术前纤维蛋白原与中性粒细胞/淋巴细胞比率联合系统评价食管鳞状细胞癌预后因素的研究  

Combination of preoperative fibrinogen and neutrophil to lymphocyte ratio is a predictive prognostic factor in esophageal squamous cell carcinoma systematic review

作　　者：林金兰[1] 郭天兴[2] 潘小杰[2] Lin jinlan;Guo Tianxing;Pan Xiaojie(Department of Thoracic Oncology,Fujian Cancer Hospital,Fujian Medical University Cancer Hospital,Fuzhou 350014,China;Department of Thoracic Surgery,Fujian Provincial Hospital,Provincial Clinical College of Fujian Medical University,Fuzhou 350001,China)

机构地区：[1]福建省肿瘤医院胸部肿瘤内科福建医科大学附属肿瘤医院,福州350014 [2]福建省立医院胸外科,福建医科大学省立临床医学院,福州350001

出　　处：《中华实验外科杂志》2019年第12期2279-2282,共4页Chinese Journal of Experimental Surgery

基　　金：2017年福建省科技引导性项目(2017Y0018)。

摘　　要：目的探讨在食管鳞状细胞癌(ESCC)患者中检测术前纤维蛋白原和中性粒细胞/淋巴细胞比率(NLR)的临床价值.方法接受ESCC根治性手术的患者327例,单变量和多变量COX回归分析评价总生存率(OS)的预后因素.纤维蛋白原和NLR的最佳临界值分别为3.09 g/L和1.89,根据临界值标准定义纤维蛋白原和NLR(F-NLR)评分标准,高纤维蛋白原(≥3.09 g/L)和高NLR(≥1.89)者定义为2分,高纤维蛋白原或高NLR患者为1分,而无高纤维蛋白原和高NLR者评分为0分.结果高纤维蛋白原的ESCC患者OS显著低于低纤维蛋白原者(31.4%比63.3%,P<0.01),而NLR升高的ESCC患者OS也显著低于低NLR者(40.4%比50.3%,P<0.01).F-NLR评分与肿瘤的大小(P<0.01)和病理分期(P<0.05)均呈显著相关.F-NLR评分0、1、2组的5年OS率分别为69.1%、42.6%和31.9%,亚组间比较差异有统计学意义(P<0.01).多因素分析显示肿瘤大小(P<0.01)、病理分期(P<0.01)及F-NLR(P<0.01)是OS的独立预后因素.结论术前F-NLR评分可作为ESCC患者独立的预后指标.Objective To explored the clinical value of preoperative fibrinogen and neutrophil to lymphocyte ratio(NLR)in patients with esophageal squamous cell carcinoma(ESCC)in this study.Methods 327 patients undergoing ESCC radical surgery was performed to evaluate prognostic factors for overall survival(OS)by univariate and multivariate COX regression analyses.The optimal cut-off values for fibrinogen and NLR were 3.09 g/L and 1.89,respectively.The fibrinogen and NLR(F-NLR)scoring criteria were defined according to the cut-off criteria.High fibrinogen(≥3.09 g/L)and high NLR(M1.89)were defined as 2 points,patients with high fibrinogen or high NLR were defined as 1 point,and neither hyperfibrinogen or high NLR scored 0 points.Results The OS of patients with high brinogen ESCC was significantly poor than patients with low fibrinogen(31.4%vs.63.3%,P<0.01),while the OS of patients with elevated NLR was also significantly poor than patients with low NLR(40.4%vs.50.3%).The F-NLR score was significantly correlated with tumor size(P<0.01)and pathological stage(P<0.01).The 5-year OS rates for F-NLR score groups 0,1,and 2 were 69.1%,42.6%,and 31.9%,respectively,there were significant differences between subgroups(P<0.01).Multivariate analysis showed that tumor size(P<0.01),pathological stage(P<0.01),and F-NLR(P < 0.01)were independent prognostic factors for OS.Conclusion Preoperative F-NLR score can be used as an independent prognostic indicator for ESCC patients.

关 键 词：食管鳞状细胞癌 纤维蛋白原 中性粒细胞/淋巴细胞比率 预后因素 

分 类 号：R73[医药卫生—肿瘤]