术前外周血淋巴细胞与单核细胞比值(LMR)早期预测甲状腺乳头状癌复发的价值  

The value of preoperative peripheral blood lymphocyte to monocyte ratio for early prediction of papillary thyroid cancer recurrence

作　　者：周春燕[1,2] 邓婕 黄颖 刘双[1] 段东 ZHOU Chunyan;DENG Jie;HUANG Ying;LIU Shuang;DUAN Dong(Department of Nuclear Medicine,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China;Department of Nuclear Medicine,Chongqing General Hospital,Chongqing 401147,China)

机构地区：[1]重庆医科大学附属第一医院核医学科,重庆400016 [2]重庆市人民医院核医学科,重庆401147

出　　处：《现代肿瘤医学》2022年第10期1758-1763,共6页Journal of Modern Oncology

基　　金：重庆市自然科学基金项目(编号:cstc2019jcyj-msxmX0327)。

摘　　要：目的:探讨术前外周血淋巴细胞与单核细胞比值(LMR)早期预测甲状腺乳头状癌复发的价值。方法:回顾性收集429例甲状腺乳头状癌患者的临床资料。采用受试者工作曲线(ROC)确定术前LMR预测PTC复发的最佳截断值,根据最佳截断值将患者分为低LMR组和高LMR组,比较两组患者间临床特征及复发率的差异。采用Kaplan-Meier法绘制生存曲线,并进行Log-rank检验。使用Cox回归比例风险模型进行单因素及多因素分析,确定与PTC复发相关的危险因素。结果:术前LMR预测PTC复发的最佳截断值为5.2466。低LMR组患者的复发率明显高于高LMR组(11%vs 2%,P=0.000)。多因素分析显示术前LMR<5.2466(P=0.006)及肿瘤多灶性(P=0.039)是预测PTC复发的独立危险因素。结论:术前LMR对早期预测PTC复发具有一定价值,临床实践中可将其作为复发危险度分层的补充,联合应用以提高预测的准确性。Objective:To investigate the value of preoperative peripheral blood lymphocyte to monocyte ratio(LMR)for early prediction of papillary thyroid cancer recurrence.Methods:A retrospective study was performed to analyze the clinical and pathological data of 429 patients with thyroid papillary carcinoma.The receiver operating curve(ROC)was used to determine the optimal cut-off value for preoperative LMR to predict PTC recurrence,and patients were divided into low LMR and high LMR groups according to the optimal cut-off value,and the differences in clinical characteristics and recurrence rates between the two groups were compared.Taking the recurrence of the disease as the end event,survival curves were plotted using the Kaplan-Meier method and log-rank tests were performed.Cox proportional hazards model were used for univariate and multivariate analyses to identify risk factors associated with PTC recurrence.Results:The best cut-off value for preoperative LMR to predict PTC recurrence was 5.2466,the recurrence rate was significantly higher in the low LMR group than in the high LMR group(11%vs 2%,P=0.000).Multifactorial analysis showed that preoperative LMR<5.2466(P=0.006)and tumor multifocality(P=0.039)were independent risk factors for predicting PTC recurrence.Conclusion:Preoperative LMR is valuable for early prediction of PTC recurrence,and it can be used in clinical practice as a supplement to recurrence risk stratification and used in combination to improve the accuracy of prediction.

关 键 词：甲状腺乳头状癌 淋巴细胞与单核细胞比值 危险度分层 复发 

分 类 号：R736.1[医药卫生—肿瘤]