中国癌症杂志
中國癌癥雜誌
중국암증잡지
CHINA ONCOLOGY
2013年
6期
457-461
,共5页
李健%叶定伟%姚旭东%张世林%戴波%张海梁%沈益君%朱耀%施国海%朱一平%马春光%秦晓健%林国文%肖文军
李健%葉定偉%姚旭東%張世林%戴波%張海樑%瀋益君%硃耀%施國海%硃一平%馬春光%秦曉健%林國文%肖文軍
리건%협정위%요욱동%장세림%대파%장해량%침익군%주요%시국해%주일평%마춘광%진효건%림국문%초문군
上尿路尿路上皮癌%血小板/淋巴细胞比值%肿瘤分期%预后因素
上尿路尿路上皮癌%血小闆/淋巴細胞比值%腫瘤分期%預後因素
상뇨로뇨로상피암%혈소판/림파세포비치%종류분기%예후인소
Upper tract urothelial carcinoma%Platelet to lymphocyte ratio%Tumor stage%Prognostic factor
背景与目的：血小板/淋巴细胞比值(platelet to lymphocyte ratio，PLR)被认为是反映机体内炎性反应的重要指标，PLR在上尿路尿路上皮癌中的临床价值国内外尚没有相关研究。本研究旨在探讨术前PLR在判断上尿路尿路上皮癌临床分期及预后的价值。方法：收集2007年1月至2012年3月单中心手术治疗的无远处转移的上尿路尿路上皮癌病例，术前、术后无瘤期及复发或转移期PLR。随访采用门诊与电话相结合。采用PLR=150：1为分界值将病例分为低PLR组和高PLR组，分析其与肿瘤分期、是否合并膀胱肿瘤、复发或转移、生存、肿瘤部位、术前血尿、术前肾积水、性别及年龄的关系。进一步分析不同PLR分组的无病生存时间、总生存时间。结果：共收集上尿路尿路上皮癌51例，术后中位随访时间21(9~51)个月，出现复发或转移20例(39.2%)，中位无病生存时间15(2~51)个月，死亡9例(17.6%)，中位生存时间21(9~51)个月。单因素分析显示术前PLR与肿瘤分期、生存率、血尿及性别具有相关性，P值分别为0.028、0.008、0.045、0.036。高PLR组更易发生器官非局限性肿瘤，术前PLR判断非器官局限性肿瘤的敏感性为57%、特异性为74%。Kaplan-Meier法生存分析显示，两组无病生存时间差异无统计学意义(P=0.155)、高PLR组总生存时间明显短于低PLR组(P=0.006)。Cox多因素生存分析显示仅肿瘤分期是总生存时间的独立影响因素(P=0.029)。结论：在上尿路尿路上皮癌中，术前PLR是判断非器官局限性肿瘤的潜在因素，高PLR组更易发生器官非局限性肿瘤。肿瘤分期是总生存时间的独立影响因素。
揹景與目的：血小闆/淋巴細胞比值(platelet to lymphocyte ratio，PLR)被認為是反映機體內炎性反應的重要指標，PLR在上尿路尿路上皮癌中的臨床價值國內外尚沒有相關研究。本研究旨在探討術前PLR在判斷上尿路尿路上皮癌臨床分期及預後的價值。方法：收集2007年1月至2012年3月單中心手術治療的無遠處轉移的上尿路尿路上皮癌病例，術前、術後無瘤期及複髮或轉移期PLR。隨訪採用門診與電話相結閤。採用PLR=150：1為分界值將病例分為低PLR組和高PLR組，分析其與腫瘤分期、是否閤併膀胱腫瘤、複髮或轉移、生存、腫瘤部位、術前血尿、術前腎積水、性彆及年齡的關繫。進一步分析不同PLR分組的無病生存時間、總生存時間。結果：共收集上尿路尿路上皮癌51例，術後中位隨訪時間21(9~51)箇月，齣現複髮或轉移20例(39.2%)，中位無病生存時間15(2~51)箇月，死亡9例(17.6%)，中位生存時間21(9~51)箇月。單因素分析顯示術前PLR與腫瘤分期、生存率、血尿及性彆具有相關性，P值分彆為0.028、0.008、0.045、0.036。高PLR組更易髮生器官非跼限性腫瘤，術前PLR判斷非器官跼限性腫瘤的敏感性為57%、特異性為74%。Kaplan-Meier法生存分析顯示，兩組無病生存時間差異無統計學意義(P=0.155)、高PLR組總生存時間明顯短于低PLR組(P=0.006)。Cox多因素生存分析顯示僅腫瘤分期是總生存時間的獨立影響因素(P=0.029)。結論：在上尿路尿路上皮癌中，術前PLR是判斷非器官跼限性腫瘤的潛在因素，高PLR組更易髮生器官非跼限性腫瘤。腫瘤分期是總生存時間的獨立影響因素。
배경여목적：혈소판/림파세포비치(platelet to lymphocyte ratio，PLR)피인위시반영궤체내염성반응적중요지표，PLR재상뇨로뇨로상피암중적림상개치국내외상몰유상관연구。본연구지재탐토술전PLR재판단상뇨로뇨로상피암림상분기급예후적개치。방법：수집2007년1월지2012년3월단중심수술치료적무원처전이적상뇨로뇨로상피암병례，술전、술후무류기급복발혹전이기PLR。수방채용문진여전화상결합。채용PLR=150：1위분계치장병례분위저PLR조화고PLR조，분석기여종류분기、시부합병방광종류、복발혹전이、생존、종류부위、술전혈뇨、술전신적수、성별급년령적관계。진일보분석불동PLR분조적무병생존시간、총생존시간。결과：공수집상뇨로뇨로상피암51례，술후중위수방시간21(9~51)개월，출현복발혹전이20례(39.2%)，중위무병생존시간15(2~51)개월，사망9례(17.6%)，중위생존시간21(9~51)개월。단인소분석현시술전PLR여종류분기、생존솔、혈뇨급성별구유상관성，P치분별위0.028、0.008、0.045、0.036。고PLR조경역발생기관비국한성종류，술전PLR판단비기관국한성종류적민감성위57%、특이성위74%。Kaplan-Meier법생존분석현시，량조무병생존시간차이무통계학의의(P=0.155)、고PLR조총생존시간명현단우저PLR조(P=0.006)。Cox다인소생존분석현시부종류분기시총생존시간적독립영향인소(P=0.029)。결론：재상뇨로뇨로상피암중，술전PLR시판단비기관국한성종류적잠재인소，고PLR조경역발생기관비국한성종류。종류분기시총생존시간적독립영향인소。
