ⅡA/ⅡB期睾丸精原细胞瘤术后患者放疗前后肿瘤标志物、LMR动态变化及其对近期疗效的影响  

Dynamic changes of tumor markers and lymphocyte-to-monocyte ratio in postoperative patients with stageⅡA/ⅡB testicular seminoma before and after radiotherapy and their impact on short-term efficacy

作　　者：邢天俊[1] 王玮 刘洪宇 杨芳[1] XING Tianjun;WANG Wei;LIU Hongyu;YANG Fang(Department of Urology,Shanxi Provincial Cancer Hospital,Taiyuan 030013,Shanxi,China)

机构地区：[1]山西省肿瘤医院泌尿外科,太原030013

出　　处：《中国性科学》2024年第8期15-19,共5页Chinese Journal of Human Sexuality

摘　　要：目的分析ⅡA/ⅡB期睾丸精原细胞瘤术后患者放疗前后肿瘤标志物、淋巴细胞/单核细胞比值(LMR)动态变化及其与放疗效果的关系。方法回顾性分析山西省肿瘤医院2012年7月至2020年7月收治的70例ⅡA/ⅡB期睾丸精原细胞瘤术后患者的临床资料,根据放疗近期疗效情况将患者分为有效组(n=16)和无效组(n=54)。记录并整理患者基线资料、放疗前后肿瘤标志物水平及LMR值,分析肿瘤标志物、LMR与放疗近期疗效的关系。结果肿瘤直径>40 mm、睾丸血管浸润是影响ⅡA/ⅡB期睾丸精原细胞瘤术后患者放疗近期效果的危险因素(P<0.05)。有效组放疗后血清乳酸脱氢酶(LDH)水平低于放疗前,LMR值高于放疗前(P<0.05);无效组放疗前、后血清LDH水平高于有效组,LMR值低于有效组(P<0.05)。两组放疗前、后血清甲胎蛋白(AFP)、人绒毛膜促性腺激素(hCG)水平比较及组内比较,差异均无统计学意义(P>0.05)。放疗前、后血清LDH水平与肿瘤直径、睾丸血管浸润均呈正相关(r>0,P<0.05);放疗前、后LMR值与肿瘤直径、睾丸血管浸润均呈负相关(r<0,P<0.05)。放疗前血清LDH水平、LMR值及联合预测放疗无效的曲线下面积均>0.7,联合预测的价值更高。结论睾丸精原细胞瘤患者术后血清LDH水平、LMR值与放疗近期疗效密切相关。Objective To analyze the dynamic changes of tumor markers,lymphocyte-to-monocyte ratio(LMR)before and after radiotherapy in patients with stageⅡA/ⅡB testicular seminoma after surgery,and the relationship between them and the efficacy of radiotherapy.Methods The clinical data of postoperativepatients with stageⅡA/ⅡB testicular seminoma treated in Shanxi Provincial Cancer Hospital from July 2012 toJuly 2020 were retrospectively analyzed.According to the short-term efficacy status of radiotherapy,the patientswere divided into effective group(n=16)and ineffective group(n=54).The baseline data of patients,tumormarkers and LMR levels before and after radiotherapy were recorded and sorted out,and the relationship betweentumor markers,LMR and short-term efficacy of radiotherapy was analyzed.Results Tumor diameter>40 mmand testicular vascular invasion were the risk factors affecting the short-term effect of radiotherapy in patientswith stageⅡA/ⅡB testicular seminoma after surgery(P<0.05).Serum lactate dehydrogenase(LDH)afterradiotherapy in the effective group was lower than that before radiotherapy,and LMR was higher than that beforeradiotherapy(P<0.05).The serum LDH of the ineffective group before and after radiotherapy was higher thanthat of the effective group,and the LMR value was lower than that of the effective group(P<0.05).There wasno statistically significant difference in the levels of serum alpha fetoprotein(AFP)and human chorionicgonadotropin(hCG)before and after radiotherapy between the two groups and intra-group comparison(P>0.05).The serum LDH levels before and after radiotherapy were positively correlated with tumor diameter andtesticular vascular infiltration(r>0,P<0.05).LMR level before and after radiotherapy was negativelycorrelated with tumor diameter and testicular vascular infiltration(r<0,P<0.05).The area under the curveof serum LDH level,LMR value before radiotherapy,and combined prediction of ineffective radiotherapy wereall greater than 0.7,the value of combined prediction was relativ

关 键 词：睾丸精原细胞瘤 螺旋断层放疗 肿瘤标志物 淋巴细胞/单核细胞比值 近期疗效 

分 类 号：R691[医药卫生—泌尿科学]