D-二聚体和中性粒细胞/淋巴细胞比值评估卵巢癌预后的临床价值

目的:研究D-二聚体（D-dimer,D-D）和中性粒细胞/淋巴细胞比值（neutrophil to lymphocyte ratio,NLR）与卵巢癌临床病理特征及预后的关系。方法:回顾性分析2012年1月至2015年12月于我院妇科行手术治疗的卵巢恶性肿瘤患者387例和卵巢良性肿瘤患者250例临床资料。比较血清D-D和外周血NLR在卵巢良、恶性肿瘤中的表达水平；确定D-D和NLR临界值，D-D+NLR=0（D-D≤0.555 mg/L和NLR≤2.792）,D-D+NLR=1（D-D>0.555 mg/L或NLR>2.792），D-D+NLR=2（D-D>0.555 mg/L和NLR>2.792），分析两者联合的评分系统与卵巢癌临床病理特征和预后的关系。结果:血清D-D和外周血NLR在卵巢良、恶性肿瘤患者中的表达水平有统计学差异（P＜0.001）。D-D高水平组与低水平组相比，患者的分期、分级、淋巴结转移、腹水、CA125水平、残余瘤大小有统计学差异（P＜0.05）。NLR高水平组与低水平组相比，患者的年龄、分期、淋巴结转移、腹水、CA125水平、残余瘤大小有统计学差异（P＜0.05）。D-D+NLR为0、1、2分的平均总生存期（OS）分别为70个月、58个月、40个月。D-D+NLR评分是影响OS的独立预后因素。结论:术前血清D-D和外周血NLR与卵巢癌临床病理特征和OS相关，D-D+NLR评分可以作为评估卵巢癌预后的指标。

Prognostic value of D-dimer and neutrophil to lymphocyte ratio in ovarian carcinoma

Objective:To evaluate the clinicopathologic featureand prognostic significance of combination of D-dimer(D-D)and neutrophil to lymphocyte ratio(NLR)in ovarian carcinoma.Methods:We proceeded retrospective analysis of a sequence of 387 patients with ovarian carcinoma and 250 patients with benign ovarian masses from January 2012 to December 2015 to compare D-D and NLR levels.The cut-off values of D-D and NLR were estimated.The D-D+NLR score was 0 for low D-D(≤0.555 mg/L)and NLR(≤2.792),1 for high D-D(>0.555 mg/L)or NLR(>2.792),2 for high D-D(>0.555 mg/L)and NLR(>2.792).The correlation of the index and overall survival(OS)was analyzed.Results:D-D and NLR values were higher in ovarian carcinoma compared with benign ovarian masses(P<0.001).There was statistical difference between D-D high level group and D-D low level group in stage,grade,lymph node metastasis,ascites,CA125 level and residual tumor(P<0.05).There was statistical difference between NLR high level group and NLR low level group in age,stage,lymph node metastasis,ascites,CA125 level and residual tumor.The median OS for score 0,1,2 was 70,58,40 months,respectively.The index was independent prognostic factor for OS.Conclusion:D-D and NLR were related to clinicopathologic features and OS.Combining of two markers could be used to predicate prognosis of ovarian carcinoma.