Background and purpose: Platelet to lymphocyte ratio (PLR) is an important factor reflected systematic inflammation. The clinical value of PLR has not been confirmed. The present study was to explore the value of preoperative PLR in predicting clinical stage and prognosis in upper tract urothelial carcinoma. Methods:Patients who underwent surgical therapy with postoperative pathology upper tract urothelial carcinoma without metastasis from Jan. 2007 to Mar. 2012, were collected. Following up was done by telephone and clinic work, 150 vs 1 was taken as the threshold value of PLR, and the association of PLR with tumor stage, whether suffered bladder cancer as comorbidity, recurrent or metastasis, overall survival, tumor lesion, preoperative hematuria, gender and age was analyzed. We further analyzed the association difference of disease free survival (DFS) time and overall survival (OS) time between different PLR groups. Results:Fifty-one cases of UTUC were collected, and the postoperative mean following up time is 21 (9–51) months. Twenty cases recurred or metastasis and 9 cases died. The mean DFS time was 15 (2–51) months,and the mean OS time was 21 (9–51) months. One-factor analysis of variance showed that preoperative PLR was associated with tumor stage, overall survival rate, hematuria and gender, and the P value were 0.028, 0.008, 0.045, 0.036 respectively. High PLR group was intended to be non-organ confined disease, the sensitivity was 57%and the specificity was 74%. Survival analysis by Kaplan-Meier method showed there is no statistical difference in DFS between high and low PLR groups (P=0.155). But OS time in high PLR group was significantly less than that in low PLR group (P=0.006). Cox regression confirmed that only tumor stage is an independent prognostic factor of OS (P=0.029). Conclusion:PLR has potential clinical value in predicting advanced stage disease and Cox regression confirmed that only tumor stage is an independent prognostic factor of OS.
