术前NLR、PLR和CA125水平对子宫内膜癌预后的评估价值  

The prognostic value of preoperative NLR,PLR andserum CA125 levels in endometrial carcinoma

作　　者：高敏[1] 王巍 宋楠[1] 张乃怿[1] 郑虹[1] 高雨农[1] GAO Min;WANG Wei;SONG Nan;ZHANG Naiyi;ZHENG Hong;GAO Yunong(Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of gynecologic oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China)

机构地区：[1]北京大学肿瘤医院(暨北京市肿瘤防治研究所)妇科,恶性肿瘤发病机制及转化研究教育部重点实验室,北京100142

出　　处：《中国生育健康杂志》2021年第6期519-523,共5页Chinese Journal of Reproductive Health

摘　　要：目的探讨子宫内膜癌患者术前外周血中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)和血清CA125水平与子宫内膜癌预后的关系。方法回顾性分析2010年10月至2013年11月期间在北京大学肿瘤医院妇科接受治疗的145例子宫内膜癌患者的临床资料及随访结果,患者年龄30~77岁,平均年龄(53.4±7.9)岁,采用FIGO 2009年的子宫内膜癌手术病理分期标准确定分期。测定术前1周内的血常规和血清CA125水平,计算出NLR和PLR值,绘制受试者工作特性(ROC)曲线,通过约登指数最大值确定预测复发和死亡的最佳临界值。通过单因素和多因素分析评估NLR、PLR和CA125对子宫内膜癌预后的影响。结果Ⅲ/Ⅳ期子宫内膜癌患者和淋巴结转移患者的NLR、PLR和CA125水平明显高于Ⅰ/Ⅱ期和无淋巴结转移患者。多因素分析显示,NLR、病理分级和淋巴结转移是无进展生存期(PFS)的独立预后因素;NLR和组织学类型是OS的独立预后因素。而PLR和CA125水平变化没有显示出对预后的明确预测价值。结论术前NLR值测定对评估子宫内膜癌预后具有很好的临床价值,高NLR值是子宫内膜癌预后不良的独立预测因素。Objective To investigate the relationship between preoperative peripheral blood neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR)and serum CA125 level with prognosis of endometrial carcinoma.MethodsA retrospective analysis of 145 patients with endometrial cancer who were treated in the Department of Gynecology of Peking University Cancer Hospital between Oct 2010 and Nov 2013 was performed.The mean age of patients was(53.4±7.9)years(range 30-77 years).The surgical staging of endometrial cancer was determined according to the International Federation of Gynecology and Obstetrics(FIGO)2009 guidelines.We assessed values of preoperative NLR,PLR and serum CA125.Receiver operating characteristic(ROC)curves were plotted and the optimal cut-off values of NLR,PLR and CA125 were calculated for predicting recurrence and death.Univariate and multivariate analyses were performed to assess the effect of preoperative NLR,PLR and CA125 on the prognosis of endometrial cancer.ResultsThe levels of NLR,PLR,and CA125 in patients with stage Ⅲ/Ⅳ endometrial cancer and lymph node metastasis were significantly higher than those with stage Ⅰ/Ⅱ and no lymph node metastasis.Multivariate analysis showed that NLR,pathological grade and lymph node metastasis were independent prognostic factors for progression-free survival(PFS).NLR and histologic type are independent prognostic factors for overall survival(OS).However,PLR and CA125 levels did not show the predictive value for prognosis.ConclusionPreoperative NLR value has a good clinical value in evaluating the prognosis of endometrial cancer,and high NLR value is an independent predictor of poor prognosis in endometrial cancer.

关 键 词：子宫内膜癌 中性粒细胞与淋巴细胞比值(NLR) 血小板与淋巴细胞比值(PLR) 糖类抗原125(CA125) 预后 

分 类 号：R73[医药卫生—肿瘤]