术前ALI对腹腔镜前列腺癌根治术后生化复发率的预测价值  

The Predictive Value of Preoperative ALI for the Biochemical Recurrence Rate after Laparoscopic Radical Prostatectomy

作　　者：李林峰 王嘉南 蒋召强 苏祥 王向阳 姬彤宇 单磊 LI Linfeng;WANG Jianan;JIANG Zhaoqiang;SU Xiang;WANG Xiangyang;JI Tongyu;SHAN Lei(Zhengzhou University People's Hospital,Zhengzhou 450003,China;不详)

机构地区：[1]郑州大学人民医院(河南省人民医院),河南郑州450003

出　　处：《中外医学研究》2025年第7期61-65,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：河南省重点研发与推广专项项目(212102310155)。

摘　　要：目的:探讨术前晚期肺癌炎症指数(advanced lung cancer inflammatory index,ALI)对腹腔镜前列腺癌根治术(laparoscopic radical prostatectomy,LRP)患者术后出现生化复发(biochemical recurrence,BCR)的预测价值。方法:回顾性分析2021年1月—2023年3月在河南省人民医院泌尿外科接受LRP的232例患者的临床资料,包括年龄、身高、体重、吸烟史、体重指数(body mass index,BMI)、外周血清学检查结果及术后病理回示结果,以2019年欧洲泌尿外科协会(European Association of Urology,EAU)对于BCR的定义,将232例患者根据术后1年内是否出现BCR分为阳性组和阴性组,比较两组血清学指标、ALI及病理指标之间的差异,将影响因素纳入多因素回归,采用受试者工作特征(receiver operating characteristic,ROC)曲线评价ALI对BCR的预测效果,得出最佳截断值并将ALI分为高ALI组和低ALI组,分析其与临床病理特征的相关性。结果:232例患者有99例出现了BCR,总体复发率为42.67%,单因素分析结果显示,术前1周,BCR组血清前列腺特异性抗原(prostate specific antigen,PSA)>8.74μg/L、淋巴-单核比(lymphocyte-to-monocyte ratio,LMR)≤4.07、ALI≤434.98、有吸烟史、预后营养指数(prognostic nutritional index,PNI)≤48.12、术后病理Gleason评分>7分、肿瘤T分期为T3、切缘情况阳性占比高于非BCR组,差异有统计学意义(P<0.05)。术前ALI是发生BCR的独立保护性因素(P<0.05),有吸烟史,PSA、术后Gleason评分高、切缘阳性是发生BCR的独立危险性因素(P<0.05)。使用ROC曲线计算出ALI的最佳临界值为302.5(其中低ALI有66例,高ALI组有166例),最大约登指数为0.402,特异度为88.7%,敏感度为51.5%,AUC曲线下面积为0.750。低ALI组、高ALI组患者PNI、肿瘤T分期及Gleason评分比较,差异有统计学意义(P<0.05)。结论:术前ALI水平是行LRP后出现BCR的独立保护性因素,对于术后生化复发的出现有一定的预测价值,可以作为评估LRP后预测生化�Objective:To investigate the predictive value of preoperative advanced lung cancer inflammation index(ALI)for postoperative biochemical recurrence(BCR)in patients undergoing laparoscopic radical prostatectomy(LRP).Method:Clinical data of 232 patients receiving LRP in the Department of Urology,Henan Provincial People's Hospital from January 2021 to March 2023 were retrospectively analyzed,including age,height,weight,smoking history,body mass index(BMI),peripheral blood serological examination results and postoperative pathological findings.According to the definition of BCR issued by the European Association of Urology(EAU)in 2019,232 patients were divided into positive group and negative group according to whether BCR occurred within 1 year after surgery,and the differences between the two groups in serological indicators,ALI and pathological indicators were compared.The influencing factors were included in multi-factor regression,and receiver operating characteristic(ROC)curve was used to evaluate the prediction effect of ALI on BCR,and the optimal cut-off value was obtained.ALI was divided into high ALI group and low ALI group,and the correlation between ALI and clinicpathological characteristics was analyzed.Result:Among 232 patients with 99 cases in the BCR,overall recurrence rate was 42.67%,the single factor analysis,according to the results of preoperative 1 week,BCR group serum prostate specific antigen(PSA)>8.74μg/L,lymphocyte-to-monocyte ratio(LMR)≤4.07,ALI≤434.98,smoking history,prognostic nutritional index(PNI)≤48.12,postoperative pathological Gleason score>7 points,tumor T stage was T3,and the proportion of positive margin was higher than that of non-BCR group,the differences was statistically significant(P<0.05).ALI before surgery was an independent protective factor for BCR(P<0.05),smoking history,PSA,high postoperative Gleason score and positive incisal margin were independent risk factors for BCR(P<0.05).The ROC curve was used to calculate the optimal critical value of ALI as 302.5(66 cases

关 键 词：腹腔镜前列腺癌根治术 生化复发 晚期肺癌炎症指数 预后 

分 类 号：R737.25[医药卫生—肿瘤]