平均血小板体积/淋巴细胞比值与晚期肺癌患者临床特征、铂类化疗预后的关系  

Relationship between MPVLR and Clinical Characteristics and Prognosis of Advanced Lung Cancer Patients with Platinum Chemotherapy

作　　者：吴慕云 韩翠云 张道荣 梅劲松 杨星 李德岩[2] 龚平 WU Muyuna;WU Muyun;HAN Cuiyun;ZHANG Daorong;MEI Jingsong;YANG Xing;LI Deyan;GONG Ping(Department of Oncology,Anhui Wannan Rehabilitation Hospital/The Fifth People’s Hospital of Wuhu,Wuhu,Anhui 241000,China;Department of Neurorehabilitation,Anhui Wannan Rehabilitation Hospital/The Fifth People’s Hospital of Wuhu,Wuhu,Anhui 241000,China)

机构地区：[1]安徽省皖南康复医院(芜湖市第五人民医院)肿瘤内科,安徽芜湖241000 [2]安徽省皖南康复医院(芜湖市第五人民医院)神经康复科,安徽芜湖241000

出　　处：《转化医学杂志》2024年第3期376-380,共5页Translational Medicine Journal

基　　金：安徽省临床医学研究转化专项项目(202304295107020091)。

摘　　要：目的 分析平均血小板体积/淋巴细胞比值(MPVLR)与晚期肺癌患者临床特征、铂类化疗预后的关系。方法 选取2019年3月至2022年2月于安徽省皖南康复医院接受铂类化疗的90例晚期肺癌患者作为研究对象。绘制受试者工作特征(ROC)曲线,确定MPVLR截断值,并分为低MPVLR组(MPVLR <4.72,n=52)和高MPVLR组(MPVLR≥4.72,n=38),分析2组晚期肺癌患者临床特征差异;采用Kaplan-Meier法进行生存分析;采用多因素Cox回归分析MPVLR对晚期肺癌患者铂类化疗预后的影响因素。结果 MPVLR预测晚期肺癌患者铂类化疗预后的ROC曲线下面积(AUC),95%CI为0.872 (0.820~0.925),截断值为4.72,特异度为0.659,敏感度为0.912。高MPVLR组临床分期Ⅳ期、肿瘤直径> 5 cm、有远处转移、有胸腔积液的比例均高于低MPVLR组,比较差异均有统计学意义(P <0.05)。Kaplan-Meier生存分析显示,临床分期Ⅳ期、肿瘤直径> 5 cm、有远处转移、MPVLR≥4.72患者的中位生存期小于临床分期Ⅲ期、肿瘤直径≤5 cm、无远处转移、MPVLR <4.72患者,比较差异均有统计学意义(P <0.05)。多因素Cox回归分析结果显示,临床分期Ⅳ期(HR=2.143,95%CI:1.459~3.146)、有远处转移(HR=2.408,95%CI:1.602~3.621)、MPVLR≥4.72 (HR=2.726,95%CI:1.792~4.147)是晚期肺癌患者铂类化疗预后的独立危险因素(P <0.05)。结论 MPVLR水平升高与晚期肺癌患者临床分期、肿瘤直径、远处转移、胸腔积液有关,可作为预测晚期肺癌患者铂类化疗预后的重要标记物。Objective To explore the relationship between the mean platelet volume to lymphocyte ratio(MPVLR)and both clinical manifestations and platinum-based chemotherapy prognosis in patients with advanced lung cancer.Methods Ninety patients with advanced lung cancer who underwent platinum-based chemotherapy at Anhui Wannan Rehabilitation Hospital between March 2019 and February 2022 were selected as study subjects.Receiver operating characteristic(ROC)curves were plotted to determine MPVLR cutoff values,and patients were subsequently divided into a low MPVLR group(MPVLR<4.72,n=52)and a high MPVLR group(MPVLR≥4.72,n=38).Chi-square tests were employed to analyze the association between MPVLR levels and clinical manifestations in these patients.Kaplan-Meier survival analysis was conducted,and multivariate Cox regression analysis was utilized to investigate the factors influencing platinum-based chemotherapy prognosis in advanced lung cancer.Results The area under the ROC curve(AUC)for MPVLR in predicting the prognosis of platinum-based chemotherapy in advanced lung cancer patients was 0.872(95%CI:0.820-0.925),with a cutoff value of 4.72,specificity of 0.659,and sensitivity of 0.912.The high MPVLR group exhibited a higher proportion of clinical stage IV,tumor diameter>5 cm,distant metastasis,and pleural effusion compared to the low MPVLR group,with statistically significant differences(P<0.05).Kaplan-Meier survival analysis revealed that patients with clinical stage IV,tumor diameter>5 cm,distant metastasis,and MPVLR≥4.72 had a significantly shorter median survival time compared to those with clinical stage III, tumor diameter ≤ 5 cm, no distant metastasis, and MPVLR < 4.72 ( P < 0.05 ) . Multivariate Coxregression analysis indicated that clinical stage IV ( HR = 2.143, 95% CI: 1.459 - 3.146 ) , distant metastasis ( HR = 2.408, 95%CI: 1.602 - 3.621 ) , and MPVLR ≥ 4.72 ( HR = 2.726, 95% CI: 1.792 - 4.147 ) were independent risk factors for the prognosisof platinum - based chemotherapy in advanced lung cancer patient

关 键 词：平均血小板体积/淋巴细胞比值 肺部肿瘤 铂化合物 化学疗法 预后 ROC曲线 曲线下面积 回归分析 

分 类 号：R734.2[医药卫生—肿瘤] R730.7[医药卫生—临床医学]