术前外周血血小板/淋巴细胞比值与前列腺癌患者临床病理特征及根治术后生存时间的相关性分析

目的 研究术前外周血血小板/淋巴细胞（PLR）比值与前列腺癌患者临床病理特征及根治术后生存时间的相关性，旨在为更好地治疗前列腺癌患者提供有效的理论依据。方法 回顾性分析2007年6月至2012年6月期间在本院行根治性手术切除并经病理诊断明确的164例前列腺癌患者的临床资料，并将其设为观察组，同时选取164例健康居民作为对照组。利用受试者工作特征（ROC）曲线，最终确定PLR的截点值为130，分为高PLR组（PLR≥130）和低PLR组（PLR<130），分析术前PLR比值与前列腺癌患者临床病理特征以及术后生存时间的相关性，并采用Cox回归分析影响前列腺癌患者预后的独立危险因素。结果 术前PLR值与患者年龄、组织类型无明显相关（P>0.05），与Gleason评分、临床分期、淋巴结转移、远处转移、分化程度、浸润深度存在明显的相关性（P<0.05）；术前PLR<130患者在1、3、5年中的无病生存期与总生存期明显高于术前PLR≥130患者（P<0.05）；经单因素分析，Gleason评分、临床分期、淋巴结转移、分化程度、术前PLR值、术后辅助治疗是影响前列腺癌患者预后的因素（P<0.05），而年龄、远处转移、组织类型、浸润深度与前列腺癌患者预后无相关性（P>0.05）；经Cox回归分析显示：Gleason评分、临床分期、术前PLR≥130是影响前列腺癌患者预后的独立危险因素，而术后辅助治疗是提高患者预后生存率的保护因素；PLR联合PSA对前列腺癌患者诊断的灵敏度、特异度、阳性预测值以及阴性预测值明显高于PSA（P<0.05）。结论 术前PLR比值是影响前列腺癌患者预后的独立危险因素，可作为评价前列腺癌患者预后的指标之一，并且PLR联合PSA能提高对前列腺癌的诊断率，两种指标存在一定程度上存在一定的互补性。

Correlation between peripheral blood platelet/lymphocyte ratio and clinicopathological features and survival time after radical prostatectomy in patients with prostate cancer

Objective  To investigate the correlation between peripheral blood platelet/lymphocyte ratio and clinicopathological features and survival time after radical prostatectomy in patients with prostate cancer to provide an effective theoretical basis for better treatment of prostate cancer.Methods   The clinical data of 164 patients with prostate cancer diagnosed by pathology who underwent radical resection in our hospital from June 2007 to June 2012 were analyzed retrospectively. The  receiver operating characteristic (ROC) curve was used to determine the cutoff value of PLR with 130. According to the cutting point, the patients were divided into the high PLR group (PLR≥130) and the low PLR group (PLR<130). The correlation between peripheral blood platelet/lymphocyte ratio and clinicopathological features and survival time were investigated. The independent prognostic factors were analyzed by Cox regression. Results   There were 64 cases of preoperative PLR<130 and 100 cases of preoperative PLR≥130. There was no significant relationship between preoperative PLR value and patient age, histological type(P>0.05). The preoperative PLR value was significantly correlated with Gleason score, clinical stage, lymph node metastasis, distant metastasis, degree of differentiation and depth of invasion(P<0.05). The no disease survival and overall survival at the 1, 3, 5 years in patients with PLR<130 were significantly higher than that of patients with preoperative PLR≥130 (P<0.05). The single factor analysis showed that Gleason score, clinical stage, lymph node metastasis, differentiation, preoperative PLR, postoperative adjuvant therapy were prognostic factors for patients with prostate cancer(P<0.05). The age, distant metastasis, histological type, depth of invasion didn’t correlate with the prognosis of patients with prostate cancer(P>0.05). Cox regression analysis showed that Gleason score, clinical stage, preoperative PLR≥130 were independent prognostic risk factors for patients with prostate cancer [HR=1.709 (1.264-2.611), HR=1.582 (1.103-2.270), HR=1.531 (1.104-2.124)], and the postoperative adjuvant treatment was protective prognosis factors of survival rate [HR=0.530 (0.408-0.690)]. Conclusions  Preoperative PLR ratio is an independent risk factor for the prognosis of patients with prostate cancer, which can be used as an indicator of the prognosis of patients with prostate cancer.