纤维蛋白原联合中性粒细胞与淋巴细胞比值对前列腺癌的预后价值  

Prognostic value of combined fibrinogen concentration and neutrophil-to-lymphocyte ratio in prostate cancer

作　　者：赵亚伟[1] 马旺[1] 马柳疆 李志坤[1] 李前跃[1] 汤磊[1] ZHAO Yawei;MA Wang;MA Liujiang;LI Zhikun;LI Qianyue;TANG Lei(Department of Urology Surgery,Xinjiang Production and Construction Crops Hospital,Second Affiliated Hospital,School of Medicine,Shihezi University,Urumqi,830002,China)

机构地区：[1]新疆生产建设兵团医院、石河子大学第二附属医院泌尿外科,乌鲁木齐830002

出　　处：《临床泌尿外科杂志》2022年第12期915-919,共5页Journal of Clinical Urology

基　　金：兵团财政科技计划项目(No:2021AB036);兵团医院科技计划项目(No:2021008)。

摘　　要：目的探讨术前纤维蛋白原(FIB)联合中性粒细胞与淋巴细胞比值(NLR)形成的FIB-NLR评分系统对前列腺癌(PCa)的预后价值。方法回顾性分析新疆生产建设兵团医院泌尿外科2012年1月1日—2022年1月1日收治的210例经前列腺穿刺活检及前列腺根治性切除术后病理首次确诊为PCa患者的临床病例资料。用受试者工作特征曲线(ROC)确定NLR与FIB区分组织分级的最佳截断值分别为2.24 g/L和3.88 g/L,并对FIB-NLR评分值进行分组,分别计为FIB-NLR 0、1、2分。用χ^(2)检验分析FIB-NLR评分与PCa患者的临床病理特征间的关系。通过Kapian-Meier法进行生存分析,建立单因素及多因素Cox比例风险模型,探讨影响PCa预后的危险因素和独立危险因子。结果根据ROC曲线最佳截点分组为FIB-NLR 0分组:FIB≤3.88 g/L且NLR≤2.24;FIB-NLR 1分组:FIB>3.88 g/L或NLR>2.24;FIB-NLR 2分组:FIB>3.88 g/L且NLR>2.24。FIB-NLR 0分95例(47.5%)、FIB-NLR 1分53例(26.5%)、FIB-NLR 2分52例(26.0%);FIB-NLR 0、1、2分患者的5年生存期分别为91.88%、87.15%、59.72%,5年无疾病进展生存期分别为87.83%、77.18%、43.95%,差异均有统计学意义(P<0.001)。PCa患者术前不同FIB-NLR评分肿瘤病理分期、Gleason评分、危险程度分级、术前tPSA差异有统计学意义(P<0.05)。单因素分析结果表示FIB-NLR评分、FIB浓度、NLR值、肿瘤病理分期、Gleason评分、术前tPSA浓度是影响PCa患者总生存期与无病生存期的危险因素;多因素分析结果表明FIB-NLR评分是PCa患者的独立预后因子。结论FIB-NLR评分对预测PCa患者预后有一定的价值。Objective To investigate the prognostic value of fibrinogen(FIB)-neutrophil-to-lymphocyte ratio(NLR)scoring system formed by FIB level combined with NLR in prostate cancer(PCa).Methods We retrospectively analyzed the clinical data of 210 patients with PCa diagnosed by prostate biopsy and postoperative pathology in the Department of Urology,Xinjiang Production and Construction Corps Hospital from January 1st,2012 to January 1st,2022.Receiver operating characteristic(ROC)curve was used to determine the optimal cut-off values of NLR and FIB to differentiate tissue grading,and optimal cut-off values were 2.24 and 3.88 g/L,respectively.FIB-NLR scores were divided into three groups,which were 0,1 and 2 FIB-NLR scores.Chi-square test was used to analyze the relationship between FIB-NLR score and clinical pathological features of patients with PCa.Kaplan-Meier method was used for survival analysis,and log rank method was used for difference type test.Univariate and multivariate Cox proportional hazard models were established to explore the risk factors and independent risk factors affecting the prognosis of PCa.Results According to the results of ROC curve,FIB-NLR 0 score group inclouded FIB≤3.88 g/L and NLR≤2.24;FIB-NLR 1 group:FIB>3.88 g/L or NLR>2.24;FIB-NLR 2 group:FIB>3.88 g/L and NLR>2.24.There were 95 cases(47.5%)with FIB-NLR 0,53 cases(26.5%)with FIB-NLR 1 and 52 cases(26.0%)with FIB-NLR 2.The 5-year survival time of patients with FIB-NLR 0,1,2 points were 91.88%,87.15%,59.72%,respectively,and the 5-year progression free survival time were 87.83%,77.18%,43.95%,respectively(P<0.001).There were significant differences in tumor pathological stage,Gleason score,risk grade and TPSA(P<0.05)among different FIB-NLR score groups.Univariate analysis showed that FIB-NLR score,FIB concentration,NLR value,tumor pathological stage,Gleason score and preoperative TPSA concentration were risk factors for overall survival(OS)and disease-free survival(DFS)of PCa patients(P<0.05).Multivariate analysis showed that FIB-NLR score w

关 键 词：前列腺癌 纤维蛋白原 中性粒细胞与淋巴细胞比值 FIB-NLR评分 预后 

分 类 号：R737.25[医药卫生—肿瘤]