炎症反应指标和肿瘤标志物对子宫内膜癌手术患者预后的预测价值

Value of inflammatory response indicators and tumor markers in predicting the prognosis of endometrial carcinoma patients undergoing surgery

  • 摘要:
    目的 探讨炎症反应指标血小板与淋巴细胞比值(PLR)、中性粒细胞与淋巴细胞比值(NLR)和肿瘤标志物糖类抗原125(CA125)、糖类抗原199(CA199)对子宫内膜癌手术患者预后的预测价值。
    方法 选取在扬州大学附属医院接受手术治疗的131例子宫内膜癌患者作为研究对象, 通过检索临床病历系统提取有效的临床数据,采用COX比例风险模型对不同临床变量进行单因素和多因素生存分析,采用χ2检验分析炎症反应指标与临床变量之间的关系,采用Kaplan-Meier分析比较术前和术后NLR水平不同患者的总生存率。
    结果 单因素分析结果显示, FIGO分期、CA199水平、术前NLR水平均分别与总生存期、无病生存期显著相关(P < 0.05), 术后放疗、术后NLR水平仅与无病生存期显著相关(P < 0.05); 多因素分析结果显示,术后放疗、CA199水平与总生存期显著相关(P < 0.05), 术前NLR水平、术后NLR水平均分别与总生存期、无病生存期显著相关(P < 0.05)。Kaplan-Meier生存分析结果显示,高水平的术前NLR(χ2=16.871, P < 0.001)和高水平的术后NLR(χ2=3.966, P=0.046)均与较低的总生存率显著相关。
    结论 术前高NLR和术后高NLR均与子宫内膜癌术后患者较低的总生存率显著相关,或可用于预测子宫内膜癌术后患者的预后。

     

    Abstract:
    Objective To explore the significance of inflammatory response indicatorsplatelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR)and tumor markerscarbohydrate antigen 125 (CA125), carbohydrate antigen 199 (CA199)in predicting the prognosis of patients undergoing endometrial carcinoma surgery.
    Methods A total of 131 patients with endometrial carcinoma who underwent surgeryat the Affiliated Hospital of Yangzhou University were selected as study subjects. Effective clinical data were extracted by searching the clinical medical record system. Univariate and multivariate survival analysis of different clinical variables was performed using COX proportional risk model, and chi-test was used to analyze the relationship between inflammatory response indicators and clinical variables, and Kaplan-Meier analysis was used to compare the overall survival rate of patients with different preoperative and postoperative NLR levels.
    Results The results of univariate analysis showed that FIGO stage, CA199 level and preoperative NLR level were correlated with overall survival and disease-free survival, respectively (P < 0.05). Postoperative radiotherapy and postoperative NLR levels were only significantly correlated with disease-free survival (P < 0.05). The results of multivariate analysis showed that postoperative radiotherapy and CA199 level were significantly correlated with overall survival (P < 0.05), and preoperative NLR level and postoperative NLR level were separately significantly correlated with overall survival and disease-free survival (P < 0.05). Kaplan-Meier survival analysis showed that both high preoperative NLR (χ2=16.871, P < 0.001) and high postoperative NLR (χ2=3.966, P=0.046) were significantly associated with lower overall survival.
    Conclusion Both preoperative and postoperative high NLR are significantly associated with lower overall survival after endometrial cancer surgery, and may be used to predict the prognosis of patients with endometrial cancer after surgery.

     

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