外周血FAR联合NLR在局部晚期或转移性胰腺癌患者预后评估中的价值  

The value of peripheral blood FAR combined with NLR in the evaluation of survival prognosis of patients with locally advanced or metastatic pancreatic cancer

作　　者：王海静[1] 秦芳[2] WANG Haijing;QIN Fang(Department of Laboratory Medicine,Donghai People′s Hospital of Lianyungang City,Xuzhou,Jiangsu 222399,China;Department of Laboratory Medicine,Drum Tower Hospital Affiliated to Medical School of Nanjing University,Nanjing,Jiangsu 210008,China)

机构地区：[1]连云港市东海人民医院检验科,江苏徐州222399 [2]南京大学医学院附属鼓楼医院检验科,江苏南京210008

出　　处：《国际检验医学杂志》2022年第13期1587-1592,1597,共7页International Journal of Laboratory Medicine

基　　金：江苏省“六大人才高峰”高层次人才选拔培养资助计划项目(WSW-039)。

摘　　要：目的探讨外周血纤维蛋白原/清蛋白比值(FAR)联合中性粒细胞/淋巴细胞比值(NLR)在局部晚期或转移性胰腺癌患者预后评估中的价值。方法该研究以2017年1月至2020年5月于连云港市东海人民医院诊断为胰腺癌并接受一线化疗的局部晚期或转移性胰腺癌患者作为研究对象进行回顾性分析。通过受试者工作特征(ROC)曲线确定FAR、NLR及血小板/淋巴细胞比值(PLR)等炎症指标用于预测胰腺癌患者死亡的最佳临界值。采用Kaplan-Meier生存曲线及单、多变量Cox回归分析FAR、NLR、PLR等指标对患者预后的影响。结果根据FAR、NLR用于预测胰腺癌患者死亡的ROC曲线得出:FAR的最佳临界值为0.08,曲线下面积(AUC)为0.721(95%CI:0.613~0.829);NLR的最佳临界值为2.69,AUC为0.658(95%CI:0.550~0.766)。根据最佳临界值,将106例胰腺癌患者分为高FAR组(>0.08,63例)与低FAR组(≤0.08,43例)。患者高FAR与高CA19-9水平(>200 U/L)、肿瘤侵犯大血管、远处转移有关(P<0.05)。高FAR组患者的中位生存期短于低FAR组(10.0个月vs.24.0个月),两组预后比较,差异有统计学意义(P<0.05)。多变量Cox分析显示,高CA19-9水平、远处转移、高FAR及高NLR是局部晚期或转移性胰腺癌患者预后不良的独立危险因素(P<0.05)。此外,FAR联合NLR用于预测局部晚期或转移性胰腺癌患者死亡的AUC为0.773(95%CI:0.674~0.871),灵敏度为78.7%,特异度为74.1%。结论FAR有望成为一项评估接受一线化疗的局部晚期或转移性胰腺癌患者预后的指标,而FAR联合NLR或许能够提供更为准确的预后分层。Objective To investigate the value of peripheral-blood fibrinogen-to-albumin ratio(FAR)combined with neutrophil-to-lymphocyte ratio(NLR)in the evaluation of prognosis in patients with locally advanced or metastatic pancreatic cancer.Methods This study retrospectively analyzed patients with locally advanced or metastatic pancreatic cancer who were diagnosed with pancreatic cancer and received first-line chemotherapy in Donghai People′s Hospital of Lianyungang City from January 2017 to May 2020.Receiver operating characteristic(ROC)curve was used to determine the best cut-off values of inflammatory indicators such as FAR,NLR and platelet-to-lymphocyte ratio(PLR)for predicting the death of patients with pancreatic cancer.Kaplan-Meier survival curve and univariate and multivariate Cox regression analysis were used to analyze the effects of FAR,NLR,PLR and other indicators on the prognosis of patients.Results According to the ROC curve of FAR and NLR which were used to predict the death of patients with pancreatic cancer,it was concluded that the optimal cut-off value of FAR was 0.08,and the area under the curve(AUC)was 0.721(95%CI:0.613-0.829);the optimal cut-off value of NLR was was 2.69,and the AUC was 0.658(95%CI:0.550-0.766).According to the optimal cut-off value,106 pancreatic cancer patients were divided into high FAR group(>0.08,63 cases)and low FAR group(≤0.08,43 cases).High FAR was associated with high CA19-9 level(>200 U/L),tumor invasion into large blood vessels,and distant metastasis(P<0.05).The median survival time of patients in the high FAR group was shorter than that in the low FAR group(10.0 months vs.24.0 months),and the difference in prognosis was statistically significant(P<0.05).Multivariate Cox analysis showed that high CA19-9 level,distant metastasis,high FAR and high NLR were independent risk factors for poor prognosis in patients with locally advanced or metastatic pancreatic cancer(P<0.05).In addition,the AUC of FAR combined with NLR for predicting death in patients with locally advanced

关 键 词：胰腺癌 纤维蛋白原/清蛋白比值 中性粒细胞/淋巴细胞比值 预后 

分 类 号：R446.11[医药卫生—诊断学]