术前PLR联合NLR预测卵巢上皮性肿瘤患者预后的效能分析  

Predictive value of preoperative PLR combined with NLR levels in prognosis of patients with epithelial ovarian tumor debulking

作　　者：杨芳[1] 陈友国[1] 施秀[1] 黄慧妙[1] Yang Fang;Chen You-guo;Shi Xiu;Huang Hui-miao(Department of Obstetrics and Gynecology,The First Affiliated Hospital of Suzhou University,Suzhou,Jiangsu 215000,China)

机构地区：[1]苏州大学附属第一医院妇产科,江苏苏州215000

出　　处：《中国现代医学杂志》2023年第3期13-18,共6页China Journal of Modern Medicine

基　　金：国家自然科学基金(No:82202898)。

摘　　要：目的 探讨术前血小板与淋巴细胞比值(PLR)联合中性粒细胞与淋巴细胞比值(NLR)对卵巢上皮性肿瘤患者预后的预测效能。方法 回顾性分析2016年1月-2020年3月苏州大学附属第一医院192例行卵巢上皮性肿瘤减灭术患者的临床资料,记录患者术前7 d的PLR和NLR。术后随访2年,根据患者是否复发记为复发组与未复发组。采用多因素Logistic回归模型分析卵巢上皮性肿瘤减灭术后复发的危险因素,以受试者工作特征(ROC)曲线分析术前PLR、NLR及二者联合对卵巢上皮性肿瘤减灭术后复发的预测效能,根据上述各独立危险因素的回归系数构建卵巢上皮性肿瘤术后复发风险评估模型。结果 截至随访结束,192例患者复发74例,其余118例均未复发。复发组Ⅲ期、淋巴结转移、低分化患者占比、糖类抗原125(CA125)、PLR、NLR高于未复发组(P<0.05);多因素Logistic回归分析结果显示,临床分期Ⅲ期■为上皮性卵巢肿瘤减灭术后复发的危险因素(P<0.05)。ROC曲线分析结果显示,术前PLR、NLR及两者联合预测上皮性卵巢肿瘤减灭术后复发的敏感性为74.32%、67.57%和68.92%,特异性为66.10%、73.73%和91.53%,AUC值为0.707、0.737和0.795。风险评估模型的敏感性、特异性分别75.64%、86.84%,AUC为0.812(95%CI:0.927,0.889),HH-L检验结果为0.097,取5分为临界值,该风险模型的特异性与敏感性较高,分别为0.662和0.784。结论 术前PLR、NLR与卵巢上皮性肿瘤患者预后密切相关,两者联合对患者预后具有良好的预测效能,且基于危险因素构建的风险评估模型具有一定的预测效能。Objective To investigate the predictive value of preoperative platelet-to-lymphocyte ratio (PLR)combined with neutrophil-to-lymphocyte ratio (NLR) in the prognosis of patients with epithelial ovarian tumor debulking.Methods The clinical data of 192 patients with epithelial ovarian tumor debulking who were treated in the hospital from January 2016 to March 2020 were retrospectively analyzed,and the levels of PLR and NLR 7 days before surgery were recorded.The patients were followed up for 2 years after operation,and the patients were recorded as the recurrence group and the non-recurrence group according to whether the patients had recurrence or not.Risk factors for postoperative recurrence of epithelial ovarian tumors was analyzed.Receiver operating characteristic curve (ROC) was used to analyze the predictive value of preoperative PLR,NLR,and their combination on postoperative recurrence of epithelial ovarian tumors.Based on the regression coefficients of the above-mentioned independent risk factors,a risk assessment model for postoperative recurrence of epithelial ovarian tumors was constructed.Results As of the end of follow-up,74 of 192 patients with epithelial ovarian tumor debulking had recurrence,and the remaining 118 patients had no recurrence.StageⅢ,lymph node metastasis,the proportion of poorly differentiated cases,carbohydrate antigen 125 (CA125),PLR,and NLR in the recurrence group were higher than those in the non-recurrence group (P<0.05).Logistic multivariate regression analysis showed that stageⅢ■were risk factors for postoperative recurrence of epithelial ovarian cancer (P<0.05).ROC curve results showed that the sensitivities of preoperative PLR,NLR,and their combination in predicting postoperative recurrence of epithelial ovarian cancer were 74.32%,67.57%and 68.92%,respectively;the specificities were 66.10%,73.73%and 91.53%,respectively;the AUC values were 0.707,0.737 and 0.795,respectively.The sensitivity and specificity of the risk assessment model were 75.64%and 86.84%,the AUC was 0.812,

关 键 词：卵巢上皮性肿瘤 血小板与淋巴细胞比值 中性粒细胞与淋巴细胞比值 减灭术 预后 预测效能 

分 类 号：R737.31[医药卫生—肿瘤]