子宫颈癌同步放化疗前鳞状细胞癌抗原、外周血淋巴细胞与单核细胞比值、血小板与淋巴细胞比值的复发预测价值研究  

Study on the predictive value of squamous cell carcinoma antigen,peripheral blood lymphocyte-to-monocyte ratio and platelet-to-lymphocyte ratio before concurrent chemoradiotherapy for recurrence of cervical cancer

作　　者：袁红琴[1] 王霞[1] 马晓捷[1] Yuan Hongqin;Wang Xia;Ma Xiaojie(Department of Abdominal-Pelvic Radiotherapy 1,Shanxi Provincial Cancer Hospital,Taiyuan 030013,China)

机构地区：[1]山西省肿瘤医院放疗腹盆一病区,太原030013

出　　处：《肿瘤研究与临床》2021年第12期901-907,共7页Cancer Research and Clinic

摘　　要：目的探讨子宫颈癌同步放化疗前鳞状细胞癌抗原(SCC)、外周血淋巴细胞与单核细胞比值(LMR)、血小板与淋巴细胞比值(PLR)与子宫颈癌同步放疗后复发的相关性及对复发的预测价值。方法回顾性分析2018年1月至12月山西省肿瘤医院90例行同步放化疗治疗的子宫颈癌患者资料,根据是否复发分为复发组与未复发组。记录患者基本信息及同步放化疗前SCC水平、LMR、PLR,中位随访17个月(5~24个月)。采用logistic回归分析子宫颈癌患者同步放化疗后复发的危险因素,用得到的危险因素构建复发预测模型,采用受试者工作特征(ROC)曲线分析不同指标对复发的预测效能。结果90例患者中,随访期间26例(28.9%)复发,64例(71.1%)未复发。复发组肿瘤长径≥4 cm[57.7%(15/26)比34.4%(22/64)]、淋巴结转移[53.8%(14/26)比31.2%(20/64)]、Karnofsky评分70~75分[30.8%(8/26)比21.9%(14/64)]、Karnofsky评分76~80分[42.3%(11/26)比17.2%(11/64)]、国际妇产科联盟(FIGO)分期Ⅳ期[42.3%(11/26)比17.2%(11/64)]患者比例均高于未复发组,差异均有统计学意义(均P<0.05)。复发组同步放化疗前SCC、PLR分别为(4.26±0.53)ng/ml、144.02±11.16,均高于未复发组[(2.91±0.48)ng/ml和125.18±12.32],复发组同步放化疗前LMR为3.93±0.61,低于未复发组(4.68±0.55),两组间SCC、PLR、LMR差异均有统计学意义(均P<0.05)。同步放化疗前SCC、LMR、PLR单独预测子宫颈癌同步放化疗后复发的ROC曲线下面积分别为0.819(95%CI 0.708~0.948)、0.763(95%CI 0.677~0.860)、0.735(95%CI 0.590~0.916),最佳临界值分别为2.13 ng/ml、4.08、133.65。多因素logistic回归分析显示,肿瘤长径≥4 cm(OR=2.116,95%CI 1.204~3.718)、淋巴结转移(OR=2.669,95%CI 1.022~6.970)、FIGO分期Ⅳ期(OR=2.699,95%CI 1.359~5.362)及同步放化疗前SCC≥2.13 ng/ml(OR=4.256,95%CI 1.194~15.170)、LMR≤4.08(OR=5.216,95%CI 2.987~9.108)及PLR≥133.65(OR=3.256,95%CI 1.456~7.281)是子宫颈癌同步放化疗后复发的危�Objective To investigate the correlations of squamous cell carcinoma antigen(SCC),peripheral blood lymphocyte-to-monocyte ratio(LMR)and platelet-to-lymphocyte ratio(PLR)before concurrent chemoradiotherapy with recurrence of cervical cancer after concurrent chemoradiotherapy,and to explore the predictive value of the three above indicators for recurrence.Methods The data of 90 cervical cancer patients who received concurrent chemoradiotherapy in Shanxi Provincial Cancer Hospital from January to December 2018 were retrospectively analyzed,and the patients were divided into recurrence group and non-recurrence group according to whether they relapsed.The patients'basic information and the levels of SCC,LMR and PLR before concurrent chemoradiotherapy were recorded,and the median follow-up was 17 months(5-24 months).Logistic regression was used to analyze the risk factors affecting the recurrence of cervical cancer after concurrent chemoradiotherapy,the obtained risk factors were used to construct a recurrence prediction model,and the receiver operating characteristic(ROC)curve was used to analyze the predictive value of different indicators for recurrence.Results Among 90 patients,26 patients(28.9%)relapsed and 64 patients(71.1%)did not relapse during follow-up.The proportions of patients with tumor maximum diameter≥4 cm[57.7%(15/26)vs.34.4%(22/64)],lymph node metastasis[53.8%(14/26)vs.31.2%(20/64)],Karnofsky score 70-75 points[30.8%(8/26)vs.21.9%(14/64)],Karnofsky score 76-80 points[42.3%(11/26)vs.17.2%(11/64)],International Federation of Gynecology and Obstetrics(FIGO)stageⅣ[42.3%(11/26)vs.17.2%(11/64)]in the recurrence group were higher than those in the non-recurrence group,and the differences were statistically significant(all P<0.05).The SCC and PLR in the recurrence group before concurrent chemoradiotherapy were(4.26±0.53)ng/ml and 144.02±11.16,which were higher than those in the non-recurrence group[(2.91±0.48)ng/ml and 125.18±12.32],and the LMR in the recurrence group before concurrent chemoradiothera

关 键 词：宫颈肿瘤 复发 同步放化疗 鳞状细胞癌抗原 淋巴细胞与单核细胞比值 血小板与淋巴细胞比值 

分 类 号：R737.33[医药卫生—肿瘤]