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

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。

The relationship between the prognostic of epithelial ovarian cancer and inflammatory prognostic index based on preoperative NLR,LMR and serum albumin

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.