外周血炎症细胞对胆囊癌患者术后病情复发风险的预测效能研究  

Predictive Efficacy of Peripheral Blood Inflammatory Cells on the Risk of Postoperative Recurrence of Gallbladder Cancer

作　　者：孟瑜 Meng Yu(The Third Ward,Department of Hepatobiliary and Pancreatic Surgery,The First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan,450000,China)

机构地区：[1]郑州大学第一附属医院肝胆胰外科三病区,河南郑州450000

出　　处：《黑龙江医学》2025年第8期910-913,共4页Heilongjiang Medical Journal

摘　　要：目的:分析外周血炎症细胞对胆囊癌患者术后病情复发风险的预测效能。方法:回顾性分析2021年1月—2023年8月郑州大学第一附属医院收治的113例胆囊癌手术患者临床资料。所有患者均已接受胆囊癌根治术治疗,依据术后病情是否复发将入组患者分为复发组(33例)和未复发组(80例),收集并对比两组患者的一般资料、临床资料,经单因素分析及logistic回归分析归纳可导致胆囊癌患者术后病情复发的危险因素。比较两组患者中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)、单核细胞/淋巴细胞比值(MLR)、全身炎症反应指数(SIRI)等外周血炎症细胞指标,通过绘制受试者工作特征曲线(ROC)并观察线下面积(AUC)评估上述指标对患者术后病情复发风险的预测效能。结果:统计学单因素分析结果显示,复发组患者的肿瘤TNM分期>ⅡB期、病理组织分级>Ⅱ级、癌胚抗原(CEA)>5 n/mL、糖类抗原19-9(CA199)>27 U/mL、总蛋白(TP)<60 g/L、白蛋白(ALB)<35 g/L、转铁蛋白(TRF)<2.5 g/L、NLR>4.0、PLR>130、MLR>0.25、SIRI>1.19占比均高于未复发组,差异均有统计学意义(χ^(2)=8.075、8.496、12.960、7.748、4.889、7.956、6.185、24.529、35.027、21.778、56.609,P<0.05);logistic回归分析结果显示,NLR>4.0、PLR>130、MLR>0.25、SIRI>1.19为胆囊癌患者术后病情复发的危险因素(OR=3.297、3.631、3.707、3.628,P<0.05)。复发组患者的NLR、PLR、MLR、SIRI均高于未复发组,差异均有统计学意义(t=4.413、3.510、11.005、11.520,P<0.05);经ROC曲线验证后结果显示,NLR、PLR、MLR、SIRI对胆囊癌患者术后病情复发风险有较高预测效能(AUC>0.85)。结论:机体存在炎症反应为导致胆囊癌患者术后病情复发的危险因素,外周血炎症细胞指标对患者术后病情复发有较高预测效能,NLR=4.0、PLR=130、MLR=0.25、SIRI=1.19为预测其病情复发风险的最佳截断值。Objective:To analyze the predictive efficacy of peripheral blood inflammatory cells on the risk of postoperative recurrence of gallbladder cancer.Methods:113 patients with gallbladder cancer who underwent surgery in the hospital from January 2021 to August 2023 were selected as the research subjects.All patients have received radical surgery for gallbladder cancer treatment.According to whether the postoperative condition relapses,the enrolled patients were divided into recurrent group(33 cases)and non recurrent group(80 cases).General and clinical data of the two groups were collected and compared.The risk factors that can lead to postoperative recurrence of gallbladder cancer patients through statistical univariate analysis and logistic multiple regression analysis.NLR,PLR,MLR,SIRI and other peripheral blood inflammatory cell indicators between the recurrent and non recurrent groups were compared.The predictive efficacy of these indicators on the risk of postoperative disease recurrence in patients by plotting ROC were evaluated,and AUC was observed.Results:The results of statistical single factor analysis showed that in the recurrence group,the TNM stage of tumor was>ⅡB stage,histological grade>Ⅱstage,carcinoembryonic antigen(CEA)>5 n/mL,carbohydrate antigen 19-9(CA199)>27,the proportion of U/mL,total protein(TP<60g/L,albumin(ALB)<35g/L,transferrin(TRF)<2.5g/L,NLR>4.0,PLR>130,ML>0.25,SIRI>1.19 were higher than those in non-recurrence group.The difference was statistically significant(χ^(2)=8.075,8.496,12.960,7.748,4.889,7.956,6.185,24.529,35.027,21.778,56.609;P<0.05).Logistic regression analysis showed that NLR>4.0,PLR>130,MLR>0.25,SIRI>1.19 were risk factors for postoperative recurrence of gallbladder cancer(OR=3.297,3.631,3.707,3.628;P<0.05).NLR,PLR,MLR and SIRI in the relapse group were higher than those in the non-relapse group,and the differences were statistically significant(t=4.413,3.510,11.005,11.520;P<0.05).After ROC curve verification,NLR,PLR,MLR and SIRI showed high predictive efficacy(AUC>0.8

关 键 词：胆囊癌根治术 病情复发 危险因素分析 外周血炎症细胞 预测效能 

分 类 号：R735.8[医药卫生—肿瘤]