术前血清学标志物对早期食管鳞状细胞癌预后的预测价值  

The value of preoperative serological markers in predicting the prognosis for early esophageal squamous carcinoma

作　　者：钱梦 冯硕 王松[2] 张开光 Qian Meng;Feng Shuo;Wang Song;Zhang Kaiguang(Graduate School,Bengbu Medical College,Bengbu 233000,China)

机构地区：[1]蚌埠医学院研究生院,蚌埠233000 [2]中国科学技术大学附属第一医院(安徽省立医院)消化内科

出　　处：《中国临床保健杂志》2023年第2期237-243,共7页Chinese Journal of Clinical Healthcare

基　　金：国家外国专家科研项目(G2021019004)。

摘　　要：目的 探讨术前血清学标志物对早期食管鳞状细胞癌预后的预测价值。方法 回顾性分析2017年1月至2021年12月中国科学技术大学附属第一医院(安徽省立医院)收治的693例早期食管鳞状细胞癌患者的临床资料并进行随访。采用受试者工作特征(ROC)曲线确定中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)、淋巴细胞/单核细胞比值(LMR)、全身免疫炎症指数(SII)、预后营养指数(PNI)的最佳截断值。Kaplan-Meier曲线和Cox比例风险模型用于识别与总生存期(OS)、无复发生存期(RFS)相关的独立危险因素。结果 NLR、PLR、LMR、SII、PNI的最佳截断值分别为3.23、157.74、2.37、451.25、45.00。Cox回归分析显示年龄、淋巴脉管浸润、NLR≥3.23、PLR≥157.74是早期食管鳞状细胞癌患者术后总体生存的独立危险因素。同时,年龄、NLR≥3.23是早期食管鳞状细胞癌患者术后复发生存的独立危险因素。结论 年龄、NLR是早期食管鳞状细胞癌术后生存和复发的独立危险因素,对其预后具有潜在的预测价值。Objective To explore the value of preoperative serological markers in predicting the prognosis for early esophageal squamous carcinoma(ESCC).Methods A retrospective analysis of the clinical data of 693 patients with early ESCC who were treated in The First Affiliated Hospital of USTC(Anhui Provincial Hospital)from January 2017 to December 2021,and then we performed follow-up on them.The receiver operating curve(ROC)curves were used to determine the optimal cut-off value of neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),lymphocyte to monocyte ratio(LMR),systemic immune-inflammation index(SII),and prognostic nutritional index(PNI).Kaplan-Meier curves and Cox proportional hazard model were used to identify independent risk factors associated with over survival(OS)and recurrence-free survival(RFS).Results The optimal cut-off value of NLR,PLR,LMR,SII,and PNI were 3.23,157.74,2.37,451.25 and 45.00,respectively.Cox regression analysis showed that age,lymphatic vascular infiltration,NLR≥3.23 and PLR≥157.74 were independent risk factors for OS of early ESCC,while age and NLR≥3.23 were independent risk factors for RFS of early ESCC.Conclusions Age and NLR are independent risk factors for survival and recurrence in patients with early ESCC,which may provide potential predictive value for their prognosis.

关 键 词：癌 鳞状细胞 食管肿瘤 生物标记 危险因素 预后 

分 类 号：R735.1[医药卫生—肿瘤]