国际肿瘤学杂志

国际肿瘤学杂志 ›› 2020, Vol. 47 ›› Issue (8): 467-471.doi: 10.3760/cma.j.cn371439-20190712-00059

• 论著 • 上一篇    下一篇

术前LMR、PLR对食管鳞状细胞癌术后早期复发的预测价值

汪婷婷1, 刘连科2()   

  1. 1蚌埠医学院第一附属医院肿瘤科 233004
    2南京医科大学第一附属医院肿瘤科 210000
  • 收稿日期:2019-07-12 修回日期:2020-01-10 出版日期:2020-08-08 发布日期:2020-10-22
  • 通讯作者: 刘连科 E-mail:liulianke@jsph.org.cn

Predictive values of preoperative LMR and PLR in early postoperative recurrence of patients with esophageal squamous cell carcinoma

Wang Tingting1, Liu Lianke2()   

  1. 1Department of Oncology, First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China
    2Department of Oncology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China
  • Received:2019-07-12 Revised:2020-01-10 Online:2020-08-08 Published:2020-10-22
  • Contact: Liu Lianke E-mail:liulianke@jsph.org.cn

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摘要：

目的 探讨术前外周血淋巴细胞与单核细胞比值(LMR)和血小板与淋巴细胞比值(PLR)对食管鳞状细胞癌术后早期复发的预测价值。方法 收集南京医科大学第一附属医院2015年11月至2018年12月行食管鳞状细胞癌根治术的患者83例,根据1年内复发情况将患者分为复发组(n=41)和对照组(n=42),采用全自动血液分析仪测定术前LMR和PLR水平,比较两组患者LMR和PLR的差异;采用受试者工作特征(ROC)曲线分析LMR、PLR及两者联合检测对术后早期复发的预测价值。结果 与对照组相比,复发组患者的LMR值较小(3.91±1.73 vs. 5.08±2.15;t=2.710,P=0.008)、PLR值较大(142.81±67.80 vs. 114.03±42.47;t=2.324,P=0.023)、肿瘤直径较大[(4.28±1.61)cm vs. (3.19±1.30)cm;t=3.420,P=0.001]、浸润较深(Z=2.633,P=0.008)、临床分期较晚(Z=2.616,P=0.009),差异均具有统计学意义。LMR预测食管癌术后复发的敏感性和特异性分别为69.0%和58.5%,ROC曲线下面积为0.666(95%CI为0.551~0.782,P=0.009),临界值为4.12。PLR预测食管癌术后复发的敏感性和特异性分别为51.2%和78.6%,ROC曲线下面积为0.642(95%CI为0.522~0.761,P=0.026),临界值为130.85。LMR和PLR联合检测预测食管癌复发的敏感性和特异性分别为68.3%和61.9%,ROC曲线下面积为0.675(95%CI为0.560~0.791,P=0.006)。低LMR高PLR组患者的复发率[81.0%(17/21)]高于高LMR低PLR组患者[35.1%(13/37)],差异有统计学意义(P=0.001)。结论 术前LMR、PLR值是预测食管鳞状细胞癌患者术后早期复发的有效指标,两者联合检测预测价值更高。

关键词: 食管肿瘤, 淋巴细胞, 单核细胞, 血小板, 复发

Abstract:

Objective To explore the predictive values of preoperative peripheral blood lymphocyte-to-monocyte ratio (LMR) and platelet-to-lymphocyte ratio (PLR) in early postoperative recurrence of patients with esophageal squamous cell carcinoma. Methods A total of 83 patients with esophageal squamous cell carcinoma who underwent radical surgery in the First Affiliated Hospital of Nanjing Medical University from November 2015 to December 2018 were collected. Patients were divided into recurrent group (n=41) and control group (n=42) according to the recurrence within 1 year. The levels of LMR and PLR before operation were detected by automatic blood analyzer, and the differences of LMR and PLR between the two groups were compared. The values of LMR, PLR and the combination of LMR and PLR in predicting early postoperative recurrence of esophageal squamous cell carcinoma were analyzed by receiver operating characteristic (ROC) curve. Results Compared with the control group, the recurrence group had smaller LMR (3.91±1.73 vs. 5.08±2.15; t=2.710, P=0.008), larger PLR (142.81±67.80 vs. 114.03±42.47; t=2.324, P=0.023), larger tumor diameter [(4.28±1.61) cm vs.(3.19±1.30) cm; t=3.420, P=0.001], deeper infiltration (Z=2.633, P=0.008) and later clinical stage (Z=2.616, P=0.009), with statistically significant differences. The sensitivity and specificity of LMR in predicting recurrence of esophageal cancer after surgery were 69.0% and 58.5% respectively, with the area under the curve of 0.666 (95%CI: 0.551-0.782, P=0.009) and a critical value of 4.12. The sensitivity and specificity of PLR in predicting recurrence of esophageal cancer after surgery were 51.2% and 78.6% respectively, with the area under the curve of 0.642 (95%CI: 0.522-0.761, P=0.026) and a critical value of 130.85. The sensitivity and specificity of LMR combined with PLR were 68.3% and 61.9% respectively, and area under the curve of ROC was 0.675 (95%CI: 0.560-0.791, P=0.006). Patients with low LMR and high PLR had higher risk of recurrence rate [81.0%(17/21)] than those with high LMR and low PLR [35.1%(13/37)], and the difference was statistically significant (P=0.001). Conclusion Preoperative LMR and PLR are effective indicators for early postoperative recurrence in patients with esophageal squamous cell carcinoma, and the combination of LMR and PLR has a higher predictive value.

Key words: Esophageal neoplasms, Lymphocytes, Monocytes, Blood patelets, Recurrence