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基于术前NLR、LMR及白蛋白的炎症预后指数评估上皮性卵巢癌患者预后的价值
引用本文:陈 玲,王 衍,孙洪芳,刘洪双.基于术前NLR、LMR及白蛋白的炎症预后指数评估上皮性卵巢癌患者预后的价值[J].现代肿瘤医学,2021,0(17):3069-3073.
作者姓名:陈 玲  王 衍  孙洪芳  刘洪双
作者单位:1.沧州医学高等专科学校临床系妇产科,河北 沧州 061000; 2.沧州医学高等专科学校,河北 沧州 061001; 3.沧州市人民医院妇科,河北 沧州 061001; 4.泊头市医院,河北 泊头 062150
摘    要:目的:探讨以中性粒细胞-淋巴细胞比率(neutrophil-lymphocyte ratio,NLR)、淋巴细胞-单核细胞比率(lymphocyte-monocyte ratio,LMR)及血清白蛋白(serum albumin,ALB)为基础的炎症预后指数(inflammatory prognostic index,IPI)对评估上皮性卵巢癌(epithelial ovarian cancer,EOC)患者术后预后的价值。方法:回顾分析2016年09月至2018年09月在沧州市人民医院接受手术治疗的EOC患者240例,采用随访方式追踪患者术后生存预后,并计算IPI=NLR/(ALB×LMR)。用受试者工作特征(receiver operating characteristic curve,ROC)曲线计算IPI截断值,并根据截断值进行分组,比较高IPI组和低IPI组患者临床病理特征及生化指标情况。用Kaplan-Meier(K-M)法分析两组患者生存情况。对影响患者存活的因素进行单因素和多因素Logistic回归分析。结果:根据IPI截断值将240例EOC患者分为高IPI组(n=137)和低IPI组(n=103)。两组在FIGO分期(P=0.003)、CA-125水平(P=0.000)、LDH水平(P=0.003)上的差异有统计学意义,且高IPI组生存率显著低于低IPI组(P=0.000)。单因素和多因素分析显示FIGO分期(OR=1.063,95%CI 1.004~1.125)、CA-125(OR=3.353,95%CI 2.976~3.779)、NLR(OR=1.885,95%CI 1.827~1.945)、LMR(OR=1.125,95%CI 1.030~1.229)、ALB(OR=1.092,95%CI 1.042~1.145)、IPI(OR=2.804,95%CI 2.717~2.893)是患者预后不良的独立危险因素。结论:FIGO分期、CA-125、NLR、LMR、ALB、IPI是患者预后不良的独立危险因素,以NLR、LMR、ALB为基础计算的IPI可以作为EOC患者术后生存预后的独立危险因素,值得进一步临床推广。

关 键 词:炎症预后指数  上皮性卵巢癌  预后

The relationship between the prognostic of epithelial ovarian cancer and inflammatory prognostic index based on preoperative NLR,LMR and serum albumin
CHEN Ling,WANG Yan,SUN Hongfang,LIU Hongshuang.The relationship between the prognostic of epithelial ovarian cancer and inflammatory prognostic index based on preoperative NLR,LMR and serum albumin[J].Journal of Modern Oncology,2021,0(17):3069-3073.
Authors:CHEN Ling  WANG Yan  SUN Hongfang  LIU Hongshuang
Institution:1.Department of Obstetrics and Gynecology,Cangzhou Medical College Clinical,Hebei Cangzhou 061000,China;2.Cangzhou Medical College,Hebei Cangzhou 061001,China;3.Department of Obstetrics and Gynecology,Cangzhou People's Hospital,Hebei Cangzhou 061001,China;4.Botou City Hospital,Hebei Botou 062150,China.
Abstract:Objective:To explore the prognostic value of inflammatory prognostic index(IPI) calculated by neutrophil-lymphocyte ratio(NLR),lymphocyte-monocyte ratio(LMR) and serum albumin(ALB) in patients with epithelial ovarian cancer(EOC).Methods:240 EOC patients who received surgery in Cangzhou People's Hospital from September 2016 to September 2018 were enrolled.IPI was calculated as NLR/(ALB×LMR).Patients were divided into high IPI group and low IPI group according to the cut-off values of receiver operating characteristic(ROC) curve.The difference of the survival rates between these 2 groups were analyzed by Kaplan-Meier.The factors affected the prognosis of EOC patients were analyzed by single factor analysis and Logistic regression.Results:240 patients were divided into high IPI group(n=137) and low IPI group(n=103) according to the cut-off value.FIGO stages(P=0.003),CA-125 level(P=0.000),LDH level(P=0.003) had significant differences between the 2 groups.The overall survival was higher in the low IPI group than that in the high IPI group(P=0.000).The results of single factor analysis and Logistic regression demonstrated that FIGO stages(OR=1.063,95%CI 1.004~1.125),CA-125 level(OR=3.353,95%CI 2.976~3.779),NLR(OR=1.885,95%CI 1.827~1.945),LMR(OR=1.125,95%CI 1.030~1.229),ALB(OR=1.092,95%CI 1.042~1.145),IPI(OR=2.804,95%CI 2.717~2.893) were the independent risk factors of EOC patients survival.Conclusion:FIGO stages,CA-125 level,NLR,LMR,ALB,IPI were the independent risk factors of EOC survival.IPI calculated by NLR,LMR,ALB could be the prognostic factor of EOC.
Keywords:inflammatory prognostic index  epithelial ovarian cancer  prognosis
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