平均血小板体积与淋巴细胞比值对老年食管癌放疗患者预后的评估价值  

Value of mean platelet volume-to-lymphocyte ratio in assessing the prognosis of elderly patients treated with radiotherapy for esophageal cancer

作　　者：郭群煌 郦守国[1] 郭瑞祥[1] 徐辉[1] Guo Qunhuang;Li Shouguo;Guo Ruixiang;Xu Hui(Department of Oncology and Radiotherapy,Zhongshan Hospital Affiliated to Xiamen University,Xiamen 361004,China)

机构地区：[1]厦门大学附属中山医院肿瘤放疗科,厦门361004

出　　处：《肿瘤研究与临床》2024年第5期371-375,共5页Cancer Research and Clinic

摘　　要：目的探讨平均血小板体积与淋巴细胞比值(MPVLR)对老年食管癌放疗患者预后的评估价值。方法回顾性病例系列研究。回顾性分析2015年9月至2020年9月厦门大学附属中山医院接受放疗的102例老年食管癌患者的临床资料。入院后采用全自动血液分析仪检测患者血清平均血小板体积、淋巴细胞水平,并计算MPVLR。根据受试者工作特征(ROC)曲线确定MPVLR最佳临界值,根据MPVLR最佳临界值将患者分组,比较两组临床病理特征。采用Kaplan-Meier法分析患者放疗后总生存;采用多因素Cox比例风险模型分析患者放疗后总生存的影响因素。结果102例患者年龄(77±3)岁;男性58例,女性44例;中高分化67例,低分化35例;TNM分期Ⅰ~Ⅱ期65例,Ⅲ~Ⅳ期37例。ROC曲线分析显示,MPVLR预测老年食管癌患者放疗后总生存的曲线下面积为0.905(95%CI:0.855~0.955),MPVLR最佳临界值为5.442。根据MPVLR最佳临界值将患者分为低MPVLR组(MPVLR≤5.442,60例)、高MPVLR组(MPVLR>5.442,42例)。高MPVLR组低分化、Ⅲ~Ⅳ期患者比例均高于低MPVLR组(均P<0.001)。高MPVLR组放疗后3年总生存率低于低MPVLR组(23.81%比51.67%),两组总生存差异有统计学意义(P<0.05)。不同分化程度、TNM分期的老年食管癌患者放疗后总生存比较,差异均有统计学意义(均P<0.05)。多因素Cox回归分析显示,TNM分期Ⅲ~Ⅳ期(HR=3.034,95%CI:1.805~5.101)、低分化(HR=2.872,95%CI:1.791~4.606)、MPVLR>5.442(HR=3.789,95%CI:2.000~7.178)均是老年食管癌患者放疗后总生存的独立危险因素(均P<0.001)。结论老年食管癌患者放疗前MPVLR与预后密切相关,MPVLR>5.442的患者放疗后总生存可能较差。Objective To investigate the value of mean platelet volume-to-lymphocyte ratio(MPVLR)in assessing the prognosis of elderly patients treated with radiotherapy for esophageal cancer.Methods A retrospective case series study was conducted.The clinical data of 102 elderly esophageal cancer patients who received radiotherapy from September 2015 to September 2020 in Zhongshan Hospital Affiliated to Xiamen University were retrospectively analyzed.After admission,all patients were tested for serum mean platelet volume and lymphocyte levels by using a fully automated hematology analyzer,and MPVLR was calculated.The optimal cut-off value of MPVLR was determined based on the receiver operating characteristic(ROC)curve.The patients were grouped according to the optimal cut-off value of MPVLR,and clinicopathological characteristics of the two groups were compared.The Kaplan-Meier method was used to analyze the overall survival of patients after radiotherapy,and the multivariate Cox proportional risk model was used to analyze the factors affecting the overall survival of patients after radiotherapy.Results The age of 102 patients was(77±3)years;there were 58 male cases,44 female cases;67 cases of middle and high differentiation,35 cases of low differentiation;65 cases of TNM stageⅠ-Ⅱ,37 cases of stageⅢ-Ⅳ.ROC curve analysis showed that the area under the curve of MPVLR predicting the overall survival of esophageal cancer patients after radiotherapy was 0.905(95%CI:0.855-0.955).The optimal cut-off value of MPVLR was 5.442.All patients were divided into the low MPVLR group(MPVLR≤5.442,60 cases)and the high MPVLR group(MPVLR>5.442,42 cases)according to the optimal cut-off value of MPVLR.The proportion of patients with low differentiation and stageⅢ-Ⅳin the high MPVLR group was higher than that in the low MPVLR group(all P<0.001).The 3-year overall survival rate after radiotherapy in the high-MPVLR group was lower than that in the low-MPVLR group(23.81%vs.51.67%),and the difference in the overall survival of both gro

关 键 词：食管肿瘤 老年人 放射治疗 平均血小板体积与淋巴细胞比值 预后 

分 类 号：R735.1[医药卫生—肿瘤]