中国肿瘤临床
中國腫瘤臨床
중국종류림상
CHINESE JOURNAL OF CLINICAL ONCOLOGY
2014年
16期
1045-1048
,共4页
宫颈癌%新辅助化疗%血小板与淋巴细胞比值%预后
宮頸癌%新輔助化療%血小闆與淋巴細胞比值%預後
궁경암%신보조화료%혈소판여림파세포비치%예후
uterine cervical neoplasm%neoadjuvant chemotherapy%platelet-to-lymphocyte ratio%prognosis
目的：评价治疗前外周血血小板和淋巴细胞比值（PLR）与ⅠB2～ⅡB期宫颈癌新辅助化疗疗效及预后的相关性。方法：回顾性分析2010年1月至2012年12月第二军医大学附属长海医院妇产科75例新辅助化疗后行根治性手术的ⅠB2～ⅡB期患者的临床病理资料，绘制ROC曲线分析PLR与新辅助化疗疗效的关系，预测新辅助化疗疗效的最佳临界（cutoff）值。建立Lo-gistic回归模型分析影响新辅助治疗疗效的独立相关因素，采用单因素及Cox回归模型分析PLR和其他临床病理因素与3年生存率的关系。结果：PLR与新辅助化疗的疗效显著相关，预测新辅助化疗疗效的PLR最佳临界值为123.0，敏感性和特异性分别为0.885和0.522。患者PLR>123.0的3年生存率低于PLR≤123.0（59.8%vs.82.4%），但差异无统计学意义（P=0.116）。单因素分析显示脉管浸润、肿瘤直径>4 cm、淋巴结转移对患者的3年生存率有影响，多因素分析显示仅淋巴结转移是影响患者生存率的独立危险因素（RR=5.375，95%CI为1.351～21.379，P=0.017）。结论：治疗前PLR作为一种简单、经济、可重复的全身炎症反应指标，可有效预测新辅助化疗的疗效，但对预后评估无明显临床价值。
目的：評價治療前外週血血小闆和淋巴細胞比值（PLR）與ⅠB2～ⅡB期宮頸癌新輔助化療療效及預後的相關性。方法：迴顧性分析2010年1月至2012年12月第二軍醫大學附屬長海醫院婦產科75例新輔助化療後行根治性手術的ⅠB2～ⅡB期患者的臨床病理資料，繪製ROC麯線分析PLR與新輔助化療療效的關繫，預測新輔助化療療效的最佳臨界（cutoff）值。建立Lo-gistic迴歸模型分析影響新輔助治療療效的獨立相關因素，採用單因素及Cox迴歸模型分析PLR和其他臨床病理因素與3年生存率的關繫。結果：PLR與新輔助化療的療效顯著相關，預測新輔助化療療效的PLR最佳臨界值為123.0，敏感性和特異性分彆為0.885和0.522。患者PLR>123.0的3年生存率低于PLR≤123.0（59.8%vs.82.4%），但差異無統計學意義（P=0.116）。單因素分析顯示脈管浸潤、腫瘤直徑>4 cm、淋巴結轉移對患者的3年生存率有影響，多因素分析顯示僅淋巴結轉移是影響患者生存率的獨立危險因素（RR=5.375，95%CI為1.351～21.379，P=0.017）。結論：治療前PLR作為一種簡單、經濟、可重複的全身炎癥反應指標，可有效預測新輔助化療的療效，但對預後評估無明顯臨床價值。
목적：평개치료전외주혈혈소판화림파세포비치（PLR）여ⅠB2～ⅡB기궁경암신보조화료료효급예후적상관성。방법：회고성분석2010년1월지2012년12월제이군의대학부속장해의원부산과75례신보조화료후행근치성수술적ⅠB2～ⅡB기환자적림상병리자료，회제ROC곡선분석PLR여신보조화료료효적관계，예측신보조화료료효적최가림계（cutoff）치。건립Lo-gistic회귀모형분석영향신보조치료료효적독립상관인소，채용단인소급Cox회귀모형분석PLR화기타림상병리인소여3년생존솔적관계。결과：PLR여신보조화료적료효현저상관，예측신보조화료료효적PLR최가림계치위123.0，민감성화특이성분별위0.885화0.522。환자PLR>123.0적3년생존솔저우PLR≤123.0（59.8%vs.82.4%），단차이무통계학의의（P=0.116）。단인소분석현시맥관침윤、종류직경>4 cm、림파결전이대환자적3년생존솔유영향，다인소분석현시부림파결전이시영향환자생존솔적독립위험인소（RR=5.375，95%CI위1.351～21.379，P=0.017）。결론：치료전PLR작위일충간단、경제、가중복적전신염증반응지표，가유효예측신보조화료적료효，단대예후평고무명현림상개치。
Objective:To evaluate the predictive value of pretreatment platelet-to-lymphocyte ratios (PLRs) in response to neoad-juvant chemotherapy and prognostic outcome in patients with International Federation of Gynecologists and Obstetricians (FIGO) Stag-es IB2-IIB cervical cancer. Methods:An investigation was conducted from January 2010 to December 2012 on 75 patients with FIGO Stages IB2-IIB cervical cancer, who underwent neoadjuvant chemotherapy and radical surgery in Changhai Hospital, Shanghai. A re-ceiver operating characteristic (ROC) curve was used to determine the best PLR cut-off value in predicting the response to neoadjuvant chemotherapy. The relationships between the pretreatment variables and the response to neoadjuvant chemotherapy were assessed in univariate and multivariate settings. The overall three-year survival rates were analyzed using the log-rank test and Cox regression mod-el. Results:The response to neoadjuvant chemotherapy was associated with PLR. At the threshold of 123.0, the PLR was 88.5%sensi-tive and 52.2%specific. Multivariate analysis showed that the low independent PLR predicted the response to neoadjuvant chemothera-py well. Based on the log-rank test, the three-year survival rate was lower in patients with PLR >123.0 than those with PLR <123.0 (59.8%vs. 82.4%), but no statistically significant differences were observed between them (P=0.116). Mono-factorial analysis showed that vascular invasion (a tumor that is>4 cm in diameter) and lymph node metastasis influenced the three-year survival rate. In the Cox regression model, only the lymph node metastasis was identified as an independent risk factor for poor prognosis (RR:5.375;95%CI:1.351-21.379; P=0.017). Conclusion: Pretreatment PLR is an easily measured, reproducible, and inexpensive marker of systemic in-flammation and thus shows a prognostic and independent predictive value for the response to neoadjuvant chemotherapy in cervical can-cer. However, pretreatment PLR is not a clinically significant factor for the assessment of cervical cancer prognosis.
