关键词: 血小板计数, 喉肿瘤, 复发率, 生存率

Abstract: Objective  To explore the effect of preoperative platelet (PLT) count on the prognosis of patients with laryngeal squamous cell carcinoma. Methods  The clinical data of 286 patients with laryngeal squamous cell carcinoma were retrospectively analyzed to determine the optimal critical value of PLT count for end point of recurrence and death. The effects of preoperative PLT count on the recurrence and 5-year survival rates of patients with laryngeal squamous cell carcinoma after surgery were analyzed. Results  The optimal critical value of PLT count for end point of recurrence was 242.5×10⁹/L. The patients were divided into PLT≥242.5×10⁹/L group (n=115) and PLT<242.5×10⁹/L group (n=171). Single factor analysis indicated that the recurrence was not related to age (χ2=0.005, P=0.942), gender (χ2=0.309, P=0.579) and pathological differentiation (Z=2.858, P=0.240), and was related to T staging (χ2=10.509, P=0.001), lymph node metastasis (χ2=7.297, P=0.007), primary tumor site (χ2=16.797, P<0.001) and preoperative PLT count (χ2=12.081, P=0.001). Multivariate analysis indicated that T staging (OR=0.518, 95%CI: 0.2810.954, P=0.035), primary tumor site (OR=2.371, 95%CI: 1.2834.382, P=0.006), and PLT count (OR=2.885, 95%CI: 1.6075.179, P<0.001) were the independent factors affecting the recurrence of laryngeal squamous cell carcinoma. The optimal critical value of PLT count for end point of death was 251.5×10⁹/L. The patients were divided into PLT≥251.5×10⁹/L group (n=94) and PLT<251.5×10⁹/L group (n=192). Single factor analysis indicated that the 5year survival rate was not related to age (χ2=0.030, P=0.863), gender (χ2=0.000, P=0.945) and pathological differentiation (χ2=4.050, P=0.133), and was related to T staging (χ2=41.630， P<0.001), lymph node metastasis (χ2=58.110， P<0.001), primary tumor site (χ2=36.250, P<0.001) and preoperative PLT count (χ2=4.790， P=0.029). Multivariate analysis indicated that T staging (HR=0.353, 95%CI: 0.1930.645, P=0.001), primary tumor site (HR=2.151, 95%CI: 1.3123.526, P=0.002), lymph node metastasis (HR=2.819, 95%CI: 1.6334.867, P<0.001), and PLT count (HR=1.853, 95%CI: 1.1602.960, P=0.010) were the independent factors affecting 5year survival rates of laryngeal squamous cell carcinoma. KaplanMeier survival analysis indicated that the 5year survival rate of PLT≥251.5×109/L group and PLT<251.5×109/L group were 58.23%, 67.87%, with significant difference (χ2=4.79, P=0.029). Conclusion  Preoperative PLT count is the influence factor of recurrence and 5-year survival rate of laryngeal squamous cell carcinoma patients, which has important significance to the prognosis of laryngeal squamous cell carcinoma patients.

Key words: Platelet count, Laryngeal neoplasms, Recurrence rate, Survival rate