术前纤维蛋白原-前白蛋白比值联合血小板-淋巴细胞比值评分对结直肠癌根治性切除术患者的预后评估价值  

Preoperative Fibrinogen-Prealbumin Ratio Combined with Platelet-Lym-phocyte Ratio in Predicting Clinical Outcomes of Colorectal Cancer Pa-tients After Radical Resection

作　　者：李静 刘继斌 江晓晖 崔小鹏[2] 张晨程 张思铭 吴俊 LI Jing;LIU Jibin;JIANG Xiaohui;CUI Xiaopeng;ZHANG Chencheng;ZHANG Siming;WU Jun(Nantong Tumor Hospital/Affiliated Tumor Hospital of Nantong University,Nantong 226361,China;Affiliated Hospital of Nantong University,Nantong 226001,China)

机构地区：[1]南通大学附属肿瘤医院/南通市肿瘤医院,江苏南通226361 [2]南通大学附属医院,江苏南通226001

出　　处：《肿瘤学杂志》2024年第6期467-476,共10页Journal of Chinese Oncology

基　　金：南通市科技局基础研究计划项目(JC22022027,JC22022009);南通市卫生健康委员会科研课题面上项目(MS2021046)。

摘　　要：[目的]探讨术前纤维蛋白原-前白蛋白比值指数(fibrinogen-prealbumin ratio index,FPRI)联合血小板-淋巴细胞比值(platelet-lymphocyte ratio,PLR)评分对根治性切除术结直肠癌患者的预后价值。[方法]对249例手术结直肠癌患者的术前FPRI、纤维蛋白原-白蛋白比值指数(fibrinogen-albumin ratio index,FARI)、中性粒细胞-淋巴细胞比值(neutrophil-lymphocyte ratio,NLR)和PLR进行分析。通过受试者工作特征(receiver operating characteristics,ROC)曲线分析确定各指标的最佳截断值,并通过Kaplan-Meier曲线和Cox回归模型评估它们对总生存期(overall suvival,OS)、无病生存期(disease-free survival,DFS)的预后价值。[结果]ROC曲线结果显示,FPRI、FARI、NLR和PLR的最佳截断值分别为11.8%、8.2%、3.26和158.65。单因素分析结果显示,FPRI、FARI、NLR和PLR均是CRC患者的预后影响因素(P均<0.05)。FPRI对OS和DFS的预测价值优于FARI、NLR和PLR (OS:AUC_(FPRI)=0.658,AUC_(FARI)=0.581,AUC_(NLR)=0.536,AUC_(PLR)=0.588;DFS:AUC_(FPRI)=0.618,AUC_(FARI)=0.545,AUC_(NLR)=0.511,AUC_(PLR)=0.549)。多因素分析结果显示,高FPRI、高PLR和FPRI联合PLR评分高是患者OS和DFS的独立危险影响因素(P均<0.001)。[结论]FPRI和PLR均可预测根治性切除术结直肠癌患者的预后,且两者联合比单独FPRI和PLR效果更优。[Objective]To investigate the prognostic value of preoperative fibrinogen-prealbumin ratio index(FPRI)combined with platelet/lymphocyte ratio(PLR)in colorectal cancer(CRC)patients after radical resection.[Methods]The preoperative FPRI,fibrinogen/albumin ratio index(FARI),neutrophil/lymphocyte ratio(NLR)and PLR in 249 CRC patients with radical surgery were analyzed.The optimal cutoff values for each indicator were determined by receiver operating characteristics(ROC)curve analysis,and their prognostic value for overall sur-vival(OS)and disease-free survival(DFS)were evaluated by Kaplan-Meier curves and Cox regression models.[Results]The ROC results showed that the optimal cutoff values for FPRI,FARI,NLR,and PLR were 11.8%,8.2%,3.26,and 158.65,respectively.The univariate analysis results showed that FPRI,FARI,NLR,and PLR were significantly associated with the prognosis of CRC patients(all P<0.05).FPRI has better predictive value for OS and DFS than FARI,NLR and PLR(OS:AUC_(FPRI)=0.658,AUC_(FARI)=0.581,AUC_(NLR)=0.536,AUCPLR=0.588;DFS:AUC_(FPRI)=0.618,AUC_(FARI)=0.545,AUC_(NLR)=0.511,AUCPLR=0.549).The multivariate analysis results showed that high FPRI,high PLR,and high FPRI combined with PLR scores(all P<0.001)were independent risk factors for OS and DFS in CRC patients.[Conclusion]Both FPRI and PLR have certain predictive value for colorectal cancer pa-tients undergoing radical resection,and the combination of the two is more effective than FPRI and PLR alone.

关 键 词：结直肠癌患者 NLR 根治性切除术 PLR 淋巴细胞比值 前白蛋白 预后评估 纤维蛋白原 

分 类 号：R735.35[医药卫生—肿瘤] R735.37[医药卫生—临床医学]