摘要
目的观察射波刀治疗肝细胞癌患者预后的影响因素。方法回顾性分析2015年8月至2017年4月接受射波刀治疗的肝细胞癌患者91例,检测治疗前后血清中性粒细胞与淋巴细胞比值(NLR),随访记录患者的生存时间,并采用Cox回归模型进行多因素风险分析。结果肝细胞癌患者射波刀治疗后第3天NLR高于治疗前,差异有统计学意义(P<0.05)。采用X-tile软件计算得到的NLR最佳临界值为2.53,低NLR组(NLR<2.53)患者中位总生存时间为10.9个月,高NLR组(NLR≥2.53)患者中位总生存时间为7.0个月,两组比较差异有统计学意义(P<0.05)。多因素Cox回归分析发现,肝外转移、门静脉癌栓、NLR是影响肝细胞癌患者射波刀治疗后生存时间的独立危险因素(P<0.05)。结论肝外转移、门静脉癌栓及高NLR水平均为肝细胞癌患者预后的影响因素,临床可根据患者的NLR水平、是否发生肝外转移及门静脉栓实施针对性治疗。
Objective To analyze the prognostic factors of patients with hepatocellular carcinoma treated with cyberknife.Methods A retrospective analysis was performed on 91 patients with hepatocellular carcinoma treated with cyberknife from August 2015 to April 2017.Changes in serum NLR before treatment were detected and the survival time of patients was recorded.Cox regression model was used to analyze the relationship between different tumor factors and prognosis.Results Three days after cyberknife treatment,the NLR of the patients with hepatocellular carcinoma was higher than that before treatment,and the difference was statistically significant(P<0.05).The best critical value calculated by X-tile was 2.53.The median overall survival of the patients in the low NLR group(NLR<2.53)was 10.9 months,while the median overall survival of the patients in the high NLR group(NLR≥2.53)was 7.0 months,and the difference was statistically significant(P<0.05).Multivariate Cox regression model analysis showed that extrahepatic metastasis,portal vein thrombus and NLR were independent risk factors for survival time of patients with hepatocellular carcinoma treated by cyberknife(P<0.05).Conclusion Extrahepatic metastasis,portal vein thrombosis and high level of NLR are the prognostic factors of patients with hepatocellular carcinoma.Targeted treatment could be performed according to the NLR of the patient,whether extrahepatic metastasis and portal vein thrombosis have occurred.
作者
潘波
徐晓婉
朱晓俊
郭玉玉
刘群
郁沙莎
翟笑枫
PAN Bo;XU Xiaowan;ZHU Xiaojun;GUO Yuyu;LIU Qun;YU Shasha;ZHAI Xiaofeng(Department of Traditional Chinese Medicine Oncology,Shanghai Changhai Hospital,Shanghai 200433,China;Department of Emergency Pharmacy of Medicine,Shanghai Changhai Hospital,Shanghai 200433,China)
出处
《国际检验医学杂志》
CAS
2020年第19期2320-2322,2327,共4页
International Journal of Laboratory Medicine
基金
国家自然科学基金项目(81774077)。
