摘要
目的探讨术前淋巴细胞与单核细胞比值(LMR)-血小板与淋巴细胞比值(PLR)评分模型对胰腺导管腺癌(PDAC)根治术后预后的预测价值.方法采用回顾性队列研究方法.收集2015年1月至2019年12月兰州大学第二医院收治的116例PDAC患者的临床病理资料;男73例,女43例;年龄为61.5(29.0~75.0)岁.患者均行胰腺癌根治术.观察指标:(1)LMR、PLR的最佳截断值.(2)不同术前LMR-PLR评分患者的临床病理特征.(3)随访和生存情况.(4)PDAC患者预后的影响因素分析.(5)列线图预测模型构建及验证.偏态分布的计量资料以M(范围)表示.计数资料以绝对数表示,组间比较采用χ^(2)检验.等级资料比较采用Mann-Whitney U检验.采用Graphpad prism 8绘制生存曲线,Kaplan-Meier法计算生存率,Log-Rank检验进行生存分析.单因素和多因素分析采用COX比例风险回归模型.采用X-tile软件确定LMR、PLR的最佳截断值.根据多因素分析结果构建列线图预测模型,绘制受试者工作特征(ROC)曲线,以曲线下面积(AUC)评价列线图预测模型的区分度.以校准曲线评价列线图预测模型的一致性.以决策曲线评价临床获益度.结果(1)LMR、PLR的最佳截断值.LMR、PLR的最佳截断值分别为1.9和156.3.(2)不同术前LMR-PLR评分患者的临床病理特征.术前LMR-PLR评分为0、1、2分患者分别为11、42、63例.上述3者CA125(<12.4 U/mL)、脉管侵犯、术后化疗分别为1、8、24例,9、27、27例,3、26、43例,不同LMR-PLR评分患者上述指标比较,差异均有统计学意义(χ^(2)=6.73、8.37、6.68,P<0.05).(3)随访和生存情况.116例患者均获得随访,随访时间为39(2~86)个月.116例PDAC患者术后1、2、3生存率分别为50.9%、37.9%、19.3%,生存时间为13(1~85)个月.LMR-PLR评分为0、1、2分患者生存时间分别为3(1~9)个月、7(2~56)个月、26(2~85)个月,3者生存情况比较,差异有统计学意义(χ^(2)=48.78,P<0.05).(4)PDAC患者预后的影响因素分析.多因素分析结�
Objective To investigate the predictive value of preoperative lymphocyte-tomonocyte ratio(LMR)combined with platelet-to-lymphocyte ratio(PLR)(LMR-PLR)scoring model for prognosis of pancreatic ductal adenocarcinoma(PDAC)after radical resection.Methods The retrospective cohort study was conducted.The clinicopathological data of 116 patients with PDAC who were admitted to the Second Hospital of Lanzhou University from January 2015 to December 2019 were collected.There were 73 males and 43 females,aged 61.5(range,29.0-75.0)years.All patients underwent radical resection for PDAC.Observation indicators:(1)optimal cut-off value of LMR and PLR;(2)clinicopathological features of patients with different scores of preoperative LMR-PLR scoring model;(3)follow-up and survival;(4)influencing factors for prognosis of PDAC patients;(5)construction and verification of nomogram prediction model.Measurement data with skewed distribution were represented as M(range).Count data were described as absolute numbers,and comparison between groups was conducted using the chi-square test.Comparison of ordinal data was conducted using the Mann-Whitney U test.The Graphpad prism 8 was used to draw survival curve,the Kaplan-Meier method was used to calculate survival rate,and the Log-Rank test was used for survival analysis.The Cox proportional hazard regression model was used for univariate and multivariate analyses.The X-tile software was used to determine the optimal cut-off values of LMR and PLR.The nomogram prediction model was conducted based on the results of multivariate analysis,and the receiver operating characteristic(ROC)curve was drawn.The area under curve(AUC)was used to evaluate the discrimination of nomogram prediction model.The calibration curve was used to evaluate the consistency of nomogram prediction model and the decision curve was used to evaluate the clinical benefits.Results(1)Optimal cut-off value of LMR and PLR.The optimal cut-off values of LMR and PLR were 1.9 and 156.3.(2)Clinicopathological features of patients wit
作者
刘旭东
王云生
杜鹏
赵斌
张国强
郑强
赖佳敏
程志斌
Liu Xudong;Wang Yunsheng;Du Peng;Zhao Bin;Zhang Guoqiang;Zheng Qiang;Lai Jiamin;Cheng Zhibin(Department of General Surgery,the Second Hospital of Lanzhou University,Lanzhou 730030,China;Department of Head and Neck Surgery,Gansu Provincial Cancer Hospital,Lanzhou 730050 China)
出处
《中华消化外科杂志》
CAS
CSCD
北大核心
2023年第11期1351-1360,共10页
Chinese Journal of Digestive Surgery
基金
甘肃省高等学校创新基金项目(CY2020-MS04)
甘肃省卫生行业科研计划项目(GSWS KY-2019-66)
