摘要
目的探究术前血小板淋巴细胞比值(PLR)、中性粒细胞淋巴细胞比值(NLR)及白蛋白球蛋白比值(AGR)在评估乳腺癌患者预后中的价值。方法选取2013年1月至2017年12月收治的1184例浸润性乳腺癌女性患者为浸润性乳腺癌组,随机选取仅患乳腺纤维腺瘤的患者279例为乳腺纤维腺瘤组。收集患者一般资料、术后病理资料、血型、术前外周血血小板、中性粒细胞、淋巴细胞数量以及血清白蛋白和球蛋白水平,并计算得出PLR、NLR及AGR。应用受试者功能特征曲线下面积来评估三者预测乳腺癌患者预后的能力。本研究使用SPSS 20.0及MedCalc软件进行统计学分析和绘图,P<0.05代表差异具有统计学意义。结果浸润性乳腺癌患者的术前PLR及NLR均值显著高于乳腺纤维腺瘤患者(P<0.05),而AGR低于乳腺纤维腺瘤患者(P<0.05)。Cox比例回归风险分析显示,患者的诊断年龄、PLR、NLR、AGR、肿瘤直径、组织学分级、阳性淋巴结个数和分子分型均为乳腺癌的预后危险因素(P<0.05)。ROC曲线分析结果得出,PLR、NLR及AGR的最佳诊断临界值分别为147.4、2.9及1.7。应用术前PLR(AUC=0.796,P<0.001)、NLR(AUC=0.716,P<0.001)及AGR(AUC=0.748,P<0.001)预测乳腺癌患者预后均有价值,且PLR价值更高。结论术前PLR、NLR及AGR对乳腺癌患者预后的判断均具价值,三者相比,PLR价值更高,有望成为判断乳腺癌患者预后的补充指标。
Objective To investigate the value of platelet lymphocyte ratio(PLR),neutrophilic lymphocyte ratio(NLR)and albumin to globulin ratio(AGR)in evaluating the prognosis of breast cancer patients.Methods 1184 female patients with invasive breast cancer admitted from January 2013 to December 2017 were selected as the invasive breast cancer group,279 patients with breast fibroadenoma were randomly selected as breast fibroadenoma group.General data,postoperative pathological data,blood type,preoperative peripheral blood platelets,neutrophils,lymphocytes,serum albumin and globulin levels were collected.PLR,NLR and AGR were calculated.The area under the receiver functional characteristic curve was used to evaluate the prognostic ability of the three groups.I SPSS 20.0 and MedCalc software were used for statistical analysis and plotting,and P<0.05 indicated statistically significant differences.Results The preoperative PLR and NLR of the invasive breast cancer patients were significantly higher than those of the breast fibroadenoma patients(P<0.05),while the AGR was lower than those in patients with breast fibroadenoma(P<0.05).Cox proportional regression risk analysis showed that age at PLR,NLR,AGR,tumor diameter,histological grade,number of positive lymph nodes and molecular type were all prognostic risk factors for breast cancer(P<0.05).ROC curve analysis shouwed that the optimal diagnostic thresholds for PLR,NLR and AGR were 147.4,2.9 and 1.7.Preoperative PLR(AUC=0.796,P<0.001),NLR(AUC=0.716,P<0.001)and AGR(AUC=0.748,P<0.001)were all valuable in predicting the prognosis of breast cancer patients,and the value of PLR is higher.Conclusion Preoperative PLR,NLR and AGR are all valuable for the prognosis of breast cancer patients.Compared with the three ratios,PLR has higher value and is expected to be a supplementary indicator for the prognosis of breast cancer patients.
作者
孙曼迪
符德元
Sun Mandi;Fu Deyuan(Department of Thyroid and Breast Surgery,Northern Jiangsu People’s Hospital,Yangzhou Jiangsu Province 225001,China)
出处
《中华普外科手术学杂志（电子版）》
2022年第2期137-141,共5页
Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)
基金
国家自然科学基金资助项目(82072909)
江苏省第十六批“六大人才高峰”高层次人才选拔培养资助方案(YY-217)
湖北陈孝平科技发展基金会2019年度肿瘤防治研究槐耳专项基金(CXPJJH11900002-014)
江苏省333高层次人才培养工程(BRA2019182)。
