术前C-反应蛋白、血小板/淋巴细胞比值对肝细胞肝癌患者预后评估价值  

Value of preoperative C-reactive protein and platelet/lymphocyte ratio in evaluating the prognosis of patients with hepatocellular carcinoma

作　　者：梁寻杰 陈椿 黄桂柳 黄赞松 覃小珊[1,2] Liang Xunjie;Chen Chun;Huang Guiliu;Huang Zansong;Qin Xiaosan(Graduate School,Youjiang Medical University for Nationalities,Baise 533000,Guangxi,China;The Affiliated Hospital of Youjiang Medical University for Nationalities,Guangxi Clinical Medical Research Center for Hepatobiliary Diseases,Baise 533000,Guangxi,China)

机构地区：[1]右江民族医学院研究生学院,广西百色533000 [2]右江民族医学院附属医院,广西肝胆疾病临床医学研究中心,广西百色533000

出　　处：《右江民族医学院学报》2021年第5期617-621,647,共6页Journal of Youjiang Medical University for Nationalities

基　　金：广西科技基地与人才专项[广西分子病理学(肝胆疾病)重点实验室](No.12);广西医药卫生自筹经费计划课题(No.20210316);广西高校中青年教师科研基础能力提升项目(No.2021KY0562)。

摘　　要：目的探讨术前C-反应蛋白(CRP)、血小板/淋巴细胞比值(PLR)评估肝细胞肝癌(HCC)患者术后预后的价值。方法回顾性分析2016年1月—2019年11月于本院初次行根治性手术治疗的60例HCC患者,利用受试者工作曲线确定术前CRP、PLR的最佳临界值,比较高低CRP、PLR水平HCC患者的临床病理特征,并分析影响HCC预后的危险因素。结果参照患者的生存状态,术前CRP的最佳临界值为2.055,曲线下面积为0.638,敏感度为66.70%,特异度为61.40%;术前PLR的最佳临界值为90.144,曲线下面积为0.588,敏感度为80.00%,特异度为47.70%。与CRP高水平组比较,低水平组的TNM分期处于更早期(P<0.05);与PLR高水平组比较,低水平组的男性人数较少、肿瘤直径较小(P<0.05)。单因素分析结果显示,HCC患者预后与巴塞罗那(BCLC)分期、TNM分期、是否微血管侵犯(MVI)、凝血酶原时间(PT)、是否复发有关(P<0.05)。多因素分析结果显示,微血管侵犯、PT≥13 s、肿瘤复发是影响HCC预后的独立危险因素(P<0.05)。结论BCLC分期、TNM分期对HCC的早期预后有一定的判断价值。肿瘤微血管侵犯、PT≥13 s、肿瘤复发是影响HCC预后的独立危险因素。术前低CRP水平表明肝癌TNM分期处在更早期,术前低PLR水平肝癌直径较小,这提示术前低CRP、PLR水平患者预后较好。Objective To investigate the value of preoperative C-reactive protein(CRP)and platelet/lymphocyte ratio(PLR)in evaluating the prognosis of patients with hepatocellular carcinoma(HCC).Methods This study retrospectively analyzed the data of 60 HCC patients who underwent radical surgery for the first time in The Affiliated Hospital of Youjiang Medical University for Nationalities from January 2016 to November 2019.The receiver operating characteristic(ROC)curve was used to determine the optimal cut-off values of preoperative CRP and PLR.Clinical pathological characteristics were compared between the HCC patients with high levels of CRP and PLR and those with low levels of CRP and PLR.The risk factors affecting the prognosis of HCC were also analyzed.Results According to the survival status of patients,the optimal cut-off value of preoperative CRP was 2.055 and the area under the curve was 0.638,;the sensitivity was 66.70%,and the specificity was 61.40%.The optimal cut-off value of preoperative PLR was 90.144,and the area under curve was 0.588;the sensitivity was 80.00%,and the specificity was 47.70%.Compared with the high CRP group,the low CRP group had earlier TNM stage(P<0.05).There were fewer male patients and smaller tumor diameter in the low PLR group compared with the high PLR group(P<0.05).Univariate analysis showed that the prognosis of patients with HCC was related to the Barcelona Clinic Liver Cancer(BCLC)stage,TNM stage,micro vascular invasion(MVI),prothrombin time(PT)and recurrence(P<0.05).Multivariate analysis showed that MVI,PT≥13 s and recurrence were independent risk factors affecting the prognosis of HCC(P<0.05).Conclusion BCLC stage and TNM stage have certain value for the early prognosis of HCC.MVI,PT≥13 s and recurrence are independent risk factors affecting the prognosis of HCC.Low preoperative CRP level indicates that TNM stage of liver cancer is at an earlier stage,and low preoperative PLR level indicates smaller liver cancer diameter.This suggests that patients with low preoperative CRP a

关 键 词：C-反应蛋白 血小板/淋巴细胞比值 癌 肝细胞 预后 

分 类 号：R730.261[医药卫生—肿瘤]