摘要
目的 探讨淋巴细胞/单核细胞比值(LMR)联合CA19-9在预测胰头癌可根治性切除的价值.方法 回顾性分析在2014年1月至2017年9月就诊的56例影像学资料评估可切除或交界性可切除胰头癌患者的临床资料,分为可根治性切除组和不可切除组,单因素和多因素二分类Logistic回归筛选胰头癌可根治性切除的影响因素.采用受试者工作特性曲线(ROC)与曲线下面积(AUC)分析,单一指标与联合指标在预测胰头癌可根治性切除的效果及其差异性.结果 56例胰头癌患者中,可根治性切除组23例(41.07%),不可切除组33例(58.93%),两组治疗前LMR和CA19-9是预测胰头癌可根治性切除独立影响因素.ROC分析得出:治疗前LMR和CA19-9对胰头癌可根治性切除均具有良好预测价值,最佳临界值分别为3.27kU/L和713.61kU/L,AUC值分别为0.852和0.786(均P<0.05),灵敏性分别为75.76%和57.57%,特异性分别为78.26%和91.30%.LMR联合CA19-9判断灵敏性为81.81%,特异性为82.61%,准确性为82.14%,与两者单独预测相比,其灵敏性增加,特异性也较LMR单独预测有所提高,具有较好的预测效能.结论 治疗前LMR和CA19-9可作为预测胰头癌可根治性切除的辅助指标,LMR联合CA19-9可进一步提高胰头癌可根治性切除的预测效果.
Objective To investigate the value of lymphocyte/monocyte ratio(LMR)combined with CA19-9 in predicting radical resection of pancreatic head cancer.Methods The clinical data of 56 patients with cancer in the head of the pancreas admitted between January 2014 and September 2017 were analyzed retrospectively.The patients were divided into two groups in according to radical resection.Univariate and multivariate analysis were performed to evaluate the clinical factors afiecting radical resection of pancreatic binary logistic regression Indicators predictive values for the resectability of pancreatic head cancer were determined by receiver operating characteristic curve(ROC)and the area under ROC curve(AUC).Results Among 56 cases of head of the pancreas,the tumors in 41.07% cases were considered resectable(resectable group)and in 58.93% cases were unresectable(unresectable group).LMR and CA19-9 were considered as the independent influencing factors of radical resection of pancreatic head cancer in both groups before treatment.ROC analysis showed that both CA19-9 and LMR had predictive significance for the radical resectability of pancreatic head cancer.The optimal cut-off values of LMR and CA19-9 were 3.27 and 713.61kU/L,with AUC of 0.852 and 0.786 respectively(both P<0.05).The sensitivity were 75.76%and 57.57%,respectively,and the specificities were 78.26% and 91.30%,respectively.The sensitivity of LMR combined with CA19-9 was 81.81%and the specificity was 82.61%.The combined detection could improve the sensitivity and specificity of LMR and CA19-9 alone.The effect of LMR combined with CA19-9 was better than LMR or CA19-9 alone.Conclusion The detection of serum LMR and CA19-9 levels before treatment can be used as an auxiliary index to estimate the radical resection.Their combined detection may improve the predictive effect.
出处
《浙江临床医学》
2020年第8期1188-1190,共3页
Zhejiang Clinical Medical Journal
