肿瘤微环境相关临床血液指标临床特征及预后分析  

Clinical Characteristics and Prognostic Analysis of Clinical Blood Indexes Related to Tumor Microenvironment

作　　者：潘丽娜[1] 孙雯雯[1] 高蓓莉[2] 徐志红[1] 胡家安[1] PAN Li-na;SUN Wen-wen;GAO Be-li;XU Zhi-hong;HU Jia-an(Shanghai Jiaotong University School of Medicine affiliated Ruijin Hospital Geriatric Department, Shanghai ,200025 ,China;Shanghai Jiaotong University School of Medicine affiliated Ruijin Hospital,Respiratory division, Shanghai ,200025 ,China)

机构地区：[1]上海交通大学医学院附属瑞金医院老年病科,上海200025 [2]上海交通大学医学院附属瑞金医院呼吸科,上海200025

出　　处：《血栓与止血学》2019年第4期545-550,共6页Chinese Journal of Thrombosis and Hemostasis

基　　金：上海市卫生局面上课题(201840083);上海市卫计委重要薄弱学科建设基金(2015 ZB0503)资助

摘　　要：目的旨在探讨晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)IV期患者肿瘤微环境的临床常见血液检测指标,建立新的特异性较高的预后参数。方法收集基线特征包括年龄、性别、吸烟史、PS评分、病变位置、临床TNM期、器官转移数量以及病理类型。研究对象分为回顾性及前瞻性研究组,前者用于建立预测预后的模型并内部验证,后者用于外部验证。将1年后生存状况作为研究终点。采用卡方检验分析死亡率在不同临床病理特征和血液指标的分布,并探讨该研究建立的新指标与器官转移之间关系。回顾性研究患者变量Cox回归分析用于建立临床预后模型。结果本研究建立的预后模型较TNM分期有较高的预后精准度。NLDA(嗜中性粒细胞计数/淋巴细胞计数×D二聚体计数/白蛋白)与器官转移显著相关,其抗肿瘤治疗前的水平可能是一种方便经济的特异性较高的预测预后的指标。结论本研究建立肿瘤微环境预后模型,发现NLDA是一种新的临床预后的预测指标。Objective The aim of research was to retrospectively and prospectively study the patients with advanced non-small cell lung cancer stage IV,explores the common clinical blood test indicators of tumor microenvironment,establishes new prognostic parameters with high specificity.Methods Clinical baseline features collected for analysis that included age,gender,smoking history,PS score,lesion location,clinical TNM stage,M stage,organ metastasis count and pathological type.The subjects were divided into retrospective study group and prospective study group,the retrospective study group is used to establish prognostic models and conduct internal verification,the prospective study group is used to conduct external verification.One-year survival status was used as the research endpoint.Chi-square test was used to analyze the distribution of mortality in different clinicopathological features and blood indicators,analyzed the relationship between the new indicators and organ metastasis.Retrospective study of univariate and multivariate Cox regression analysis in patients to establish prognostic models.Results The research established a prognostic models have higher prognostic accuracy than TNM staging,which included smoking,number of metastatic organs,SII,PNI and NLDA.NLDA(Neutrophil count/lymphocyte count *D-dimer count/albumin)is significantly associated with organ metastasis,its level of antineoplastic therapy may be a convenient and economical indicator,it has higher specificity,it may predict the prognosis of clinical stage IV NSCLC patients.Conclusion This research established a prognostic model for tumor microenvironment,NLDA was found to be a new prognostic marker.

关 键 词：非小细胞肺癌 肿瘤微环境 转移 预后 

分 类 号：R734.2[医药卫生—肿瘤]