血清清蛋白/球蛋白比值联合血小板/淋巴细胞比值预测食管鳞状细胞癌预后的价值  

Prognostic value of serum albumin-to-globulin ratio combined with platelet-to-lymphocyte ratio for esophageal squamous cell carcinoma

作　　者：陈赛华[1] 施民新[1] 樊怿辉[1] 居冠军[1] 郑丽云 CHEN Saihua;SHI Minxin;FAN Yihui;JU Guanjun;ZHENG Liyun(Department of Thoracic Surgery,Nantong Tumor Hospital/Tumor Hospital Affiliated to Nantong University,Nantong,Jiangsu 226361,China)

机构地区：[1]江苏省南通市肿瘤医院/南通大学附属肿瘤医院胸外科,江苏南通226361

出　　处：《国际检验医学杂志》2022年第21期2601-2606,共6页International Journal of Laboratory Medicine

基　　金：2020年江苏省重点研发计划专项(BE2020783);2020年度江苏省南通市科技局计划项目(MS12020027)。

摘　　要：目的探讨血清清蛋白/球蛋白比值(AGR)和外周血血小板/淋巴细胞比值(PLR)与食管鳞状细胞癌(ESCC)患者总体生存期(OS)的关系,评估AGR联合PLR对ESCC患者预后的预测价值。方法选择2014年3月至2017年3月因食管癌于该院接受根治性手术治疗的125例ESCC患者为研究对象,并根据患者术前实验室检查结果计算AGR和PLR。通过受试者工作特征(ROC)曲线分析AGR和PLR预测ESCC患者OS的cut-off值。采用Kaplan-Meier曲线评估AGR与PLR对ESCC患者的预后价值。采用单变量、多变量Cox回归分析ESCC患者OS的独立预测指标。结果ROC曲线分析显示,AGR与PLR预测患者OS的cut-off值分别为1.57和126.80,曲线下面积(AUC)分别为0.653(95%CI:0.556~0.750)和0.647(95%CI:0.548~0.747)。生存分析表明,AGR≤1.57组OS(22.0个月,95%CI:14.2~29.8)短于AGR>1.57组(43.0个月,95%CI:36.1~49.9),差异有统计学意义(χ^(2)=10.743,P=0.001)。PLR>126.80组OS(23.0个月,95%CI:10.9~35.1)明显短于PLR≤126.80组(43.0个月,95%CI:36.2~49.8),差异有统计学意义(χ^(2)=8.983,P=0.003)。单变量、多变量Cox分析进一步证实AGR≤1.57与PLR>126.80是ESCC患者OS短的独立预测指标(P<0.05)。根据AGR和PLR的cut-off值,设计了一个AGR联合PLR评分(APS评分):AGR>1.57且PLR≤126.80为0分;AGR≤1.57且PLR>126.80为1分;AGR≤1.57且PLR>126.80为2分。0、1、2分组OS分别为49.0个月(95%CI:36.0~60.9),36.0个月(95%CI:22.1~49.9)和13.0个月(95%CI:9.1~16.9),差异均有统计学意义(P<0.05)。结论术前AGR与PLR是预测ESCC患者预后的有效血液学指标。Objective To explore the relationships between serum albumin-to-globulin ratio(AGR),peripheral platelet-to-lymphocyte ratio(PLR)and overall survival(OS)of esophageal squamous cell carcinoma(ESCC)patients,and evaluate the predictive value of their combination for clinical outcome.Methods A total of 125 ESCC patients who underwent radical surgery from March 2014 to March 2017 were selected as the research objects,and AGR and PLR were calculated according to the results of preoperative laboratory tests.The receiver operating characteristic(ROC)curve was used to identify the optimal cut-off values of preoperative AGR and PLR for survival prediction.Kaplan-Meier curves were plotted to evaluate the prognostic value of AGR and PLR for ESCC,and the univariate,multivariate Cox regression analysis were conducted to evaluate the independent predictors of OS in ESCC patients.Results ROC curve analysis showed that the cut-off values of AGR and PLR in predicting OS were 1.57 and 126.80,and the AUC were 0.653(95%CI:0.556-0.750)and 0.647(95%CI:0.548-0.747)respectively.Survival analysis showed that the OS of AGR≤1.57 group(22.0 months,95%CI:14.2-29.8)was shorter than AGR>1.57 group(43.0 months,95%CI:36.1-49.9),the difference was statistically significant(χ^(2)=10.743,P=0.001).The OS of PLR>126.80 group(23.0 months,95%CI:10.9-35.1)was significantly shorter than that of PLR≤126.80 group(43.0 months,95%CI:36.2-49.8),the difference was statistically significant(χ^(2)=8.983,P=0.003).Univariate and multivariate Cox analysis further confirmed that AGR and PLR were independent predictors of shorter OS in ESCC patients(P<0.05).According to the cut-off value of AGR and PLR,joint score of AGR-PLR(APS score)was designed:AGR>1.57 and PLR≤126.80 was 0 score,AGR≤1.57 and PLR>126.80 was 1 score,AGR≤1.57 and PLR>126.80 was 2 score.The OS of 0,1 and 2 score group were 49.0 months(95%CI:36.0-60.9),36.0 months(95%CI:22.1-49.9)and 13.0 months(95%CI:9.1-16.9)respectively,and the differences were statistically significant(P<0.05).Conclusion

关 键 词：食管鳞状细胞癌 血清清蛋白/球蛋白比值 血小板/淋巴细胞比值 预后 

分 类 号：R446.1[医药卫生—诊断学]