中性粒细胞-白蛋白比值对胰腺癌患者PD术后预后的预测价值  

Predictive value of neutrophil-to-albumin ratio for postoperative prognosis in patients with pancreatic cancer after pancreaticoduodenectomy

作　　者：赵强 黄苠杰 李秋 ZHAO Qiang;HUANG Minjie;LI Qiu(Department of Hepatobiliary Surgery,the Affiliated Hospital of Southwest Medical University,Luzhou,Sichuan 646000,China)

机构地区：[1]西南医科大学附属医院肝胆外科,四川泸州646000

出　　处：《肝胆胰外科杂志》2024年第10期598-603,共6页Journal of Hepatopancreatobiliary Surgery

摘　　要：目的探究中性粒细胞-白蛋白比值(NAR)对胰腺癌患者胰十二指肠切除(PD)术后预后的预测价值。方法回顾性分析西南医科大学附属医院肝胆外科2014年1月至2022年1月期间收治的117例行PD的胰腺癌患者的临床资料。采用ROC曲线分析确定NAR的最佳截断值,Kaplan-Meier法比较两组患者生存曲线的差异,采用单因素和多因素Cox回归模型分析影响胰腺癌患者PD术后总生存时间的危险因素,ROC曲线评估NAR对胰腺癌患者PD术后OS的预测价值。结果ROC曲线分析结果显示,NAR的最佳截断值为0.137,高NAR组(NAR>0.137)46例,低NAR组(NAR≤0.137)71例。与低NAR组相比,高NAR组CA242>15 IU/mL、淋巴结转移、脉管侵犯、临床分期为Ⅱ期的患者比例明显增高(均P<0.05)。Kaplan-Meier生存分析结果显示,低NAR组的OS高于高NAR组(P<0.001)。多因素Cox回归分析显示,NAR(P=0.021)、肿瘤最大径(P<0.001)、肿瘤分化程度(P<0.001)是胰腺癌患者PD术后OS的独立危险因素。NAR、肿瘤最大径、肿瘤分化程度及三者联合预测胰腺癌患者OS的ROC曲线下面积(AUC)分别为0.711、0.669、0.704和0.829。结论NAR可用于预测胰腺癌患者PD术后的OS,NAR联合肿瘤最大径、肿瘤分化程度对OS的预测则更有价值。Objective To investigate the prognostic value of neutrophil-to-albumin ratio(NAR)in patients with pancreatic cancer after pancreaticoduodenectomy(PD).Methods A retrospective study was conducted on clinical data from a cohort of 117 patients,who were diagnosed with pancreatic cancer and underwent PD in the Affiliated Hospital of Southwest Medical University from Jan.2014 to Jan.2022.The optimal cut-off value of NAR was calculated with ROC curve analysis.The Kaplan-Meier method was employed to compare the difference in survival curves between the two patient groups.Independent risk factors influencing postoperative overall survival(OS)in pancreatic cancer patients were identified by single-factor and multiple-factor Cox regression models(P<0.05),ROC curve was used to evaluate the predictive value of NAR for OS in pancreatic cancer patients after PD.Results The ROC curve analysis showed that the optimal cut-off value of NAR was 0.137,the High-NAR group(NAR>0.137)with 46 cases and the Low-NAR group(NAR≤0.137)with 71 cases.Compared with the Low-NAR group,the High-NAR group exhibited a significantly higher patients proportion regarding to CA242>15 IU/mL,lymph node metastasis,vascular invasion,and clinical stageⅡ(all P<0.05).The Kaplan-Meier survival curve demonstrated that the OS in the Low-NAR group was higher than that in the High-NAR group(P<0.001).Multivariate Cox regression analysis revealed that NAR value(P=0.021),tumor maximum diameter(P<0.001)and tumor differentiation degree(P<0.001)were independent risk factors for OS of pancreatic cancer patients after PD.The area under the ROC curve(AUC)for NAR,tumor maximum diameter,tumor differentiation degree,and the combination of these three indicators to predict OS of pancreatic cancer patients were 0.711,0.669,0.704,and 0.829,respectively.Conclusion NAR can be used to predict the OS of patients with pancreatic cancer after PD.Furthermore,the prediction value will be enhanced when NAR combined with tumor maximum diameter and tumor differentiation degree.

关 键 词：胰腺癌 胰十二指肠切除术 中性粒细胞-白蛋白比值 预后 总生存时间 

分 类 号：R735.9[医药卫生—肿瘤]