoperative recurrence or metastasis. Results The Cox proportional hazards model showed that the neoplasia type,TNM stage,and blood PLR were independent risk factors for OS（RR=0.069-1.010,95%CI=0.008-1.455,P〈0.05）,and neoplasia type,TNM stage,lymphatic,vascular,and neural invasion,and blood PLR were independent risk factors for RFS（RR=0.032-3.522,95%CI=0.004-11.322,P〈0.05）.The ROC curve analysis revealed that PLR had a sensitivity of 0.757 and a specificity of 0.681 for predicting survival outcome and a sensitivity of 0.757 and a specificity of 0.681 for predicting neoplasm recurrence. Conclusion Preoperative PLR is one of the prognostic markers for gNEN patients after surgery.The patients with higher preoperative PLR are more likely to develop recurrence and metastasis.Therefore,reinforced postoperative follow-ups are required.
作者
张文勇
叱军涛
夏玉萍
巩玉亮
ZHANG Wenyong, CHI Juntao, XIA Yuping, GONG Yuliang(Department of Gastrointestinal Surgery, Shangluo Central Hospital, Shangluo 726000, Chin)
出处
《青岛大学医学院学报》
CAS
2017年第6期676-680,686,共6页
Acta Academiae Medicinae Qingdao Universitatis
