血液炎症相关指标在晚期胰腺癌中的预后价值  

Prognostic value of peripheral blood inflammation-based markers in metastatic pancreatic cancer

作　　者：孙婧 史幼梧 贾军[1] 杨颖[1] 孙志伟[1] 杜丰[1] 余靖[1] 肖艳洁 张晓东[1] Sun Jing;Shi Youwu;Jia Jun;Yang Ying;Sun Zhiwei;Du Feng;Yu Jing;Xiao Yanjie;Zhang Xiaodong(VIP-Ⅱ Gastrointestinal Cancer Division of the Department of Medicine, Peking University Cancer Hospital & Institute, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), 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VIP-Ⅱ病区,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：《首都医科大学学报》2022年第2期299-304,共6页Journal of Capital Medical University

摘　　要：目的评估血液炎症相关指标中性粒细胞-淋巴细胞比值(neutrophil-lymphocyte ratio,NLR)、血小板-淋巴细胞比值(platelet-lymphocyte ratio,PLR)、淋巴细胞-单核细胞比值(lymphocyte-monocyte ratio,LMR)、白蛋白(albumin,ALB)及联合炎症指标在晚期胰腺癌中的预后价值。方法回顾性收集2012年7月至2020年10月北京大学肿瘤医院VIP-Ⅱ病区收治的晚期胰腺癌患者诊断时的基线资料。根据受试者工作特征(receiver operating characteristic,ROC)曲线确定炎症相关指标临界值,根据曲线下面积(area under curve,AUC)估计预后因素的准确性。通过单因素和多因素分析评估预后价值。结果50例晚期胰腺癌患者中位生存时间7.2个月(95%CI:3.568~10.699)。炎症相关指标的临界值分别为:NLR=4.5(AUC=0.840,95%CI:0.732~0.948,P<0.001),PLR=138(AUC=0.671,95%CI:0.517~0.826,P=0.038),LMR=4.0(AUC=0.873,95%CI:0.770~0.975,P<0.001),ALB=41.5(AUC=0.726,95%CI:0.582~0.870,P=0.006)。单因素及多因素分析显示:NLR≥4.5(HR=11.936,95%CI:4.571~31.169,P<0.001)、PLR≥138(HR=2.246,95%CI:1.045~4.828,P=0.038)、ALB<41.5 g/L(HR=3.214,95%CI:1.463~7.060,P=0.004)为独立危险因素;LMR≥4(HR=0.336,95%CI:0.165~0.687,P=0.003)为独立保护因素。联合炎症指标NLR_ALB、PLR_ALB、LMR_ALB为独立预后指标,评分越高,预后越差。结论NLR、LMR、PLR、ALB可以作为晚期胰腺癌的预后指标,联合血液炎症相关指标有助于简便、迅速地评估预后,有一定的临床应用前景。Objective To evaluate significance of the inflammation-based prognostic markers,including neutrophil-lymphocyte ratio(NLR),platelet-lymphocyte ratio(PLR),lymphocyte-monocyte ratio(LMR),albumin(ALB)and combined inflammation-based markers in metastatic pancreatic cancer.Methods The clinical data of 50 patients with metastatic pancreatic cancer admitted to VIP-ⅡDepartment of Peking University Cancer Hospital from July 2012 to October 2020 were collected retrospectively.Receiver operating characteristic(ROC)curve analysis were performed to determine the cut-off values of NLR,LMR,PLR and prognostic nutritional index(PNI).The accuracy of the prognostic indicators were evaluated by area under curve(AUC).The prognostic significance of the clinical characteristics and inflammation-based markers were evaluated by univariate and multivariate analysis.Results In 50 patients with metastatic pancreatic cancer,the median overall survival was 7.2 months(95%CI:3.568-10.699).The optimal cut-off of inflammation-based markers were:NLR=4.5(AUC=0.840,95%CI:0.732-0.948,P<0.001),PLR=138(AUC=0.671,95%CI:0.517-0.826,P=0.038),LMR=4.0(AUC=0.873,95%CI:0.770-0.975,P<0.001),ALB=41.5(AUC=0.726,95%CI:0.582-0.870,P=0.006),respectively.Univariate and multivariate analysis showed that NLR≥4.5(HR=11.936,95%CI:4.571-31.169,P<0.001),PLR≥138(HR=2.246,95%CI:1.045-4.828,P=0.038),ALB<41.5 g/L(HR=3.214,95%CI:1.463-7.060,P=0.004)were independent risk factors;LMR≥4(HR=0.336,95%CI:0.165-0.687,P=0.003)was an independent protective factor.NLR_ALB,PLR_ALB and LMR_ALB were independent prognostic indicators,and the higher the score,the worse the prognosis.Conclusion Peripheral blood inflammation-based marker NLR,LMR,PLR and ALB can be used as prognostic indicators for metastatic pancreatic cancer,the combined inflammation-based markers will promote simple and rapid prognosis assessments and has a certain clinical application prospect.

关 键 词：胰腺肿瘤 炎症相关指标 预后 

分 类 号：R735.9[医药卫生—肿瘤]