三种指标联合检测对中晚期宫颈鳞癌患者预后的预测价值

目的 探讨治疗前外周血血小板/淋巴细胞比值（PLR）、中性粒细胞/淋巴细胞比值（NLR）及鳞状细胞癌抗原（SCC）联合检测对行根治性放疗的中晚期宫颈鳞癌患者预后的预测价值。方法 回顾性分析2016年1月至2019年2月在南通大学附属肿瘤医院接受根治性放疗的127例中晚期宫颈鳞癌患者的临床资料,根据治疗结束后3年末的生存情况将入组病例分为生存组和死亡组。收集治疗前外周血实验室指标,计算出PLR、NLR,比较两组患者临床参数的差异。建立预测模型,通过受试者操作特征（ROC）曲线比较PLR、NLR、SCC单独预测及联合预测模型对中晚期宫颈鳞癌患者3年总生存（OS）的预测效能。通过logistic回归模型进行预后的单因素及多因素分析。结果 共127例中晚期宫颈鳞癌患者纳入研究,生存组96例,死亡组31例。两组患者在FIGO分期、肿瘤最长径、淋巴结转移、PLR、NLR和SCC方面比较,差异有统计学意义（P<0.05）。PLR、NLR、SCC的ROC曲线下面积（AUC）分别为0.660、0.712、0.700,PLR+NLR+SCC联合预测模型的AUC可提高至0.784。logistic多因素分析显示,FIGO Ⅲ期、FIGO Ⅳ期、淋巴结转移、PLR≥205.555、NLR≥3.060及SCC≥6.950 ng/ml是影响中晚期宫颈鳞癌患者3年OS的独立危险因素（P<0.05）。结论 PLR、NLR、SCC对预测中晚期宫颈鳞癌患者的3年OS具有较好的价值,PLR+NLR+SCC联合预测模型的预测价值更高。

Prognostic value of combined detection of three indexes in patients with advanced cervical squamous cell carcinoma

Objective To evaluate the prognostic value of combined detection of platelet‐to‐lymphocyte ratio (PLR), neutrophil‐to‐lymphocyte ratio (NLR) and squamous cell carcinoma antigen (SCC) for patients with advanced cervical squamous cell carcinoma undergoing radical radiotherapy. Methods Clinical data of 127 patients with advanced cervical squamous cell carcinoma who received radical radiotherapy in the Affiliated Tumor Hospital of Nantong University from January 2016 to February 2019 were analyzed retrospectively. The enrolled cases were divided into the survival group and death group according to the survival at the end of 3 years after treatment. The laboratory indexes of peripheral blood were collected before treatment, PLR and NLR were calculated, and the differences of clinical parameters were compared between two groups. The prediction model was established, and the prediction efficiency of PLR, NLR and SCC alone and combined prediction models for 3‐year overall survival (OS) in patients with advanced cervical squamous cell carcinoma was compared through the ROC curve. Univariate and multivariate analyses of prognosis were carried out by binary logistic regression model. Results A total of 127 patients with advanced cervical squamous cell carcinoma were included in the study. There were 96 cases in the survival group and 31 cases in the death group. There were significant differences between two groups in FIGO stage, longest diameter of tumor, lymph node metastasis, PLR, NLR and SCC (all P<0.05). The area under ROC curve (AUC) of PLR, NLR and SCC was 0.660, 0.712 and 0.700, respectively. The AUC of PLR+NLR+SCC combined prediction model was increased to 0.784. Logistic multivariate analysis showed that FIGO Ⅲ, FIGO Ⅳ, lymph node metastasis, PLR≥205.555, NLR≥3.060 and SCC≥6.950 ng/ml were the independent risk factors for 3‐year OS in patients with advanced cervical squamous cell carcinoma (all P<0.05). Conclusions PLR, NLR and SCC have good value in predicting the 3‐year OS of patients with advanced cervical squamous cell carcinoma, and the combined prediction model of PLR+NLR+SCC has higher prediction value.