血小板与淋巴细胞比值及Ki-67表达对晚期非小细胞肺癌化疗效果及预后判断的意义  

Significances of platelet-to-lymphocyte ratio and Ki-67 expression in judging the chemotherapy efficacy and prognosis of patients with advanced non-small cell lung cancer

作　　者：单彬彬[1] 李媛[1] 杜凤兰[1] 贾雅丽[2] 张全卯[3] Shan Binbin;Li Yuan;Du Fenglan;Jia Yali;Zhang Quanmao(Department of Respiration, Shanxi Provincial Cancer Hospital, Taiyuan 030013, China;Department of Prevention and Health Section, Shanxi Provincial Cancer Hospital, Taiyuan 030013, China;Department of Endoscope, Shanxi Provincial Cancer Hospital, Taiyuan 030013, China)

机构地区：[1]山西省肿瘤医院呼吸一科,太原030013 [2]山西省肿瘤医院预防保健科,太原030013 [3]山西省肿瘤医院内镜中心,太原030013

出　　处：《肿瘤研究与临床》2019年第5期300-304,共5页Cancer Research and Clinic

摘　　要：目的探讨初治晚期非小细胞肺癌(NSCLC)患者外周血血小板与淋巴细胞比值(PLR)、肺癌组织细胞增殖抗原Ki-67在化疗效果及预后判断中的价值。方法回顾性分析2015年1月至2016年1月于山西省肿瘤医院经病理及免疫组织化学确诊的132例晚期NSCLC患者的临床资料。采集患者化疗前外周静脉血,应用血细胞分析仪检测血小板、淋巴细胞数,计算PLR;免疫组织化学SP法检测组织切片Ki-67表达情况。一线化疗采用含铂双药方案治疗至少4个周期。计数资料比较采用χ2检验;有效率影响因素采用logistic回归模型进行分析;应用Kaplan-Meier法进行生存分析,并行log-rank检验;Cox风险比例模型进行预后多因素分析。结果一线化疗有效率41.7%(55/132)。患者1、2年总生存(OS)率分别为26.1%、10.4%,中位无进展生存(PFS)时间5.7个月(95% CI 3.2~10.9个月),中位OS时间14.1个月(95% CI 6.8~18.4个月)。中位PLR为172.0。PLR<172.0组有效率高于PLR≥172.0组[60.6%(40/66)比22.7%(15/66),χ^2=19.481,P<0.05],中位OS时间较PLR≥172.0组长(17.6个月比15.0个月,χ^2=4.976,P<0.05),两组中位PFS时间差异无统计学意义(8.6个月比6.5个月,χ^2=0.078,P>0.05)。Ki-67阴性组与阳性组间有效率差异无统计学意义[40.0%(28/70)比43.5%(27/62),χ^2=0.170,P>0.05],阴性组中位PFS时间、OS时间均较阳性组长(7.6个月比6.5个月,χ^2=7.170,P<0.05;18.3个月比14.5个月,χ^2=15.870,P<0.05)。多因素分析显示,PLR是有效率的独立影响因素(P<0.05),Ki-67是PFS的独立影响因素(P<0.05),PLR、Ki-67是OS的独立影响因素(P<0.05)。结论PLR和Ki-67可以作为预测晚期NSCLC化疗效果和预后评估的有意义指标。Objective To investigate the value of platelet-to-lymphocyte ratio (PLR) and cell proliferation antigen Ki-67 in judging the chemotherapy efficacy and prognosis of patients with advanced non-small cell lung cancer (NSCLC). Methods The clinical data of 132 patients with advanced NSCLC diagnosed by pathology and immunohistochemistry from January 2015 to January 2016 in Shanxi Provincial Cancer Hospital were retrospectively analyzed. Peripheral venous blood cells were collected before chemotherapy, the platelet and lymphocyte counts were detected by using blood cell analyzer to calculate PLR. Immunohistochemical SP method was used to detect the expression of Ki-67 in tissue sections. The platinum-containing dual-drug regimen was used in the first-line chemotherapy for at least 4 cycles. The χ2 test was used to compare the count data, and the logistic regression model was used to analyze the factors affecting the effective rate. The Kaplan-Meier method and log-rank test were used for survival analysis, and the Cox proportional hazards regression model was used for multivariate analysis of prognosis. Results The total effective rate of the first-line chemotherapy was 41.7%(55/132). The 1-year and 2-year overall survival (OS) rates were 26.1% and 10.4%, respectively. and the mean progression-free survival (PFS) time was 5.7 months (95% CI 3.2-10.9 months) and the median OS time was 14.05 months (95% CI 6.8-18.4 months). The median PLR was 172.0. The effective rate in PLR < 172.0 group was higher than that in PLR≥172.0 group [60.6%(40/66) vs. 22.7%(15/66),χ^2= 19.481, P < 0.05], and the median OS time in PLR < 172.0 group was longer than that in PLR ≥172.0 group (17.6 months vs. 15.0 months,χ^2= 4.976, P < 0.05), and there was no significant difference in the median PFS time between the two groups (8.6 months vs. 6.5 months,χ^2= 0.078, P > 0.05). There was no significant difference in the effective rate between Ki-67 negative group and positive group [40.0%(28/70) vs. 43.5%(27/62),χ^2= 0.170, P > 0.05]. The med

关 键 词：癌 非小细胞肺 血小板与淋巴细胞比值 KI-67抗原 预后 

分 类 号：R734.2[医药卫生—肿瘤]