术前F-NLR评分对胰腺导管腺癌根治术后患者预后的评估价值  

Evaluation value of F-NLR score before surgery on prognosis of patients with pancreatic ductal adenocarcinoma after radical resection

作　　者：彭洁[1] 谢亮[1] 郑柳[1] PENG Jie;XIE Liang;ZHENG Liu(Department of Hepatobiliary Surgery,Chengdu No.6 People's Hospital,Chengdu 610000,Sichuan,China)

机构地区：[1]成都市第六人民医院肝胆外科,四川成都610000

出　　处：《贵州医科大学学报》2021年第10期1183-1187,1194,共6页Journal of Guizhou Medical University

基　　金：四川省医学(青年创新)科研课题(Q20023)。

摘　　要：目的探讨术前F-NLR评分对胰腺导管腺癌(PDAC)根治术后患者预后的评估价值。方法以95例行PDAC根治术患者为研究对象,于术前采集外周血检测纤维蛋白原(FIB)水平及中性粒细胞与淋巴细胞比值(NLR),采用受试者工作特征曲线(ROC)确定FIB和NLR阈值后计算F-NLR评分,采用Kaplan-Meier生存分析和Cox比例风险回归模型评估F-NLR评分对PDAC根治术后患者预后的评估价值。结果ROC曲线分析结果显示,当FIB=3.47 g/L、NLR=2.56时,曲线下面积(AUC)分别为0.709、0.687,对PDAC术后患者预后的评估均有统计学意义(P<0.05);PDAC患者F-NLR评分0分26例(27.37%)、1分39例(41.05%)、2分30例(31.58%),不同F-NLR评分患者的肿瘤切缘状态、术前糖类抗原19-9(CA19-9)水平和淋巴结阳性率比较,差异有统计意义(P<0.05);F-NLR评分为0、1及2分的中位生存期分别为32.81个月(95%CI为29.22~36.39)、30个月(95%CI为26.60~33.46)及25个月(95%CI为1.78~28.36),高F-NLR评分PDAC患者的预后情况明显差于F-NLR评分为0~1分PDAC患者(P<0.05);多因素Cox回归分析结果显示,R1切缘、CA19-9≥200000 U/L、淋巴结阳性率≥20%和术前高F-NLR评分是影响PDAC患者术后总生存期的独立危险因素(P<0.05)。结论PDAC患者术前F-NLR评分,对预测PDAC术后患者的生存期有一定的价值。Objective To investigate the evaluation value of peripheral blood fibrinogen(FIB)combined with neutrophil-lymphocyte ratio(NLR)before surgery on prognosis of patients with pancreatic ductal adenocarcinoma(PDAC)after radical resection.Methods Ninety-five patients scheduled for PDAC radical resection were chosen as subjects.FIB level and NLR were detected by collecting peripheral blood before surgery.The thresholds of FIB and NLR were determined by receiver operating characteristic(ROC)curves,and F-NLR score was calculated accordingly.The evaluation value of F-NLR score on prognosis of PDAC after radical resection was analyzed by Kaplan-Meier survival analysis and Cox proportional hazard regression model.Results The results of ROC curve analysis showed that the area under the curve(AUC)values of FIB(3.47 g/L)and NLR(2.56)were 0.709 and 0.687,respectively,which were of statistical significance on prognosis evaluation of PDAC patients(P<0.05).F-NLR score were 26 cases(27.37%)with 0 points,39 cases(41.05%)with 1 point,and 30 cases(31.58%)with 2 points.The differences in tumor resection margin status,preoperative level of carbohydrate antigen 19-9(CA19-9)and positive rate of lymph nodes among patients with different F-NLR scores were statistically significant(P<0.05).The median survival time in patients with F-NLR scores of 0,1 point,and 2 points were 32.81 months(95%CI was 29.22-36.39),30 months(95%CI was 26.60-33.46),and 25 months(95%CI was 1.78-28.36),respectively.The prognosis of patients with high F-NLR score was significantly worse than those with F-NLR score of 0 to 1 point(P<0.05).The results of multivariate Cox regression analysis showed that R1 resection margin,CA19-9 not lower than 200000 U/L,positive rate of lymph nodes not lower than 20%and high preoperative F-NLR score were independent risk factors affecting overall survival time of PDAC patients after surgery(P<0.05).Conclusion For PDAC patients undergoing radical resection,F-NLR score shows certain value in predicting the overall survival time of patien

关 键 词：胰腺导管腺癌 纤维蛋白原 中性粒细胞与淋巴细胞比值 F-NLR 预后 

分 类 号：R735.9[医药卫生—肿瘤]