术前外周淋巴细胞和单核细胞比值在根治术后内分泌治疗前列腺癌患者预后评估中的研究  

Prognostic value of preoperative peripheral lymphocyte-to-monocyte ratio in prostate cancer patients treated with endocrine therapy after radical prostatectomy

作　　者：刘妍[1] 张泗扬 连振鹏 刘冉录[2] 徐勇[2] Liu Yan;Zhang Siyang;Lian Zhenpeng;Liu Ranlu;Xu Yong(Tianjin Institute of Urology,Tianjin 300211,China;Department of Urology,the Second Hospital of Tianjin Medical University,Tianjin 300211,China)

机构地区：[1]天津市泌尿外科研究所,300211 [2]天津医科大学第二医院泌尿外科,300211

出　　处：《中华老年医学杂志》2021年第7期881-885,共5页Chinese Journal of Geriatrics

基　　金：国家重点基础研究发展计划(973计划)(2017YFC0908003)。

摘　　要：目的探讨术前淋巴细胞和单核细胞比值(LMR)与前列腺癌根治性切除术(RP)后接受内分泌治疗的前列腺癌(PCa)患者生化复发及预后的关系。方法采用回顾性研究分析2008年6月至2019年6月我院术后接受内分泌治疗的306例PCa患者的临床和随访资料。所有患者均行RP。观察终点为无生化复发生存期(RFS)。通过Kaplan-Meier法绘制受试者工作特征曲线(ROC),获得患者术前LMR的最佳临界值,将患者分为高LMR组(LMR≥2.8)和低LMR组(LMR<2.8),其中低LMR组213例(69.6%),高LMR组93例(30.4%),比较不同LMR组间PCa临床指标之间的差异。采用单因素和多因素Cox风险比例回归模型,分析术前LMR对术后接受内分泌治疗的PCa患者预后的影响。结果 306例患者随访4~132个月。通过绘制ROC曲线,LMR曲线下面积为0.582,得出术前LMR的临界值为2.8(95%CI:0.511~0.652,P<0.05),并以此将患者分为高LMR组(LMR≥2.8)和低LMR组(LMR<2.8),具有一定的诊断价值。术前LMR水平与临床病理T分期(P=0.023)和淋巴转移(P=0.031)显著相关。Kaplan-Meier生存分析结果表明低LMR组无复发生存期(RFS)(31.0个月)较高LMR组RFS(38.5个月)时间短,预后差(P<0.05)。淋巴转移和术前LMR是术后接受内分泌治疗的PCa患者RFS的独立预后因素(均P<0.05)。结论对于RP术后接受内分泌治疗的PCa患者,术前LMR可作为辅助指标判断RP术后经内分泌治疗的PCa患者预后。Objective To investigate the correlation of preoperative peripheral lymphocyte to-monocyte ratio(LMR)with the biochemical relapse and prognosis in prostate cancer(PCa)patients treated with endocrine therapy after radical prostatectomy(RP).Methods Clinical data of 306 prostale cancer patients treated with endocrine therapy after radical prostatectomy were retrospectively analyzed in our hospital from June 2008 to June 2019.The end point of observation was biochemical relapse free survival(RFS)in all patients receiving RP.The best cutoff value of preoperative LMR was calculated by receiver operating characteristic(ROC)curve.All patients were divided into the high LMR group(LMR≥2.8.n=93,30.4%)and the low LMR group(LMR<2.8.n=213.69.6%).The difflerences in clinical indicators of PCa were compared between high and low LMR groups.CoX regression model on the risk ratio of single and multiple factors were used to analyze the survival effect of preoperative LMR on the prognosis of PCa patients undergoing endocrine therapy after operation.Results The median follow up time was ranged from 4 to 132 months.The area under the ROC curve of LMR was 0.582(95%CI:0.511-0.652.P<0.05),and the eutoff value of the preoperative LMR was 2.8.which was significantly associated with elinical T stage(P=0.023)and lymphatic metastasis(P=0.031).Kaplan Meier analysis demonstrated that the low LMR group had a short RFS and a poor prognosis(31.0 months vs.38.5 months)than those in the high LMR group(P<0.05),Lymphatic metastasis and preoperative LMR were independent predictors for RFS in PCa patients treated with endocrine therapy after radical prostatectomy.Conclusions Preoperative peripheral LMR can be used as an auxiliary indicator of the prognosis in PCa patients treated with endocrine therapy after radical prostatectomy.

关 键 词：前列腺肿瘤 淋巴细胞和单核细胞比值 预后 

分 类 号：R737.25[医药卫生—肿瘤]