术前LMR与晚期卵巢癌满意肿瘤细胞减灭术的相关性分析  

Correlation analysis of preoperative lymphocyte⁃to⁃monocyte ratio with optimal debulking sur⁃gery in patients with advanced ovarian cancer

作　　者：蒋潇 郑雪梅 苏彬 杜建梅 唐英[1] 胡辉权[1] JIANG Xiao;ZHENG Xue⁃mei;SU Bin;DU Jian⁃mei;TANG Ying;HU Hui⁃quan(Department of Gynaecology,Nanchong Central Hospital,North Sichuan Medical College,Nanchong City,Sichuan Province,Nanchong,637000,China)

机构地区：[1]川北医学院附属南充市中心医院妇产科,南充637000 [2]南充市高坪区人民医院妇科

出　　处：《妇产与遗传（电子版）》2023年第2期8-13,共6页Obstetrics-Gynecology and Genetics (Electronic Edition)

基　　金：南充市科技局市合作课题(22SXQT034)。

摘　　要：目的探讨术前外周血淋巴细胞/单核细胞计数比(lymphocyte-to-monocyte ratio,LMR)与晚期卵巢癌满意肿瘤细胞减灭术(optimal debulking surgery,ODS)的相关性。方法回顾性分析2019年1月至2022年1月在南充市高坪区人民医院和川北医学院附属南充市中心医院初始治疗为手术治疗的102例晚期卵巢癌患者的临床资料。根据患者是否实现ODS,分为ODS组和不满意肿瘤细胞减灭术(suboptimal debulking surgery,SODS)组,比较两组的临床指标(病理学类型、恶性腹水、淋巴结转移、肿瘤标志物等)。根据受试者工作特征(ROC)曲线分析得到LMR预测晚期卵巢癌ODS的最佳截止值。采用binary logistic分析影响卵巢癌ODS的可能因素。结果102例晚期卵巢癌患者中,70例行ODS,32例行SODS。根据约登指数最大原则,LMR预测晚期卵巢癌ODS的最佳临界值为3.67,此时ROC曲线下面积为0.860(95%CI:0.778~0.921,P<0.001),灵敏度为87.1%,特异度为84.4%。多因素binary logistic分析结果提示LMR(OR=6.570,95%CI:1.740~24.80,P=0.005)、血清CA125、恶性腹水(≤500 mL)、Suidan评分与晚期卵巢癌ODS有关。结论术前外周血LMR(LMR>3.67)可单独或联合Suidan评分作为预测晚期卵巢癌初治时实现ODS的参考指标。Objective To investigate the association between preoperative lymphocyte-to-monocyte(LMR)and optimal debulking surgery(ODS)in advanced ovarian cancer(AOC).Methods The clinical data of 102 patients with advanced ovarian cancer whose initial treatment was surgery at the People's Hospital of Gaoping District,Nanchong City and the Nanchong Central Hospital affiliated with the Chuanbei Medical College from January 2019 to January 2022 were retrospectively analyzed.Patients were divided into ODS group and unsatisfactory tumor cell reduction surgery(suboptimal debulking surgery,SODS)group according to whether they achieved ODS or not,and clinical indicators(pathological type,malignant ascites,lymph node metastasis,tumor markers,etc.)were compared between the two groups using chi-square test or t-test.The optimal cut-off value for LMR to predict ODS in advanced ovarian cancer was obtained based on subject operating characteristic(ROC)curve analysis.A binary logistic analysis was used to analyze the possible factors affecting the ODS of ovarian cancer.Results Of 102 AOC patients,70 cases were underwent ODS,and 32 were underwent SODS.According to the ROC,the optimal cut-off value,sensitivity and specificity of LMR predicting ODS in AOC patients were 3.67,87.1%and 84.4%.Multivariate binary logisti analysis showed LMR(OR=6.570,95%CI:1.740~24.80,P=0.005),serum CA125,malignant ascties(≤500 mL)and Suidan score were valuable factors to predict ODS in AOC.Conclusions The preoperative LMR(LMR>3.67)alone or combined with Suidan score might be related to the ODS of AOC and beneficial to predict ODS in the primary debulking surgery of AOC.

关 键 词：卵巢肿瘤 淋巴细胞/单核细胞计数比 满意肿瘤细胞减灭术 

分 类 号：R737.31[医药卫生—肿瘤]