C反应蛋白/清蛋白比率 乳酸脱氢酶预测非小细胞肺癌患者预后的应用价值

目的 探究C反应蛋白/清蛋白比率(CAR)、乳酸脱氢酶(LDH)预测非小细胞肺癌患者预后的应用价值。方法 回顾性分析安徽省胸科医院2017年3月至2020年3月收治的95例非小细胞肺癌患者的临床资料,所有患者均接受手术、化疗或靶向治疗等常规一线治疗,随访2年,根据患者的生存状态绘制受试者工作特征(ROC)曲线计算治疗前患者的CAR及LDH最佳截断值,按照截断值分为CAR高值组及CAR低值组,LDH高值组及LDH低值组,采用Kaplan-Meier分别分析CAR高值组及CAR低值组、LDH高值组及LDH低值组的总生存时间,Cox生存分析治疗前CAR及LDH对非小细胞肺癌患者生存的预测价值。结果 共纳入患者95例,治疗后随访2年,其中死亡60例,生存35例。根据患者的生存状态绘制ROC曲线,计算出截断值CAR=0.421、LDH=190.00 U/L。CAR高值组与CAR低值组相比,肿瘤临床分期较高、CRP水平较高,差异有统计学意义(P<0.05)。LDH高值组及LDH低值组相比,CAR值较高,差异有统计学意义(P<0.05)。患者的中位生存时间为(329.07±135.70) d,行Log-rank检验结果显示,CAR高值组的中位生存时间低于CAR低值组,差异有统计学意义(P<0.05)。LDH高值组中位生存时间明显低于LDH低值组,差异有统计学意义(P<0.05)。Cox多因素分析结果显示,高水平的LDH和CAR是非小细胞肺癌生存期缩短的独立危险因素(P<0.05)。结论 高水平的CAR及LDH可作为非小细胞肺癌患者预后的高危因素,具有较高的临床指导意义。

The application value of C-reactive protein/albumin ratio (CAR) and lactate dehydrogenase (LDH) in predicting prognosis of patients with non-small cell lung cancer

Objective To explore and analyze the application value of C-reactive protein/albumin ratio (CAR) and lactate dehydrogenase (LDH) in predicting the prognosis of patients with non-small cell lung cancer. Methods The clinical data of 95 patients with non-small cell lung cancer admitted to Anhui Chest Hospital from March 2017 to March 2020 were retrospectively analyzed. All patients received conventional first-line treatment such as surgery, chemotherapy or targeted therapy, and were followed up for twoyears. Depending on the patients survival condition,the receiver operating characteristic (ROC) curve was used to analyze the cutoff values of preoperative CAR and LDH, and the cutoff values were divided into CAR high value group and CAR low value group, LDH high value group and LDH low value group. Kaplan- Meier was employedto analyze the overall survival time of CAR high value group and CAR low value group, LDH high value group and LDH low value group respectively. The prognostic value of CAR and LDH in patients with non-smallcell lung carcinoma before treatment wasanalyzed.The predictive value of CAR and LDH before treatment for survival in patients was analyzed with Cox survival analysis.Results A total of 95 patients in this group were followed up for two years after treatment. A total of 60 patients died and 35 survived. Depending on the patients survival condition, the ROC curve was drawn. When CAR was 0.421, using the same method, LDH=190.00 U/L iwas calculated. Compared with the low CAR value group, the tumor clinical stage was higher and the LDH level was higher in the CAR high value group, and the difference was statistically significant (P<0.05). Compared with the LDH high-value group and the CRP low-value group, the CAR value was higher, and the difference was statistically significant (P<0.05). All patients in this group were followed up for two years, and the median survival time of patients was (329.07±135.70) days. Log-rank test results showed that the median survival time of the high CAR value group was significantly lower than that of the low CAR value group, and the difference was statistically significant (P<0.05). Using the same method to analyze the relationship between LDH and prognosis, it could be seen that the median survival time of the LDH high value group was significantly lower than that of the LDH low value group, and the difference was statistically significant (P<0.05). The multivariate Cox analysis showed that high levels of LDH and CAR were independent risk factors for shortened survival in non-SCLC (P<0.05).Conclusions High levels of CAR and LDH are considered to be high-risk factors affecting the prognosis of patients with non-small cell lung cancer, which have high clinical guiding significance.